A Pilot Comparison of Two Adverse Childhood Experiences Questionnaires Among Parents and Guardians in Ecuador

Adverse childhood experiences (ACEs) are associated with psychological difficulties across the life course, making their assessment important for developmental adversity research. This pilot compared a conventional 10-item questionnaire (ACE-10) with a modified 14-item version (ACE-14) in a school-based convenience sample of 93 parents and guardians in Ecuador. Participants completed both versions in Spanish about their own childhood; ACE-14 responses were mapped to 10 domains. Paired analyses examined agreement on individual adversity domains, total scores, and exposure categories using confidence intervals (CIs), McNemar tests, and Holm adjustment for multiple comparisons. Mean domain counts were similar (1.23 versus 1.25), but Bland–Altman limits for individual score differences were −2.00 to 2.04 domains. Any ACE was reported by 47 versus 56 participants (difference 9.7 percentage points; Holm-adjusted p = 0.099). Deprivation or impaired caregiving showed the clearest directional difference: 12 participants endorsed mapped ACE-14 only and one endorsed ACE-10 only (difference 11.8 percentage points, 95% CI [5.1, 20.3]; domain-adjusted p = 0.023; exact-test adjusted p = 0.034). Forty-five participants (48.4%) gave different answers for at least one domain. The study did not assess how often answers would change if the same questionnaire were completed twice. These findings show that similar average scores can conceal differences in individual exposure classification. Future studies should use cognitive interviews, randomized questionnaire order, and repeated administration of the same version to clarify how wording and question format contribute to these differences.