Adverse Childhood Experiences and Increased Risk of Traumatic Brain Injury

Brain Injury / Head Injury

By Arthur D. Leritz

January 14, 2021

traumatic brain injury

A new study published this month has investigated whether the existence of multiple adverse childhood experiences (ACEs) can lead to an increased risk of sustaining a traumatic brain injury (TBI) later on in life.[1]  While ACEs and their impact on mental health have been studied extensively, few studies before now have researched the relationship of multiple ACEs, TBI and poor health outcomes.

The study identified eight events that are generally accepted as an adverse childhood experience:

  • Divorce/separation of a parent/guardian;
  • Death of a parent/guardian;
  • Parent/guardian serving time in jail;
  • Violence in the home by either parent;
  • Child was a victim of violence or witnessed violence;
  • Child lived with anyone who was mentally ill;
  • Child lived with anyone who had a problem with alcohol or drugs;
  • Child treated or judged unfairly due to their race or ethnicity

Sadly, in the U.S. alone, 34 million children report at least one adverse childhood experience, with more than 20% reporting two or more ACEs.  These experiences are empirically linked to a wide range of poor life outcomes including sleep disturbances, cancer, cardiovascular disease, opioid use, food insecurity and antisocial behavior.

The study used a cross-sectional weighted probability sample of children in the U.S. with a focal child age of 12-17, and the study sample included 42,204 adolescents in this age range.   Parents were asked a serious of questions about the adolescent participants, including whether they had been involved in any youth sports in the 12 months prior to the survey.

The data revealed some startling results:

  • As ACE exposure increased, the likelihood of a sustaining a TBI after experiencing physical trauma also increased;
  • TBI with multiple ACEs is greater without sports than with sports and multiple ACEs:
    • Four or more ACEs with sports:  76% increase in risk of TBI
    • Four or more ACEs without sports: 441% increase in risk of TBI

The study revealed a strong correlation between multiple ACEs and the chances of sustaining a TBI.   As for the increased risk of TBI without sports activity, the researchers concluded that ADHD and psychiatric issues could partly explain the elevated risk.  The researchers suggested that screening for TBI among maltreated and ACE – exposed children and adolescents might reveal additional TBI risks and could provide opportunities to engage them in rehabilitation treatment protocols. The study does not indicate that multiple ACEs alone cause a traumatic brain injury.  Rather, a child with multiple ACEs is at an increased risk for sustaining a TBI later in adolescence after trauma.

The attorneys at Adler Giersch understand traumatic brain injury and the importance of staying current with important studies in this area.  We also understand the critical importance in getting your patient on the proper road to recovery.  We are always ready and willing to assist you in any and all questions when it comes to handling a traumatic brain injury case for your patients.  If you have any questions, please don’t hesitate to contact us.


[1] Adverse childhood experiences and traumatic brain injury among adolescents: findings from the 2016–2018 National Survey of Children’s Health; Jackson, et al; European Child & Adolescent Psychiatry; January 2, 2021; https://doi.org/10.1007/s00787-020-01687-1.