Infant Mental Health and the Assessment of Adverse and Protective Childhood Experiences

Abstract

This chapter provides an overview of contemporary approaches to the assessment of adverse and protective childhood experiences. The growing interest in preventing the impact of adversity during childhood and mitigating the intergenerational transmission of trauma is discussed through describing assessment approaches to reduce risk and promote resilience in infancy, early childhood, and among caregivers. Assessment for both caregiver and infant adversity and protection is necessary for screening, eligibility determination, and prevention intervention. This chapter describes psychometrically strong and feasible assessment tools for adversity, including the Adverse Childhood Experiences Scale (ACE-SQ), the Maltreatment and Abuse Chronology of Exposure (MACE) Scale, and The Family Map, as well as for protection, including the Protective and Compensatory Experiences (PACE) Scale, the Benevolent Childhood Experiences (BCE) Scale, and Positive Childhood Experiences (PCE) Scale. The importance of cultural and international perspectives on assessment is emphasized, as well as new directions in assessment that will better inform research and practice in infant and early childhood mental health.

Appendix

Protective and Compensatory Experiences (Baby PACEs)

When answering these questions, think about the last 12 months. On a scale of 1–5, fill the circle of the number that best describes how often each of the items occurred.

Never	Rarely	Sometimes	Often	Very Often
1	2	3	4	5

		1	2	3	4	5
1.	When my child was upset, I was able to comfort and soothe them.	Never O	Rarely O	Sometimes O	Often O	Very Often O
2.	My child was attached to at least one other adult caregiver.	Never O	Rarely O	Sometimes O	Often O	Very Often O
3.	My child had opportunities to play with a child of the same age or a sibling close in age.	Never O	Rarely O	Sometimes O	Often O	Very Often O
4.	My child was part of a formal or informal play group with children of similar ages.	Never O	Rarely O	Sometimes O	Often O	Very Often O
5.	I encouraged my child to be helpful and caring in their interactions with others.	Never O	Rarely O	Sometimes O	Often O	Very Often O
6.	My child had daily, weekly, or other routines (bath time, meal time, etc.) and consistent rules and limits appropriate for their age.	Never O	Rarely O	Sometimes O	Often O	Very Often O
7.	My child lived in a home where needs were met, for example, safe to explore, regular meals, and clean and uncluttered.	Never O	Rarely O	Sometimes O	Often O	Very Often O
8.	My child had at least one caregiver (mom, dad, teacher) who read or talked to them daily.	Never O	Rarely O	Sometimes O	Often O	Very Often O
9.	My child had opportunities to play and be physically active.	Never O	Rarely O	Sometimes O	Often O	Very Often O
10.	My child had outings at parks, zoos, libraries, or other places where they could experience drawing, painting, or music.	Never O	Rarely O	Sometimes O	Often O	Very Often O

Protective and Compensatory Experiences in Adulthood (Current Adulthood PACEs)

When answering these questions, think about the last 12 months. On a scale of 1–5, fill the circle of the number that best describes how often each of the items occurred.

Never	Rarely	Sometimes	Often	Very Often
1	2	3	4	5

		1	2	3	4	5
1.	I felt loved and did not doubt that I was cared for.	Never O	Rarely O	Sometimes O	Often O	Very Often O
2.	I had someone I trust that I could turn to for advice, mentorship, or support.	Never O	Rarely O	Sometimes O	Often O	Very Often O
3.	I had at least one best friend, someone I could count on and had fun with.	Never O	Rarely O	Sometimes O	Often O	Very Often O
4.	I was engaged in at least one social or faith-based group.	Never O	Rarely O	Sometimes O	Often O	Very Often O
5.	I did things to benefit others or participated in community-helping projects.	Never O	Rarely O	Sometimes O	Often O	Very Often O
6.	I had regular routines for things like sleeping, eating, and exercising.	Never O	Rarely O	Sometimes O	Often O	Very Often O
7.	I lived in a space that was clean, safe, and uncluttered.	Never O	Rarely O	Sometimes O	Often O	Very Often O
8.	I had opportunities to learn and grow as a person or in my work.	Never O	Rarely O	Sometimes O	Often O	Very Often O
9.	I was physically active, either alone or with others.	Never O	Rarely O	Sometimes O	Often O	Very Often O
10.	I enjoyed at least one hobby or leisure activity.	Never O	Rarely O	Sometimes O	Often O	Very Often O