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Childhood trauma, often hidden, yields lifelong effects: Guest commentary

Aclinic

At the Long Beach community health clinic where I’m a pediatrician, I’ve learned that the way you ask questions can be more powerful than any medication.

 

For example, we saw a child who was struggling with her vision and clearly needed glasses. But a couple of months later, the girl’s mother still hadn’t followed up with the eye doctor.

 

The case manager wondered whether the mom should be reported for neglect. But instead of interrogating the mom about why she had failed to complete this seemingly simple task, she asked the question another way: “Is there something going on in your life that is keeping you from getting your daughter her glasses?”

 

It turned out that after years of experiencing domestic violence, the mom was in the process of leaving the abusive relationship to save herself and her family. If all she had done was to question her about the glasses, then she would have missed the most important thing going on in the family: the impact of the violence, abuse and other types of trauma that can have a lifelong impact on mental and physical health.

 

For the rest of this op-ed by Dr. Elisa Nicholas, go to http://www.presstelegram.com/o...cts-guest-commentary

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And, Doctors can ask similar questions in the same way.  A few weeks back a parent came into the office for a well child visit for her 5 yr old son.  At the end of the visit, I asked her if there was anything else she needed help with.... She was concerned about her son's "hyperactivity" so we talked about it.  In this discussion, she then proceeded to tell me that her real worry was her 18 month old son who had started having violent temper tantrums, head banging, biting, hitting and drawing blood.  We discussed this more in a non-threatening manner, I asked her if she had any ideas where this behavior may have come from and she let me know that the father has recently been physically violent with this child, that there was a CPS case and that his behavior started after the father was forced to leave the home.   I told here a little about aces and asked her to followup with the child.  The next week she was in my office with the Spokane ACEs/Resilience handout (modified for our group that I had placed at the checkin desk) which I got from Jane.  She wanted to learn everything she could about aces/resilience so we had a very frank discussion.  It turns out that her aces score was 7 and her son at 18 months old was already 6.   I gave her information about multiple community resources and she left feeling somewhat empowered.  She then came back a week later to discuss how the high aces in the household could be contributing to the hyperactivity she was noticing in her 5 year old.  We discussed this and she was motivated to change the environment for her children.  We also got her help with domestic violence issues and anxiety and depression that she herself was suffering from.   All in all a great start!!!! 

 

Oh and I wanted to add, that handout or something similar is great to have at your reception desk.  A couple days after I put it out, in one day I saw 3 people with the handout on the chair next to them.  People come to the doctor thinking that we care for physical complaints.  My experience however is that they are pleased to know pediatricians care for the whole family (in one week the 20 sheets I put out were all gone). 

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