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Brief Report: Examining the Association of Autism and Adverse Childhood Experiences in the National Survey of Children’s Health: The Important Role of Income and Co-occurring Mental Health Conditions

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Abstract

Adverse childhood experiences (ACEs) are risk factors for mental and physical illness and more likely to occur for children with autism spectrum disorder (ASD). The present study aimed to clarify the contribution of poverty, intellectual disability and mental health conditions to this disparity. Data on child and family characteristics, mental health conditions and ACEs were analyzed in 67,067 youth from the 2011–2012 National Survey of Children’s Health. In an income-stratified sample, the association of ASD and ACEs was greater for lower income children and significantly diminished after controlling for child mental health conditions, but not intellectual disability. Findings suggest that the association of ACEs and ASD is moderated by family income and contingent on co-occurring mental health conditions.

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Fig. 1

Notes

  1. Results for analyses using ≥2 ACEs as the primary outcome are presented here for simplicity; however, these analyses were also conducted using ≥4 ACEs as the primary outcome and the pattern of results was the same.

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Acknowledgments

We are grateful to the families who participated in this research.

Author Contributions

CMK conceived of the study, participated in its design, interpretation of data and drafted and finalized the manuscript; CJN and SB participated in the interpretation of the data and revision of the manuscript; BKL participated in the design of the study, performed the statistical analysis and contributed to the drafting of the manuscript. All authors read and approved the final manuscript.

Funding

This study was funded by the National Institute for Child and Human Development (K23 HD087472).

Author information

Authors and Affiliations

  1. AJ Drexel Autism Institute, Department of Psychology and Community Health and Prevention, Drexel University, Philadelphia, PA, USA

    Connor Morrow Kerns

  2. AJ Drexel Autism Institute, Department of Epidimiology and Biostatistics, Drexel University, Philadelphia, PA, USA

    Craig J. Newschaffer & Brian K. Lee

  3. Penn Center for Youth and Family Trauma, University of Pennsylvania, Philadelphia, PA, USA

    Steven Berkowitz

Authors
  1. Connor Morrow Kerns
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  2. Craig J. Newschaffer
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  3. Steven Berkowitz
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  4. Brian K. Lee
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Corresponding author

Correspondence to Connor Morrow Kerns.

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Conflict of interest

All authors have received research funding from NIH. Dr. Berkowitz has also received funding from SAMHSA. The authors report no other conflicts of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Kerns, C.M., Newschaffer, C.J., Berkowitz, S. et al. Brief Report: Examining the Association of Autism and Adverse Childhood Experiences in the National Survey of Children’s Health: The Important Role of Income and Co-occurring Mental Health Conditions. J Autism Dev Disord 47, 2275–2281 (2017). https://doi.org/10.1007/s10803-017-3111-7

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  • DOI: https://doi.org/10.1007/s10803-017-3111-7

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