Measuring Adverse and Protective Experiences in Early Childhood: Development and Initial Validation of the Child and Family Experiences Survey (CAFES)

Background Adverse childhood experiences (ACEs) are associated with a wide range of negative health, behavioral, and developmental outcomes across the lifespan. However, many individuals demonstrate resilience, and protective factors play a critical role in buffering the effects of adversity. Yet most existing ACE measures overlook these protective experiences and rely primarily on retrospective adult self-reports. To address this gap, we developed the Child and Family Experiences Survey (CAFES), a caregiver-report tool designed to assess both adverse and protective experiences in early childhood across diverse settings. Methods Caregivers ( N  = 157) from two counties in New York State completed the CAFES, which assessed adverse experiences, protective factors, and social determinants of health items. Summary scores were calculated for both adverse and protective experiences. Descriptive statistics, bivariate correlations, and principal components analysis (PCA) were conducted to evaluate item performance and inform item reduction. Results Descriptive analyses showed a range of endorsement across items related to adverse experiences, protective factors, and social determinants of health items. Correlations within protective and adverse experience items were moderate, supporting internal consistency. PCA was conducted for protective factors and social determinants of health items, and a four-component solution emerged for each. The CAFES was refined based on results from descriptive findings and the PCA. Conclusions The CAFES is a novel, caregiver-report tool designed to assess both adverse and protective childhood experiences, as well as family needs. Developed through a community-engaged process, CAFES addresses key limitations in existing ACE measures by incorporating protective factors and offering applicability across clinical, educational, and research settings. Future efforts will focus on refining the tool through qualitative feedback, improving data collection processes, and ensuring cross-cultural relevance, for example among underrepresented and immigrant populations, while also integrating appropriate supports to enhance its clinical implementation.