Teoría y Conceptos

Although the idea that traumatic events in early childhood can affect adult wellbeing is not new (going back at least as far as Freud), it is only in more recent years that this area has been subject to more serious investigation. Something of a landmark study in this area has been the Adverse Child Experiences (ACE) study in the United States (see for example

several subsequent studies. They can be grouped under three broad headings of ‘abuse’, ‘neglect’ and ‘household dysfunction’ (e.g. household substance abuse, parental separation or divorce). Typically, but not exclusively, information is collected from adults asked to recall events from childhood. Although the rates vary somewhat across different studies, it is still possible to discern a trend whereby the most frequent adverse child experiences tend to be household substance abuse and parental separation or divorce.

However, the ACE study is not the only taxonomy of negative childhood experiences. Other researchers, such as Briggs-Gowan, Ford, Fraleigh, McCarthy and Carter (2010), have thought in terms of PTEs or Potentially Traumatic Events, the definition for which they cite as “events that involve actual or threatened death or serious injury to the physical or psychological integrity of the child or another person” (p. 725, citing Zero to Three, 1994). These, and earlier, authors further distinguish between events that are ‘interpersonal’ such as seeing someone threatened with a weapon and ‘noninterpersonal’ events such as a car accident—with the former thought to be more detrimental.

The Briggs-Gowan et al. work is particularly useful in that it collects timely information from a healthy birth cohort study on events that occurred before 5 years of age: longitudinal data were collected in two waves and the children were aged 12–36 months in Year 1 and 24–48 months in Year 2 (n=1,152). Overall, by Year 2, more than a quarter of the children (26.3%) had experienced at least one of the PTEs: 14.5% had experienced at least one ‘noninterpersonal event’ (major injury or burn/dog bite/car accident) and 13.8% witnessed at least one incident with violence (violence in the neighbourhood/family member being hit, pushed or kicked/family member hurt by or threatened with a weapon). The most frequent individual events were seeing a family member being hit, pushed or kicked (12.3%) followed by car accidents (10.3%).

Other birth cohort studies have asked about ‘stressful life events’ during childhood, although frequently using different measures that make direct comparisons difficult. Thinking of events as stressful because of the change they bring about will obviously encompass a wider range of events, as some changes while stressful at the time may ultimately bring about positive change. For example moving house could mean an increase in the size and standard of accommodation. Data from Growing Up in Scotland (GUS) estimates that by age 5 years, 30% had experienced the death of a grandparent or other close relative, and 40% had moved house (Chanfreau et al, 2011). Among children in the birth cohort of LSAC it is estimated that around 7% had experienced the death of a grandparent, parent or sibling (Jacobs, Agho & Raphael, 2012) and there had been the death of a ‘close family friend or another relative’ in the lifetime of at least 25% of the children (Qu, Baxter, Weston, Moloney & Hayes, 2012) by the time they were aged 4–5 years. Interestingly, GUS and LSAC also include the birth of a new sibling as one of the ‘significant’ life events in the life of a child due to the change this particular event

is likely to bring about. This type of change had occurred in the lives of 38% of the GUS 5- year-olds, with 31% of parents of the LSAC children reporting being pregnant or having a new baby by the time the Study Child was aged 2–3 years. While Growing Up in Ireland does not specifically include the birth of a new sibling in its taxonomy of stressful events (see Table 3.1), it is perhaps worth noting that nearly a third of the Growing Up in Ireland Infant Cohort had experienced the arrival of a new sibling by the time they were 3 years old.

These types of events vary in both their potential for a negative effect on the child, and also the extent to which policy might reasonably be expected to tackle their occurrence. For example, policy cannot limit new births in a family to safeguard the current status of a first- born child; although there may be scope for providing parents with useful information on managing the transition to siblinghood. On the other end of the spectrum, however, policy may actively seek to protect children from being abused or witnessing abuse by putting in place protocols for the management, reporting and support of ‘at risk’ children.

Table 3.1 Prevalence of stressful life events for equivalent categories for Growing Up in Scotland age 5 years, LSAC (Birth Cohort) aged 4–5 years and Growing Up in Ireland (Child Cohort) age 9 years

Event GUS (age 5 years) LSAC (age 4–5 years) GUI (age 9 years)

Death of a parent 1(parent or sibling) ₇ (grandparent, parent or sibling)

plus 2516(other relative or friend)

3 Death of close family member 30 43 Divorce/separation of parents 1217 _{15 15}

Serious illness/injury of family member

1118 ₁₂ (parent injury/assault only) ₁₃

Moving house 40 42 Moving country 10 Drug-taking/alcoholism in

immediate family

5 4 Stay in foster/residential care 0.1 5 Conflict between parents 10 12 Mental disorder in immediate

family

4 Serious illness/injury to child 5 Parent in prison 1

Growing Up in Ireland collected data from parents of the Infant Cohort at age 5 on whether

they had experienced any of the potentially stressful events given in Table 3.1 (Williams et al.

16_{Prevalence estimates for death of a ‘close family friend or another relative’ only available on a year-by-year basis.}

The highest figure was 25% at age 1 year - 18% in the year preceding the age 4-5 year interview.

17_{GUS category wording was ‘parent has stopped living in the household’.}

2010). This listing had already been adopted with the Growing Up in Ireland Child Cohort at age 9 years and the prevalence for each event at that stage is provided in Table 3.1, along with that for comparable events from the GUS and LSAC studies. This table shows that, as with GUS, the 9-year-olds in Growing Up in Ireland were most likely to have experienced the death of a close family member (43%) and moving house (42%), and overall nearly 80% of children had experienced at least one of the events listed. However, not all children will experience distress, especially prolonged distress, as a reaction to such an event.