Throughout this text, we have discussed many factors that influence development. In this section, we will focus on adverse childhood experiences (ACEs), child maltreatment, and preschool access.

Adverse Childhood Experiences

Although many studies have been conducted since then, the ACE study conducted in the late 1990s by CDC-Kaiser Permanente is one of the most notable studies to closely examine the effects of childhood trauma. As defined by the CDC, adverse childhood experiences (ACEs) are “potentially traumatic events that occur in childhood (0–17 years)” (CDC, 2022). Traumatic events include experiences related to violence, abuse, and neglect, witnessing violence in the home or community, and instability due to parental separation. ACEs have been linked to chronic health problems, mental illness, and substance use problems in adolescence and adulthood. Additionally, ACEs can negatively impact education outcomes, job opportunities, and earning potential (CDC, 2022).

Furthermore, although preventable, ACEs are common. About 61 percent of adults across 25 states reported they had experienced at least one type of ACE before reaching 18 years of age, and almost one in six reported they had experienced four or more types of ACEs. Unsurprisingly, ACEs are not experienced equally across the board. Some children, women, and many racial and ethnic minority groups are at a greater risk for experiencing four or more types of ACEs (CDC, 2022).

ACEs and related social determinants of health including living in low-income or racially segregated neighborhoods, unstable housing, and experiencing food insecurity, can cause toxic stress (experiencing stress for an extended or prolonged period). Toxic stress derived from ACEs negatively impacts children’s brain development, immune systems, and stress-response systems. Children that grow up with toxic stress may find it difficult to form healthy and stable relationships, therefore impacting their social and emotional development. Moreover, these effects can be generational, meaning they might be passed onto future generations. Some children experience toxic stress stemming from historical and ongoing systemic racism and poverty resulting from limited educational and economic opportunities (CDC, 2022).

Child Maltreatment

Child abuse is the physical, sexual, or emotional mistreatment or neglect of a child or children. Different jurisdictions have developed their own definitions of what constitutes child abuse for the purposes of removing children from their families and for prosecuting criminal charges. There are four major categories of child abuse: neglect, physical abuse, psychological/emotional abuse, and sexual abuse. Neglect is the most common type of abuse in the United States and accounts for over 60 percent of child abuse cases.

Neglect is a passive form of abuse in which a perpetrator is responsible for providing care for a victim who is unable to care for themselves, but fails to provide adequate care. Neglect may include the failure to provide sufficient supervision, nourishment, or medical care or the failure to fulfill other needs for which the victim is helpless to provide for themself. The term is also applied when necessary care is withheld by those responsible from animals, plants, and even inanimate objects. Neglect can have many long-term side effects, such as physical injuries, low self-esteem, attention disorders, violent behavior, and even death. In the United States, neglect is defined as the failure to meet the basic needs of children, including housing, clothing, food, and access to medical care. Researchers found over 91,000 cases of neglect in 1 year using information from a database of cases verified by protective services agencies.

Child physical abuse involves physical aggression directed at a child by an adult. Most nations with child abuse laws consider the deliberate infliction of serious injuries, or actions that place the child at obvious risk of serious injury or death, to be illegal. Beyond this, there is considerable variation. The distinction between child discipline and abuse is often poorly defined. Cultural norms about what constitutes abuse vary widely among both professionals and the wider public. Some professionals claim that cultural norms that sanction physical punishment are one of the causes of child abuse and have undertaken campaigns to redefine such norms.

Child sexual abuse is a form of child abuse in which person abuses a child for sexual stimulation. Effects of child sexual abuse include guilt and self-blame, flashbacks, nightmares, insomnia, and fear of things associated with the abuse. Approximately 15 percent to 25 percent of women and 5 percent to 15 percent of men were sexually abused when they were children.

Out of all the possible forms of abuse, emotional abuse is the hardest to determine. Child emotional abuse involves a pattern of behavior in which a caregiver insults, humiliates, instills fear in, or controls a child. It could include name-calling, ridicule, degradation, destruction of personal belongings, torture or killing of a pet, excessive criticism, inappropriate or excessive demands, withholding communication, and routine labeling or humiliation.

Preschool Access

Providing universal preschool has become an important lobbying point for federal, state, and local leaders throughout our country. In his 2013 State of the Union address, President Obama called upon Congress to provide high quality preschool for all children. He continued to support universal preschool in his legislative agenda, and in December 2014, the President convened state and local policymakers for the White House Summit on Early Education (White House Press Secretary, 2014). However, universal preschool covering all 4-year-olds in the country would require significant funding. Furthermore, how effective preschools are in preparing children for elementary school, and what constitutes high quality preschool, has been debated.

To set criteria for designation as a high-quality preschool, the National Association for the Education of Young Children (NAEYC) identifies 10 standards (NAEYC, 2016). These include:

• promotion of positive relationships among all children and adults

• a curriculum that supports learning and development in social, emotional, physical, language, and cognitive areas

• teaching approaches that are developmentally, culturally, and linguistically appropriate

• assessment of children’s progress to provide information on learning and development

•promotion of the health and nutrition of children, as well as protection from illness and injury

• teacher possession of the educational qualifications, knowledge, and commitment needed to promote children’s learning

• collaborative relationships with families that are established and maintained

• relationships with agencies and institutions in the children’s communities that support the program’s goals

• indoor and outdoor physical environments that are safe and well-maintained

• leadership and management personnel that are well qualified, effective, and maintain licensure status with the applicable state agency

Parents should review preschool programs using the NAEYC criteria as a guide for asking questions that will assist them in choosing the best program for their child. Selecting the right preschool is also difficult because there are so many types of preschools available. Journalist Anne Zachry, from the online resource parents.com, identified Montessori, Waldorf, Reggio Emilia, High Scope, Parent Co-Ops, and Bank Street as types of preschool programs that focus on children learning through discovery (Zachry, 2013). Teachers act as guides and create activities based on the child’s developmental level.

Head Start: For children who live in poverty, Head Start has been providing preschool education since 1965 when it was established by President Lyndon Johnson as part of his war on poverty. It currently serves nearly one million children and annually costs approximately $7.5 billion (United States Department of Health and Human Services, 2015). However, concerns about the effectiveness of Head Start have been ongoing since the program began. Armor (2015) reviewed existing research on Head Start and found there were no lasting gains, and the average child in Head Start had not learned more than children who did not receive preschool education.

A 2015 report evaluating the effectiveness of Head Start comes from the What Works Clearinghouse. The What Works Clearinghouse identifies research that provides reliable evidence of the effectiveness of programs and practices in education and is managed by the Institute of Education Services for the United States Department of Education. After reviewing 90 studies on the effectiveness of Head Start, only one study was deemed scientifically acceptable, and this study showed disappointing results (Barshay, 2015). This study revealed that 3- and 4-year-old children in Head Start received “potentially positive effects” on general reading achievement, but no noticeable effects on math achievement or social-emotional development.

Nonexperimental designs are a significant problem in determining the effectiveness of Head Start programs because a control group is needed to show group differences that would demonstrate educational benefits. Because of ethical reasons, low-income children are usually provided with some type of preschool programming in an alternative setting. Additionally, Head Start programs differ depending on the location, with some programs having longer school days or better qualified teachers. These differences make it difficult to examine Head Start as a single entity. Lastly, testing young children is difficult and strongly dependent on their language skills and comfort level with an evaluator, which further hinders the ability of researchers to analyze Head Start programs (Barshay, 2015).

Licenses and Attributions for Health and Wellness

“Adverse Childhood Experiences” by Esmeralda Janeth Julyan is licensed under CC BY 4.0.

“Preschool Access” from Lifespan Development – A Psychological Perspective by Martha Lally and Suzanne Valentine-French is licensed under CC BY 4.0; minor edits.

Figure 8.11. “A Child Hiding” by Joint Base Elmendorf-Richardson Alaska is in the public domain.