Adverse Childhood Experiences in Autistic and Neurotypical Girls

Adverse childhood experiences (ACEs) are potentially traumatic, life-altering events that occur in childhood with long-term negative physical and/or mental health outcomes. Previous research, while limited and largely focused on males, suggests children with autism spectrum disorder (ASD) are at higher risk of experiencing ACEs than typically developing (TD) peers. The study aimed to enhance our understanding of ACEs by focusing on female participants comparing diagnostic (ASD, TD), developmental (age, puberty), and mental health (anxiety, depression) factors. Participants included 212 female children with ASD (N = 112) or TD (N = 100) between 6:0 to 12:11 years. Following diagnostic testing, the 10-item ACEs questionnaire was administered. Statistical analyses included Wilcoxon rank-sum tests, negative-binomial models, linear regression, and Spearman correlations. There was a significant group difference in the total number of ACEs such that autistic children had more parent-reported total adverse events (p = 0.024). There were no significant diagnosis by age or puberty stage interactions (p > 0.05). Depressive symptoms were significantly positively associated with autism diagnosis (p < 0.001, RESI = 0.574) and ACE total (p < 0.001, RESI = 0.282), indicating overall higher rates of depressive symptoms in autistic youth, and an increase in depressive symptoms for participants with at least one ACE. There were similar findings for anxiety. Results highlight that having autism along with ACEs may place youth at a higher risk of mental health conditions. Treatments developed to address the unique challenges of adverse events in autism may be warranted to prevent long-term sequelae and poor mental health outcomes.