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Improving the Adverse Childhood Experiences Study Scale

As we move towards working with state legislatures, or thinking about this, I believe it is important to devise the best screening scale.  This should take into account rural vs urban ACEs. I believe we should seriously consider this because we don't want to have folks (especially the professionals who would be required to start this screening and who don't know of or are dubious of the efficacy of ACEs screening or especially pharmaceutical companies with deep pockets) questioning the screening instrument we use.  

In fact we want to be well positioned and with 10 years plus behind us --- we on ACEsconnection should be thinking hard .... what are the best screening questions that will "get the job done well?"

1. obtain the most accurate response

2. have the best specificity with best sensitivity....with the best positive predictive value... I am not a statistician!!!! But the point remains. It is time to think about our questions.  

I believe that we should have questions that cover the diversity of our population. A Harvard researcher is currently looking at this question...

My question is what do you think? 

If we move too quickly with the wrong screening instrument we could suffer a setback.

It is obvious that poverty, social isolation, lack of eduction are important ACEs (intuitively speaking) 

What do you think (my Myers Briggs is INFP and strongly so... Just an FYI.) ? This is no research article....It is a question.....That I consider seriously......Though this is a complex subject... I don't think we should wait to screen but I do believe we should pool our knowledge NOW to create the best screen to propose to the public.... If we are looking at legislative efforts in states but we do not have the best screen that we can have.... We may set ourselves back by decades and this has already been a decades long struggle. Thanks Tina

Improving the Adverse Childhood Experiences Scale

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Well I guess the only questions I would change are 

6. Were your parents ever separated or divorced or were you placed in foster care? (this is still a way you loose you parents but worse yet your siblings which is an adversity).

7. Was you mother or stepmother or a sibling ever.....(Dr. Teicher's work shows witnessing sibling violence is far more severe than against a parent... and maybe I am biased).

However, I wouldn't want to loose sight of the forest by looking with a magnifying glass at the bark of one tree. This work in prevention is far too important... And with the years of data behind it and the mountains of work....The need to screen and work for prevention starting in pediatrics and especially with pregnant mothers is where the field of medicine needs to go and go NOW (so the biggest groups to reach are Ob-GYN's and Pediatricians I believe).

But if you are asked, "what is your evidence behind your screening tool?" Ask "what is the evidence behind yours (for example for pediatric bipolar)?" You will find that the DSM is a group of academic doctors getting together to decide these symptoms mean this diagnosis. The evidence is slim at best.  They can give not genetic, epigenetic, demographic or you name it ... answers.... So the evidence behind childhood adversity and severe adverse mental, physical, and societal outcomes is clear (You don't have to have 5 million ACE studies to come to the conclusion that there is a significant link)... and that society will save in term of money spent and human suffering...... however beware.... if ACEs were to become a reality...a business that makes lots of money on drugs and a profession who learned only to give out drugs may fight back and they fight HARD.....

They have the money and the resources to do so... 

I did cancer research before medical school... we studied a cancer drug that is now making big money for a drug company... I am not 100% sure but I do believe most of the grant funding came from the NCI (National Cancer Institute) little from the drug company but that company is currently reaping the profits of my and our lab's work

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