Abstract
OBJECTIVE: The objective of this study is to identify socioecological predictors of child flourishing and family resilience status among U.S. school-aged children with a history of childhood adverse experiences (ACEs). STUDY DESIGN: This study is a secondary analysis of the 2024 National Survey of Children's Health (NSCH), a cross-sectional and nationally representative survey of noninstitutionalized U.S. children. Parental reports of child flourishing and family resilience measures were used to create a categorical variable with four different types of resilience status: neither child flourishing nor family resilience, child flourishing only, family resilience only, and both child flourishing and family resilience. Multinomial logistic regression was performed to investigate multi-level factors predicting the child flourishing and family resilience status of children aged between 6 and 17 years (N = 13,571). RESULTS: Among children with ACEs, 46.5% were classified as both child flourishing and family resilience; 33.3% were in the family resilience only group, 14.0% were in the neither child flourishing nor family resilience group, and 6.6% were in the child flourishing only group. School safety, supportive neighborhoods, and neighborhood amenities were positively associated with resilient status, whereas parenting stress and higher cumulative ACE exposure were negatively associated with the resilience status. CONCLUSIONS: Children and families can demonstrate resilience despite ACE exposure in the presence of supportive socioecological conditions. Efforts to promote healthy development among children with ACEs may benefit from multilevel prevention and intervention strategies that strengthen caregiving resources, reduce parenting stress, and improve school and neighborhood environments.