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Policy recommendations re Adverse Childhood Experiences - 2

In my previous blog, we started to look at ACE-Aware policies that have been enacted in USA and Canada since 2014. There seemed to be a great awareness of the effect of ACEs by legislators but what policies did they enact?

I've analysed about 20 bills - there is legislation at federal (national) level and a state level. Legislation seems to be directed towards four main policy considerations:

  • Building knowledge and expertise of trauma-informed best practice
  • Building capability and capacity in services and communities for trauma-informed best practice
  • Collecting evidence of the extent of adverse childhood experiences
  • Innovating new models


Let's look at strands in the first of these:

1. Building knowledge and expertise of trauma-informed best practice

Creating a cross-government, multi-agency group of practitioners to promote trauma-informed practice by establishing best practices for identifying and supporting children that have experienced trauma and promoting their use.

Major sub-strands:

  • Consider findings from evidence-based, evidence-informed, and promising practice-based models, including from institutions of higher education, community practice, recognised professional associations, and programs of the Departments of Health, Education and Justice and other agencies that reflect the science of healthy child, youth, and family development, and have been developed, implemented, and evaluated to demonstrate effectiveness or positive measurable outcomes.
  • Recommend models for settings in which individuals may come into contact with children and youth, and their families as appropriate, who have experienced or are at risk of experiencing trauma, including schools, hospitals, settings where health care providers, including primary care and pediatric providers, provide services, preschool and early childhood education and care settings, home visiting settings, after-school program facilities, child welfare agency facilities, public health agency facilities, mental health treatment facilities, substance abuse treatment facilities, faith-based institutions, domestic violence centres, homeless services system facilities, refugee services system facilities, juvenile justice system facilities, and law enforcement agency facilities.
  • Recommend best practices that are evidence-based, are evidence-informed, or are promising and practice-based, and that include guidelines for:
    • training of front-line service providers, including teachers, providers from child- or youth-serving organisations, health care providers, individuals who are mandatory reporters of child abuse or neglect, and first responders, in understanding and identifying early signs and risk factors of trauma in children and youth, and their families as appropriate, including through screening processes.
    • implementing appropriate responses including procedures or systems that are designed to quickly refer children and youth, and their families as appropriate, who have experienced or are at risk of experiencing trauma to appropriate partners to ensure the children, youth, and appropriate family members receive, the appropriate trauma-informed screening and support, including treatment
    • educating children and youth to understand trauma, identify the signs, effects, or symptoms of trauma and build the resilience and coping skills to mitigate the effects of experiencing trauma
    • supporting, including through skills building, parents, foster parents, adult caregivers in fostering safe, stable, and nurturing environments and relationships that prevent and mitigate the effects of trauma for children and youth who have experienced or are at risk of experiencing trauma. Assisting parents, foster parents, and adult caregivers in learning to access resources related to such prevention and mitigation.
    • collecting and utilising data from screenings, referrals, or the provision of services and supports, to evaluate and improve processes for trauma-informed support and outcomes.
    • improving disciplinary practices in early childhood education and care settings and schools, including use of positive disciplinary strategies that are effective at reducing the incidence of punitive school disciplinary actions, including school suspensions and expulsions.Consider whether integration of school-based health centres with the larger health system or system of community clinics would advance measurable outcomes. Consider whether integration of other  services to meet the needs of children, adolescents and families would advance measurable outcomes.
  • Recommend best practices that include practices that are culturally sensitive, age- and gender-relevant, appropriate for LGBT populations and can be applied across underserved geographic areas and engage entire organizations in training and skill building related to the best practices.
  • Recommend best practices that are designed not to lead to unwarranted custody loss or criminal penalties for parents or guardians in connection with children and youth who have experienced or are at risk of experiencing trauma.


Some resources:

British Columbia have produced a Trauma-Informed Practice Guide and a Healing Families, Helping Systems: A Trauma-Informed Practice Guide for Working with Children, Youth and Families.
Manitoba have produced a Trauma-Informed Toolkit.
There will be others like this.

In my next blog, I'll look at enacted policies for Building capability and capacity in services and communities for trauma-informed best practice.

This article was originally published on Word on the Streets

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