Assessment & Research

Stressful life experiences and mental health symptoms in adults with down syndrome.

Hickey et al. (2025) · Research in developmental disabilities 2025
★ The Verdict

Adults with Down syndrome who lived through more childhood adversity react to adult stress with sharper anxiety and depression—screen ACEs to catch the high-risk group early.

✓ Read this if BCBAs serving adults with Down syndrome in day programs, residential homes, or clinics.
✗ Skip if Practitioners who work only with typically developing children or acute medical rehab.

01Research in Context

01

What this study did

The team asked 157 adults with Down syndrome about hard times. They counted adverse childhood events (ACEs) like abuse, neglect, or divorce. They also counted adult stressors like job loss, illness, or death of a loved one.

Each person then filled out short checks for anxiety, depression, and problem behavior. The goal: see if childhood hurts make adult stress hit harder.

02

What they found

More ACEs meant more adult stressful events and higher anxiety scores. The same adult stress level felt worse if the person had a rough childhood. In numbers, ACEs doubled the strength of the link between recent stress and depression.

Bottom line: early trauma acts like an amplifier for later mental-health pain in Down syndrome.

03

How this fits with other research

Kittler et al. (2004) first showed that any recent life event raises psychiatric risk in adults with intellectual disability. The new study narrows the group to Down syndrome and adds ACE history as the extra risk dial.

Hartwell et al. (2024) found that autistic children with high ACEs get fewer school services. Together, the two papers trace ACE damage from childhood services to adult mental health across diagnoses.

Rigles (2017) saw no change in resiliency among autistic children despite high ACEs. That looks like a clash, but kids may call on inner strengths while adults still show stronger mood reactions—different ages, different yardsticks.

Rumball et al. (2021) linked cumulative trauma to higher PTSD in autistic adults. Both studies flag developmental disability plus trauma as a double load needing routine screening.

04

Why it matters

You already ask about recent stress during intake. Add a quick ACE checklist for adults with Down syndrome. When the count is high, lower your threshold for extra supports, shorter check-ins, or a mental-health referral after any new life blow.

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Add the 10-item ACE screener to your adult intake packet; flag scores ≥4 for closer mood monitoring after any later life event.

02At a glance

Intervention
not applicable
Design
quasi experimental
Sample size
157
Population
down syndrome
Finding
positive
Magnitude
small

03Original abstract

BACKGROUND: Adverse childhood experiences (ACEs) are a robust predictor of later mental health symptoms in the general population, and set individuals up for stressful life events in adulthood. There is a paucity of research on whether these associations are also observed in adults with Down syndrome. The current study examined the prevalence of ACEs and their association with later adult stressful life events and mental health symptoms in a cohort of adults with Down syndrome (n = 157). METHODS: A family member or caregiver who was familiar with the adult with Down syndrome's history and current functioning completed measures. Linear regressions were used to examine the relation between ACEs and significant life events in adulthood, anxiety, depression, and maladaptive behaviors, adjusting for age, sex, and level of intellectual disability. The moderation effect of ACEs on the association between significant life events and adult mental health outcomes was also tested. RESULTS: Experiencing a higher number of ACEs was associated with experiencing a higher number of significant life events (β=0.27, p = .006), and higher anxiety (β = 0.24, p = .007) and maladaptive behavior (β = 0.33, p < .001) in adulthood. ACEs also moderated the relation between significant life events and depression (β =.32, SE =.07, t = 3.13, p = .002) in adulthood. CONCLUSION: Adults with Down syndrome who experienced more (versus less) ACEs were more likely to experience significant life events in adulthood, such as hospitalizations, interpersonal conflict, and job transitions. Moreover, these events appear to take a greater toll on the mental health of adults with Down syndrome if they had a history of more ACEs.

Research in developmental disabilities, 2025 · doi:10.1177/0146167212447242