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Children's School Performance Dips as Stressful Experiences Rise, But Parent and Neighborhood Factors May Play Protective Role


A new study in the August 2019 Pediatrics shows a higher number of Adverse Childhood Experiences (ACEs) is associated with worse academic performance and attitudes toward school. At the same time, the more “protective factors” in a child’s life—especially a parent that the child can freely talk with--the more likely they are to do well in school. For the study, “Adverse Childhood Experiences and Protective Factors With School Engagement,” published online July 8, researchers did a cross-sectional analysis of 2011-2012 National Survey of Children’s Health data collected from a demographically representative sample of 65,680 children ages 6-17. The survey identified up to 9 ACEs in each child, such as abuse or neglect and being separated from a parent due to death, incarceration or divorce—all of which, research shows, can produce “toxic stress” in children. It also looked at seven protective factors: safe neighborhood; supportive neighbors; neighborhood amenities such as parks and libraries; well-kept neighborhood; a non-smoking household; at least five family meals each week; and having a parent the child can talk with. School performance and attitude, one of the strongest and most consistent predictors of future health, were measured by whether the child repeated one or more school grades, completes homework, and cares about school. The most powerful protective factor, the researchers found, was having a parent that can talk to their child about “things that matter and share ideas.” Study authors said their analysis suggests pediatric providers and educators should not only screen children for ACEs, but also identify protective factors. These strengths, they said, can be built upon for resilience, as well as help guide treatment, referral, and advocacy.

Editor’s note: The solicited commentary, “Addressing Adverse Childhood Experiences: It’s Not What You Know But Who You Know,” accompanies this study.


The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit and follow us on Twitter @AmerAcadPeds