Adverse and Positive Childhood Experiences Associated with Emotional Self-Regulation Among Children In U.S. Children

Background and Purpose: Child emotional self-regulation is a crucial developmental competency that underpins emotional functioning, academic engagement, and long-term behavioral health outcomes. The capacity to remain calm and manage responses in challenging situations develops within the early relational and environmental contexts, where both adversity and positive experiences play influential roles. Adverse childhood experiences (ACEs) have been associated with disruptions in regulatory processes, while positive childhood experiences (PCEs) may foster resilience, adaptive coping, and emotional stability. Despite growing attention to both risk and protective processes, limited population-level research has examined how ACEs and PCEs influence children’s self-regulatory capacities. This study addresses that gap by examining associations between ACEs, PCEs, and children’s emotional self‑regulation among U.S children.

Methods: This study analyzed data from the 2023 National Survey of Children's Health (NSCH) for children ages 6–17 (N = 26,534). The outcome variable included emotional self-regulation assessed using a four-level ordinal item assessing how often the child is able to stay calm and in control when faced with challenges (ranging from never to always). The two independent variables included ACEs and PCEs. ACE was operationalized as a cumulative index derived from eleven child-reported adversities (e.g., economic hardship, exposure to violence, parental incarceration, discrimination), categorized as 0 ACEs, 1 ACE, and 2 or more ACEs. PCEs included seven experiences (e.g., family resilience, guided mentorship, after-school and community activities, safe and supportive neighborhood, social-emotional competence) ranging from 0 to 7. Weighted ordinal logistic regression estimated odds ratios (AORs) while adjusting for child and family-related characteristics. Statistical analyses were conducted using Stata 17(p < .05).

Results: Out of 26,534 children, 33.61% of children had experienced at least one ACE, and 30.41% had been exposed to two or more ACEs. After adjusting for covariates, an increase in ACEs was associated with reduced odds of higher self-regulation (AOR=0.71, 95% CI [0.70, 0.73], p<.001). In contrast, PCEs were positively associated with higher self-regulation (AOR=1.51, 95% CI [1.48, 1.54], p<.001), indicating a strong protective effect. Additionally, older child age (AOR=1.08, 95% CI [1.07, 1.09], p<.001) and older caregiver age (AOR=1.12, 95% CI [1.08, 1.17], p< .001) were associated with greater odds of higher self-regulation. Conversely, higher levels of poverty (AOR=0.93, 95% CI [0.91, 0.95], p<.001) and lower caregiver education (AOR=0.87, 95% CI [0.83, 0.90], p< .001) were associated with reduced odds of higher self-regulation.

Conclusions and Implications: The findings demonstrate that ACEs function as eminent risk factors for children’s self-regulatory development, while PCEs serve as critical protective resources that promote resilience and emotional stability for children. This underscores the need for trauma-informed and strength-based approaches across child-serving systems, including schools, healthcare, and family support services, supportive relationships, stable environments, and community resources in fostering self-regulation even in the context of adversity. Efforts to strengthen protective environments while addressing structural inequities are essential for promoting healthy developmental trajectories. Interventions grounded in relational support and community engagement may be critical for buffering the effects of adversity and promoting children's self-regulatory development in resource constrained settings in the U.S.