Prevalence of and relationship between adverse childhood experiences and family context risk factors among children with intellectual disabilities and borderline intellectual functioning.
Over 80 % of kids with ID or borderline IQ in care have ACEs, so screen for trauma at intake.
01Research in Context
What this study did
The team read 78 files of kids in Dutch residential care. All had IQ scores below 75 or in the 70-85 borderline range. They counted how many adverse childhood events (ACEs) each child had. They also noted family risks like parent mental illness or crime.
What they found
Eight out of ten kids with ID had at least one ACE. Nine out of ten kids with borderline IQ had at least one ACE. Family risks were high in both groups. No treatment was tested; this was a head-count study.
How this fits with other research
Titlestad et al. (2019) saw the same pattern in U.S. kids with any developmental disability. They found 28-60 % higher ACE rates than typical peers. The new Dutch numbers match that jump.
Rigles (2017) first showed autistic children also carry extra ACEs. Andrzejewski et al. (2023) later found the trauma passes from caregiver to child in autism families. Together these papers say: across DD labels, kids live more trauma.
Hartwell et al. (2024) and Jackson et al. (2025) link each extra ACE to worse school attendance and grades in autistic pupils. The Dutch study did not look at school outcome, but the combined message is clear: high ACE counts in DD groups are already hurting learning.
Why it matters
If you intake a child with ID or borderline IQ, assume trauma until proven otherwise. Add an ACE screener to your standard forms. Share the score with teachers and therapists so the whole team uses trauma-informed prompts. This one extra minute at intake can save months of puzzling behavior later.
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02At a glance
03Original abstract
BACKGROUND: Adverse Childhood Experiences (ACEs) are an overlooked risk factor for behavioural, mental and physical health disparities in children with intellectual disabilities (ID) and borderline intellectual functioning (BIF). AIMS: To gain insight into the presence of the 10 original Wave II ACEs and family context risk variables in a convenience sample of children with ID and BIF in Dutch residential care. METHODS AND PROCEDURES: 134 case-files of children with ID (n = 82) and BIF (n = 52) were analysed quantitatively. OUTCOMES AND RESULTS: 81.7 % of the children with ID experienced at least 1 ACE, as did 92.3 % of the children with BIF. The average number of ACEs in children with ID was 2.02 (range 0-8) and in children with BIF 2.88 (range 0-7). About 20 % of the children with moderate and mild ID experienced 4 ACEs or more. Many of their families faced multiple and complex problems (ID: 69.5 %; BIF 86.5 %). Multiple regression analysis indicated an association between family context risk variables and the number of ACEs in children. CONCLUSIONS AND IMPLICATIONS: The prevalence of ACEs in children with ID and BIF appears to be considerably high. ACEs awareness in clinical practice is vital to help mitigate negative outcomes.
Research in developmental disabilities, 2021 · doi:10.1016/j.ridd.2021.103935