A MULTI-LEVEL META-ANALYSIS FOR PREVALENCE OF ADVERSE CHILDHOOD EXPERIENCES AMONG STUDENTS WITH EMOTIONAL AND BEHAVIORAL DIFFICULTIES OR DISORDERS

DR. S. THANGAMAYAN , DR CHITKALA VENKAREDDY , ANUSHREE PANDEY , K. LOKESH ,DR. BRAJESH KUMAR , DR. JAINENDRA SINGH , MOHIT KUMAR

Students identified with emotional and behavioral difficulties or disorders (EBD) represent a vulnerable population for whom early adverse experiences may be a significant etiological factor. Despite a growing body of primary research, a comprehensive synthesis quantifying the prevalence of adverse childhood experiences (ACEs) within this specific subgroup is lacking. This study conducted a multi-level meta-analysis to pool prevalence estimates of one or more ACEs and multiple ACEs (two or more) among students with EBD. A systematic search of electronic databases identified 28 eligible studies encompassing 15,432 individuals with EBD. The pooled prevalence of at least one ACE was 78.4% (95% CI: 71.6–84.0), while the prevalence of multiple ACEs was 56.1% (95% CI: 48.9–63.1). Significant heterogeneity was observed, which was partially explained by moderators such as geographical region, EBD identification setting (clinical vs. school-based), and type of ACE measure used. These findings robustly indicate that students with EBD are disproportionately burdened by ACEs compared to general population estimates. The results underscore the critical need for trauma-informed approaches within educational and clinical settings serving this population, emphasizing early screening, targeted intervention, and a paradigm shift from purely behavioral management to understanding the underlying trauma.