Tagged With "Toxic Stress"
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Building a Trauma-Informed Approach with Pediatric Physical Therapists
In the profession of physical therapy (PT), the word "trauma" typically leads one to think of the physical manifestations of a catastrophic injury, subsequent emergency medical care, and lengthy rehabilitation services. However, the psychological aspects of trauma are not always as visible. Throughout an individual’s lifespan, PTs will provide services to restore function, manage pain, and increase physical activity. We provide education, hands-on care, and therapeutic exercise to improve...
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Building trust is now a critical part of health care
In a video clip , a hospital patient turns away in protest as a physician enters the room. “Why do you all keep coming in my room!” she asks in frustration. The physician moves a chair out of the way and sits down at eye level with the patient. “You’ve had to see so many people,” he acknowledges. “And I’m tired of it!” she yells. “I already know I have to get both of my legs cut off. That’s what they keep saying. I don’t have a choice!” “You don’t feel like you have a choice,” he repeats...
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CA pediatrician develops, tests, gets state OK for whole-child assessment tool that includes ACEs
Over the last dozen years or so, many pediatricians, astounded by the ramifications of the science of adverse childhood experiences (ACEs) on the children they care for, began integrating this science into their practices. The most common approach has been to ask parents about ACEs using a questionnaire, and to use this information to counsel parents and identify resources for the family. Different practices have been using different questionnaires: Some ask parents for their ACE scores...
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CA pediatrician develops, tests, gets state OK for whole-child assessment tool that includes ACEs
[Editor's note: This blog was first posted in April 2017. Dr. Marie-Mitchell updated the assessment by modifying a few of the questions, so we are republishing with the new assessment, one in Spanish and one in English.] Over the last dozen years or so, many pediatricians, astounded by the ramifications of the science of adverse childhood experiences (ACEs) on the children they care for, began integrating this science into their practices. The most common approach has been to ask parents...
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CA to reimburse for only one of three ACEs screeners
California health care providers will soon begin to learn how many of the 13.2 million California children and adults in the state’s MediCal program have been exposed to adverse childhood experiences (ACEs). But the state’s proposed decision to reimburse only one of three recommended options for screening children has drawn mixed reactions from pediatricians. “If we have mandated legislation that only looks at one screening tool, it really limits the opportunity to improve that screening...
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California ACES Learning & Quality Improvement Collaborative (CALQIC) - Opportunity to be a part of the Learning Collaborative!
Apply to be a part of ACEs Aware's California ACES Learning & Quality Improvement Collaborative (CALQIC) In partnership with the UCSF Center to Advance Trauma-Informed Healthcare and other key partners, we'll select 15 organizations across California to participate in this 18-month learning collaborative to support clinics in screening for and responding to adverse childhood experiences (ACEs) in children and adults. This is a challenging time, and we know that many of our health care...
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California gets its first ever surgeon general (ktvu.com)
California's first-ever Surgeon General has launched a listening tour that will take her around the state to hear about people's hopes for the new position and the state's new commitment to improving Californians' health. Dr. Nadine Burke Harris is a pediatrician with degrees from U.C. Berkeley, U.C. Davis Medical School, and Harvard University. She says, as the daughter of a biochemist and a nurse, she knew what her dream job was at an early age. "My immediate priorities as Surgeon General...
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California has Begun Screening for Early Childhood Trauma, But Critics Urge Caution [sciencemag.org]
By Emily Underwood, Science, January 29, 2020 On 1 January, California became the first U.S. state to screen for adverse childhood experiences (ACEs)—early life hardships such as abuse, neglect, and poverty, which can have devastating health consequences in later life. The project is not just a public health initiative, but a vast experiment. State officials aim to cut the health impacts of early life adversity by as much as half within a generation. But critics say the health benefits of...
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California healthcare providers adapt ACEs screening from in-person to virtual environment
Dr. Amy Shekarchi, a pediatrician based in Los Angeles, CA, was helping to lead the rollout of ACEs screening among 50 health care providers at six clinics affiliated with the L.A. County Department of Health Services when the COVID-19 pandemic hit—days before she was set to launch the effort. “We had trained everybody in doing face-to-face [ACEs screening], and when COVID-19 happened we thought, let’s not throw the screening out. Everybody was ready,” says Shekarchi, who is the pediatric...
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California unveils ACEs Aware initiative to screen for trauma
Will screening for adverse childhood experiences (ACEs) in California be mandatory? No, but it’s recommended. Will there be training for physicians and staff on how to screen? Yes. Who will be reimbursed for screening patients in California? Physicians who serve patients in the state’s Medi-Cal program — for now. For more answers to these and other questions that surfaced during a Dec. 4 webinar introducing Californians to a new statewide initiative, read on. Come January 1, California will...
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Chicago healthcare providers start center for ACEs science education; aim to reach all medical, health students by 2025
In 2017, Dr. Audrey Stillerman and three other women from the Chicago healthcare community founded the THEN Center . Its goal is lofty: By 2025, it wants every graduating student in medical and health sciences across the United States to apply core concepts of childhood adversity, neurobiology, resilience and health equity into their work. Dr. Audrey Stillerman Today, the THEN Center (The Collaborative Study of Trauma, Health Equity and Neurobiology) is well on its way. Its founders are...
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Childhood Stress and Adversity is Associated with Late-Life Dementia in Aboriginal Australians
This was just sent by the RACP “Paediatric Pot-Pourri”. It continues the developing and worrying themes presented at the recent NBPSA and CCCH satellites days before the RACP Congress. I cannot see any reason to imagine that these same outcomes do not also apply to those children living anywhere in the world where ACE’s are flooding into their lives. John Goldsmith “All paediatricians, particularly those with an interest in child development, are aware of the Adverse Childhood Experiences...
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Chronic Stress Exposure Among Young African American Children with Asthma: Racism is a Factor [annallergy.org]
By Bridgette L. Jones, Vincent Staggs, and Brianna Woods-Jaeger, Annals of Allergy, Asthma & Immunology, September 17, 2019 African American and Hispanic children are more likely to have a diagnosis of asthma and significantly higher disease related morbidity in comparison to non-Hispanic white children. Mortality rates are likewise higher as African American children are 8 times more likely than non-Hispanic white children to die from asthma 1. The cause of this striking health...
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Commentary: Pediatricians called to address racism, intolerance to achieve health equity [AAPPublications.org]
As pediatricians, we champion the need to address social determinants of health, such as poverty and food insecurity, in an effort to achieve health equity. We emphasize screening for toxic stress. In our conversations about equity, we include data about racial and ethnic disparities. Because of our commitment to work for the health and well-being of all children, pediatricians are uniquely positioned to consider and address the needs and concerns of the at-risk communities for whom we care.
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Connecting with Families During Quarantine: Virtual Support and Telehealth
The New Jersey Chapter, American Academy of Pediatrics Healthy Spaces program offers this webinar to provide strategies for health care providers to provide trauma-informed care during virtual patient encounters. Drs. Nicole Leopardi and Ruth Gubernick will share guidance on outreach messaging, stress management, and positive discipline. Participants will also engage in thoughtful reflection on how to implement small tests of change to adapt patient care and support connections with families...
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Conversation-starting Resilience Project posters
The American Academy of Pediatrics has created several posters to use as conversation starters to recognize toxic stress and adverse childhood experiences in children and build their resilience. Pediatricians are encouraged to hang the...
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Conversations about Emotional Health AAP
The AAP developed 2 promotional ads — Mom! Dad! Ask the doctor about my emotional development, too! — to promote the importance of mental health as part of a health supervision visit. - See more at: ...
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Course credit for "Childhood Adversity and Toxic Stress in Medical Care: Promoting Health and Healing Throughout the Lifespan"
Dr. Beth Grady, a pediatrician at South San Francisco Clinic, developed a course called: "Childhood Adversity and Toxic Stress in Medical Care: Promoting Health and Healing throughout the Lifespan". She did the presentation on June 15, 2016, and the webinar was posted on June 22, 2016. The termination date for the webinar is June 22, 2019. Instructions for earning 1 AMA PRA Category 1 Credit TM for this enduring material: Watch the video of the presentation, which can be accessed via this...
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Cultivating Deliberate Resilience During the Coronavirus Disease 2019 Pandemic [jamanetwork.com]
By Abby R. Rosenberg, JAMA Pediatrics, April 14, 2020 Coronavirus disease 2019 (COVID-19) is affecting our health care community in unprecedented ways. As a pediatric oncologist who studies resilience in the context of illness, I started thinking about what this pandemic means for our professional resilience a few weeks ago, when the first US patient with fatal COVID-19 died in my home city of Seattle, Washington. Promoting resilience among health care workers and organizations starts with...
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CYW's Provider Training Courses now available online
In response to an overwhelming demand for information about ACEs science, screening tools, and guidance on how to implement ACEs screening, CYW has developed a suite of online courses in order to make our training more accessible to a broader audience. Developed by a team of pediatricians, research scientists, public health experts, and clinical quality improvement experts, these courses are the first of four online courses that will aid medical providers/practitioners in understanding and...
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CYW's Provider Training Courses now available online
In response to an overwhelming demand for information about ACEs science, screening tools, and guidance on how to implement ACEs screening, CYW has developed a suite of online courses in order to make our training more accessible to a broader audience. Developed by a team of pediatricians, research scientists, public health experts, and clinical quality improvement experts, these courses are the first of four online courses that will aid medical providers/practitioners in understanding and...
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Defang ACEs: End toxic stress by developing resilience through physician-community partnerships [Pediatrics]
" When I was 12, my parents became part of the Maryland foster care system. Over many years, we took care of a total of 6 boys who had been placed in foster care. Some had suffered from physical and sexual abuse, others from neglect. Often, their parents struggled with mental health and substance use disorders. The traumas my siblings had experienced had clear impacts on their immediate mental and physical health. What we did not know was that these adverse experiences could also have...
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10 Nature Activities to Help Get Your Family Through the Coronavirus Pandemic [childrenandnature.org]
By Richard Louv, Children & Nature Network, March 16, 2020 If the coronavirus spreads at the rate that experts believe it will, schools, workplaces and businesses will continue to close. Here’s a thread of silver lining. We’ll have more time for each other and nature. And, at least so far, nature’s always open. Getting outside — but at a safe distance from other people — can be one way to boost your family’s resilience. If you spend too much time indoors, “your vitamin D level goes...
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10 Things Every Parent Should Know about Play
1. Children learn through their play. Don’t underestimate the value of play. Children learn and develop: cognitive skills – like math and problem solving in a pretend grocery store physical abilities – like balancing...
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10 ways to avoid ACEs (during the pandemic)
How can we reduce ACEs and toxic stress during the COVID-19 pandemic? Many of us are concerned that increased stress might increase the risk for ACEs. For example, most child abuse happens when adults reach their breaking point. However, we are not powerless in the face of these challenges. Using HOPE ( Healthy Outcomes from Positive Experiences ) as a guide, here are 10 suggestions to reduce ACEs now: Think about social connection and physical distance , not social distance. Continuing to...
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12 Things I Wish My Doctor Understood About Childhood Trauma
It doesn’t happen that often anymore, but one place where I almost always get triggered with my Childhood PTSD symptoms is when I visit the doctor. I could never even put this into words before. But now that I’m mostly healed from my Childhood PTSD symptoms, I want to express what I wish my doctors – all the doctors of my life – had understood about the effects of Childhood trauma, about me. Note: This is one of my most personal posts ever. Unless you’re someone who really prefers text, I...
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Introducing NEW Becoming Trauma-Informed & Beyond Community
Earlier this year @Dawn Daum wrote to us when she was ready to share ACEs science with people in the organization she works in to make a case for moving towards more trauma-informed care for the benefit of the staff and those they serve. She was frustrated because almost all the training and resources she found were geared towards schools, clinical staff or to organizations working with children and families rather than ACE-impacted adults in the workplace and who are...
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Iowa project aims to have all pediatricians, family docs screen for ACEs
Dr. Amy Shriver is on a mission: to convince every pediatrician and family doctor in the State of Iowa to screen children for Adverse Childhood Experiences (ACEs). Dr. Amy Shriver The Des Moines-based Blank Children’s Hospital pediatrician is not alone. She’s part of Central Iowa ACES 360, a regional cross-sector coalition formed in 2011 that is working toward that ambitious goal. And they’re making substantial inroads. Central Iowa ACES 360 has just developed a one-hour trauma-informed...
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January 2019 NPPC Announcements
The NPPC team at the Center for Youth Wellness is excited to share details about our second cohort of Pilot Sites, our ACEs webinar series with OptumHealth education and our new podcast series: ‘Voices from the Field’. Read on to find out more. Apply for the National Pediatric Practice Community Pilot Site Cohort 2! The National Pediatric Practice Community(NPPC) is pleased to open the application process for NPPC's second cohort of pilot sites. Participation will not only support your...
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Join us in San Antonio for the 2019 AAP Trauma Informed Pediatric Provider course
The American Academy of Pediatrics will once again be holding the Trauma-Informed Pediatric Provider Course: Addressing Childhood Adversity and Promoting Resilience March 2-5, 2019 in San Antonio, TX. The Trauma-Informed Pediatric Provider course will assist health care providers and those working in or with child servicing agencies to identify children who have experienced adversity, trauma and toxic stress and will discuss their presentation and the risk factors involved. This three and...
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Kaiser family medicine clinic launches 4-question ACE survey pilot for adults
In July, medical residents in family medicine at Kaiser Permanente in San Jose, CA, began screening adult patients for adverse childhood experiences (ACEs). But it’s an ACE survey with a twist: it’s shorter, not the 10-question survey of the original CDC-Kaiser Permanente ACE Study , according to Dr. Kathryn Ridout who is leading the pilot along with Dr. Francis Chu and Dr. Alec Uy . Why a shorter ACE survey? Dr. Kathryn Ridout “When we were doing our initial discussions with stakeholders in...
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Latest ACEs science research from PubMed, May 7, 2019
Clinic and park partnerships for childhood resilience: A prospective study of park prescriptions. Razani N, Niknam K, Wells NM, Thompson D, Hills NK, Kennedy G, Gilgoff R, Rutherford GW. Health Place . 2019 May 3;57:179-185. doi: 10.1016/j.healthplace.2019.04.008. [Epub ahead of print] PMID:31060017 Family Resilience And Connection Promote Flourishing Among US Children, Even Amid Adversity. Bethell CD, Gombojav N, Whitaker RC. Health Aff (Millwood) . 2019 May;38(5):729-737. doi:...
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Left untreated, stress can affect kids’ health for a lifetime. Here’s how to help them cope. [WashingtonPost.com]
I woke up in an ambulance. The last thing I could remember was standing on a ledge in an auditorium and practicing for my school’s choir performance. I was in ninth grade, it was my first field trip in my new home here in the United States, and I was nervous. Then everything went black. I had fainted. Although my front teeth bore the brunt of my fall and saved me from serious injury, I had broken them all. As the paramedic gently explained to me why there was blood gushing from my mouth, he...
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List of Free Courses (if you create a Login) from the NCTSN
I have done many of these courses over the years. I think the National Child Traumatic Stress Network is a real gem, so I just wanted to put a link to their list here, so that you would all have access too and could share with others. Thanks...
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Little kids and 'toxic stress': we can solve this [cnn.com]
All children have incredible potential, most with parents, teachers and other adults in their lives who want the best for them. Unfortunately, many schools, particularly those that serve children with the greatest need, face obstacles that limit children's educational success -- rote curriculums, insufficient support for teachers and scant extracurricular options, to name a few. Educators, parents and policymakers have long acknowledged such obstacles, but we now know that there is another...
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Managing Post-Traumatic Stress in a Pandemic: Practices & Resources Updated Regularly
[Ed. note: Cissy posted this in the Practicing Resilience community, and it's cross-posted here to make sure everyone sees it. We don't want anyone to miss out on these resources!] Are you looking for new ways to get connected, supported, or to manage stress while managing post-traumatic stress during this pandemic? I am. No matter what our past or present life circumstances, it's safe to say a whole bunch of us are feeling more stressed and if we live with chronic post-traumatic stress to...
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Marin Community Clinics in California screen babies for ACEs, provide support in effort to prevent trauma
When Marin Community Clinics (MCC) first considered screening their patients for adverse childhood experiences (ACEs) they already had decided that if they were going to prevent children from acquiring ACEs, they had to take a radical approach.
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Montefiore Medical in Bronx screens 12,000+ kids for ACEs
Creative Commons/Flickr/Family drawing by Meggy ____________________________________ Since 2016, more than 12,000 children beginning at the age of 1-years-old have been screened for adverse childhood experiences (ACEs) at Montefiore Medical Center in Bronx, New York, according to Miguelina German, the director of Quality & Research in the Pediatric Behavioral Health Integration Program and project director of Trauma Informed Care at the center. Parents of infants are asked to fill out...
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“Motherless Children Have the Hardest Time”: Epigenetic Programming and Early Life Environment [pediatrics.aappublications.org]
The Blind Willie Johnson blues song “Motherless Children” highlights the maternal bonds that we all know are critical to emotional and cognitive development. Authors of previous work looking at infant stress response have found that these bonds begin in utero and can be influenced by both maternal and paternal influences and across multiple generations. 1 The observations of Barker et al 2 on the Dutch famine birth cohort of World War II were perhaps the first published observations of this...
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Nadine Burke Harris debuts "The Deepest Well: Healing the Long-Term Effects of Childhood Adversity" in Philadelphia
Dr. Nadine Burke Harris debuted her book, The Deepest Well: Healing the Long-Term Effects of Childhood Adversity , at the Philadelphia Free Library this evening in a talk and book signing. This first stop in an ambitious book tour that crisscrosses the country reflects a mission that Burke Harris has pursued for nearly a decade: to spread the knowledge about the science of adverse childhood experiences, and about how people can use this knowledge to help solve our most intractable problems.
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National collaborative provides roadmap for doctors to ask about adult patients' ACEs, current trauma
How do you ask patients about current and past trauma? And how do you respond to their disclosures? Those are two key questions that members of a national collaborative who are among the early adopters of trauma-informed care practices have answered in a recent article in the journal Women’s Health Issues. Dr. Edward Machtinger To Dr. Edward Machtinger, the lead author of the paper entitled, “ From treatment to Healing: Inquiry and response to recent and past trauma in adult health care” ,...
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National Homeless Youth Awareness Month (November 2014) Resources from the National Child Traumatic Stress Network
Each year more than 1.6 million children are homeless at some point in their lives, and that number is increasing ( The National Center on Family Homelessness ). Along with losing their home, community, friends, and routines as well as their sense of...
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NCTSN Resource List by Title
The NCTSN Resource List By Title is an alphabetical listing of all products developed by the National Child Traumatic Stress Network. Each of the products listed is linked to provide easy access to all materials. The resource list was...
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New Health Resiliency Stress Questionnaire debuts for pediatricians, family practice, internal medicine...but anyone can use it
There's a new ACEs-resiliency survey in town! It came out of a conversation between two physicians having a conversation on a bus. Here's the story about how it was developed, and how to use it. Pilots were done in a pediatric clinic, internal medicine, addiction treatment center, group therapy, and psychiatric practice. It's now being used in two community clinics.
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New Member of Congress—Rep. Lauren Underwood (D-IL)—brings laser focus on toxic stress at hearing on immigration
At a March 6 hearing of the House Committee on Homeland Security, Rep. Lauren Underwood (D-IL) addressed the impact of family separation on the mental and physical health of children at the border. Her questions to Homeland Security Secretary Kirstjen Nielsen focused on the impact of toxic stress caused by family separation on short and long-term health outcomes for children. Sec. Nielsen was unfamiliar with the concept of “toxic stress.” Here’s a short description of the 6-minute exchange...
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New organization calls all pediatricians to end crisis that's "hiding in plain sight"
When the question of screening patients for adverse childhood experiences (ACEs) was first raised a couple of years ago, Santa Barbara pediatrician Andria Ruth had mixed feelings about it.
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New Report Calls for Statewide Coordinated Response to Protect New Jersey's Children from Adverse Childhood Experiences [finance.yahoo.com]
By PR Newswire, Yahoo Finance, July 30, 2019 NEWARK, N.J., July 30, 2019 /PRNewswire/ -- A new report released today details the challenges New Jersey faces in addressing Adverse Childhood Experiences (ACEs) and sets forth opportunities and actions for a coordinated statewide response to mitigate their lasting effects on children's health and well-being. ACEs are stressful or traumatic events, including abuse, neglect, domestic violence, household mental illness, household substance misuse,...
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New survey paints dire picture of challenges black moms face in health care system [centerforhealthjournalism.org]
A new California survey of pregnant and new mothers paints a bleak picture of what it’s like to be a black mother. In Listening to Mothers in California, black mothers reported not being heard by their health providers and said they experienced discrimination during childbirth. They also experienced higher rates of anxiety and depression during and after pregnancy than white women. The findings add fuel to a growing sense of urgency on maternal health. On Wednesday, California Gov. Brown...
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New Website Provides ACEs Screening Resources for Pediatric Practitioners
The Center for Youth Wellness (CYW) has launched its new National Pediatric Practice Community on ACEs (NPPC) member website ( nppcaces.org ). The website supports CYW’s efforts to grow a national, co-designed peer group of pediatric-serving medical practitioners interested in ACES screening and in expanding knowledge, building capacity, accessing resources and shaping the field of ACEs research and trauma-informed care. NPPC’s goal is to support pediatric medical providers in making ACEs...
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Next "A Better Normal" community discussion series: April 3, 2020/ Maternal health and pediatrics in the time of COVID-19
Steve Sack • Star Tribune The "Better Normal" community discussion for Friday, April 3, 2020, features two wonderful staff members from ACEs Connection: Karen Clemmer, community facilitator for the Northwest, Far Northern California, Alaska and Hawaii; and reporter Laurie Udesky, who is also community manager for the ACEs in Pediatrics community on ACEsConnection.com. Karen Clemmer Join them at noon PT/ 1 pm MT/ 2 pm CT/ 3 pm ET and share your thoughts, ideas, questions, concerns, and...