Examining Multifactorial Behavior Responses to ACEs (EMBRACE)

ith the increasing prevalence of children with autism (CWA) in the United States and the well-documented accompaniment of mental and physical health disparities researchers and healthcare providers should be aware of the increased likelihood of early childhood trauma. The social determinants of health including household dysfunction and ACES that affect educational outcomes of CWA need further examination. In a systematic review Marie-Mitchell and Kostolansky (2019) posit a direct relationship exists between ACEs and educational attainment that can be mediated through social relationships including community services and primary care utilization. As resilience among CWA has been shown to be less affected by these adverse childhood experiences (ACEs) limited research has been conducted to measure the dose-response relationships between ACEs and educational outcomes nor brain development. We hypothesize that ACEs among CWA will directly and negatively impact educational outcomes and indirectly through access to educational assistance and professional service utilization. Further we will explore the impact of ACEs among the parahippocampal cortex of CWA - a region that processes contextual familiarity - which has shown deviations in development among other children in the presence of trauma. In Aim 1 we will create a quasi-causal statistical model of the relationships between ACEs and educational outcomes mediated through the use of mental health services and school special needs assistance programs using the 2016-2019 cycles of the National Survey of Children's Health to following aims. In Aim 2 we will use the Adolescent Brain Cognitive Development study to compare brain structures among CWA with and without trauma. Findings from this study could be used to support and prioritize social service and community interventions focused on ACEs among CWA