Research: Evidence of the Need for Prevention

Numerous studies have been conducted over the years which show strong correlations between early child abuse and neglect and what have been termed later “rotten outcomes” for older children and adults. Most of these poor outcomes are both very costly and more difficult to treat as individuals become older. There is agreement among those involved in research on the need for and cost benefit of prevention and early intervention.

The Adverse Childhood Experiences study (Drs. Felitti, Robert Anda, 2000) of some 17,000 older Kaiser Medical Center patients links adverse experiences in early childhood (ACE factors) with a range of costly health problem later in life. The ACE factors include early experiences such as trauma, neglect, emotional abuse, sexual abuse, domestic violence,  living with a mentally ill or substance abusing parent, having an incarcerated parent,  and death of a parent. The poor health outcomes include obesity and diabetes; unintended pregnancy, heart and lung disease; drug, alcohol and tobacco dependency; depression, suicide, IV drug use, poor work attendance related to illness. The severity of later problems were directly related to the number of “ACE” factors. The ACE study concludes that adverse experiences in early childhood are more common that most people realize and also have life long consequences;  people don’t “just get over” these traumas. The study concludes that many health issues are actually rooted in early trauma.  It notes the need to prevent such trauma and for therapeutic intervention as soon as possible when early trauma occurs .

What Can Happen to Abused Children When They Grow Up? (Office of Trauma Services, Maine, 2001, pdf) summarizes many studies showing strong correlations between child abuse and neglect with mental health and substance abuse problems, delinquency and crime and other debilitating outcomes. They attribute 25% of developmental disabilities, as well as homelessness, re-victimization and chronic health problems to early abuse and neglect. The authors conclude that (1) our mental health systems are filled with survivors of prolonged childhood trauma; (2) re-enactment of childhood victimization is the major cause of violence in our society.

Studies in Neuro-science of Early Brain Development

Recent studies in neuro-science have provided tremendous insights into both early child development and the impact of trauma on the developing brain. The 1996 Newsweek article “Your Child’s Brain” opens with: “A baby’s brain is a work in progress; trillions of neurons are waiting to be wired into a mind. The experiences of childhood, pioneering research shows, help form the brain’s circuits-for music and math, language and emotion.“  This article introduces the work of Dr. Bruce Perry, who has shown how trauma and neglect during early periods of brain development affect how the brain becomes structured or wired causing short and long term difficulties. The abstract in the next paragraph provides further insight to this research.

Childhood trauma has a profound impact on the emotional, behavioral, cognitive, social and physical functioning of children.  Early developmental experiences determine the organizational and functional status of the mature brain.  The impact of traumatic experiences on the development and function of the brain are discussed in the context of basic principles of neuro-development. There are various adaptive mental and physical responses to trauma, including physiological hyper arousal and dissociation. Because the developing brain organizes and internalizes new information in a use-dependent fashion, the more a child is in a state of hyper arousal or dissociation, the more likely they are to have neuro-psychiatric symptoms following trauma. The acute adaptive states, when they persist, can become maladaptive states. The clinical implication of this new neuro-developmental conceptualization of childhood trauma is discussed.” Childhood Trauma, The Neurobiology of Adaptation, and “Use-Dependent” Development of The Brain: How “States” Become “Traits” , pdf).

Emotional Abuse

Developmental Consequences of Emotional Abuse: A Neuro-developmental Perspective (PDF).  Tuppett M. Yates at

With much concern for physical abuse, often less attention is given to the impact of neglect and emotional abuse. This paper notes that in their longitudinal study of a high risk, low income sample of young children, Byron Egeland MD and colleagues demonstrated prospective relationship between childhood emotional abuse and insecure attachment to caregivers with the children’s non-compliance, low persistence, low enthusiasm, poor concentration and decline in cognitive and motor competence in the first few years of life.  By school age, childhood emotional abuse was associated with high levels of negativity, impulsivity, poor social competence, low academic achievement and increased pathology.  Clearly early childhood neglect is a huge contributor to the large number of young children in Hawaii who lack characteristicsa of school readiness,  particularly in low income communities.

Child Sexual Abuse

Sexual abuse does occur among very young children.  A child who is the victim of prolonged sexual abuse usually develops low self-esteem, a feeling of worthlessness and an abnormal or distorted view of sex. The child may become withdrawn and mistrustful of adults, and can become suicidal. Some children who have been sexually abused have difficulty relating to others except on sexual terms. Some sexually abused children become child sexual abusers or prostitutes, or have other serious problems when they reach adulthood. (American Academy of Child and Adolescent Psychiatry, Child Sexual Abuse Facts for Families, No. 9, 5/08)

Economics of Early Child Development

The research of Dr. James Heckman, Nobel Laureate Economist  with the University of Chicago has conducted research and identified the economic benefits of intervening early with disadvantaged young children to promote school readiness. This research and related policy recommendations are discussed in more depth in the next section on policy.

The research of two economists with the Minneapolis Federal Reserve, Art Rolnick and Rob Grunewald is contributing strongly to an understanding of the importance of investing in early childhood.  Their research on traditional economic policies and practices has resulted in their conclusion  that these are not especially effective. Following up on the common theory of investing in K-12  education, they also studied the current research in early childhood.  These economists currently advocate that investing in human capital, by investing in evidence-based services for at risk children beginning pre-natally through age  five is the most effective approach to economic development. Watch a related video.  (See more in the Policy section.)

Follow us RSS