Adverse childhood experiences (ACE) have been studied using various methods and previous research consistently shows that these adverse childhood experiences are associated with elevated health risks and other problems later in life.
In Finland, such large-scale data collection covering childhood experiences comprehensively, including, for example, experiences of violence, has not previously been conducted. The aim of developing the childhood experiences questionnaire (ACE-THL) was to create a brief instrument that captures the phenomenon comprehensively, with clear statements and appropriate response options.
Goals
The goal has been to create a short questionnaire on adverse childhood experiences, with clear statements, sufficiently comprehensive coverage of the phenomenon, and appropriate response options.
In the pilot phase, the goal was to develop a psychometrically sound questionnaire on adverse childhood experiences that includes the key ACE dimensions, with clear statements and suitable response alternatives.
The childhood experiences questionnaire (ACE-THL) was developed for Finnish Institute for Health and Welfare's (THL) Healthy Finland study. The next steps are to validate the ACE-THL questionnaire and to examine the long-term effects of adverse childhood experiences in the Finnish general population.
Implementation
The questionnaire design study was carried out in two phases. In the first stage, adults were interviewed, and they completed the preliminary questionnaire on childhood experiences. The interviewer then filled in the same questionnaire without knowing the respondent's answers. In addition, the respondent was asked about the comprehensibility of the questions. Data gained from the interviews were used to adapt the questionnaire and improve item clarity.
In the second stage, the ACE-THL was completed by a larger group of respondents, who were also asked to complete the same questionnaire two weeks later. The repeated survey data were used to assess the test-retest reliability and structural validity of the questionnaire.
Next, psychometric validation of the ACE-THL questionnaire will be repeated using the Healthy Finland dataset. Additionally, an indicator will be developed from the Childhood Experiences Questionnaire, with scoring that takes into account criticisms raised in previous research — for example, the need to weight different adverse childhood experiences differently, to account for the recurrence of ACEs, and to incorporate the recurrence of protective factors when assessing the effects of ACEs.
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