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PACEs in Pediatrics

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Chicago healthcare providers start center for ACEs science education; aim to reach all medical, health students by 2025

Laurie Udesky ·
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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Child abuse could leave 'molecular scars' on its victims [medicalxpress.com]

Alicia Doktor ·
Children who are abused might carry the imprint of that trauma in their cells—a biochemical marking that is detectable years later, according to new research from the University of British Columbia and Harvard University. The findings, based on a comparison of chemical tags on the DNA of 34 adult men, still need confirmation from larger studies, and researchers don't know if this tagging—known as methylation—affects the victims' health. But the difference in methylation between those who had...
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Child’s behavior may be linked to parent’s adverse childhood experiences [contemporarypediatrics.com]

Alicia Doktor ·
Parents who have experienced adverse childhood experiences (ACEs), such as abuse, neglect, or household dysfunction, are more likely than parents without these experiences to have children with behavioral health problems, according to an analysis of data from several large, nationally representative surveys of US households that addressed ACEs and children’s behavioral problems and diagnoses. Of the more than 2500 children for whom researchers had data, one-fifth had a parent who reported...
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Child Sexual Abuse: Talking Points in the Office [AAPPublications.org]

Samantha Sangenito ·
Pediatricians are experts at prevention dialogue in practice settings: from fevers, car seats and safety gates, to locking up medications, toxins and guns — and everything in between — keeping kids safe and promoting healthy development is core to our commitment to families. Surveys have shown, however, that dialogues about preventing child sexual abuse often are a challenge, with the most common barriers to providing guidance being lack of time, training and uncertainty about how to...
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Childhood Anxiety Linked to Later Problems With Alcohol [psychcentral.com]

Alicia Doktor ·
New research has found evidence that children and adolescents with higher levels of anxiety may be at a greater risk of developing alcohol problems. Many studies have investigated the relationship between anxiety and alcohol use, but the evidence has been unclear, say researchers at the University of Bristol in the U.K.. Some studies found higher anxiety is linked to greater alcohol use, while others found anxiety is linked to lower alcohol use, or there was no association. For their study,...
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Children of Color Face Higher Barriers to Success, New Casey Report Says [jjie.org]

Alicia Doktor ·
The children of immigrants make up less than one-fourth of the nation’s youth population yet account for 30 percent of children living in poverty, a new report finds. More than that, young black and brown Americans were worse off compared to white and Asian-American children, the Annie E. Casey Foundation said. The foundation analyzed youth welfare along several axes, including education, health and economic indicators, to come up with an index of how well young people in various racial and...
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Colorado Launches Two Generation Approach to Family Services [chronicleofsocialchange.org]

Alicia Doktor ·
Colorado is testing a new approach to providing services to struggling families in an effort to address the intergenerational cycle of poverty, incarceration and foster care. Two Generation (2Gen) is a new initiative by the state recognizing that children and their parents are best served by recognizing the needs of the entire family unit. “CDHS embedded the 2Gen approach into all of our services, recognizing that our clients only succeed when their providers or children also get the support...
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Come Chat with Dr. Claudia M. Gold: An ACE-Informed Pediatrician

Christine Cissy White ·
Date: July 11th Time: 10 AM PST / 1 PM EST Location: Parenting with ACEs Group , Online Flyer: Attached below. Please share. Dr. Claudia M. Gold has practiced general and behavioral pediatrics for 25 years and specializes in early childhood mental health. She is on the faculty of the University of Massachusetts, Boston Infant-Parent Mental Health program, William James College, and the Austen Riggs Center where she is a Human Development consultant. Dr. Gold is author of the following...
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Commentary: Pediatricians called to address racism, intolerance to achieve health equity [AAPPublications.org]

Samantha Sangenito ·
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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Conversations about Emotional Health AAP

Former Member ·
  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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Daddy, Papi, Papa, or Baba: The Influence of Fathers on Young Children’s Development - Zero to Three

Former Member ·
In this podcast, Dr. Kyle Pruett talks about the important and unique role fathers play in the lives of young children.  Dr. Pruett is clinical professor of child psychiatry at the Yale School of Medicine and is a past president of ZERO TO...
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Data-for-Equity Research Brief [nichq.org]

Alicia Doktor ·
Child care offers a safe space for children to grow and learn while their families are at work, making it a critical resource to support healthy development. However, child care is unaffordable for the majority of working parents, especially for low-income and black and Hispanic working parents. This research brief provides insight and analysis about the challenges families face in affording childcare, which can exacerbate inequities in early childhood health and development. [For more on...
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Developing Healthy Minds: It’s Never Too Early to Start! [Blog.SAMHSA.gov]

Samantha Sangenito ·
The human mind is one of the most complex structures in the universe. Even in early infancy, it is capable of taking in a wide variety of inputs. Still, in our early years, we’ve only unlocked a small portion of its potential. Our brains actually continue to develop into our twenties . Accordingly, the U.S. Government embraces a definition of youth that continues until we turn 25. Nurturing the development of young minds to stay healthy through adulthood is a primary goal of SAMHSA’s Project...
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Developmental, behavioral issues more common among rural children [Healio.com]

Samantha Sangenito ·
“Indicators of poor mental health among adults — for example, serious mental illness among men, major depressive episodes among men and women, and recent serious psychological distress among women — have been found to be higher in large rural counties than in small, rural, suburban and urban counties,” Lara R. Robinson, PhD, from the National Center on Birth Defects and Developmental Disabilities at the CDC, and colleagues wrote. “Most studies examining children’s mental health in rural and...
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Disabled Kids at Higher Risk of Abuse, Study Finds [Consumer.HealthDay.com]

Samantha Sangenito ·
Children with certain mental or behavioral disorders are at increased risk of abuse or neglect, a new study suggests. The findings add to evidence that children with disabilities face higher abuse risks. But they also suggest those risks vary depending on the type of disorder a child has. "We've known for years that children with disabilities have an increased risk of abuse," said Dr. Vincent Palusci, a pediatrician at NYU Langone Medical Center, in New York City. But the new study "took a...
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Do The Roots Of Mental Health Issues Lie In Early Childhood? [WAMU.org]

Samantha Sangenito ·
Rahil Briggs, a child psychologist, is walking the corridors of the Pediatrics department at the Montefiore Comprehensive Healthcare Center . We’re in the South Bronx, New York. It’s one of the poorest urban areas in the country. Crying babies don’t faze Briggs. She looks serene — like she’s just finished a yoga class. Briggs says babies’ brains are “sticky.” “Their brains are disproportionately receptive. So whatever we throw sticks. That’s why they can learn Spanish in six months when it...
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Docs: Kids to Suffer Under Trump's Tough Immigration Policies [Consumer.Healthday.com]

Samantha Sangenito ·
U.S. pediatricians are taking President Donald Trump to task after he issued executive orders Wednesday that -- the doctors said -- will make the country a much less welcoming place for immigrant children. Not only will refugee children be harmed by the new policies, but children of immigrants already living in the United States will become frightened for their family's safety, according to the American Academy of Pediatrics (AAP). "Children do not immigrate, they flee," AAP President Dr.
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10 Things Every Parent Should Know about Play

Former Member ·
  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)

Bob Sege ·
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

Anna Runkle ·
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

Christine Cissy White ·
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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JAMA Forum: Building Blocks for Addressing Social Determinants of Health [newsatjama.jama.com]

Alicia Doktor ·
Our health care system is waking up to the fact that the health of individuals and families does not depend solely on good coverage and good medical care; it also requires us to address social and other factors that are major contributors to a person’s physical and mental well-being. That’s why more and more clinics are screening incoming patients for challenges in areas ranging from housing conditions, nutrition, access to transportation, and even their ability to afford utilities . It’s...
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Kaiser family medicine clinic launches 4-question ACE survey pilot for adults

Laurie Udesky ·
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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Keeping Kids in Families [AECF.org]

Samantha Sangenito ·
In this data snapshot, the Annie E. Casey Foundation examines how placements for young people in foster care have changed from 2007 to 2017. Using data from all 50 states and the District of Columbia, Casey finds that child welfare systems are doing a better job of placing kids in families. At the same time, racial disparities persist for kids of all ages and progress eludes teens in care. To push for further progress, the four-page snapshot tells how states can leverage the federal Family...
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“Landmark” Maternal Health Legislation Clears Major Hurdle [propublica.org]

Alicia Doktor ·
Update, Dec. 13, 2018 at 8:15 p.m. ET: On Thursday evening, the Senate unanimously passed its version of the Preventing Maternal Deaths Act, sending it to the president to sign. Congress moved a big step closer on Tuesday toward addressing one of the most fundamental problems underlying the maternal mortality crisis in the United States: the shortage of reliable data about what kills American mothers. The House of Representatives unanimously approved H.R. 1318 , the Preventing Maternal...
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Little kids and 'toxic stress': we can solve this [cnn.com]

Alicia Doktor ·
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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Love in the TIme of Coronavirus: Inequities and Supporting Children

Bob Sege ·
This blog is re-posted from positiveexperience.org/blog/ Link there for associated resources, and for the other blogs in the series. Having safe, stable, and equitable environments to live, learn and play forms the second of the 4 Building Blocks of HOPE. Children need homes where they feel safe and secure and have their basic needs met. Children thrive in an environment that encourages curiosity and provides opportunities for learning to play and interact with other children. Today’s blog...
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Managing Post-Traumatic Stress in a Pandemic: Practices & Resources Updated Regularly

Christine Cissy White ·
[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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Maternal Depression and Intimate Partner Violence: Impacts on Children [aappublications.org]

Alicia Doktor ·
Among the many adverse childhood experiences, one must consider are the effects of maternal depression and of mothers being the victim of physical or sexual violence. What is the toll of these on children? Neamah et al. ( 10.1542/peds.2017-3457 ) decided to evaluate this by looking at the strength of such an association on the cognitive development as well as physical growth of over a thousand toddlers between 18 to 36 months living in Tanzania. These children underwent developmental testing...
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Medical emergency department visits can indicate increased suicide risk among teens and young adults [medicalxpress.com]

Alicia Doktor ·
A new study published in the American Journal of Preventive Medicine provides detailed insights on the increased risk of self-directed violence that patients aged 15-29 years visiting the emergency department (ED) for medical complaints subsequently experience. This underscores the importance of EDs in suicide prevention. The broad number of physical health conditions associated with an increased risk of self-directed violence may serve to support expanded or broader screening among teens...
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Migrant Children Moved Under Cover of Darkness to a Texas Tent City [nytimes.com]

Alicia Doktor ·
In shelters from Kansas to New York, hundreds of migrant children have been roused in the middle of the night in recent weeks and loaded onto buses with backpacks and snacks for a cross-country journey to their new home: a barren tent city on a sprawling patch of desert in West Texas. Until now, most undocumented children being held by federal immigration authorities had been housed in private foster homes or shelters, sleeping two or three to a room. They received formal schooling and...
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Mitigating the Effects of Trauma among Young Children of Immigrants and Refugees: The Role of Early Childhood Programs [migrationpolicy.org]

Alicia Doktor ·
A child’s early years are a time of exceptional growth, and ones that can be profoundly affected by traumatic experiences. Research has firmly disproven the idea that infants and toddlers are “too young” to be affected by such experiences, leading to an increased awareness of the need for trauma-informed services for children. Early childhood education and care (ECEC) programs have the potential to play a central role in identifying and addressing the effects of trauma, with lifelong...
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Modifiable Resilience Factors to Childhood Adversity for Clinical Pediatric Practice / Abstract Link

Christine Cissy White ·
I learned about a new research paper entitled, "Modifiable Resilience Factors to Childhood Adversity for Clinical Pediatric Practice" co-authored by Flora Taub and Renée Boynton-Jarret (pictured above). It was just published in Pediatrics which is the official journal of the American Academy of Pediatrics). Here's the link to the abstract. I'm not going to pretend I subscribe to Pediatrics. I don't. However, I have been interested in the work of Renée Boynton-Jarret ever since writing a...
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Montefiore Medical in Bronx screens 12,000+ kids for ACEs

Laurie Udesky ·
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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More American children and teens aren't just obese. They're morbidly obese. [Vox.com]

Samantha Sangenito ·
Public health researchers cheered an encouraging trend recently : Childhood obesity rates, which rose steadily through the 1980s and 1990s, seemed to have plateaued in the 2000s. But new research suggests a different, troubling problem lurking behind that plateau — a steep rise in the rates of severe obesity, particularly among older and minority children. The fraction of adolescents with severe obesity — a body mass index of 40 or greater — has more than doubled from 0.9 percent in 1999 to...
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Mother's attitude towards baby during pregnancy may have implications for child's development [medicalxpress.com]

Alicia Doktor ·
Mothers who 'connect' with their baby during pregnancy are more likely to interact in a more positive way with their infant after it is born, according to a study carried out at the University of Cambridge. Interaction is important for helping infants learn and develop. Researchers at the Centre for Family Research carried out a meta-analysis, reviewing all published studies in the field, in an attempt to demonstrate conclusively whether there was a link with the way parents think about...
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“Motherless Children Have the Hardest Time”: Epigenetic Programming and Early Life Environment  [pediatrics.aappublications.org]

Alicia Doktor ·
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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Mothers’ Adverse Childhood Experiences and Their Young Children’s Development [ajpmonline.org]

Alicia Doktor ·
Introduction This study examined how mothers’ Adverse Childhood Experiences (ACEs) relate to their children’s developmental risk and assessed how the association is mediated through mothers’ depressive symptoms and fair/poor health. Methods Mothers of children aged between 4 months and 4 years were recruited from the emergency department of a children’s hospital between March 2012 and June 2015 and interviewed about ACEs, mothers’ depressive symptoms and health status, and children’s...
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New Federal Opportunities to Advance Two-Generation Approaches to Improving the Lives of Children and Parents [ascend.aspeninstitute.org]

Alicia Doktor ·
Because of recent legislation passed in February and March of this year, the federal government will be providing significant new funding to state and local governments in 2018 and future years through an array of programs serving low-income children and parents. These new funding streams, and the legislations’ increased focus on improving outcomes using evidence-based approaches, create a remarkable opportunity for path-breaking governors and local leaders to transform how government...
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New Health Resiliency Stress Questionnaire debuts for pediatricians, family practice, internal medicine...but anyone can use it

Susie Wiet ·
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 HRSA Funding Opportunity! Pediatric Mental Health Care Access Program

Jane Stevens ·
[Ed. note: This is from Hae Young Park, Acting Director of the Division of MCH Workforce Development, Maternal and Child Health Bureau, Health Resources and Services Administration] We are pleased to announce a new notice of funding opportunity (NOFO) for the Pediatric Mental Health Care Access Program. Please share broadly with your stakeholders and grantees. The purpose of this program is to promote behavioral health integration in pediatric primary care by supporting the development of...
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New Sesame Street Tools Help Build Resiliency [rwjf.org]

Alicia Doktor ·
The Robert Wood Johnson Foundation and Sesame Workshop share a common vision of giving all children—especially the most vulnerable among us—a strong and healthy start in life. We know that childhood experiences lay the foundation for children to grow into productive and successful adults, and promoting healthy behaviors and supporting families from the very beginning can help kids thrive. But it’s equally important to address challenges that can undermine their healthy development. That’s...
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New survey paints dire picture of challenges black moms face in health care system [centerforhealthjournalism.org]

Alicia Doktor ·
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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NJ medical school program requires all first-year students to learn about ACEs science

Laurie Udesky ·
In 2015, Dr. Beth Pletcher, a pediatrician and associate professor specializing in genetics, was at the annual conference of the American Academy of Pediatrics in Washington D.C. when she heard two speakers that forever changed her work with medical students. Dr. Beth Pletcher “I went to two talks on adverse childhood experiences (ACEs) that were so mind-boggling to me that I decided on my drive back to New Jersey that I had to do something about it,”says Pletcher, director of the Division...
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Nobel Winner’s Research Shows Home Nurse Visits for New Moms Boost Children’s Cognitive Skills [The74Million.org]

Samantha Sangenito ·
When medical professionals make home visits to first-time mothers, their children’s cognitive skills and socio-emotional development improve, reports a new paper authored by acclaimed economist James Heckman. The study is the latest evidence from the Nobel Prize winner that such initiatives, while benefiting children of both genders, make a greater impact on boys. Heckman’s research focuses on one of the first implementations of the Nurse-Family Partnership, a home visitation program that...
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NPPC News and Resources

Molly Peterson ·
As 2019 comes to a close, we wish you a peaceful and healthy holiday season. As trauma-informed healthcare practitioners, this is also a time to acknowledge that the holidays can trigger loneliness and anxiety -- so please take time to care for yourself and perhaps provide extra support for your patients and families. As always, below you’ll find other news, webinars and resources we hope you find helpful for your ACEs screening efforts. Medi-Cal Funding Available for ACEs Screening Starting...
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NPPC shares lessons learned and results from ACEs screening pilot sites

Laurie Udesky ·
For Dr. Mercie Digangi, a pediatrician at Kaiser Southern California in Downey, CA, ACEs screening provided a crystal clear before-and-after in how she changed treatment plans for her pediatric patients, she explained to attendees of a December 2 webinar organized by the National Pediatric Practice Community on ACEs (NPPC) and cosponsored by ACEs Connection. Dr. Mercie Digangi One case that turned ACEs screening into a never-go-back moment for her was a three-year-old who was speech-delayed.
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Opioid gene variant in adolescents reduces reward, may increase later substance abuse risk [medicalxpress.com]

Alicia Doktor ·
Adolescents with a particular variant of an opioid receptor gene have less response in a part of prefrontal cortex that evaluates rewards, compared to those with the other version of the gene, say researchers at Georgetown University Medical Center (GUMC). For the study, presented Monday at Neuroscience 2018, the annual meeting of the Society for Neuroscience (abstract #7517), the investigators scanned adolescents who have never used drugs or alcohol with functional magnetic resonance...
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Oxytocin Blunts Social Vigilance in the Rhesus Macaque (But this is the end of the last Talk I just listened to).

Former Member ·
      I'm listening to Van Der Kolk, MD (My Hero!!!!) tell us what he has to say about  Stephen J. Suomi's  talk:   "Thanks Steve, I am really delighted that these presentations are being video taped and the reason why I...
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Parent Handouts: Understanding ACEs, Parenting to Prevent & Heal ACEs (English)

Christine Cissy White ·
Please see the main post for these parent handouts in the ACEs Connection Resources Center. These two flyers ( Understanding ACEs and Parenting to Prevent & Heal ACEs ) can be downloaded, distributed, and used freely. One is brand new and the other is a revision. Both flyers were made with generous support from Family Hui, a Program of Lead for Tomorrow. Translations of these flyers are in progress and will be shared by Family Hui and updated on ACEs Connection when available.
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