Adverse childhood experiences and preschool suspension expulsion: A population study.

Background: Preschool suspension and expulsion rates are typically based on teacher reports, and don't simultaneously account for adverse childhood experiences (ACEs).

Objective: To examine estimates in the United States of parent-reported preschool suspension and expulsion rates, in the context of ACEs.

Participants And Setting: Parents of children aged 3-5 years old (N = 6,100) in the 2016 National Survey of Children's Health dataset.

Method: We reported the prevalence estimates of preschool suspension and expulsion, and estimated the unique variance of ACEs as risk factors using weighted sequential logistic regression.

Results: An estimated 174,309 preschoolers (2.0%) were suspended, and 17,248 (0.2%) children were expelled annually. If divided by 36 school weeks, the instances of weekly suspension and expulsion were at least 4,842 and 479 respectively. Controlling for previous risk factors (i.e., age, gender, race, ethnicity), the odds ratio increased by 80% for every unit of ACEs increment. Children were more likely to be suspended or expelled if they had domestic violence (OR = 10.6, p <  .001), living with mental illness (OR = 9.8, p <  .001), adult substance abuse (OR = 4.8, p <  .001), and victim of violence (OR = 4.5, p =  .004), living in high poverty (OR = 3.9, p =  .001), divorced parents (OR = 3.3, p =  .001), and parent incarceration (OR = 3.0, p =  .009).

Conclusion: The alarming suspension and expulsion rates call for more comprehensive outreach prevention and response efforts in preschool settings. Cross system collaboration and family support are essential to this work.