Tagged With "Trauma-informed Care"
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Book review: "Once I was very, very scared," a book on childhood trauma
The past few years have brought a wealth of evidence for the impact of childhood trauma on lifelong health. The AAP has recognized the importance of childhood trauma with conferences (2015 Violence, Abuse and Toxic Stress: An Update on Trauma-informed Care in Children and Youth) and resources ( AAP Trauma Toolbox for Primary Care .) Like many pediatricians, I have been grateful for the attention to and evidence base for an area of pediatrics I see on a daily basis but for which I have felt...
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Book review: "Once I was very, very scared," a book on childhood trauma
The past few years have brought a wealth of evidence for the impact of childhood trauma on lifelong health. The AAP has recognized the importance of childhood trauma with conferences (2015 Violence, Abuse and Toxic Stress: An Update on Trauma-informed Care in Children and Youth) and resources ( AAP Trauma Toolbox for Primary Care .) Like many pediatricians, I have been grateful for the attention to and evidence base for an area of pediatrics I see on a daily basis but for which I have felt...
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Boston’s architect of community well-being: Pediatrician Renée Boynton-Jarrett
She talks with parents about the relationship between childhood adversities they have experienced and how that may have an impact on parenting.
“I frame things a bit more broadly than ACEs,” she said, “because I think it’s very important to reflect on a broader number of exposures than were covered in the original study, such as poverty or structural violence and racism.”
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Bright Futures/Child Care Health Partnership Handouts for Parents
Bright Futures and Healthy Child Care America Parent Resources: Introducing new handouts that provide parents with tips on what child care programs will be working on with a child based on the child’s age. Each handout...
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Bringing trauma-informed care to children in need can ease toxic stress [statnews.com]
During my 22 years as a pediatrician in an urban area, I have seen the worst of what America’s children must sometimes endure. Severe medical illness in children is thankfully rare. But severe adversity in homes and communities is all too common and causes toxic stress that has long-term consequences for my patients and future generations. A 6-year-old patient of mine called 911 on the third day that she and her younger siblings couldn’t wake their intoxicated mother. We cared for their...
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Building a Movement to Birth a More Just and Loving World [Groundswell March 2018]
The National Perinatal Task Force: Building a Movement to Birth a More Just and Loving World - In my 20 years as a public health nurse, I've never seen race called out so clearly in a report like this. Data has shown disparities, however the data was presented in a tidy way — very apolitical, purposely written to not ruffle any feathers or point fingers - " persistent racial gap ". This report written by The National Perinatal Task Force is refreshingly honest and this is important. We need...
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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 Resilience Grant
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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 announces robust perinatal depression prevention for Medi-Cal recipients
Melinda Coates experienced a tumultuous pregnancy. “I was really mentally upset literally from day one (of the pregnancy),” she says. (Melinda Coates is a pseudonym. To protect her and her children’s privacy and safety, we are not using her real name.) Coates had hoped to get counseling last October, when she was seven months pregnant. That’s when she enrolled in the state’s Medi-Cal program, shortly after she and her abusive husband moved to California, “but nobody was able to get me in...
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CA announces robust perinatal depression prevention for Medi-Cal recipients
Melinda Coates experienced a tumultuous pregnancy. “I was really mentally upset literally from day one (of the pregnancy),” she says. (Melinda Coates is a pseudonym. To protect her and her children’s privacy and safety, we are not using her real name.) Coates had hoped to get counseling last October, when she was seven months pregnant. That’s when she enrolled in the state’s Medi-Cal program, shortly after she and her abusive husband moved to California, “but nobody was able to get me in...
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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 Surgeon General and DHCS Launch ACEs Aware Initiative and Website
Join a live webinar with California Surgeon General Dr. Nadine Burke Harris and Dr. Karen Mark Medical Director, Department of Health Care Services for a Medi-Cal provider introduction to the new ACEs Aware Initiative and the www.ACEsAware.org website. The Office of the California Surgeon General and the Department of Health Care Services (DHCS), in the first public unveiling of the initiative, will host a live webinar to share details of the new ACEs Aware Initiative for Medi-Cal providers...
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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 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 Is Giving Doctors Incentives To Ask Patients About Childhood Trauma [capradio.org]
By Sammy Caiola, Capital Public Radio, December 9, 2019 California health officials want children and adults on Medi-Cal to get screened for traumatic childhood events that can cause negative health effects down the line. Now the state has started giving doctors and nurses tools to do the screenings. People who experience adversity early in life have much higher chances of substance abuse, depression, or chronic diseases than their peers, according to national research. Gov. Gavin Newsom’s...
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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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Call For Workshop and Poster Submissions: Third Philadelphia Trauma Training Conference
The 3rd Annual Philadelphia Trauma Training Conference: Promoting Equitable Access to High Quality Services for Vulnerable Children and Families , will be held on Thomas Jefferson University's East Falls Philadelphia Campus July 29 th -August 1st, 2019 . This unique training conference will provide an intensive, collaborative, and engaging experience to providers, educators, and leaders across health, education, and social service disciplines, as well as to community members invested in...
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Can We Harness Pediatrician T. Berry Brazelton's Message of Hope?
Photo courtesy of Brazelton Touchpoints Center As our nation mourns the passing of renowned pediatrician T. Berry Brazelton, hearing his voice through the outpouring of articles, video clips, and conversations on social media feels like a balm for the soul. In these trying times, his simple shift from learning "what's wrong" to listening for "what's right" in a child and family seems very much needed. In his 50 years practicing pediatrics, he saw up close the ways parents can struggle. With...
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Care Provider Facilities Described Challenges Addressing Mental Health Needs of Children in HHS Custody [cmhnetwork.com]
By Joanne M. Chiedi, Department of Health and Human Services, September 18, 2019 Care Provider Facilities Described Challenges Addressing Mental Health Needs of Children in HHS Custody. Facilities that care for children in the Office of Refugee Resettlement’s (ORR’s) custody face the difficult task of addressing the mental health needs of all the children in their care, including children who have experienced intense trauma. According to those who treat them, many children enter the...
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Caring adult relationships can make the difference for children in trauma [register-herald.com]
Social workers, law enforcement officers and other children’s advocates gathered Wednesday for the first day of the West Virginia Children’s Justice “Handle With Care” Conference to learn more about child trauma, intervention and ways to help children become successful. In a state that leads the nation for opioid overdose deaths and babies born with Neonatal Abstinence Syndrome, West Virginia children are often witnesses to and victims of trauma. The West Virginia Defending Childhood...
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Center for Youth Wellness ACEs questionnaire and guide
The Center for Youth Wellness’ Adverse Childhood Experiences (ACEs) Questionnaire (CYW ACE-Q) is available for physicians to download from the CYW web site. The questionnaire is designed for use in the primary care home only....
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Change Package is Now Available!
Click here for the Change Package : Fostering Resilience and Recovery: A Change Package for Advancing Trauma – Informed Primary Care Earlier this year, to help primary care address the impacts of trauma, the National Council for Behavioral Health, with the support of Kaiser Permanente, launched a three-year initiative, Trauma-Informed Primary Care: Fostering Resilience and Recovery . “Trauma work is not new to the National Council. With effects across the lifespan, we’ve spent the last...
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CHCS brief outlines foundational steps toward implementing trauma-informed care
A newly-released brief by the Center for Health Care Strategies details some practical strategies and recommendations for health care organizations seeking to implement trauma informed practices. “It draws from the experiences of pilot sites in Advancing Trauma-Inform ed Care , a CHCS-led national initiative made possible through support from the Robert Wood Johnson Foundation.” Here is a related video CHCS-organized webinar entitled Implementing Trauma-Informed Care in Pediatric and Adult...
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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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Children and US Federal Policy on Health and Health Care Seen but Not Heard
Children account for 73.5 million Americans (24%), but 8% of federal expenditures. Data on health and health care indicate that child well-being in the United States has been in decline since the most recent recession. Childhood poverty has...
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Colorado Launches Two Generation Approach to Family Services [chronicleofsocialchange.org]
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
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]
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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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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Cover Story November Issue of Journal of Family Practice: Childhood Adversity and Lifelong Health
I was honored to have my review article, “Childhood Adversity and Lifelong Health: from research to action”, chosen as the November 2018 cover story of the Journal of Family Practice . Here is a link to the article. Access is free after registration with the journal and retrievable directly by anyone who has Medline PubMed access. https://www.mdedge.com/jfponline/article/178388/pediatrics/childhood-adversity-lifelong-health-research-action Highlights from the article include: - recognition...
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COVID-19 and our dialogue with death
[Editor's note: Dr. Cristian Zanartu, an internist and palliative medicine specialist, is currently volunteering at Bellevue Hospital during the pandemic.] I was angry. So angry. How come the smartest country in the world is acting like the dumbest? Why aren’t health authorities giving us clear guidelines now, before this starts? Like: how to quarantine, how to quarantine from a symptomatic loved one in the same household (we knew by late February from Chinese data that most spread happened...
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COVID-19 Response: Using Telehealth for Maternal & Infant Healthcare - Mahmee 03-20-2020
For those of you unable to join the 'COVID-19 Response: Using Telehealth for Maternal & Infant Healthcare' webinar today (Friday, March 20, 2020), here is a link to the webinar recording. Hosted by Mahmee , a maternal-infant health care coordination platform committed to equity, discussed how to make adjustments to clinical workflows and triage prenatal and postpartum concerns. Best practices were offered for identifying patients who should continue receiving in-clinic and in-home...
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COVID-19: The Trauma of Witnessing So Much Illness and Death Will Have Lasting Effects [medicinenet.com]
From MedicineNet, May 3, 2020 The tragic death by suicide this week of an emergency department physician who had been caring for COVID-19 patients in New York City underscores the huge psychological impact of the pandemic -- which will linger long after the virus is gone, experts say. "For frontline responders, the trauma of witnessing so much illness and death will have lasting effects for many," Bruce Schwartz, MD, president of the American Psychiatric Association (APA), said during the...
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COVID-19: What’s equity got to do with it? [George Washington University Milken Institute School of Public Health]
Editor’s note: This illustration is a new COVID specific Pair of ACEs tree shown along with the original tree. The post is by Wendy Ellis, DrPH, MPH the Director of the Building Community Resilience Collaborative and Networks at the George Washington University Milken Institute School of Public Health. It took less than two months for a virus undetectable to the naked eye to lay bare what lies in plain sight — exposing long-standing inequities, driven by social policies that have created...
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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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Data-for-Equity Research Brief [nichq.org]
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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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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Developing Trauma Informed Systems that can Support People in the Community
Love this powerpoint. Especially the section on what is and what is not "trauma informed care". Nice to keep in mind. http://www.nasmhpd.org/docs/NCTIC/Trauma_and_Community_Integration.pdf
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Developmental, behavioral issues more common among rural children [Healio.com]
“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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Developmental Delay Referrals Improve With QI Plan
Children with developmental delays stand a better chance of getting the early-intervention services they need if clinicians take the time to document screening efforts and follow-up with a simple telephone call, investigators say. When a...
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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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2014's Best and Worst States for Underprivileged Children
In an ideal world, children live carefree. They play with friends, eat nutritious food and receive a good education. They don’t worry about paying bills or searching for their next meal. They’re nurtured, protected and guided by caring...
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2017 Children's Mental Health Report
Of the 74.5 million children in the United States, an estimated 17.1 million have or have had a mental health disorder — more than the number of children with cancer, diabetes and AIDS combined. Half of all mental illness occurs before the age of 14, and 75 percent by the age of 24. In spite of the magnitude of the problem, lack of awareness and entrenched stigma keep the majority of these young people from getting help. Children and adolescents struggling with these disorders are at risk...
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2020 Pediatric Brain Health Summit [txsafebabies.org]
From Pediatric Brain Health Summit, February 2020 The 2020 Pediatric Brain Health (PBH) Summit is being held March 23-24 at the AT&T Executive Conference Center in Austin, Texas. The purpose of the Summit is to bring together community-based organizations and health care professionals from around the state to discuss and learn about strategies for promoting PBH. Thanks to generous support from the conference partners, registration is free and includes breakfast, lunch, conference...