J Paediatr Child Health. 2025 Oct 23. doi: 10.1111/jpc.70218. Online ahead of print.
ABSTRACT
BACKGROUND: Adverse Childhood Experiences (ACEs) are associated with long-term health risks, including behavioural, physical and mental health issues. However, there is limited data on the prevalence and impact of ACEs among school-age children in Thailand.
OBJECTIVES: To determine the prevalence of ACEs and their associations with behavioural and health outcomes in primary school Thai children.
METHODS: A cross-sectional study was conducted from July 2023 to June 2024, involving 399 primary school students aged 6-12 years, selected through stratified random sampling. Data were collected using the Paediatric ACEs and Related Life Events Screener (PEARLS) to measure ACEs, the Thai Youth Checklist (TYC) for behavioural assessments, and a health screening questionnaire for physical and mental health. The relationship between cumulative ACEs and health conditions was analysed.
RESULTS: Among the 399 participants (median age: 9.5 years, IQR: 8-11), 48.7% of surveyed children reported experiencing at least one ACE. The most prevalent ACE was caregiver divorce or separation (33%), followed by neglect (9.3%) and domestic violence (8.3%). Children with four or more ACEs had a significantly increased risk of behavioural problems, including internalising problems (adjusted odds ratio [AOR] = 7.57; 95% CI: 2.54-22.64), externalising problems (AOR = 5.52; 95% CI: 1.82-16.79), and total behavioural issues (AOR = 8.65; 95% CI: 2.97-25.24). No significant association was found between ACEs and health conditions.
CONCLUSION: Nearly half of the surveyed Thai primary school children experienced ACEs, and a graded association was found between the number of ACEs and behavioural problems. These findings underscore the need for early, strength-based interventions to reduce long-term risks. Primary prevention strategies should prioritise supporting families before adversity occurs.
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