Adverse childhood experiences among early care and education teachers: Prevalence and associations with observed quality of classroom social and emotional climate

Abstract

This study examines the prevalence of self-reported adverse childhood experiences (ACEs) among a sample of 349 early care and education teachers. Seventy-three percent of the sample reported experiencing at least one ACE and 22% reported experiencing 4 or more ACEs. Live observational assessments of the quality of the social and emotional climate in teacher’s classrooms were conducted for a subsample of 58 teachers. Within this subsample, reporting a higher number of ACEs was associated with facilitating a lower quality social and emotional classroom climate. Individual ACEs were also examined. Teachers who reported experiencing incarceration of a family member, physical abuse, or emotional abuse were observed to facilitate a lower quality social and emotional classroom climate. This study provides preliminary insight into the prevalence of ACEs among members of the early care and education workforce. Further, it extends previous work examining the multi-generational impacts of ACEs within families by showing that ACEs may influence the care that is provided to children in childcare settings.

1. Introduction

The capacity of adults to provide nurturing early care environments shapes the foundation of children’s health and wellbeing (Biglan, Flay, Embry, & Sandler, 2012; Britto et al., 2017; Shonkoff, 2017). In the lives of many young children, early care and education (ECE) teachers are important adults. As maternal participation in the workforce has increased over the course of recent decades, so has the percentage of children cared for outside of the home, with a great deal of growth in the use of center-based care (US Department of Health and Human Services, 2014). Specifically, approximately 59% of children under the age of 5 who were not enrolled in kindergarten participated in center-based ECE programs in 2016 (National Center for Education Statistics, 2018). Center-based early care occurs in non-residential settings, typically staffed by a director and numerous teachers.

A particularly important role of the ECE teacher is interacting with children in a sensitive and responsive manner thereby promoting a healthy social and emotional classroom climate (Cassidy, King, Wang, Lower, & Kintner-Duffy, 2017; Howes, 2000; Mortensen & Barnett, 2016; Reyes, Brackett, Rivers, White, & Salovey, 2012). A healthy social and emotional climate supports young children’s cognitive, social, emotional, physical, and behavioral development (Chazan-Cohen et al., 2017; Gerber, Whitebook, & Weinstein, 2007; Ritblatt, Hokoda, & Van Liew, 2017; Skinner, 2018; Whitaker et al., 2014). A fairly large body of research shows that demographic and workplace characteristics, such as the ECE teacher’s level of training, income, support from supervisors, and relationships with co-workers influence the quality of their interactions with young children (Castle et al., 2016; Gerber et al., 2007; Hossain, Noll, & Barboza, 2012; Kinman, Wray, & Strange, 2011; Klassen & Chiu, 2010; Mortensen & Barnett, 2016). Further, a smaller body of research has shown that broader issues, such as the ECE teacher’s mental health, personal resources, and access to support outside the workplace also play an important role in influencing capacity to provide sensitive and responsive care (Hamre & Pianta, 2004; Manlove, Vazquez, & Vernon-Feagans, 2008; Weaver, 2002). However, an area that has not been examined is how the social and emotional climate in ECE classrooms might be impacted by teacher’s experiences of adversity in their own childhoods. Research has shown that adults who have experienced higher levels of adverse childhood experiences (ACEs) are at increased risk for a wide variety of problems in adulthood, including in interpersonal functioning areas such as relationships with others and parenting (McDonald et al., 2019; Poole, Dobson, & Pusch, 2018; Steele et al., 2016). If adversity experienced in childhood affects ECE teachers in similar areas, their ability to promote a healthy social and emotional classroom climate might be negatively impacted (Jeon, Hur, & Buettner, 2016). The purpose of the current study is to examine the prevalence of exposure to ACEs among a sample of ECE teachers and the relationship between ACEs and the observed quality of the social and emotional climate in their classrooms.

1.1. Social and emotional climate in ECE classrooms

The quality of social and emotional interactions between all members of the ECE classroom creates the social and emotional climate (Reyes et al., 2012). A teacher’s capacity to exhibit responsiveness, warmth, and congruent affect in interactions with children are key facilitators of a healthy social and emotional climate (de Kruif, McWilliam, Ridley, & Wakely, 2000). Quality verbal interactions with children are bidirectional, use open-ended dialogue, and are driven by the child’s interests (de Kruif et al., 2000). These interactions build trust and positivity between ECE teachers and children, which is key to the emotional functioning and motivation of students in the short and long-term (Jennings & Greenberg, 2009).

A healthy social and emotional classroom climate can provide immediate benefits to both the teacher and the child. An ECE teacher who is engaged in supportive and responsive interactions is more effective in managing classroom behaviors in a proactive, rather than reactive, manner (Jennings & Greenberg, 2009). A positive social and emotional climate can also result in feelings of fulfillment and success as well as reduced likelihood of burnout for ECE teachers (Hall-Kenyon, Bullough, MacKay, & Marshall, 2014; Hossain et al., 2012; Spilt, Koomen, & Thijs, 2011). Further, sensitive and responsive care provides scaffolding of children’s developing cognitive, linguistic, social, and emotional skills (Landry et al., 2014; Mortensen & Barnett, 2015; Trawick-Smith & Dziurgot, 2011). Longitudinal research has demonstrated that the quality of the social and emotional climate in the ECE setting can have long term benefits for developing children (Burchinal et al., 2008; Downer, Sabol, & Hamre, 2010; Mashburn et al., 2008). For example, Burchinal et al. (2008) examined 240 randomly selected pre-kindergarten programs in 6 states and utilized observational measures of teacher responsiveness and sensitivity, as well as instructional quality. Among the over 700 children included in this study who were followed through the end of the kindergarten year, both sensitive and responsive interactions with teachers and instructional quality predicted greater gains in language, academic, and social skills (Burchinal et al., 2008).

1.2. Impact of ACEs on ECE Teacher’s caregiving capacities

ACEs are very stressful occurrences that can have a toxic effect on children. ACEs include experiences such as child abuse, having a parent with a mental health disorder, or having a parent who is incarcerated (Dong et al., 2004; Felitti et al., 1998). ACEs are common. The Centers for Disease Control and Prevention (CDC) conducted a nationally representative telephone survey assessing the prevalence of ACEs during the years 2011–2014. Results of this survey of 214,157 individuals showed that 62% of respondents experienced at least one ACE and 16% of respondents experienced 3 or more ACEs (Merrick, Ford, Ports, & Guinn, 2018). The number of ACEs that a person experiences is related, in a dose-response relationship, to a host of negative social, emotional, and physical health problems that emerge across the lifespan (Felitti et al., 1998).

While studies of the impacts of ACEs on adults in the general population have proliferated since the late 1990s, we are only aware of one previous study that has examined ACEs among teachers (Whitaker et al., 2014). Whitaker and colleagues measured the prevalence of ACEs using a survey delivered to 2160 members of Head Start staff in Pennsylvania, including teachers, home visitors, and administrators. These authors examined the connection between ACEs, staff member’s level of dispositional mindfulness (e.g., one’s ability to attend to present sensations, thoughts, and feelings without judgement), and staff member’s physical health outcomes. Among the Head Start staff surveyed, the prevalence of ACEs was similar to levels in the general population. Also similar to findings from the broader ACEs literature, there was a graded dose-response relationship between a higher number of ACEs and lower health-related quality of life for the staff members. However, dispositional mindfulness appeared to play a buffering role in the relationship between ACEs and health outcomes, as staff with greater levels of dispositional mindfulness had better health outcomes regardless of their level of exposure to ACEs (Whitaker et al., 2014).

While the study by Whitaker et al. (2014) provides initial evidence that ACEs may be impacting the current functioning of some members of the workforce that serves young children, previous research has not examined linkages between ECE teacher’s exposure to ACEs and the social and emotional climate they create in their classrooms. However, investigations of relations between ACEs, adult functioning, and parenting behavior suggest that ACEs likely impact adults in areas important to their capacity for providing care to children. Experiencing multiple ACEs can alter development of the body’s stress response system (Shonkoff, Boyce, & McEwen, 2009). By adulthood, those who have experienced multiple ACEs often have poorly developed skills in managing their internal state and responses to stress, which can lead to difficulties in mental health and relationships with others (Poole et al., 2018; Teicher, Samson, Anderson, & Ohashi, 2016).

There is evidence from neurobiological research indicating that ACEs can lead to specific deficits that impair caregiving behavior (Bhandari et al., 2014; Kim, Fonagy, Allen, & Strathearn, 2014; Pechtel, Murray, Brumariu, & Lyons-Ruth, 2013). For instance, Kim et al. (2014) conducted a study using functional magnetic resonance image (FMRI) scanning to compare amygdala blood oxygenation level-dependent responses among first time mothers who were classified as either having unresolved trauma or no trauma history. Mothers in both groups were shown sad and happy images of their newborns during FMRI scans. Results indicated that mothers with unresolved trauma showed blunted amygdala responding to sad images of their newborns, which the researchers interpreted as indicative of trauma-related neurobiological changes that decreased the mother’s attunement to cues of infant distress. Observational research involving mothers exposed to ACEs and their children has provided further evidence of a link between these exposures and deficits in parenting behavior (Bailey, DeOliveira, Wolfe, Evans, & Hartwick, 2012; Gonzalez, Jenkins, Steiner, & Fleming, 2012; Julian et al., 2018; Lange, Callinan, & Smith, 2019; McDonald et al., 2019; Steele et al., 2016; Stepleton et al., 2018). Specifically, in research involving observations of mother–child interactions, mothers who have experienced a higher number of ACEs display lower levels of sensitivity (Gonzalez et al., 2012), higher levels of hostility (Bailey et al., 2012), and lower levels of positive parenting (Julian et al., 2018). Additionally, mothers who have experienced higher numbers of ACEs also report less confidence in their parenting (McDonald et al., 2019), higher levels of parenting stress (Lange et al., 2019; Steele et al., 2016), and a greater number of behavioral problems displayed by their children (Stepleton et al., 2018).

2. Current study objectives

To our knowledge, there is no previous research examining the connection between ACEs and ECE teacher’s promoting of a healthy social and emotional classroom climate. The first aim of the current study was to use self-report data from 349 ECE teachers to examine the prevalence of ACEs within the sample. It was expected that ACEs would be reported within this population at a rate similar to what has been observed in the general population (Merrick et al., 2018) and in the one previous study of which we are aware examining ACEs among teachers of young children (Whitaker et al., 2014). Second, using a subsample (N = 58) of lead teachers who were randomly selected to participate in live observations of the social and emotional climate in their classrooms, we aimed to explore the relationship between cumulative number of ACEs reported, as well as individual ACEs, and the quality of the social and emotional climate. It was expected that ECE teachers who reported experiencing a higher number of ACEs would score lower on the observational measure of classroom social and emotional climate. It was also expected that experiencing individual ACEs would be associated with lower scores on the observational measure of classroom social and emotional climate.

3. Method

3.1. Participants and procedure

The study was conducted in a southeastern state in the United States. Participants were ECE teachers from childcare centers throughout the state. The participants were enrolled in a larger project aimed at promoting the health and well-being of ECE teachers, named Be Well Care Well. Be Well Care Well is a voluntary program aimed at promoting a culture of care and support in child care settings by attending to the well-being of ECE teachers so they are able to provide relationship-based care that meets child developmental needs. When ECE teachers participated in the data collection procedures that are a focus of this study, they had just enrolled in the program and had not participated in any of the intervention components. Prior to the intervention, 349 ECE teachers completed the questionnaire assessing exposure to ACEs and these data are included in the current study analyses. The ACEs questionnaire was administered to teachers within a larger survey that collected baseline data on outcomes targeted by the Be Well Care Well program. The survey was administered in a paper and pencil format following the Be Well Care Well orientation delivered at each participating child care center. ECE teachers completed the measures independently and trained staff were available to read the measures to the participants as needed. ECE teachers received a $15 gift card as a thank you for completing the survey.

Due to budgetary and practical restraints, live observational assessments of classroom social and emotional climate could only be conducted with a proportion of the overall sample. Fifty-eight ECE teachers from the larger sample who worked in 28 child care centers throughout the state participated in observational assessments. These teachers, representing one-third of all classrooms, were randomly selected using a random digit generator. The lead ECE teacher was observed in each of the 58 classrooms. The Climate of Healthy Interactions for Learning and Development tool (CHILD; Gilliam & Reyes, 2017), which is an observation system that assesses the quality of classroom social and emotional interactions in ECE settings was used in these observations. Training and procedures for use of the observational tool are described below. The University’s Institutional Review Board (IRB) deemed the data collection procedures program evaluation and thus informed consent was not required prior to data collection. IRB approval was obtained prior to analyzing the data presented in this manuscript in a deidentified database.

3.2. Measures

3.2.1. Adverse childhood experiences

The Adverse Childhood Experiences Questionnaire (ACEs) is an 11-item measure administered to adults to identify stressful experiences that occurred during childhood (Centers for Disease Control and Prevention, 2014; Felitti et al., 1998). Questions are about child abuse and growing up with household dysfunction. To assess experiencing child physical abuse, respondents were asked “How often did a parent or adult in your home ever hit, beat, kick, or physically hurt you in anyway?” The respondent was instructed to not include spanking. Childhood experiences of sexual abuse were assessed with three questions: “How often did anyone at least five years older than you or an adult ever touch you sexually?”, “How often did anyone at least five years older than you or an adult try to make you touch them sexually?”, and “How often did anyone at least five years older than you or an adult force you to have sex?” Emotional abuse was assessed with the question “How often did a parent or adult in your home ever swear at you, insult you, or put you down?” To assess domestic violence, respondents were asked “How often did your parents or adults in your home ever slap, hit, kick, punch, or beat each other up?” Responses to these questions could include never, once, or more than once. Responses to these questions were recoded to develop the ACE categories of physical abuse, sexual abuse, emotional abuse, and domestic violence. If the respondent reported experiencing the ACE at least one time, they were categorized as experiencing that ACE.

Divorce was assessed via the question: “Were your parents separated or divorced?”; incarceration in the household was assessed via the question: “Did you live with anyone who served time or was sentenced to serve time in a prison, jail, or other correctional facility?”; household substance use was assessed via two questions: “Did you live with anyone who was a problem drinker or alcoholic?”, and, “Did you live with anyone who used illegal street drugs or who abused prescription medications?”; household mental illnesses was assed via the question “Did you live with anyone who was depressed, mentally ill, or suicidal?” Respondents who answered “Yes” to any of these questions were recorded as experiencing the respective ACEs of divorce, incarceration of a household member, household substance use, and mental illness of a household member. The ACEs questionnaire demonstrated adequate internal consistency in the current study (Cronbach’s alpha = 0.70).

3.2.2. Social and emotional classroom climate

The Climate of Healthy Interactions for Learning and Development tool (CHILD, Gilliam & Reyes, 2017) is a comprehensive observational assessment of the social and emotional climate facilitated by teachers in ECE settings. Its current use is predominately in evaluation of early childhood mental health consultation programs that aim to improve classroom social and emotional climate. The developers of the CHILD measure recommend that observers participate in an 8-h training course prior to use of the measure. The training covers related background research, instructions for use, practice coding via videotapes of classrooms, feedback on practice coding, scoring, and reliability. Further, it is recommended that following the training and before completing observations, observers meet a minimum criterion of 80% agreement with ratings by the measure developers on training tapes. All observers followed these recommendations. The 8-h course was conducted by the authors of the measure (Reyes and research associates of the Zigler Center for Child Development & Social Policy of Yale University) via live video conferencing technology. All observers also met the minimum criterion of 80% agreement on training tapes. This manuscript’s last author and program evaluator for the Be Well Care Well program also completed the training course for the CHILD and was available to observers to provide consultation on questions and issues related to coding.

Trained observers performed assessments in each classroom over a period of two hours. These two-hour assessments were divided into 4 blocks, with 20 min per block for observing and writing notes and 5–10 min for scoring. Ratings using the CHILD are on 28 items across 9 dimensions. Each item uses a 5-point scale from −2 to +2 with a midpoint of 0. The scale is anchored to: undermining children’s social and emotional development (−2), baseline expectation (0), and promoting children’s social and emotional development (+2). The CHILD assesses elements of both pedagogy (e.g., teaching methods and practices) and affect (e.g., expression of emotion). The 9 dimensions are as follows: Transitions, Directions and Rules, Social-Emotional Learning, Staff Awareness, Staff Affect, Staff Cooperation, Staff-Child Interactions, Individualized and Developmentally Appropriate Pedagogy, and Child Behaviors. Table 1 provides a description of each of the dimensions.

Table 1.

CHILD dimensions.

CHILD dimension	Description
Transitions	Transitions are scored when there is a change in activity for at least one-third of classroom children. Transitions can include moves from one activity to the next within the same physical space (e.g., a change from one activity to another while sitting at classroom tables) or from one physical space to another (e.g., from the classroom to the playground). Transitions that are scored highly are smooth, avoiding abruptness or being unnecessarily lengthy. They are made efficient through preparedness by the teacher. They also are flexible and attuned to children’s developmental level.Challenging child behaviors are prevented through high quality transitions.
Directions and Rules	This dimension focuses on behavior management through rules of conduct, modeling, encouragement of positive behavior, and use of natural/logical consequences for misbehavior. Assesses clarity in staff provision of rules and expectations, level to which staff encourages positive behavior through proactive methods, and effectiveness of behavioral management strategies.
Social-Emotional Learning	Assesses staff pedagogy and affect used to encourage a dialogue about feelings, scaffold social problem solving, and support relationships between students. Staff that score high on this dimension find opportunities to help children improve their vocabulary related to emotions, social skills, and ability to navigate social conflicts.
Staff Awareness	Focuses on staffs noticing of cues that require extra attention to children’s emotional needs. Assesses staff circulation around the classroom, active monitoring of children, and sensitivity to children’s needs. The level to which staff are able to notice signals of needs that are subtler than others, as well as divide attention across the many issues that may be occurring at once in a classroom, is also assessed.
Staff Affect	Defined as staffs display of positive and congruent facial expression and body language. To score high on this dimension, staff display affect that is appropriately positive but also appropriately matched with children’s affect during individual interactions. For instance, when children are angry and upset, staff display neutral affect rather than dismissing the child’s emotions by displaying positive affect. Also assessed is staffs body language and tone of voice, with high scores reflecting conveying of engagement, alertness, and appropriate levels of energy.
Staff Cooperation	This dimension focuses on interactions between staff. Teamwork, sharing of responsibilities, mutual respect, and enjoyment of coworkers are assessed. Staff who score high on this measure appear to work well with other staff
Staff-Child Interactions	members, treat other staff respectfully, and appear to genuinely enjoy their coworkers.Focuses on treatment of children by staff including conveying of respect and dignity, conversations that demonstrate interest in children and their lives outside of the classroom, and staffs ability to exhibit warmth and affection toward children. Equitable treatment of children, through a level of attention that is in line with individual needs, is also examined.
Individualized and Developmentally Appropriate Pedagogy	Considers the extent to which staff promotes healthy child development through child-focused interactions and pedagogy. Examines the level to which staff provides support and feedback that considers children’s specific needs; incorporate individual children’s interests, motivations, and experiences into activities and lessons; promotes self-expression; encourages creativity; and provides developmentally appropriate, stimulating activity choices.
Child Behaviors	This dimension focuses on the behavior and affect of classroom children. The goal is to assess behavior and affect across the majority of children in the classroom rather than focusing on individual children. Examines children’s self-regulation, energy, and their engagement in positive interactions with peers and staff.

An overall score on the CHILD measure for each teacher was calculated by averaging scores across all items. Previous research examining the CHILD has demonstrated high internal reliability for the full scale and its dimensions (Cronbach’s alphas from 0.88 to 0.98) and high correlations with other measures of teacher effectiveness (Reyes & Gilliam, 2018). Internal consistency was high in the current study (Cronbach’s alpha = 0.92).

3.3. Analytic approach

First, descriptive analyses were conducted to examine the prevalence of ACEs among ECE teachers. Bivariate correlations among all study variables were also examined. Teacher and classroom covariates for the multilevel model were selected based on theoretical considerations and bivariate correlations. Class size was significantly correlated with CHILD scores, r = −0.307; p = .019, and was therefore included as a covariate in the multilevel model. Although class age and teacher education were considered as potential covariates, they were not included in the model due to their nonsignificant correlations with CHILD scores (class age: r = .−157; p = .247; teacher education: r = 0.247, p = .115).

Next, multilevel modeling was conducted to estimate the associations between teacher ACEs and CHILD scores, with class size entered as a covariate. The multilevel modeling approach allowed simultaneous estimation of the variance associated with individual-level (within-teacher/classroom) and childcare center-level (between-centers) factors based on the specification of fixed- and random-effect variables entered into the model (Raudenbush & Bryk, 2002). Including indicator variables for each individual classroom allowed for analyses to control for the center in which the teacher worked. We estimated the association between ACES and CHILD score over and above class size. Finally, in order to evaluate the relation between specific types of ACEs and classroom social and emotional climate, we tested a multilevel model with individual types of ACEs predicting CHILD scores, including class size as a covariate. All analyses were run in SPSS 25.0.

4. Results

4.1. Descriptive analyses

Table 2 presents the basic descriptive statistics for the larger sample of ECE teachers who completed the ACEs questionnaire as well as the observational subsample. Table 2 also presents descriptive statistics for variables included in analyses of the relationship between ACEs and quality of social and emotional climate for observed teachers. In the overall sample, all ECE teachers were female, ranged in age from 18 to 81 years old (Mean = 40.16, SD = 14.22), and reported their ethnicity as Black (58.70%), White (31.20%), Hispanic (1.4%), or Other (9%). Forty-two percent of teachers reported that they were married and 58% were divorced, widowed, separated, or had never been married. Teachers had a range of 0 to 5 children who lived with them in their homes (Mean = 1.31; SD = 1.08). Regarding education, 19% of teachers reported that they had completed high school, 52% completed some college, and 28% had a bachelor’s degree or higher. Teachers had an average of 12.47 years (SD = 10.36) working in the childcare field (range = 1–49 years), and an average of 5.28 years (SD = 6.03) working at their current childcare center (range = 1–40 years). T-tests revealed no significant differences in the characteristics of the observational subsample (n = 58) compared to the larger overall sample (n = 349).

Table 2.

Descriptive statistics for all study variables.

Variable	Full sample (n = 349)		Observed sub-sample(n = 58)
	M or %	SD	M or %	SD
Teacher age	40.16	14.22	41.56	11.73
Number of children living with teacher	0.90	1.08	0.88	1.03
Years working in childcare field	12.47	10.36	14.61	10.60
Years at current childcare center	5.28	6.03	5.37	5.54
Race/Ethnicityc
African American	58.7%		72.1%
White	31.2%		18.6%
Asian/Pacific Islander	0.5%		0.0%
Native American	0.5%		0.0%
Hispanic	1.4%		0.0%
Other	7.8%		9.3%
Marital status
Married	42.3%		47.7%
Divorced	10.8%		18.2%
Widowed	5.0%		0.0%
Separated	5.4%		4.5%
Never married	36.5%		29.5%
Education level
Some high school	0.5%		0.0%
High school/GED	19%		18.2%
Some college/technical school	51.6%		56.8%
College degree	22.2%		20.5%
Graduate work	6.8%		4.5%
Number of ACEs	2.04	1.98	1.95	1.99
0	27.1%		31.0%
1	22.7%		24.1%
2	16.2%		10.3%
3	11.8%		10.3%
4	7.7%		10.3%
5	7.7%		8.6%
6	3.5%		1.7%
7	2.4%		3.4%
8	0.9%		0.0%
Divorce or separation of caregivers	43.5%		48.2%
Emotional abuse	43.1%		36.2%
Substance use exposure	24.0%		20.7%
Physical abuse	23.9%		24.1%
Mental illness of a caregiver	21.6%		19.0%
Domestic violence exposure	21.5%		24.1%
Sexual abuse	19.8%		15.5%
Incarceration of household	11.1%		8.6%
member
Class age
Pre-school aged class	−		25.9%
Infant and toddler aged class	−		74.1%
Class size (number of children)	−		8.96	4.58
CHILD mean score	−		0.41	0.42

Note. CHILD = Classroom Healthy Interactions for Learning & Development; ACE = Adverse Childhood Experience.

Demographic characteristics are based on participants who completed demographic data; full sample n = 219, observational subsample n = 44. For ACEs data, full sample n = 330, observational subsample n = 58. Classroom-level characteristics (i.e., class age, size) are not available for the overall sample.

Regarding center-level descriptive characteristics, all 35 centers that participated in the program provide services to infant-toddler aged children. Thirty-one centers (91.2%) offer services to preschool children as well. Seventy-five percent of centers were private, 29% were faith-based, and 6% were non-profit (non-mutually exclusive categories). Additionally, 91.4% accept state-funded financial assistance vouchers. Centers had an average of 13 staff (SD = 11.3, range = 1–50) and 76 children (SD = 56.6, range = 5–225), with an average child to staff ratio of 6.5 (SD = 4.0, range = 2.3–23.3).

Also included in Table 2 are the frequencies and percentages of ACEs reported by ECE teachers. The two most commonly reported types of ACEs were parental divorce/separation (43.5% of the sample) and childhood emotional abuse (43.1%). Nearly one-quarter of the sample experienced childhood physical abuse (23.9%) and/or lived with an adult with a substance abuse problem (24.0%). Approximately one in five teachers reported that they had lived with an adult who experienced mental health problems (21.6%), witnessed domestic violence (21.5%), and/or were sexually abused as a child (19.8%). Finally, 11.1% of the sample reported that they had lived with an adult who was incarcerated during their childhood. Overall, the average number of ACEs reported by ECE teachers was 2.04 (SD = 1.98). Most teachers (72.9%) experienced at least one type of ACE, and 22.2% experienced four or more different types of ACEs.

Table 3 shows the bivariate intercorrelations between ACEs, CHILD score, and class size. Class size was negatively correlated with CHILD score, such that teachers with larger classes displayed lower CHILD scores. Class size was positively correlated with physical abuse; teachers who had experienced physical abuse were more likely to have larger classes. CHILD scores negatively correlated with emotional abuse and incarceration of a household member. Several intercorrelations among types of ACEs were observed.

Table 3.

Bivariate correlations among all study variables (n = 58).

Variable	1	2	3	4	5	6	7	8	9	10
1. Class Size	‒
2. CHILD total score	−0.342**	−
3. Number of ACES	0.024	−0.221	−
4. Sexual Abuse	−0.100	−0.089	0.348**	-
5. Physical Abuse	0.351**	−0.194	0.667**	0.203	−
6. Emotional Abuse	0.058	−0.287*	0.763**	0.371**	0.497**	−
7. Incarceration of Household Member	0.102	−0.313*	0.474**	0.038	0.257	0.408**	−
8. Divorce/Separation of Caregivers	−0.136	− 0.087	0.538**	0.015	0.103	0.250	0.325*	−
9. Domestic Violence Exposure	0.011	−0.041	0.707**	0.092	0.623**	0.413**	0.114	0.231	−
10. Substance Use Exposure	−0.186	−0.094	0.616**	0.016	0.209	0.324*	0.146	0.243	0.408**	−
11. Caregiver Mental Illness	−0.030	0.007	0.658**	0.036	0.241	0.368**	0.165	0.297*	0.447**	0.621**

4.2. Multilevel models

Next, a series of multilevel models were tested to evaluate the relation between ACEs and CHILD score, with classrooms nested in child care centers. Table 4 displays the results from the two-level models that examined total number of ACES, as well as different types of ACEs, as predictors of CHILD score. Based on the unconditional means models, 0.7% of the variance in CHILD scores was explained by the teacher/classroom (intraclass correlation coefficient = 0.007).

Table 4.

Results of multilevel models predicting CHILD observation scores.

	B	SE	P
Total ACEs score	−0.05*	0.02	0.020
Class size	−0.04**	0.01	0.001
Sexual Abuse	−0.13	0.13	0.332
Class size	−0.03	0.01	0.002
Physical Abuse	−0.20†	0.10	0.059
Class size	−0.03	0.01	0.009
Emotional Abuse	−0.18†	0.09	0.060
Class size	−0.03	0.01	0.002
Incarcerated Household Member	−0.39*	0.15	0.012
Class size	−0.03***	0.01	0.002
Substance Use Exposure	−0.17	0.11	0.138
Class size	−0.04**	0.01	0.001
Domestic Violence Exposure	−0.05	0.11	0.672
Class size	−0.03**	0.01	0.002
Caregiver Mental Illness	−0.06	0.12	0.641
Class size	−0.03**	0.01	0.002

Note. CHILD = Classroom Healthy Interactions for Learning & Development; ACE = Adverse Childhood Experience.

^***p < .001.

^**p < .01.

^*p < .05.

^†p < .10.

In the multilevel models, we first tested the association between teacher’s overall number of ACEs and CHILD score. We found that, after controlling for class size, teachers who reported a higher number of ACEs facilitated less quality social-emotional climates in the classroom (B = −0.05, SE = 0.02, p = 0.02). Next, we examined models testing each type of ACE as a predictor of CHILD score. Due to power constraints, we examined each type of ACE in a separate model. Having lived with an adult who was incarcerated was significantly related to scores on the CHILD (B = −0.39, SE = 0.15, p = 0.012). Experiencing childhood physical abuse (B = −0.20, SE = 0.10, p = 0.059) or emotional abuse (B = −0.18, SE = 0.09, p = 0.060) were each marginally related to lower scores on the CHILD. The other types of ACEs (sexual abuse, substance use exposure, domestic violence exposure, and mental illness of a household member) were not significantly related to CHILD scores.

5. Discussion

In the current study, we aimed to document the prevalence of exposure to ACEs among ECE teachers. Among participants, ACEs were common: 73% reported experiencing at least one ACE and 22% reported experiencing 4 or more ACEs. In a recent survey of ACEs in the general population by the CDC, 62% of respondents reported experiencing 1 or more ACEs and 16% of respondents reported experiencing 4 or more ACEs (Merrick et al., 2018). In the one previous study we are aware of examining ACEs among teachers of young children, prevalence was described in categories of exposure to 0, 1, 2, and 3 or more (Whitaker et al., 2014). In this previous study, 59% of the sample experienced at least one ACE and 23% of the sample experienced three or more ACEs. In comparison to the findings reported by Whitaker and colleagues, 34% of the teachers in the current study reported experiencing three or more ACEs. Thus, overall, ECE teachers reported experiencing ACEs at higher rates than in the general population and in the only previous study that we are aware of that included teachers of young children. Outside of the work by Whitaker and colleagues, we are not aware of any other previous research examining the prevalence of ACEs among teachers working with children of any age.

The high rates of ACEs reported by the ECE teachers included in this study may be related to the socioeconomic characteristics of the sample. The percentage of participants who reported obtaining a bachelor’s degree or higher was 30% in the current study versus 60% in the study by Whitaker et al. (2014) of Head Start staff. In comparison to the general population, ECE teachers are among the most economically insecure workers in the United States (Phillips, Austin, & Whitebook, 2016). The literature on ACEs has shown that these events lead to risk for lower educational attainment as well as economic insecurity. Further, 61% of the current study sample described their ethnicity as Black or Hispanic whereas 12% of the Head Start staff in the study by Whitaker and colleagues described their ethnicity as Black or Hispanic. ACEs appear to be disproportionally experienced by members of Black and Hispanic ethnic minority groups, perhaps due to structural inequities (Cronholm et al., 2015; Metzler, Merrick, Klevens, Ports, & Ford, 2017; Slopen et al., 2016).

Previous research examining ACEs among professionals in the field of child welfare has also documented higher rates of exposure to ACEs among these child-serving professionals than in the general population (Esaki & Larkin, 2013; Howard et al., 2015; Lee, Pang, Lee, & Melby, 2017). In explaining these findings, it has been suggested that child welfare professionals may be drawn to the field because they are empathetic to needs of children and want to help improve their lives (Howard et al., 2015). In a similar manner, ECE teachers may perceive their work as an opportunity to protect and nurture young children who are experiencing similar hardships to the ones they encountered in their own childhoods. However, the current study did not assess ECE teacher’s motivations for entering or remaining in the field. Thus, more research would be necessary to confirm this explanation.

The second aim of this study was to examine the association between the cumulative number of ACEs reported by teachers and scores on a live observational assessment of the social and emotional climate in their classrooms. Related to this aim, we found that ECE teachers who reported experiencing a higher number of ACEs facilitated a lower quality social and emotional climate in their classrooms. This finding was somewhat expected given the link that has emerged in recent literature between ACEs and parenting behaviors (Gonzalez et al., 2012; Lange et al., 2019; McDonald et al., 2019; Steele et al., 2016). Some of the association between ACEs in the lives of parents and problematic parent–child interactions may be explained by heritable factors (Alink, Cyr, & Madigan, 2019). Parenting behavior is influenced by interconnected community/cultural factors, parent characteristics, and child characteristics. While there are no child characteristics that cause problematic parenting to occur, some child characteristics do influence parent–child interactions in negative ways (Belsky, 1993). To the extent that these characteristics are influenced by genetics, genetics may provide a small part of the explanation for why both a parent and a biologically related child experienced increased risk for the parent–child interactions associated with ACEs (Schulz-Heik et al., 2009). However, this study’s findings suggest that ACEs are related to reduced capacities among adults providing care professionally to children to whom they are not biologically related. Thus, an environmental pathway, through which ACEs have impaired development for teachers in areas such as neurological functioning, coping with stress, emotion-regulation, and interpersonal abilities is a likely explanation for this relationship (Evans & Kim, 2013; Kim et al., 2014; Poole et al., 2018; Rudenstine, Espinosa, McGee, & Routhier, 2018).

In the current investigation, we also examined the relationship between specific ACEs reported by teachers and the social and emotional climate in their classrooms. Of the 8 ACEs examined, we found that teachers who reported experiencing incarceration of a family member scored significantly lower on the observational assessment of social and emotional classroom climate. Further, reporting experiencing physical abuse and emotional abuse were both marginally related to lower scores on the observational measure. The nature of the adverse experiences of a family member’s incarceration, physical abuse, and emotional abuse may explain their link to teacher’s observed caregiving skills. Each of these three ACEs represents a substantive missed opportunity for children to be exposed to parental models of sensitive and responsive caregiving. Experiencing a parent’s incarceration is a disadvantage for a developing child in terms of the lack of access to a positive relationship with the incarcerated family member, potential exposure to criminal behavior prior to the family member’s incarceration, and the ongoing stress that other caregivers face when their partners or loved ones are involved in the criminal justice system (Arditti, 2016; Giordano, Copp, Manning, & Longmore, 2019; Turney & Goodsell, 2018). Both physical abuse and emotional abuse are acts of commission, typically perpetrated by a child’s caregiver. Children who experience physical and emotional abuse often are exposed to high levels of harsh, insensitive, and punitive parenting in addition to the stress and risk of physical harm (Bert, Guner, & Lanzi, 2009; Ehrensaft, Knous-Westfall, Cohen, & Chen, 2015; Wolfe & McIsaac, 2011). However, while there certainly may be some unique effects of specific ACEs, these experiences are often interrelated (Borja, Nurius, Song, & Lengua, 2019; Dong et al., 2004; Scott, Burke, Weems, Hellman, & Carrión, 2013). Further, substantial evidence supports cumulative exposure as a strong predictor of a range of adult outcomes (McDonald et al., 2019; Poole et al., 2018; Steele et al., 2016; Whitaker et al., 2014). Future research examining larger samples will be necessary to understand the differential impacts of cumulative ACEs, groups of ACEs, and individual ACEs on outcomes for ECE teachers (Lanier, Maguire-Jack, Lombardi, Frey, & Rose, 2018).

5.1. Limitations

There are several limitations to consider when interpreting the results of this preliminary investigation. As is true across the large body of literature on ACEs, this study retrospectively assessed participant’s experiences of ACEs. Recall for these experiences can be inaccurate and biased by factors such as the respondent’s current mental health (Colman et al., 2016). However, retrospective recall of past adversity tends to lead to underestimation of these occurrences rather than overestimation, and therefore the conclusion that ACEs are a prevalent and concerning problem among ECE providers likely remains a valid inference based on this study’s results (Hardt & Rutter, 2004). Another limitation was the practical and budget restraints associated with conducting live observational assessments in the community using assessors who were compensated for their time. These restraints led to collection of observational data from only a subsample of teachers. Future work in this area might be improved by conducting observational assessments with larger numbers of teachers. Further, while the assessors who completed the observations received extensive training and demonstrated reliability in use of the measure before conducting the observations, formalized procedures for assessing inter-rater reliability between independent coders or for otherwise monitoring the observer’s maintenance of reliability were not utilized. Inter-rater reliability assessments and other strategies to ensure ongoing reliability would strengthen similar future studies. This work should remain mindful of disruptions that might be caused when multiple assessors visit community ECE centers. The use of video-based reliability checks, which were used to assess observer reliability in the current study before observations began, would be an undisruptive method of monitoring observer reliability in future studies. Finally, other variables that might play a role in the relationship between ACEs and teacher’s capacities, such as social support, psychological functioning, and resilience, were not assessed. Future studies with a larger sample size will be necessary to examine potential moderators of the association found in this preliminary study.

5.2. Conclusions for practice

There is widespread recognition that decreasing the negative impact of ACEs from one generation to the next and promoting child well-being will require intervention in multiple systems. These interventions will need to focus on reducing inequality, promoting access to quality child care and education, and supporting families in accessing basic needs such as housing and nutrition (Bethell et al., 2017; Daro, 2019; Shonkoff, 2014). While this is a small and preliminary investigation, results suggest that attention to the adversity experienced by those that provide professional care for young children should be a factor to consider in planning and delivering these interventions.

ECE teachers have an enormous responsibility in promoting the healthy development of young children while being poorly compensated for their work and with infrequent opportunities for professional advancement (Phillips et al., 2016). As results of this study suggest, in addition to attention to compensation and opportunities provided to ECE teachers, attention to impacts of previous stressful experiences they have encountered and their well-being is important to ensuring that they are able to provide high-quality care.

A way to better attend to the impact of exposure to ACEs among ECE teachers is through improvements to their preparation, professional development, or ongoing supervision. One approach that seems particularly well suited to reducing the negative impacts of past exposure to ACEs is strategies that help ECE teachers cope successfully with stress. While research on ACEs among ECE teachers is newly emerging, the broader concept of stress, such as stress due to working conditions or child behavior problems, has received more attention in previous literature (Friedman-Krauss, Raver, Morris, & Jones, 2014; Shernoff, Mehta, Atkins, Torf, & Spencer, 2011; Whitaker, Dearth-Wesley, & Gooze, 2015). Findings from this literature showing negative effects of stress on a range of outcomes for teachers (e.g., decreased retention, burnout, lower quality relationships with children) have led to development of approaches for reducing these effects (Sandilos, Goble, Rimm-Kaufman, & Pianta, 2018; Zaslow, Tout, Halle, Whittaker, & Lavelle, 2010; Zhai, Raver, & Li-Grining, 2011). A particularly promising approach to training and ongoing development of ECE teachers that aims to reduce the negative effects of stress is mindfulness intervention (Jennings, Frank, Snowberg, Coccia, & Greenberg, 2013; Roeser, Skinner, Beers, & Jennings, 2012; Singh, Lancioni, Winton, Karazsia, & Singh, 2013). Mindfulness interventions for ECE teachers promote an active, non-judgmental awareness of one’s thoughts and feelings, which can improve the issues with self-regulation and reactivity that research shows are associated with chronic exposure to ACEs (Cameron, Carroll, & Hamilton, 2018; Feldman, Lavallee, Gildawie, & Greeson, 2016; Magnuson & Schindler, 2019). Findings from the study by Whitaker et al. (2014) showing the buffering role of dispositional mindfulness in the relationship between ACEs and poor health outcomes for Head Start staff provides additional support for mindfulness as capable of lessening the impacts of ACEs among ECE teachers.

Relationship-based approaches to training and ongoing development are also a promising method for reducing the impact of ACEs on ECE teacher caregiving capacity. These approaches are rooted in an attachment framework and provide teachers with skills for building positive relationships with young children (Sabol & Pianta, 2012; Sosinsky et al., 2016). Adults who have been exposed to high levels of ACEs often have not had the opportunity to develop healthy, secure attachment relationships with their primary caregivers during childhood (Cooke, Racine, Plamondon, Tough, & Madigan, 2019; Corcoran & McNulty, 2018; Frederick & Goddard, 2008; Thomson & Jaque, 2017). Therefore, they may need more support in engaging in these types of relationships when they assume adult roles that involve caring for children (Khan & Renk, 2018; Murphy et al., 2014; Steele et al., 2016). Literature on attachment-based parenting interventions supports this type of method as one that can be helpful for mitigating the extent to which ACEs decrease adult caregiving capacity (Dozier & Bernard, 2017; Slade et al., 2020; Tereno, Savelon, & Guedeney, 2019).

Finally, this study’s findings also have implications for ECE workplace interventions to promote teacher’s health and well-being. A robust literature links ACEs to engagement in health risk behaviors and poor health outcomes (Felitti et al., 1998; Hughes et al., 2017; Wade et al., 2016). Thus, our findings suggest that ECE teachers may often experience a social determinate of health that leads to an increased need for health promotion intervention. This is supported by a recent review of literature on the health status of ECE workers, which showed a high prevalence of physical and mental health problems (Lessard, Wilkins, Rose-Malm, & Mazzocchi, 2020). Data for the current study were collected during the first assessment prior to delivery of a workplace wellness program for ECE teachers, the Be Well Care Well program. Be Well Care Well is a comprehensive intervention, focusing on traditional physical wellness targets such as diet and activity level, as well as factors such as social support networks. Literature on moderators of the relationship between ACEs and adult health has shown that there are important resilience factors that can reduce the impact of ACEs on adult health (Logan-Greene, Green, Nurius, & Longhi, 2014; Nurius, Green, Logan-Greene, & Borja, 2015). Importantly, several of these resilience factors including social support, sense of community, and life satisfaction, can be promoted when wellness programs take a comprehensive approach to well-being. Although it is concerning that our findings suggest a high prevalence of ACEs and potential negative impacts on caregiving capacity for ECE teachers, it is encouraging that programs such as Be Well Care Well have the potential to bolster resilience.