April Research Spotlight: 3 Articles Examining Child Maltreatment, ACEs, and Immigration

father and daughter together Relationships between adverse childhood experiences and protective factors among parents at-risk for child maltreatment  (2020)

S. Panisch, C. A. LaBrenz , J. Lawson, B.Gerlach , P. S. Tennant , S. Nulu & M. Faulkner

A parent’s history of ACEs is a strong risk factor that can predict the likelihood of ACEs appearing in their own children. However, there’s relatively little existing research examining the connections between a parent’s history with ACEs and the protective factors that could both lower the risk of ACEs while cultivating family wellbeing.

Using data from the HOPES program evaluation, researchers from this study analyzed 581 completed surveys with domains related to ACEs and parenting. Parents in this specific study had children ages five and younger, the majority of whom were female (69%) and Hispanic (79%).

In line with previous findings, researchers found that when a parent’s ACE score was higher, the presence of known protective factors (like resiliency, social connections, concrete support in times of need, and social and emotional competence available for children) was lower. Similarly, the combination of both  high ACE scores and lower socioeconomic status were associated with lower levels of protective factors among parents. 

Using this data, researchers suggest that future interventions could better help at-risk parents by:

  1. Refocusing parental sense of self-worth from a strengths-based perspective
  2. Providing education on healthy relationships
  3. Offering skill building practice in interpersonal communication strategies
  4. Creating group-based work with other parents to build social connections and cultivate resilience

Although more research on this topic should be explored, results from this study illustrate the need to screen at-risk parents for a history of trauma, as there was a relationship between higher ACE scores and decreased protective factors— specifically resilience and social connections. More research related to the above will help further our understanding on how to tailor trauma-informed treatment plans that better fit clients’ needs.

three generations of womenAdverse Childhood Experiences and Outcomes among At-Risk Spanish-Speaking Latino Families (2019)

C.A. LaBrenz, L.S. Panisch, J. Lawson, A. L. Borcyk, B. Gerlach, P. S. Tennant, S. Nulu & M. Faulkner

As diversity increases in the United States, it becomes even more important to study the impact of Adverse Childhood Experiences (ACEs) in the context of other cultures so that we don’t generalize one cultural experience for all. This study was conducted  to better understand ACEs in the context of at-risk Spanish-speaking Latinx caregivers and families. 

The authors of this study examined a subsample of 417 surveys given to predominantly Spanish-speaking families in Texas through the Healthy Outcomes through Prevention and Early Support (HOPES) program evaluation. The surveys asked 19 questions about exposure to individual-level adversities (like physical abuse, sexual abuse, and neglect), as well as community-level adversities (like neighborhood violence and discrimination).

Similar to other studies, results showed that foreign-born Latinx participants in this study had lower traditional ACE scores and fewer mental health problems than their U.S.-born counterparts. This suggests the presence of an immigrant paradox, which is when the children of immigrant parents have better health outcomes than kids born to U.S. parents. Researchers also found that the exposure to more adversity during childhood was linked to adult mental health difficulties in participating respondents. 

Limitations for this study include potential under-reporting of sensitive topics (like substance abuse) because all measures were self-reported. Future studies of ACEs in Latinx communities might consider including measures on how immigration trauma, fear, and lack of resource accessibility relate to outcomes for at-risk Spanish-speaking Latinx people in the U.S.

smiling case workerClimate of Fear: Provider Perceptions of Latinx Immigrant Service Utilization  (2019)

M.L. Held, S. Nulu, M. Faulkner & B. Gerlach

This study used some of the data gathered for the larger Project Healthy Outcomes through Prevention and Early Support (HOPES) to learn about the experiences and perceptions of 81 providers working with Latinx communities while implementing Project HOPES. Supervisors, parent educators, and case managers were interviewed in individual and focus group settings and given an online survey on program implementation. The researchers wanted to know how the federal policies have been impacting the experiences of undocumented immigrants and mixed-status families trying to use health and social services, and the capacity of provider organizations available to meet these needs.

Unique to this study, researchers found that even when services are available, undocumented immigrants are overwhelmingly unwilling or unable to use them. This is often due to barriers like multiple insurance, cost, identification-related fear, etc. Authors from this study found that when trust was built, providers were better able to support immigrant families through community-based programming.

Based on the data gathered, the researchers proposed concrete strategies to build trust with immigrant clients, including:

  • At a direct service level:
    • Offer trainings on immigration policies, including Know Your Rights sessions. This will empower providers and clients with concrete actions if confronted by immigration enforcement officers.
    • Offer trainings on immigration fear to help foster deeper conversations about treatment needs and overcoming utilization barriers.
  • At an organizational level:
    • Be flexible about where services are provided. Offer services in a location that’s within the shortest (preferably walking) distance from a large number of clients to help mitigate fears around driving/taking the bus. Consider online sessions.
    • Keep all identifying information in secure, encrypted files so that you can guarantee confidentiality to your clients.
    • Avoid documentation of home addresses.
    • Have clear, transparent policies and procedures in place in the event that immigrant enforcement arrives onsite.
  • At a broader advocacy level:
    • Call your Senator. Support policies that help organizations to provide services to immigrants of all status levels.