SERIES OF STUDIES has established strong links between adverse childhood experiences (ACEs) and long-term behavioral health and chronic medical conditions.

1-6 Although the majority of these studies have focused on adults, the impact of these experiences are likely to become apparent during childhood and adolescence. However, collecting self-reported experiences and symptoms for children is challenging and costly. This report shows that it is possible to use state administrative data to measure adverse experiences and other household risk factors similar to those presented in the ACE studies, and to quantify associations between these experiences and behavioral health problems identified during adolescence. The adverse experiences presented here include the occurrence of the following in the child’s birth family: child abuse and/or neglect; parental substance abuse, criminal justice involvement, mental illness, or death; domestic violence; and homelessness. Behavioral health risks associated with the number and type of adverse experiences are explored in detail.