Literature Reviews

Adverse childhood experiences (ACEs) are common in the US and worldwide, with predictable, preventable negative outcomes. Behavioral and emotional challenges (EMBs; including ADHD, depression, anxiety, and conduct disorders) become particularly apparent in adolescents while at school, where EMBs become a more significant concern, and there is a strong correlation between EMBs and ACEs. Maltreated children are less likely to have adequate resilience levels to navigate the stressors that are encountered in everyday student life. Minority students are at higher risk for ACEs, EMBs and low resilience levels. Sociological interventions at home, school and healthcare settings are recommended. Evidence-based interventions such as mindfulness have been shown to reduce the adverse outcomes related to ACEs, the intensity of EMBs and increase resilience. 

Childhood obsessive-compulsive disorder (OCD) is a debilitating and enduring condition with unknown cause. There are many potential risk factors to the development, maintenance and severity of the condition, including trauma and internalized shame and/or anxiety. OCD is often comorbid with other mental health conditions, which increases treatment complexity. There are opportunities to decrease the likelihood of pediatric OCD development at school and through gamified therapy, as well as opportunities to decrease the severity of the condition through streamlined access to evidence-based treatments and parental support. 

A typical child has a parent, a teacher, and a doctor in their life from an early age. Each brings with them a set of cultural norms, expectations, and biases that are often determinative of whether a child will receive appropriate treatment, particularly when related to mental health. Various cultural factors interplay resulting in the chronic underdiagnosis of Attention Deficit Hyperactivity Disorder (ADHD) in minority children. This review explores the cultural barriers preventing effective care, by affecting parent beliefs, teacher bias, or diagnostic cultural insensitivity. 

During adolescence, unexpected behavior has the potential to become increasingly problematic and can have a significant impact on life trajectory. Adult interpretation and response to this behavior has the potential to either diffuse the problem or exacerbate it across various settings, particularly at home and at school. Adult misinterpretation of behavior often results in predictable undesirable outcomes such as underachievement, delinquency and justice involvement, misdiagnosis and psychopathology, or coercive behavior modification efforts occasionally resulting in death. This paper will explore areas of adult interaction with adolescents where behavior misinterpretation is particularly problematic, significant implications of these interactions and propose an alternative evidence-based approach to behavior interpretation that has been shown to effectively reduce both the incidence and prevalence of problematic behavior. 

The Adverse Childhood Experiences (ACEs) study identified a strong dose-responsive relationship between the quantity of different types of adverse childhood experiences (ACEs) and risk factors for many causes of adverse health events (Felitti et al., 1998). The CDC-Kaiser ACE study questions included indicators of childhood abuse (emotional (CEA), physical (CPA), sexual (CSA)) and household dysfunction (substance abuse (SUD), mental illness (MI), domestic violence (DV), imprisoned family member (IFM), divorced parents (DP). Indicators of these events were tallied and combined to create a cumulative risk (CR) score with scores ranging from 0 to 8, with graded increases in negative outcomes as scores increased. Subsequently neglect (physical (CPN), emotional (CEN)) was added to the ACEs.