Concordance of Children’s Adverse Childhood Experiences Amongst Child, Caregiver, and Caseworker

ABSTRACT

Adverse childhood experiences (ACEs), often defined as potentially traumatic experiences such as child maltreatment and household difficulties (e.g., caregiver substance misuse) that occur prior to age 18, are associated with poor health and psychiatric illness across the life span and have been increasingly used as a predictor of health outcomes in both research and practice. However, limited research has explored who should be reporting ACEs for children or to what extent reporters agree on observations of ACE exposure. This study examines respondent agreement among children, caregiver, and caseworker using data drawn from the National Survey of Child and Adolescent Well-being (NSCAW II), a longitudinal, nationally representative survey of children who have been the subject of a child welfare investigation. A sub-sample of participants aged 8–17 was used (n = 1,652). The following ACE indicators had responses from all three respondents: sexual victimization, physical abuse, emotional abuse, and home violence. Analyses were completed to understand patterns of reporter’s responses to each of the ACEs selected using sampling weights. We calculated interrater agreement using the Kappa coefficient for each ACE indicator. Children, caregivers, and caseworkers differentially reported the number of ACEs the child experienced. Children reported experiencing just over two ACEs on average, while caregivers reported two and caseworkers reported an average of one. Overall, Kappa coefficients were extremely low with caseworker-caregiver agreement the highest at .41. Given the lack of concordance, we recommend asking multiple informants while carefully considering self-report by children when assessing for ACEs.

KEYWORDS:

• Concordance
• adverse childhood experiences (ACES)
• child abuse
• child maltreatment
• child welfare