Detecting adverse childhood experiences with a little help from tablet computers

Adverse childhood experiences, ranging from abuse to emotional neglect, damage the mental and physical health and may impede the treatment of mental disorders. However, validated instruments that assess childhood adversity including the full range of childhood maltreatment are lacking. The adverse childhood experiences index (ACE; Dube et al., 2003; Felitti et al., 1998) retrospectively assessed different forms of abuse, neglect, and household dysfunctioning during the first 18 years of life, and quantified the ‘‘breadth of the experienced adversities’’, by means of the ACE score. Thus, this instrument allows quantifying the magnitude or ‘‘dose’’ of toxic childhood experiences. A recent modification of the ACE index, by Teicher and colleagues (2011, MACE Scale), gathers in even greater detailed and in more comprehensive ways information about the various types of maltreatment: self experienced abuse or neglect, as well as peer victimization and witnessing domestic violence are all explored in detail. Supplementary information gained about emotional reactions to the events, and temporal anchoring of the experienced, are highly valuable for psychotherapeutic and research purpose. We present short versions of the MACE and a pediatric version (Isele et al., in prep.), adjusted to the cognitive and emotional development status of minors. These new versions fill the need for structured clinical interviews, mapping abuse, and neglect in this sample. Their application in clinical research and therapeutic contexts is shown including an electronic tablet-computer supported assessment.