Traits, Traumas and Treatments: The Many Associations between ACEs and Autism

Background: In recent years, trauma and adverse childhood experiences (ACEs) have been discovered to be elevated in children with ASD, but little is known about how ACEs and ASD are associated, and the magnitude of the impact of trauma on children with ASD.

Objectives: The purpose of the current scoping review is to (a) summarize the current understanding of the relationships between adverse childhood experiences and Autism Spectrum Disorder, (b) synthesize key findings, and (c) make therapy recommendations based on the identified literature.

Methods: To meet the purposes proposed in the previous section, the first author performed a scoping review of the literature. The search for studies included two reference databases; PsycINFO and PubMed and limited search results to peer-reviewed English-language articles published between January 1^st, 2008 and May 31^st, 2018. Search terms included; ACEs, adversity, trauma, social determinants, and filtered the results for “autism”. A pool of 214 articles met all search criteria. The author then read the titles and abstracts of those articles meeting the search criteria and excluded those that were not within the scope of the research questions stated above, reducing the number of articles included to 53. The articles were then read and summarized in a table and subsequently grouped by thematic category. 12 articles were determined to be thematically unrelated and were removed from the review, leaving 41 articles in the final analysis.

Results: 41 articles were included in the final analysis and grouped under six thematic categories; ACES and ASD, Trauma and ASD, Trauma and ASD-like traits, Pre and Post-Natal Risk, Caretaker Burden and Resilience, and Therapy Recommendations. These subjects are discussed at multiple ecological levels with a primary focus on the impact on the individual with ASD.

Conclusions: This scoping review explored the literature of the past decade to illuminate multidirectional, multigenerational relationships amongst adversity and ASD traits. These findings highlight the need for pediatric screening for ACEs and therapeutic accommodations for children with ASD who have experienced complex trauma.