# Socioecological Predictors of Child Flourishing and Family Resilience Status Among Children with Adverse Childhood Experiences

## TL;DR

This study explores how supportive environments can help children with adverse experiences thrive and build family resilience.

## Contribution

The study introduces a new framework for understanding resilience by examining socioecological factors in children with adverse childhood experiences.

## Key findings

- Nearly half of children with ACEs show both child flourishing and family resilience.
- School safety and supportive neighborhoods are positively linked to resilience.
- Parenting stress and higher ACE exposure are negatively associated with resilience.

## Abstract

Public health relevance—How does this work relate to a public health issue?
Identifies how adverse childhood experiences (ACEs), one of the major public health concerns, intersect with child flourishing and family resilience, shifting attention from deficits to positive adaptation.Examines multilevel socioecological factors influencing resilience among children with ACEs, aligning with public health priorities on social and environmental determinants of health.

Identifies how adverse childhood experiences (ACEs), one of the major public health concerns, intersect with child flourishing and family resilience, shifting attention from deficits to positive adaptation.

Examines multilevel socioecological factors influencing resilience among children with ACEs, aligning with public health priorities on social and environmental determinants of health.

Public health significance—Why is this work of significance to public health?
Demonstrates that nearly half of children with ACEs show both child flourishing and family resilience, while a substantial minority exhibit neither, highlighting meaningful heterogeneity in resilience within a high-risk population.Provides evidence that school safety, supportive neighborhoods, and neighborhood amenities are positively associated with resilient status, whereas parenting stress and higher cumulative ACE exposure are negatively associated, highlighting modifiable contextual factors that can be targeted in public health efforts.

Demonstrates that nearly half of children with ACEs show both child flourishing and family resilience, while a substantial minority exhibit neither, highlighting meaningful heterogeneity in resilience within a high-risk population.

Provides evidence that school safety, supportive neighborhoods, and neighborhood amenities are positively associated with resilient status, whereas parenting stress and higher cumulative ACE exposure are negatively associated, highlighting modifiable contextual factors that can be targeted in public health efforts.

Public health implications—What are the key implications or messages for practitioners, policy makers and/or researchers in public health?
Suggests that promoting resilience among children with ACEs requires coordinated, multi-level strategies to reduce parenting stress and to strengthen safe school, supportive neighborhoods, and access to neighborhood amenities.Underscores the need for public health policies and programs that move beyond ACE screening alone to invest in upstream, context-focused interventions that enable children and families not only to avoid negative outcomes, but to flourish.

Suggests that promoting resilience among children with ACEs requires coordinated, multi-level strategies to reduce parenting stress and to strengthen safe school, supportive neighborhoods, and access to neighborhood amenities.

Underscores the need for public health policies and programs that move beyond ACE screening alone to invest in upstream, context-focused interventions that enable children and families not only to avoid negative outcomes, but to flourish.

Objective: The objective of this study is to identify socioecological predictors of child flourishing and family resilience status among U.S. school-aged children with a history of childhood adverse experiences (ACEs). Study design: This study is a secondary analysis of the 2024 National Survey of Children’s Health (NSCH), a cross-sectional and nationally representative survey of noninstitutionalized U.S. children. Parental reports of child flourishing and family resilience measures were used to create a categorical variable with four different types of resilience status: neither child flourishing nor family resilience, child flourishing only, family resilience only, and both child flourishing and family resilience. Multinomial logistic regression was performed to investigate multi-level factors predicting the child flourishing and family resilience status of children aged between 6 and 17 years (N = 13,571). Results: Among children with ACEs, 46.5% were classified as both child flourishing and family resilience; 33.3% were in the family resilience only group, 14.0% were in the neither child flourishing nor family resilience group, and 6.6% were in the child flourishing only group. School safety, supportive neighborhoods, and neighborhood amenities were positively associated with resilient status, whereas parenting stress and higher cumulative ACE exposure were negatively associated with the resilience status. Conclusions: Children and families can demonstrate resilience despite ACE exposure in the presence of supportive socioecological conditions. Efforts to promote healthy development among children with ACEs may benefit from multilevel prevention and intervention strategies that strengthen caregiving resources, reduce parenting stress, and improve school and neighborhood environments.