Can the effects of PCEs span across multiple generations?
The HOPE framework emphasizes the importance of positive childhood experiences (PCEs) for healthy child development. When should those experiences start? In the spirit of the HOPE framework, Dartmouth public health master’s student Jessica Leishman is helping us look backwards in time at the childhood experiences of caregivers to see what that can teach us about the chances for resiliency in future generations.
Existing research shows that ACEs experienced by caregivers contribute to delays in social-emotional development in toddlers, because they put those parents at higher risk for substance use disorders and mental health conditions that impact their parenting. The children they raise can experience higher rates of anxiety, difficulty adapting to different environments, and social changes as a result. But what happens when PCEs come into play?
“We wanted to see if PCEs had that same intergenerational aspect that ACEs do,” said Leishman. “Say that same person with the parental abuse and neglect also had PCEs… say they had a couple of non-parent adults who took genuine interest in them… does that protective factor that protects the parent … also travel through and protect the children as well?”
Understanding resilience in young children based on their caregiver’s exposure to PCEs
In 2023, Leishman and her team of RJ Gillespie, MD, and David Maher, MPH, launched a study out of the Children’s Clinic in Portland, Oregon. This clinic collects caregiver ACEs and PCEs screenings when the child is four months. At six months and at 15 months, the clinic collects the social-emotional health information on the children, using the Baby Pediatric Symptom Checklist which looks at indicators like how well a child is able to interact with others, how flexible they are in social situations, or how able they are to calm down when they experience anxiety. Leishman’s team looked at a sample of 836 caregiver-child pairs (pairings of 1-2 caregivers and their child) to see if PCEs in the caregivers correlated with any changes in social-emotional development in the child.
They found that children whose caregivers had a higher exposure to PCEs were more likely to show social-emotional improvements between six and 15 months than children whose parents had fewer PCEs. Improvements might be a child becoming more comfortable with changes in routine, being able to better regulate emotions or responding more positively to new situations or people.
This supports the hypothesis that caregiver PCEs do have an impact on the next generation.
When they looked at caregivers with higher exposure to ACEs, the data suggested that the children were more likely to stay the same instead of worsen (more difficulty regulating emotions or adapting) or improve, but more research is needed to confirm this conclusion.
Potential further research on the intergenerational effects of PCEs
“[We] view this study as a starting point … because there’s really not a lot of research on the effect of parental PCEs,” she said.
Leishman noted that in addition to caregiver PCEs, the study looked at other factors that could affect child development. These included race and socioeconomic background. But because of the makeup of the cohort, which was relatively homogeneous, they were not able to say in a definitive way that demographic factors played into it.
“I would love to look deeper into … which ACEs and PCEs are more influential upon social-emotional development? Are there larger influence factors that are related to health insurance level, race or ethnicity?” said Leishman.
Leishman will be presenting this research at the Master of Public Health program of March 2025 at Dartmouth College and will likely be pursuing publication in the fall of 2025.
