Adverse childhood experiences during childhood and academic attainment at age 7 and 11 years: an electronic birth cohort study

Annette Evans, Katie Hardcastle, Amrita Bandyopadhyay, Daniel Farewell, Ann John, Ronan A. Lyons, Sara Long, Mark A. Bellis, Shantini Paranjothy* (Corresponding Author)

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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Adverse childhood experiences (ACEs) have a negative impact on childhood health, but their impact on education outcomes is less well-known. We investigated whether or not ACEs were associated with reduced educational attainment at age 7 and 11 years.
Study design:
Population based electronic cohort study
We analysed data from a total population electronic child cohort in Wales, UK. ACEs (exposures) were living with an adult household member with any of (i) serious mental illness (SMI), (ii) common mental disorder (CMD), (iii) an alcohol problem; (iv) child victimisation, (v) death of a household member and (vi) low family income. We used multilevel logistic regression to model exposure to these ACEs and not attaining the expected level at statutory education assessments, Key Stage (KS) 1 and KS2 separately, adjusted for known confounders including perinatal, socioeconomic and school factors.
There were 107,479 and 43,648 children included in the analysis, with follow-up to 6-7 years (KS1) and 10-11 years (KS2) respectively. An increased risk of not attaining the expected level at KS1 was associated with living with adult household members with CMD (aOR 1.13 (95% CI 1.09- 1.17) or an alcohol problem (aOR 1.16 (95% CI 1.10-1.22), childhood victimisation (aOR 1.58 (95% CI 1.37-1.82), death of a household member (aOR 1.14 95% CI 1.04-1.25) and low family income (aOR 1.92 95% CI 1.84-2.01). Similar results were observed for KS2. Children with multiple adversities had substantially increased odds of not attaining the expected level at each educational assessment.
The educational potential of many children may not be achieved due to exposure to adversity in childhood. Affected children who come in to contact with services should have relevant information shared between health and care services, and schools to initiate and facilitate a coordinated approach towards providing additional support and help for them to fulfil their educational potential, and subsequent economic and social participation.
Original languageEnglish
Pages (from-to)37-47
Number of pages11
JournalPublic Health
Early online date2 Nov 2020
Publication statusPublished - 1 Dec 2020

Bibliographical note

Funding: This work was supported by the Economic and Social Research Council, Medical Research Council, Alcohol Research UK, Public Health Wales. The funders had no role in designing the study, data collection, analysis, or interpretation, or in writing the report. MAB’s role in the design, analysis, and writing was independent of the funding from Public Health Wales. The corresponding author had full access to all the data in the study and final responsibility for the decision to submit for publication. The authors do not have any competing interests to declare.


  • Adverse childhood experiences
  • social inequalities


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