Positive childhood experiences support emotional and behavioral health in middle childhood: Longitudinal mediation of adverse childhood experiences.

Background: Fostering positive childhood experiences (PCEs) is a key prevention strategy, however there is a scarcity of longitudinal studies that explore the role of PCEs with childhood outcomes.

Objective: This study examined the impact of middle childhood PCEs in the presence of earlier adverse childhood experiences (ACEs) on indices of behavioral and emotional development.

Methods: 1163 participants from the U.S. Early Head Start Research and Evaluation Project (EHSRE). Methods: Ten PCEs indicators (PCE-G5) that align with the Health Outcomes from Positive Experiences (HOPE) framework were identified in the Grade 5 EHSRE data. The convergent validity of the PCE-G5 for internalizing, externalizing, and social problems was tested with hierarchical linear regressions, controlling for infant/toddler ACEs (ACE-IT). We also examined whether PCE-G5 mediated the association between ACE-IT and internalizing, externalizing, and social problems using path analyses.

Results: Children had 7.6 PCEs, on average. PCE-G5 scores were associated with fewer internalizing (β = -1.000, p < 0.001), externalizing (β = -1.183, p < 0.001), and social problems (β = -0.420, p < 0.001). PCE-G5 partially mediated the effect of ACE-IT on internalizing, externalizing, and social problems (respective indirect effects β = 0.027; β = 0.028; β = 0.037; all p < 0.001).

Conclusions: Our study adds evidence of an inverse association between PCEs and middle childhood behavioral and emotional problems. The mediating impact of PCEs suggests that the exposure to early childhood ACEs may reduce the opportunities for involvement in PCEs, thereby increasing the risks for internalizing behavior, externalizing behavior, and social problems. Findings highlight the benefit of opportunities for PCEs for children who have been exposed to ACEs.