Cumulative Adverse Childhood Experiences ( ACEs ) and School Outcomes During Adolescence: A Scoping Review

BACKGROUND: Emerging literature suggests cumulative adverse childhood experiences (ACEs), potentially traumatic experiences before age 18, are associated with poor school outcomes. This scoping review assessed the state of the literature on the association between cumulative ACEs and adolescent school outcomes. METHODS: Following PRISMA-ScR guidelines, four databases were searched. Two independent reviewers screened 7188 titles and abstracts, then 112 articles in full. Twenty-four articles met eligibility criteria. FINDINGS: Findings overwhelmingly supported a negative association between cumulative ACEs and school outcomes. Cumulative ACEs were associated with reduced likelihood of high school completion (n = 8), poor academic performance (n = 7), and school disengagement (n = 8). Nine studies identified mediational pathways between ACEs and school outcomes via biopsychosocial processes, mental/behavioral health, and school processes. IMPLICATIONS FOR SCHOOL HEALTH, POLICY, PRACTICE, AND EQUITY: Findings underscore the importance of early identification strategies and preventive school health approaches that address trauma exposure to improve academic trajectories and reduce downstream educational disengagement. CONCLUSIONS: ACEs are negatively associated with school outcomes. Although additional research is needed, this review indicates that intervening on behavioral health and factors like school engagement, absenteeism, and academic achievement could result in improved school outcomes.