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PACEs in Pediatrics

Tagged With "Toxic Stress"

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Heyman Oo integrates ACEs science as foundation of pediatric care

Sylvia Paull ·
Dr. Heyman Oo, a 34-year-old primary care pediatrician, first learned about the science of adverse childhood experiences in medical school at a grand rounds held around 2012 at Rady Children’s Hospital in San Diego, which she attended from 2009 to 2014. The presenter was none other than Dr. Nadine Burke Harris, a pediatrician who went on to become California’s first Surgeon General. The founder and former director of the Center for Youth Wellness drew millions of views for her TED talk on...
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Hillary Clinton’s Comprehensive Agenda on Mental Health [The Briefing—Fact Sheets]

The first bullet under Early Diagnosis and Intervention of today’s release of Hillary Clinton’s mental health agenda is titled “ Increase public awareness and take action to address maternal depression, infant mental health, and trauma and stress in the lives of young children.” It states “We also know that infant mental health depends on children forming close and secure relationships with the adults in their lives, and that too many children are growing up in environments that cause them...
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How collaboration helps clinic in San Mateo County, CA, tackle ACEs in children

Laurie Udesky ·
Dr. Elizabeth Grady is a pediatrician at the South San Francisco Clinic, a community clinic of San Mateo Medical Center. She and Susana Flores , a senior public health nurse with San Mateo County Health, spoke with me about how the clinic and other health agencies in San Mateo have been able to craft ways to work together to prevent and heal toxic stress in children. Grady also talked about how she and Flores have been working with the Resilient Beginnings Collaborative (RBC), a group of...
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How do these pediatricians do ACEs screening? Early adopters tell all.

Laurie Udesky ·
Last week, three pediatricians — with a combined experience of 15 years integrating ACEs science into their practices — reflected on the urgency they felt several years ago that prompted them to begin screening patients for childhood adversity and resilience when there was practically no guidance at all. Along their journey , they accumulated a list of lessons learned for other pediatricians and family clinics to use. The three pediatricians participated in the ACEs Connection webinar,...
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How "Sesame Street" is helping kids learn to cope with trauma [abcnews.go.com]

Laura Pinhey ·
Big Bird and his " Sesame Street " buddies are taking on a new mission: helping kids learn to cope with stress and trauma. Sesame Workshop, the nonprofit offshoot of the long-running children's program "Sesame Street," launched the powerful new initiative, which was designed with the help of psychologists, the same week that the nation was rocked by the deadliest mass shooting in modern U.S. history. The initiative includes materials for parents, caregivers and social workers, as well as...
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How to Be More Resilient [nytimes.com]

Alicia Doktor ·
As a psychiatrist, I’ve long wondered why some people get ill in the face of stress and adversity — either mentally or physically — while others rarely succumb. We know, for example, that not everyone gets PTSD after exposure to extreme trauma, while some people get disabling depression with minimal or no stress. Likewise, we know that chronic stress can contribute to physical conditions like heart disease and stroke in some people, while others emerge unscathed. What makes people resilient,...
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Hundreds Attend ACEs Town Hall Featuring California Surgeon General Nadine Burke Harris (with video) [northcoastjournal.com]

By Iridian Casarez, North Coast Journal, November 22, 2019 The Sequoia Conference Center on Humboldt County Office of Education’s campus was at capacity, 448 people had landed a seat — while at least another 100 watched from a live stream in a separate room. The draw was a conversation among California’s first Surgeon General Nadine Burke Harris and a panel of locals spearheading Humboldt County’s efforts to alleviate the impacts of Adverse Childhood Experiences, also known as ACEs. “Thank...
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“I Like to Move It, Move It!" – How Dance and Rhythm Can Reduce the Impact of ACEs [stresshealth.org]

Laura Pinhey ·
If you’ve watched “Madagascar,” you’re sure to have seen King Julien leading the jungle in a rousing chant of “I Like to Move It, Move It” while doing just that. It turns out King Julien was onto something. If the iconic lemur were a scientist, he might have written a dazzling paper on what our ancestors already knew: Dance can help heal what ails you. As it is, more and more researchers studying the healing power of rhythmic movement on people who’ve experienced trauma from Adverse...
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Immigrant teens, parents explore ACEs, resilience in 5-week course with family doc

Laurie Udesky ·
Dr. Angela Bymaster, a family doctor in San Jose, Calif., was determined to find a way to teach ACEs science to her patients. Teens would come to the Washington Neighborhood Clinic clearly depressed by a range of problems at home that were contributing to risky sexual behavior and marijuana use, as well as preventable health problems like extreme obesity.
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Immune Biomarkers of Early-Life Adversity and Exposure to Stress and Violence - Searching Outside the Streetlight [jamanetwork.com]

By Nicole R. Bush and Kirstin Aschbacher, JAMA Pediatrics, November 4, 2019 Evidence of an association between early-life adversity and heightened risk of chronic disease in adulthood has been found, but the optimal biomarkers for identifying vulnerable or resilient individuals remain unclear. Global trends, including widening socioeconomic disparities, the refugee crises, and climate change, increasingly sculpt trauma exposure and call for scalable early-risk identification and treatment...
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Researchers share learned lessons from screening for adverse childhood experiences in pediatric clinics

Laurie Udesky ·
What are the reasons that parents or caregivers do not fully disclose their own or their young children’s ACEs when asked to fill out an ACE screening form in their child’s pediatrician’s office? That was one of the many questions raised in a recent webinar entitled Screening for Adverse Childhood Experiences in the Pediatric Primary Care Setting: Practical Considerations and Lessons Learned . Dr. Kavitha Selvaraj, an attending physician at the Ann & Robert H. Lurie Children’s hospital...
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In ACEs Connection webinar, physicians talk trauma, offer tips for helping pediatric immigrant patients

Laurie Udesky ·
Dr. Raul Gutierrez, a pediatrician in the San Francisco Bay Area, said he and his fellow clinicians see constant fear and its health consequences every single day among the largely immigrant and Latino population they serve. It’s all the result of anti-immigrant policies and the news cycle that feeds the fear. Dr. Raul Gutierrez “It is almost inescapable with the repercussions of immigration policy on the radio, television, social media and from friends and family,” Gutierrez told the 69...
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Integrating Healthcare and Early Childhood Systems Requires Capacity and Expertise [chapinhall.org]

By Angeline Spain, Angela Sander, and Amanda Brownd, Chapin Hall at the University of Chicago, 2020 Pediatric well-child visits represent a critical, often untapped opportunity to ask families about unmet social care needs and connect them with early childhood and other community services. Innovating in this space to address social determinants of health, early childhood organizations are increasingly building healthcare partnerships with the goal of increasing family access to services and...
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Interim report of the President’s opioid commission says its final report will address early intervention strategies for children with ACEs

On August 8, President Trump spoke to the opioid crisis in this country and declined to declare a national emergency as recommended by the “President’s Commission on Combating Drug Addiction and the Opioid Crisis.” Instead, the President emphasized the law and order aspects of the problem and the importance of preventing drug use in the first place since addiction is so hard to overcome. The Commission will make a final report in the fall. The recently released interim report makes eight...
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4 years after integrating ACEs science, Pueblo, CO clinic improves services for families; cuts ER costs, doctor stress

Laurie Udesky ·
Four years ago, Dr. Leslie Dempsey would never have talked about ACEs — adverse childhood experiences — with her patients. Now ACEs is a common topic. “Just as I don’t feel awkward asking someone if they smoke or do intravenous drugs, I don’t really feel awkward talking about their childhood traumas in a way that it relates to their health. It’s just integrated into obtaining background and social history,” she says. Dr. Leslie Dempsey Dempsey is a physician in obstetrics who oversees a team...
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5 Things to Know as California Starts Screening Children for Toxic Stress [californiahealthline.org]

By Barbara Feder Ostrov, California Healthline, January 7, 2020 Starting this year, routine pediatric visits for millions of California children could involve questions about touchy family topics, such as divorce, unstable housing or a parent who struggles with alcoholism. California now will pay doctors to screen patients for traumatic events known as adverse childhood experiences, or ACEs, if the patient is covered by Medi-Cal — the state’s version of Medicaid for low-income families. The...
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9 Big Questions as California Starts to Screen Kids for Trauma, ACEs [salud-america.org]

By Amanda Merck, Salud America!, February 12, 2020 Early childhood adversity like abuse and divorce is a root cause of many of the greatest public health challenges we face today. But doctors don’t even screen children for exposure to adversity. That’s changing in California, thanks to Dr. Nadine Burke Harris and other child advocates. As of Jan. 1, 2020, almost 100,000 physicians in 8,800 clinics will be reimbursed for routinely screening Medi-Cal patients for adverse childhood experiences...
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A Conversation with Nadine Burke Harris: How Should Pediatricians Address Childhood Adversity?

Claudia Gold ·
Pediatrician Nadine Burke Harris is a masterful storyteller. I learned in a conversation with her at Wheelock College before her presentation for the Brookline, MA organization Steps to Success , that before she decided to become doctor, Dr. Burke Harris wanted to be an author. Only after the smashing success of her TED talk: How childhood trauma affects health across a lifetime , when she was approached by a literary agent, did she find her way to writing. Her newly released book The...
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A Guide to Providing Telehealth During the COVID-19 Crisis

Daren Casagrande ·
Many of us in the mental health field are being thrust into unfamiliar territory as clinicians in the midst of the COVID-19 response. We either risk personal health (and the health of our clients) by seeing people in person, or needing to utilize technologies that we may be unfamiliar with. Further, those technologies have fluid legal/ethical standards (and is even more fluid at present to accommodate the pandemic), and which require different skill sets that in-person therapy. I am...
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A Guide to Providing Telehealth During the COVID-19 Crisis

Daren Casagrande ·
ACEs in Pediatrics community manager's note: Although this post by Daren Casagrande is geared toward mental health providers, I thought it had material that could be useful to a wider swath of health care providers. Please comment below if you have any questions or suggestions. --- Laurie Udesky Many of us in the mental health field are being thrust into unfamiliar territory as clinicians in the midst of the COVID-19 response. We either risk personal health (and the health of our clients) by...
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A Health Problem and An Opportunity: Screening for Adverse Childhood Experiences [medium.com]

Dayna Long ·
By Dayna Long, Medium, May 19, 2020 A consensus of scientific research demonstrates that cumulative adversity, especially when experienced during critical and sensitive periods of development, is a significant contributing factor to some of the most harmful, persistent, and expensive health challenges facing our nation. Adverse Childhood Experiences (ACEs) are highly prevalent, experienced in all communities, and are likely to increase during the COVID-19 emergency [i] [ii] [iii] [iv] [v].
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A Message from the President of the Illinois Chapter, American Academy of Pediatrics

Elise Groenewegen ·
Dear Illinois ACE Connection members, Children and families from all demographic and socioeconomic backgrounds in Illinois experience trauma, adversity, and chronic stress. Social determinants such as where we live, work, and play, can further exacerbate positive or negative physical, emotional, and behavioral health issues. The critical factor that determines if a child, family, and/or community can manage trauma, adversity, and chronic stress successfully is resilience : the process by...
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A National Agenda to Address Adverse Childhood Experiences

Christina Bethell ·
What are ACEs and Why Do They Matter? In 2016 1 , nearly half of U.S. children – 34 million kids – had at least one Adverse Childhood Experience (ACE) and more than 20 percent experienced two or more. The new brain sciences and science of human development explain how ACEs can have devastating, long-lasting effects on children’s health and wellbeing. These events resonate well beyond the individual child to have far-reaching consequences for families, neighborhoods, and communities. ACEs...
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A Pandemic Benefit: The Expansion of Telemedicine [nytimes.com]

Marianne Avari ·
By Jane Brody, The NY Times, May 11, 2020. Even if no other good for health care emerges from the coronavirus crisis, one development — the incorporation of telemedicine into routine medical care — promises to be transformative. Using technology that already exists and devices that most people have in their homes, medical practice over the internet can result in faster diagnoses and treatments, increase the efficiency of care and reduce patient stress. Without having to travel to a doctor’s...
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A plethora of journal articles on ACEs science

Laurie Udesky ·
As the community manager of ACEs in Pediatrics, I comb the web looking for pertinent studies and information that may be of interest to ACEs in Pediatric members. In the last several days the journals Pediatrics, the North Carolina Medical Journal, Child Abuse & Neglect and the Journal of Women's Health have published a number of articles on ACEs science. Here is a list of some of the articles and commentary featured in each journal: ACEs and Pregnancy: Time to Support All Expectant...
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A tough childhood has a long-term effect on health [businesslive.co.za]

Alicia Doktor ·
US-based pediatrician Nadine Burke-Harris had a glut of attention deficit hyperactivity disorder (ADHD) cases at the clinic where she worked in Bayview, a poor area in San Francisco. She felt in her bones that these cases didn’t come out of the blue, and were directly linked to high levels of toxic stress in the community. Toxic stress, experienced through consistent exposure to violence, abuse and the consequences of poverty and inequality, has a lasting effect on the brain, notably in the...
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AAP PRESIDENT ELECT - GIVING HER FIRST ADDRESS ALL ABOUT ACES

Former Member ·
  Sandra G. Hassink, MD, FAAP 2014 President Elect,  is giving an address now that is all about ACES, poverty, and toxic stress and the pediatricians role!!!   It is all over twitter. I am so excited. 
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AAP reiterates its opposition to separating children and parents at the border, citing the long term health hazards of trauma

Laurie Udesky ·
American Academy of Pediatrics President Dr. Colleen Craft recently visited a shelter for migrant children in Texas, according to an article in The Washington Post, and expressed concern that the traumatic separation of children from a trusted adult can have long-term health consequences for both the children and the parent. In an earlier op ed piece for the Los Angeles Times, Craft wrote, " Prolonged exposure to highly stressful situations — known as toxic stress — can disrupt a child's...
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AAP Statement in Response to Tear Gas Being Used Against Children at the U.S. Southern Border [aap.org]

Alicia Doktor ·
“Images and news reports of tear gas being used on children and families seeking asylum at our border have stunned and shaken pediatricians just as they have so many others across the country. Our objection to this type of treatment of children and their parents is grounded in our own policy: “The American Academy of Pediatrics recommends that all immigrant children and families seeking safe haven are treated with dignity and respect to protect their health and well-being. Children who are...
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ACE Fact Sheets to Give Your Doctors, Patients & Beyond (free downloads)

Veronique Mead ·
I was first inspired to create a fact sheet summarizing the effects of adverse childhood experiences (ACEs) after reading a comment in “Got Your ACE score?” A reader wished she had a form to give her doctor that documented the vast body of evidence explaining how early trauma increases risk for chronic physical and mental health conditions and much more. I could relate.
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ACEs Aware: On Jan. 1, 2020, Medi-Cal Providers Can Receive Payment for ACEs Screenings

Gail Kennedy ·
ACEs and toxic stress represent a public health crisis that has been, until recently, largely unrecognized by our state’s health care system and society, but there’s hope. Together, we can screen for ACEs, respond with trauma-informed care, and significantly improve physical and mental health across the state. All Medi-Cal providers are encouraged to get trained today . Beginning on January 1, 2020, eligible Medi-Cal providers can receive a $29 payment for conducting qualifying ACEs...
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ACES Aware Webinar: Dec 13th, 12-1pm PT - Public Comments about soon-to-be-released Request for Proposal

Gail Kennedy ·
The Department of Health Care Services and the California Office of the Surgeon General are hosting a webinar of the Trauma-Informed Care Implementation Advisory Committee’s Provider Education and Engagement Subcommittee. Subcommittee members will discuss a draft Request for Proposal (RFP) released for public comment as part of the ACEs Aware initiative. The draft RFP invites external organizations to apply for grants to support provider training activities, provider engagement activities...
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ACEs Aware Webinar: Trauma-informed practices to address stress from COVID19

Laurie Udesky ·
How can health care providers take care of themselves, their colleagues and their patients during this COVID-19 pandemic? First and foremost is recognizing how the pandemic can stir up trauma from the past, said Dr. Alicia Lieberman, a psychologist specializing in trauma. “COVID19 is reawakening traumatic reminders in many of us and in the families we work with. And that often makes it difficult for parents to protect themselves and their children,” she noted. Lieberman, the director of the...
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ACEs, biomarkers and the cost of adversity

Laurie Udesky ·
How useful and necessary are biomarkers in telling the story of how toxic stress from adverse childhood experiences and resilience can impact a child’s long-term health? In the introduction to an article in the journal BioEssays , Dr. Kathryn Ridout, a Kaiser Permanente San Jose psychiatrist, and her co-authors examine what is known about two biomarkers and quote data on child maltreatment and its economic burden over time that says it all. “When totaling the costs of health care, child...
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ACEs champion pediatricians talk about life and practice in a COVID-19 world

Laurie Udesky ·
With the advent of the COVID-19 pandemic, healthcare providers everywhere are changing how they care for their patients. I asked a few members of the ACEs in Pediatrics community what they’re doing differently. Dr. R.J Gillespie, pediatrician at The Children’s Clinic in Portland, OR. Dr. R.J. Gillespie Gillespie says that, as much as possible, they’re switching to virtual visits, which allows them “to comfort and reassure our patients face-to-face as much as possible without risking their...
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ACEs Research Corner — February 2020

Harise Stein ·
Editor's note: Dr. Harise Stein at Stanford University edits a web site — abuseresearch.info — that focuses on the health effects of abuse, and includes research articles on ACEs. Every month, she's posting the summaries of the abstracts and links to research articles that address only ACEs science. Thank you, Harise!! -- Jane Stevens] Kambeitz C, Klug MG, Greenmyer J, Popova S, Burd L. Association of adverse childhood experiences and neurodevelopmental disorders in people with fetal alcohol...
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ACEs Research Corner — January 2020

Harise Stein ·
Research papers this month include links between ACEs and bullying, dropping out of high school, adult disability, and the effects of countering ACEs.
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ACEs Research Corner — July 2019

Harise Stein ·
[Editor's note: Dr. Harise Stein at Stanford University edits a web site -- abuseresearch.info -- that focuses on the health effects of abuse, and includes research articles on ACEs. Every month, she's posting the summaries of the abstracts and links to research articles that address only ACEs. Thank you, Harise!! — Jane Stevens] Wang X, Maguire-Jack K. Family and Environmental Influences on Child Behavioral Health: The Role of Neighborhood Disorder and Adverse Childhood Experiences . J Dev...
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ACEs Research Corner — June 2019

Harise Stein ·
[Editor's note: Dr. Harise Stein at Stanford University edits a web site — abuseresearch.info — that focuses on the health effects of abuse, and includes research articles on ACEs. Every month, she posts the summaries of the abstracts and links to research articles that address only ACEs. Thank you, Harise!! -- Jane Stevens] Wickramasinghe YM, Raman S, Garg P, Hurwitz R. Burden of adverse childhood experiences in children attending paediatric clinics in South Western Sydney, Australia: a...
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ACEs Research Corner — September 2018

Harise Stein ·
[Editor's note: Dr. Harise Stein at Stanford University edits a web site -- abuseresearch.info -- that focuses on the health effects of abuse, and includes research articles on ACEs. Every month, she's posting the summaries of the abstracts and links to research articles that address only ACEs. Thank you, Harise!! -- Jane Stevens] Schickedanz A, Halfon N, Sastry N, Chung PJ. Parents' Adverse Childhood Experiences and Their Children's Behavioral Health Problems. Pediatrics. 2018 Aug;142(2).
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ACEs research roundup: Toxic stress biomarker, mitigating ACEs in Scotland, ACEs and diabetes and more

Laurie Udesky ·
Using hair cortisol to examine the role of stress in children's health inequalities at 3 years MHE Bryson, F Mensah, S Goldfeld, AMH Price - Academic Pediatrics , 2019 [HTML] How community resources mitigate the association between household poverty and the incidence of adverse childhood experiences A Blair, L Marryat, J Frank - International Journal of Public Health Developing an Indicator System to Measure Child Well-Being: Lessons Learned over Time KA Moore - Child Indicators Research,...
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ACEs screening in CA — a Q and A with Dr. Dayna Long

Laurie Udesky ·
Last year, the California Department of Health Care Services rolled out its plans for universal screening for trauma among its pediatric and adult Medicaid population. Beginning January 1, 2020, California physicians were able to receive an incentive payment of $29 for each pediatric patient screened for ACEs using the PEARLs ( Pediatrics Adverse Childhood and Resilience Study) tool. Dr. Dayna Long talked with ACEs Connection staff reporter Laurie Udesky about ACEs science, what led to the...
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Adverse Childhood Experiences Run Deep: Toxic Early Life Stress, Telomeres, and Mitochondrial DNA Copy Number, the Biological Markers of Cumulative Stress [BioEssays]

Laurie Udesky ·
" This manuscript reviews recent evidence supporting the utility of telomeres and mitochondrial DNA copy number (mtDNAcn) in detecting the biological impacts of adverse childhood experiences (ACEs) and outlines mechanisms that may mediate the connection between early stress and poor physical and mental health. Critical to interrupting the health sequelae of ACEs such as abuse, neglect, and neighborhood disorder, is the discovery of biomarkers of risk and resilience. The molecular markers of...
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After 5-year journey to integrate ACEs science, Santa Rosa, CA, pediatric clinic is trauma-informed, from head to toe

Jane Stevens ·
Dr. Meredith Kieschnick was among the first physicians in the U.S. to hear the term, "adverse childhood experiences". That was in 1998, early on in her career as a pediatrician, when the CDC-Kaiser Permanente Adverse Childhood Experiences Study (ACE Study) published its initial findings in the American Journal of Preventive Medicine . “I attended a conference at which (Dr. Vincent) Felitti spoke,” she recalls. Felitti, at that time director of the Health Appraisal Center at Kaiser Permanente...
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Alternative IHEBA with ACEs for California (and Other) Pediatricians

Ariane Marie-Mitchell ·
If you are a pediatrician serving Medicaid managed care patients in California, then you are required to use the Staying Healthy Assessment or an alternative IHEBA (Individual Health Education Behavioral Assessment) at all well-child visits. The bad news is that getting approval to use an alternative IHEBA is a tedious process. The good news is that as of October 27, 2016 the Whole Child Assessment (WCA) is available for use in English and Spanish. Most importantly, the WCA has been...
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Alternative IHEBA with ACEs for California (and Other) Pediatricians

Ariane Marie-Mitchell ·
If you are a pediatrician serving Medicaid managed care patients in California, then you are required to use the Staying Healthy Assessment or an alternative IHEBA (Individual Health Education Behavioral Assessment) at all well-child visits. The bad news is that getting approval to use an alternative IHEBA is a tedious process. The good news is that as of October 27, 2016 the Whole Child Assessment (WCA) is available for use in English and Spanish. Most importantly, the WCA has been...
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An Early Childhood Development Expert Explains How Trauma and Stress Can Derail a Kid’s Life [sarasotamagazine.com]

By Cooper Levey-Baker, Sarasota, December 19, 2019 Mimi Graham has spent her life fighting for kids. She began her career in the late 1970s as a Head Start administrator before moving into the world of academia to study child development and advocate for public policies that improve the health of mothers and children. Today, she’s the director of Florida State University’s Center for Prevention & Early Intervention Policy, a position in which she advises government agencies and...
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Announcing a New Parenting and ACEs Blog from Stress Health, an Initiative of the Center for Youth Wellness

Diana Hembree ·
Research shows that the right kind of support and care can mitigate the impact of toxic stress in children and help them bounce back.
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As California Moves to Screen Children for Childhood Trauma, Poverty Has To Be Part of the Equation

Jim Hickman ·
In California, we are coming full circle in recognizing the connection between poverty and health.
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BABY ACES: When we consider the traumas that qualify as ACEs, babies need their own list.

Laura Haynes Collector ·
Babies are obviously very different from older children developmentally, including their ability to understand and process trauma. Indeed, a baby may be completely unaware of an actual ACE— say, the incarceration of their father— which a middle schooler would be painfully aware of. Yet at the same time, the baby could be much-more-acutely impacted by the secondary effect of this same ACE: a sad, stressed, and distracted mother. Similarly, if a parent dies in a car accident when a child is in...
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