There is a growing recognition that certain harmful experiences in childhood are associated with a range of negative health and social impacts throughout life. These experiences include abuse or neglect, having a family member who is incarcerated, and living in an environment of community violence, among others. Given the enduring effects of adverse experiences during childhood on health and social issues, researchers, policymakers, a range of service providers from healthcare to education to early childhood, and communities themselves are experimenting with ways to prevent and mitigate the harm of such experiences.
However, with heightened interest and research on this topic, the rapid spread of interventions and ever-evolving theories of change, the field is lacking clarity and consensus regarding effective prevention and mitigation strategies. Further, while the long-term impacts of childhood adversity are well understood, there is less clarity and consensus about how success and outcomes from these interventions should be measured. In particular, there are gaps in the field about which outcomes are realistic, subject to impact, and suitable to track in the short and medium-term to assess whether interventions are working, why (or why not), and for whom. This literature review analysis aimed to address these gaps in information, focusing primarily on two questions:
1. What is the state of the evidence on interventions to prevent and mitigate childhood adversity among children 0 to 5 years of age in the clinical setting or with a clinical-community linkage?
2. How should impact be measured effectively and responsibly given the scale of childhood adversity, the fact that outcomes accrue over a longer-term, and real-world constraints?
This work, made possible by funding from Genentech Charitable Giving, includes this literature review and a companion piece titled, Focusing the Lens: Language and framing related to the experience of adversity in childhood. JSI. 2020.