Adverse childhood experiences (ACEs) often impact several children, but studies usually focus on individual children, overlooking the family’s needs.
A new study looked at how ACEs in firstborns during the first 1000 days (1 year before to 2 years after birth) affect the risk of mental health issues, healthcare visits, and hospital admissions in multiple children from the same mother, compared to firstborns without ACEs.
The study found that mothers whose firstborns experienced ACEs have a 71% higher risk of having children (aged 5 to 18 years) with mental health problems compared to mothers whose firstborns did not experience adversity. This means for every 100 mothers whose firstborn experienced adversity, there are 12 more children with mental health problems.
These findings show that early adversity poses a significant risk to multiple children in a family and highlight the importance of early identification and ongoing support for vulnerable families beyond the first 1,000 days of a child’s life.
The team analyzed health records from 333,048 first-time mothers and their 534,904 children (firstborns and siblings) born in England between 2002 and 2018. They focused on six types of ACEs in firstborns: child maltreatment, intimate partner violence, maternal substance misuse, maternal mental health problems, adverse family environments (e.g., homelessness), and high-risk child maltreatment cases.
Over a third (37.1%) of firstborn children had at least one ACE. The most common were living with maternal mental health problems (21.6%) and adverse family environments (14.5%), like parental criminality and housing instability.
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About one in five (19.8%) mothers had at least one child with a mental health problem between ages 5 and 18.
Mothers whose firstborns had ACEs had more children with mental health problems (30 per 100) compared to those without such experiences (17 per 100). The risk of mental health problems was the same for all siblings, no matter their birth order, in families where the firstborn faced adversity.
Children in these families also had 50% more emergency hospital visits and twice as many mental health-related healthcare contacts.
Lead author Dr. Shabeer Syed said the study reveals a cascading health risk that also affects siblings. He emphasized the need to consider the wider family context when a child or parent presents with mental health concerns, violence, or other forms of adversity.
Gene Feder explained that general practice teams are key in identifying firstborns experiencing ACEs and supporting first-time parents to reduce the impact on the whole family.
Jessica Deighton and the Anna Freud charity emphasized the importance of early and effective prevention strategies for improving well-being as more children and young people seek mental health services. They call for increased funding for prevention programs and the use of community resources like GPs and local organizations to meet the needs of vulnerable young people.
They also advocate for a comprehensive mental health prevention strategy developed with input from diverse groups of children and young people.
Based on their findings, the team is calling for more research on the impact of early health visits and primary care support. Professor Ruth Gilbert said preventing childhood mental health problems through early support for parents and their children could benefit multiple family members.
She stressed the need for research to see if early community support from health visitors, GPs, and practical parenting support for families affected by ACEs reduces mental health problems later in childhood.
Journal Reference:
- Shabeer Syed, DclinPsych et al. Adverse childhood experiences in firstborns and mental health risk and healthcare use in siblings: a population-based birth cohort study of half a million children in England. The Lancet Public Health. DOI: 10.1016/S2468-2667(24)00301-3
Source: Tech Explorist
