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Developmental literacy and epistemic dignity as primary child protection: a developmentally staged, disability-inclusive public-health framework for preventing adverse childhood experiences.

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Title: Developmental literacy and epistemic dignity as primary child protection: a developmentally staged, disability-inclusive public-health framework for preventing adverse childhood experiences.
Authors: Niederlohmann E; Kliniken Erlabrunn, Department of Psychosomatic Medicine and Psychotherapy, Breitenbrunn, Germany.
Source: Frontiers in public health [Front Public Health] 2026 Jun 10; Vol. 14, pp. 1862974. Date of Electronic Publication: 2026 Jun 10 (Print Publication: 2026).
Publication Type: Journal Article
Language: English
Journal Info: Publisher: Frontiers Editorial Office Country of Publication: Switzerland NLM ID: 101616579 Publication Model: eCollection Cited Medium: Internet ISSN: 2296-2565 (Electronic) Linking ISSN: 22962565 NLM ISO Abbreviation: Front Public Health Subsets: MEDLINE
Imprint Name(s): Original Publication: Lausanne : Frontiers Editorial Office
MeSH Terms: Adverse Childhood Experiences*/prevention & control , Children with Disabilities*/psychology , Personhood* , Child Welfare* , Child Development* , Public Health* , Respect* , Literacy*, Humans ; Child ; Health Literacy
Abstract: Adverse childhood experiences (ACEs), toxic stress, relational insecurity, and structural adversity are major public-health concerns for children and adolescents, but ACE evidence should not be treated as an individual diagnostic score or deterministic prognosis. This Hypothesis and Theory article proposes developmental literacy and epistemic dignity as linked upstream constructs for primary child protection. Developmental literacy is defined as developmentally staged and disability-inclusive neurobiopsychosocial knowledge and skills concerning bodies, emotions, stress, attachment, co-regulation, play, nutrition, safety, rights, boundaries, non-violent care, and help-seeking. Epistemic dignity refers to the supported capacity and right of children-including preverbal, disabled, neurodivergent, and communication-diverse children-to have bodily, emotional, relational, play-based, and communicative signals interpreted with seriousness, humility, and appropriate response. Drawing on research on ACEs and positive childhood experiences (PCEs), nurturing care, relational health, health-promoting schools, social and emotional learning, mental-health literacy, sexuality/safety education, child participation, epistemic injustice, disability studies, implementation science, and critiques of ACE and trauma-informed practice, the article develops a universal, proportionate, relationally safe, anti-bias, and non-coercive public-health framework. It argues that early-childhood services, schools, pediatric/public-health touchpoints, caregiver support, and community systems can provide age-appropriate developmental knowledge without turning schools into clinics, teachers into trauma detectors, or children into individual risk scores. The framework does not recommend routine individual ACE-score screening in schools as a default practice; it supports ethically governed, service-linked pathways for recognizing distress and unmet support needs. Coercive reproductive control is treated only as a rejected comparator because it targets reproductive status rather than modifiable developmental environments, support access, and institutional trust. The article concludes with safeguards and testable hypotheses for evaluating developmental literacy, epistemic dignity, relational safety, accessibility, help-seeking, response quality, caregiver support, referral continuity, and unintended harms.
(Copyright © 2026 Niederlohmann.)
Competing Interests: The author(s) declared that this work was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
References: PLoS Med. 2021 May 10;18(5):e1003602. (PMID: 33970913)
Lancet. 2017 Jan 7;389(10064):77-90. (PMID: 27717614)
J Child Psychol Psychiatry. 2022 Apr;63(4):381-396. (PMID: 34730840)
Lancet Public Health. 2019 Oct;4(10):e517-e528. (PMID: 31492648)
Health Promot Pract. 2020 Jan;21(1):62-69. (PMID: 31162978)
JAMA Pediatr. 2021 Apr 1;175(4):385-393. (PMID: 33492366)
MMWR Suppl. 2024 Oct 10;73(4):39-50. (PMID: 39378222)
Soc Sci Med. 2010 Oct;71(7):1221-1222. (PMID: 20685020)
Lancet. 2014 Oct 4;384(9950):1256-7. (PMID: 25289422)
Am Psychol. 2001 Mar;56(3):227-38. (PMID: 11315249)
JAMA Pediatr. 2019 Nov 01;173(11):e193007. (PMID: 31498386)
Pediatrics. 2012 Jan;129(1):e232-46. (PMID: 22201156)
Child Abuse Negl. 2018 Nov;85:174-179. (PMID: 28784309)
Cochrane Database Syst Rev. 2015 Apr 16;(4):CD004380. (PMID: 25876919)
J Sch Health. 2015 Nov;85(11):729-39. (PMID: 26440815)
BJPsych Bull. 2023 Oct;47(5):267-269. (PMID: 36843444)
Implement Sci. 2009 Aug 07;4:50. (PMID: 19664226)
Acad Pediatr. 2017 Sep - Oct;17(7S):S79-S85. (PMID: 28865664)
Child Dev. 2011 Jan-Feb;82(1):405-32. (PMID: 21291449)
MMWR Morb Mortal Wkly Rep. 2023 Jun 30;72(26):707-715. (PMID: 37384554)
Psychol Bull. 1990 Sep;108(2):267-90. (PMID: 2236384)
Can J Psychiatry. 2016 Mar;61(3):154-8. (PMID: 27254090)
Campbell Syst Rev. 2019 Jul 17;15(1-2):e1018. (PMID: 37131480)
Pediatrics. 2021 Aug;148(2):. (PMID: 34312296)
Front Public Health. 2019 Mar 29;7:64. (PMID: 30984733)
Pediatrics. 2012 Jan;129(1):e224-31. (PMID: 22201148)
Adm Policy Ment Health. 2011 Mar;38(2):65-76. (PMID: 20957426)
Pediatrics. 2022 Feb 1;149(2):. (PMID: 35104358)
Am J Prev Med. 1998 May;14(4):245-58. (PMID: 9635069)
Am Psychol. 2012 Apr;67(3):231-43. (PMID: 22040221)
BMC Public Health. 2012 Jan 25;12:80. (PMID: 22276600)
Psychiatry. 2021 Fall;84(3):220-222. (PMID: 34694967)
Lancet. 2017 Jan 7;389(10064):91-102. (PMID: 27717615)
Lancet Public Health. 2017 Aug;2(8):e356-e366. (PMID: 29253477)
Contributed Indexing: Keywords: adverse childhood experiences; developmental literacy; epistemic dignity; health-promoting schools; implementation science; neurodiversity; nurturing care; primary child protection
Entry Date(s): Date Created: 20260626 Date Completed: 20260626 Latest Revision: 20260813
Update Code: 20260814
PubMed Central ID: PMC13292597
DOI: 10.3389/fpubh.2026.1862974
PMID: 42359121
Database: MEDLINE
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  Data: Developmental literacy and epistemic dignity as primary child protection: a developmentally staged, disability-inclusive public-health framework for preventing adverse childhood experiences.
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  Data: <searchLink fieldCode="AU" term="%22Niederlohmann+E%22">Niederlohmann E</searchLink>; Kliniken Erlabrunn, Department of Psychosomatic Medicine and Psychotherapy, Breitenbrunn, Germany.
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  Data: <searchLink fieldCode="JN" term="%22101616579%22">Frontiers in public health</searchLink> [Front Public Health] 2026 Jun 10; Vol. 14, pp. 1862974. <i>Date of Electronic Publication: </i>2026 Jun 10 (<i>Print Publication: </i>2026).
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  Data: <searchLink fieldCode="MM" term="%22Adverse+Childhood+Experiences%22">Adverse Childhood Experiences*</searchLink>/<searchLink fieldCode="MM" term="%22Adverse+Childhood+Experiences+prevention+%26+control%22">prevention & control</searchLink> <br /><searchLink fieldCode="MM" term="%22Children+with+Disabilities%22">Children with Disabilities*</searchLink>/<searchLink fieldCode="MM" term="%22Children+with+Disabilities+psychology%22">psychology</searchLink> <br /><searchLink fieldCode="MM" term="%22Personhood%22">Personhood*</searchLink> <br /><searchLink fieldCode="MM" term="%22Child+Welfare%22">Child Welfare*</searchLink> <br /><searchLink fieldCode="MM" term="%22Child+Development%22">Child Development*</searchLink> <br /><searchLink fieldCode="MM" term="%22Public+Health%22">Public Health*</searchLink> <br /><searchLink fieldCode="MM" term="%22Respect%22">Respect*</searchLink> <br /><searchLink fieldCode="MM" term="%22Literacy%22">Literacy*</searchLink><br /><searchLink fieldCode="MH" term="%22Humans%22">Humans</searchLink> ; <searchLink fieldCode="MH" term="%22Child%22">Child</searchLink> ; <searchLink fieldCode="MH" term="%22Health+Literacy%22">Health Literacy</searchLink>
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  Data: Adverse childhood experiences (ACEs), toxic stress, relational insecurity, and structural adversity are major public-health concerns for children and adolescents, but ACE evidence should not be treated as an individual diagnostic score or deterministic prognosis. This Hypothesis and Theory article proposes developmental literacy and epistemic dignity as linked upstream constructs for primary child protection. Developmental literacy is defined as developmentally staged and disability-inclusive neurobiopsychosocial knowledge and skills concerning bodies, emotions, stress, attachment, co-regulation, play, nutrition, safety, rights, boundaries, non-violent care, and help-seeking. Epistemic dignity refers to the supported capacity and right of children-including preverbal, disabled, neurodivergent, and communication-diverse children-to have bodily, emotional, relational, play-based, and communicative signals interpreted with seriousness, humility, and appropriate response. Drawing on research on ACEs and positive childhood experiences (PCEs), nurturing care, relational health, health-promoting schools, social and emotional learning, mental-health literacy, sexuality/safety education, child participation, epistemic injustice, disability studies, implementation science, and critiques of ACE and trauma-informed practice, the article develops a universal, proportionate, relationally safe, anti-bias, and non-coercive public-health framework. It argues that early-childhood services, schools, pediatric/public-health touchpoints, caregiver support, and community systems can provide age-appropriate developmental knowledge without turning schools into clinics, teachers into trauma detectors, or children into individual risk scores. The framework does not recommend routine individual ACE-score screening in schools as a default practice; it supports ethically governed, service-linked pathways for recognizing distress and unmet support needs. Coercive reproductive control is treated only as a rejected comparator because it targets reproductive status rather than modifiable developmental environments, support access, and institutional trust. The article concludes with safeguards and testable hypotheses for evaluating developmental literacy, epistemic dignity, relational safety, accessibility, help-seeking, response quality, caregiver support, referral continuity, and unintended harms.<br /> (Copyright © 2026 Niederlohmann.)
– Name: Abstract
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  Data: The author(s) declared that this work was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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  Data: PLoS Med. 2021 May 10;18(5):e1003602. (PMID: <searchLink fieldCode="PM" term="%2233970913%22">33970913)</searchLink><br />Lancet. 2017 Jan 7;389(10064):77-90. (PMID: <searchLink fieldCode="PM" term="%2227717614%22">27717614)</searchLink><br />J Child Psychol Psychiatry. 2022 Apr;63(4):381-396. (PMID: <searchLink fieldCode="PM" term="%2234730840%22">34730840)</searchLink><br />Lancet Public Health. 2019 Oct;4(10):e517-e528. (PMID: <searchLink fieldCode="PM" term="%2231492648%22">31492648)</searchLink><br />Health Promot Pract. 2020 Jan;21(1):62-69. (PMID: <searchLink fieldCode="PM" term="%2231162978%22">31162978)</searchLink><br />JAMA Pediatr. 2021 Apr 1;175(4):385-393. (PMID: <searchLink fieldCode="PM" term="%2233492366%22">33492366)</searchLink><br />MMWR Suppl. 2024 Oct 10;73(4):39-50. (PMID: <searchLink fieldCode="PM" term="%2239378222%22">39378222)</searchLink><br />Soc Sci Med. 2010 Oct;71(7):1221-1222. (PMID: <searchLink fieldCode="PM" term="%2220685020%22">20685020)</searchLink><br />Lancet. 2014 Oct 4;384(9950):1256-7. (PMID: <searchLink fieldCode="PM" term="%2225289422%22">25289422)</searchLink><br />Am Psychol. 2001 Mar;56(3):227-38. (PMID: <searchLink fieldCode="PM" term="%2211315249%22">11315249)</searchLink><br />JAMA Pediatr. 2019 Nov 01;173(11):e193007. (PMID: <searchLink fieldCode="PM" term="%2231498386%22">31498386)</searchLink><br />Pediatrics. 2012 Jan;129(1):e232-46. (PMID: <searchLink fieldCode="PM" term="%2222201156%22">22201156)</searchLink><br />Child Abuse Negl. 2018 Nov;85:174-179. (PMID: <searchLink fieldCode="PM" term="%2228784309%22">28784309)</searchLink><br />Cochrane Database Syst Rev. 2015 Apr 16;(4):CD004380. (PMID: <searchLink fieldCode="PM" term="%2225876919%22">25876919)</searchLink><br />J Sch Health. 2015 Nov;85(11):729-39. (PMID: <searchLink fieldCode="PM" term="%2226440815%22">26440815)</searchLink><br />BJPsych Bull. 2023 Oct;47(5):267-269. (PMID: <searchLink fieldCode="PM" term="%2236843444%22">36843444)</searchLink><br />Implement Sci. 2009 Aug 07;4:50. (PMID: <searchLink fieldCode="PM" term="%2219664226%22">19664226)</searchLink><br />Acad Pediatr. 2017 Sep - Oct;17(7S):S79-S85. (PMID: <searchLink fieldCode="PM" term="%2228865664%22">28865664)</searchLink><br />Child Dev. 2011 Jan-Feb;82(1):405-32. (PMID: <searchLink fieldCode="PM" term="%2221291449%22">21291449)</searchLink><br />MMWR Morb Mortal Wkly Rep. 2023 Jun 30;72(26):707-715. (PMID: <searchLink fieldCode="PM" term="%2237384554%22">37384554)</searchLink><br />Psychol Bull. 1990 Sep;108(2):267-90. (PMID: <searchLink fieldCode="PM" term="%222236384%22">2236384)</searchLink><br />Can J Psychiatry. 2016 Mar;61(3):154-8. (PMID: <searchLink fieldCode="PM" term="%2227254090%22">27254090)</searchLink><br />Campbell Syst Rev. 2019 Jul 17;15(1-2):e1018. (PMID: <searchLink fieldCode="PM" term="%2237131480%22">37131480)</searchLink><br />Pediatrics. 2021 Aug;148(2):. (PMID: <searchLink fieldCode="PM" term="%2234312296%22">34312296)</searchLink><br />Front Public Health. 2019 Mar 29;7:64. (PMID: <searchLink fieldCode="PM" term="%2230984733%22">30984733)</searchLink><br />Pediatrics. 2012 Jan;129(1):e224-31. (PMID: <searchLink fieldCode="PM" term="%2222201148%22">22201148)</searchLink><br />Adm Policy Ment Health. 2011 Mar;38(2):65-76. (PMID: <searchLink fieldCode="PM" term="%2220957426%22">20957426)</searchLink><br />Pediatrics. 2022 Feb 1;149(2):. (PMID: <searchLink fieldCode="PM" term="%2235104358%22">35104358)</searchLink><br />Am J Prev Med. 1998 May;14(4):245-58. (PMID: <searchLink fieldCode="PM" term="%229635069%22">9635069)</searchLink><br />Am Psychol. 2012 Apr;67(3):231-43. (PMID: <searchLink fieldCode="PM" term="%2222040221%22">22040221)</searchLink><br />BMC Public Health. 2012 Jan 25;12:80. (PMID: <searchLink fieldCode="PM" term="%2222276600%22">22276600)</searchLink><br />Psychiatry. 2021 Fall;84(3):220-222. (PMID: <searchLink fieldCode="PM" term="%2234694967%22">34694967)</searchLink><br />Lancet. 2017 Jan 7;389(10064):91-102. (PMID: <searchLink fieldCode="PM" term="%2227717615%22">27717615)</searchLink><br />Lancet Public Health. 2017 Aug;2(8):e356-e366. (PMID: <searchLink fieldCode="PM" term="%2229253477%22">29253477)</searchLink>
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