Conventional and Expanded Adverse Childhood Experiences and Child Cognition: Identifying Critical Timing and Targets for Intervention

Introduction: Childhood cognition, which supports learning, memory, language, and executive functioning, is the foundation for school readiness and long-term life outcomes (Prime et al., 2023). Identifying modifiable risk factors is vital for developing interventions to narrow developmental gaps. While conventional Adverse Childhood Experiences (ACEs), such as abuse and household dysfunction, are linked to poorer cognitive functioning in adulthood (Giovanelli et al., 2023; Hawkins et al., 2021; Wetherell et al., 2018), research on their influence during childhood remains limited. Furthermore, few studies incorporate expanded ACEs (EACEs) that include community- and social-level risks (Cronholm et al., 2015) or examine how these exposures operate across specific developmental stages. This study examines how ACEs and EACEs relate to cognition at ages 3, 5, and 9 to identify critical periods and targets for intervention.

Methods: Data were drawn from the Future of Families and Child Wellbeing Study (FFCWS), a national panel dataset. The sample included children with biological primary caregivers (PCGs) interviewed at birth and at ages 3, 5, and 9 (Waves 1 and 3-5, respectively; N = 3,027–3,982 across waves). Cognition was measured via Peabody Picture Vocabulary Test (PPVT) standard score equivalents by age. Conventional ACEs were measured by the number of domains experienced by each wave (range: 0–8): biological parent’s incarceration; PCG substance use; PCG interpersonal violence; PCG mental illness; household material hardship; emotional/verbal abuse; neglect; harsh physical discipline. EACE was a binary measure of witnessed/experienced community violence. Multiple linear regressions were conducted for each wave, controlling for time-varying factors (poverty, PCG education, parental relationship) and time-invariant demographics (race, sex, parental relationship at birth, mother’s age at birth). Missing data were handled using multiple imputation by chained equations.

Results: EACE experience by age 9 was significantly associated with lower cognition (b = −2.76, SE = 1.33, p < .05) at that wave. Conversely, conventional ACEs across all ages and EACEs at ages 3 and 5 were not significantly associated with concurrent cognitive outcomes. Several covariates were significant: at age 9, children above 200% of the Federal Poverty Line (FPL) demonstrated higher cognition than those below 100% FPL. At age 3, PCG college education was a positive predictor. Children of unmarried parents exhibited greater vulnerability to lower cognition at ages 5 and 9. Racial disparities were consistent: Black children scored lower across all waves, and Hispanic children scored lower at ages 3 and 5, compared to White children.

Discussion: Findings suggest that community-level adversity may exert a more pronounced impact on cognitive development around age 9 than conventional ACEs. This association at age 9 suggests a sensitive developmental window where community environments increasingly shape cognitive outcomes, highlighting the need for community-based interventions to reduce developmental gaps. High-priority targets include children in poverty, those with lower PCG educational attainment, and those in unmarried households. Consistent racial disparities warrant further investigation into potential cultural or linguistic biases inherent in the PPVT measure itself (Stockman, 2000) and systemic disadvantages. Overall, findings underscore the importance of integrating both household- and community-level risks into early intervention frameworks.