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PACEs in Pediatrics

Tagged With "positive relationships"

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Parenting Matters: Supporting Parents of Children Ages 0-8 (The National Academies Press 2016)

Former Member ·
A study published by The National Academies of Sciences in 2016 resulting in 10 Recommendations to build support for parents... "Over the past several decades, researchers have identified parenting- related knowledge, attitudes, and practices that are associated with improved developmental outcomes for children and around which parenting- related programs, policies, and messaging initiatives can be designed. However, consensus is lacking on the elements of parenting that are most important...
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Pediatricians screen parents for ACEs to improve health of their babies

Jane Stevens ·
The  Children’s Clinic , tucked in a busy office park five miles outside downtown Portland, OR, and bustling with noisy babies, boisterous kids and energetic pediatricians, seems ordinary enough. But, for the last two years, a quiet...
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Positive Childhood Experiences and Adult Mental and Relational Health in a Statewide Sample: Associations Across Adverse Childhood Experiences Levels [jamanetwork.com]

By Christina Bethell, Jennifer Jones, Narangerel Gombojav, et al., JAMA Pediatrics, September 9, 2019 Question : Are positive childhood experiences (PCEs) associated with adult depression and/or poor mental health (D/PMH) and adult-reported social and emotional support (ARSES) independent from adverse childhood experiences (ACEs)? Findings : In this cross-sectional study, adults reporting higher PCEs had lower odds of D/PMH and greater ARSES after accounting for ACEs. The associations of...
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Positive Childhood Experiences offset ACEs: Q & A with Dr. Robert Sege about HOPE

Laurie Udesky ·
Tufts University medical professor Dr. Robert Sege directs the Center for Community-Engaged Medicine and is nationally known for his research on effective health systems approaches that address social determinants of health. He is also the principal investigator for the HOPE framework (Healthy Outcomes from Positive Experiences).The HOPE framework is based on research that shows how positive childhood experiences can mitigate the effects of adverse childhood experiences. Sege and colleagues...
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Positive Relationships Can Buffer Childhood Trauma and Toxic Stress, Researchers Say [bostonglobe.com]

By Kay Lazar, The Boston Globe, October 15, 2019 Traumatic events and toxic relationships during childhood can cast long shadows, often damaging mental health well into adulthood. But a growing body of research suggests sustained, positive relationships with caring adults can help mitigate the harmful effects of childhood trauma. And specialists say pediatricians, social workers, and others who work with kids should take steps to monitor and encourage those healthy relationships — just as...
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Prevention: Bringing Baby Home Training of Facilitators

Carolyn Curtis ·
A friend of mine recently referred her grandchild and his pregnant wife to a Bringing Baby Home class, because she noticed that the wife had a horrible background of abuse and at times had difficulty functioning. What the grandmother noticed with this couple was a change in the family dynamics. the couple knows how to get along, the father is engaged in parenting, and the baby thriving. This is really starting at the root of the problem. 20 years ago, Drs. John and Julie Gottman worked with...
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Recently released research on ACEs; incarceration; separating families at the border

Laurie Udesky ·
Behavioral risk factor surveillance system state survey on exposure to adverse childhood experiences (ACEs): Who declines to respond? [Children and Youth Services Review] "A wealth of research has examined the prevalence and impact of adverse childhood experiences (ACEs) via various research methodologies. Some of these studies have also examined the presence of nonresponse bias, showing minimal nonresponse bias effects. More recently, many states and the District of Columbia have used the...
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Report reveals how foster care, juvenile and adult justice systems traumatize youth, calls for policy shifts

Laurie Udesky ·
YWFC sponsored Sister Warriors meeting When she was 15 years old, Lucero Herrera was put in a rehab program by San Francisco’s Juvenile Court because she was getting drunk regularly. And in doing so, the court failed to explore the root of her drinking. Had they done so, she said, they would have found that anger and trauma were lurking underneath, driven by her ACEs: adverse childhood experiences. Lucero Herrera "Why did they put me in a drug program when I had an anger problem? I went...
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Report reveals how foster care, juvenile and adult justice systems traumatize youth, calls for policy shifts

Laurie Udesky ·
YWFC sponsored Sister Warriors meeting When she was 15 years old, Lucero Herrera was put in a rehab program by San Francisco’s Juvenile Court because she was getting drunk regularly. And in doing so, the court failed to explore the root of her drinking. Had they done so, she said, they would have found that anger and trauma were lurking underneath, driven by her ACEs: adverse childhood experiences. Lucero Herrera "Why did they put me in a drug program when I had an anger problem? I went...
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[Repost] Trauma-informed Care: It Takes More Than a Clipboard and a Questionnaire

Jim Hickman ·
California is about to launch an ambitious campaign to train tens of thousands of Medi-Cal providers to screen children and adults up to age 65 for trauma, starting on January 1, 2020. It is well-established that the early identification of trauma and providing the appropriate treatment are critical tools for reducing long-term health care costs for both children and adults. Research has shown that individuals who experienced a high number of traumatic childhood events are likely to die...
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Research roundup: ACEs among incarcerated women; testing technology to help reduce substance use; prenatal support as an intervention to prevent ACEs

Laurie Udesky ·
photo by Rhoda Baer/Wikimedia Common Life as she knows it: The effects of adverse childhood experiences on intimate partner violence among women prisoners [Child Abuse & Neglect] "Most incarcerated women suffer from adverse childhood experiences (ACEs), such as abuse (e.g., physical, sexual, emotional), neglect, (e.g., physical, emotional), and chaotic home environments (e.g., witnessing domestic violence), and adult intimate partner violence (IPV). Yet the majority of research on the...
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Research roundup: ACEs and children with Autism Spectrum Disorder; ACEs impact on pre-diabetes; parental incarceration and health care use; can a safe neighborhood reduce the risk of obesity?

Laurie Udesky ·
Adverse Childhood Experiences Are Associated with Unmet Healthcare Needs among Children with Autism Spectrum Disorder [The Journal of Pediatrics] Objective: "To explore associations between level of adverse childhood experiences (ACEs) and unmet healthcare needs among children with autism spectrum disorder (ASD) using a population-based sample." The Differential Impact of Adverse Childhood Experiences in the Development of Pre-Diabetes in a Longitudinal Cohort of US Adults [The Journal of...
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Researchers find connection between heart rate and peer victimization [medicalxpress.com]

Alicia Doktor ·
Penn State Scranton assistant professors of psychology Karin Machluf and P. Douglas Sellers II, along with their colleague, Christopher Aults from King's College in Wilkes-Barre, have found in a study that heart rate reactivity is a biological moderator between peer victimization (bullying) and internalizing problems (anxiety/depression) in adolescent girls. The researchers' paper, titled "Adolescent Girls' Biological Sensitivity to Context: Heart Rate Reactivity Moderates the Relationship...
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Resource list -- Books

Jane Stevens ·
Brandt, Joyelle and Daum, Dawn -- Parenting with PTSD: the impact of childhood abuse on parenting , 2017. " Our Mission: 1. To build a supportive community for parenting survivors, normalize the PTSD responses they may be having, and share resources for healing from adverse childhood experiences (ACEs) or other traumatic events. 2. To educate professionals working in the fields of physical, mental, and social health about common triggers that arise for parents with PTSD, and the challenges...
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Resource list -- Practices/ Frameworks

Morgan Vien ·
Benchmarks NC -- " Benchmarks is an alliance of nationally accredited agencies committed to providing quality care, leadership, and accountability in services to children, adults and families in North Carolina. Member agencies of Benchmarks deliver a broad continuum of behavioral health, child welfare, education, development disabilities and residential support services." Center on the Developing Child , Harvard University -- "We are a multidisciplinary team committed to driving...
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Resource List -- Research & Reports

Jane Stevens ·
AcademyHealth -- "As the professional home and leading national organization for health services researchers, policymakers, and health care practitioners and stakeholders, AcademyHealth – together with its members – increases the understanding of methods and data used in the field, enhances the professional skills of researchers and research users, and expands awareness." Anda RF, Felitti VJ, Bremner JD, Walker JD, Whitfield C, Perry BD, Dube SR, Giles WH. The enduring effects of abuse and...
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Review of ACE studies confirms supporting parent-child relationship is key

Laurie Udesky ·
When health care providers screen their pediatric patients for ACEs, what interventions might help improve outcomes for children? Dr. Ariane Marie-Mitchell, a pediatrician in the Department of Preventive Medicine at Loma Linda University, and a colleague sought an answer to that question in a systematic review of studies that was published recently in the American Journal of Preventive Medicine. As part of their inquiry, Marie-Mitchell and her co-investigator, Rashel Kostolansky , who was a...
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Boston’s architect of community well-being: Pediatrician Renée Boynton-Jarrett

Christine Cissy White ·
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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Building a Movement to Birth a More Just and Loving World [Groundswell March 2018]

Karen Clemmer ·
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

Jessica Barreca ·
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

Laurie Udesky ·
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

Jane Stevens ·
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

Jane Stevens ·
[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

Laurie Udesky ·
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 healthcare providers adapt ACEs screening from in-person to virtual environment

Laurie Udesky ·
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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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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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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Course credit for "Childhood Adversity and Toxic Stress in Medical Care: Promoting Health and Healing Throughout the Lifespan"

Jane Stevens ·
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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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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14 Ways to Show Your Child Love: Valentine's Day and Every Day [aap.org]

From the American Academy of Pediatrics, February 5, 2020 One of the most important parts of parenting is also the sweetest: showing your child plenty of love and affection. “Building strong bonds and a positive relationship with your child has a nurturing effect on their physical, emotional, and social development,” said Jennifer Shu, MD, FAAP, a spokesperson for the American Academy of Pediatrics (AAP) and medical editor of its parenting website, HealthyChildren.org. “As parents, the...
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January 2019 NPPC Announcements

Leah Medoff ·
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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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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Latest ACEs science research from PubMed, March 25, 2019

Morgan Vien ·
Adverse Childhood Experiences and Household Out-of-Pocket Healthcare Costs. Schickedanz AB, Escarce JJ, Halfon N, Sastry N, Chung PJ. Am J Prev Med . 2019 Mar 13. pii: S0749-3797(18)32445-0. doi: 10.1016/j.amepre.2018.11.019. [Epub ahead of print] PMID: 30905486 Similar articles A Systematic Review of Trials to Improve Child Outcomes Associated With Adverse Childhood Experiences. Marie-Mitchell A, Kostolansky R. Am J Prev Med . 2019 Mar 13. pii: S0749-3797(19)30031-5. doi:...
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Latest ACEs science research from PubMed, May 7, 2019

Morgan Vien ·
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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Love in the time of Coronavirus: HOPE-informed thoughts for parents

Bob Sege ·
This has been quite a week, and we are now facing major disruptions in our own family lives. There is no doubt that the events of this winter and spring will be memorable for children. In that spirit, here are a few ideas to help make those memories (at least somewhat) happy.
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Mr. Rogers, Trauma-Informed Care, and the Limits of Information

Claudia Gold ·
Fred Rogers, in his 1969 testimony before the Senate subcommittee on communications in defense of public television, transforms a clearly skeptical Senator Pastore from, "Alright Rogers you've got the floor" to, "Looks like you just earned the 20 million dollars." How does he accomplish this transformation? One line from Senator Pastore gives us some insight. Several minutes into Mr. Rogers testimony he says, "This is the first time I've had goosebumps in the last two days," to which Rogers...
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Nadine Burke Harris debuts "The Deepest Well: Healing the Long-Term Effects of Childhood Adversity" in Philadelphia

Jane Stevens ·
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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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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Next "A Better Normal" community discussion series: April 3, 2020/ Maternal health and pediatrics in the time of COVID-19

Jane Stevens ·
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...
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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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Nurturing relationships in childhood boost adult mental health, relationships

Christina Bethell ·
We're proud to announce major research that suggests that positive childhood experiences — such as supportive family interactions, caring relationships with friends, and connections in the community — are associated with reductions in chances of adult depression and poor mental health, and increases in the chances of having healthy relationships in adulthood. This association was true even among those with a history of adverse childhood experiences.
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Parental Disengagement in Childhood and Adolescent Male Gun Carrying [pediatrics.aappublications.org]

Alicia Doktor ·
OBJECTIVES: To examine the association between parental disengagement in childhood and adolescent gun carrying and determine whether this association is accounted for by externalizing problems and affiliation with delinquent peers during early adolescence. METHODS: The sample included 503 boys (55.7% African American, 40.6% white, 3.7% other) recruited from first-grade classrooms in Pittsburgh public schools. Multi-informant assessments were conducted regularly (semiannually then annually)...
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Re: The use of ACE scores for individuals

Laura Shamblin ·
Have you joined the website NPPC ACEs? They have links to most of the relevant research there. I think your question shows a bit of a difference in thinking from those who are using ACEs screening. It is not as simple as an ACE of 4 needing a referral. That would be simple. It is possible that a person with an ACE of 6 has a good relationship with a caregiver, feels safe most of the time, has good school and church support, and no current medical or mental health issues. They don't currently...
Comment

Re: Review of ACE studies confirms supporting parent-child relationship is key

Calista Scott ·
Dear, Dr. Ariane Marie-Mitchell, Please contact Megan V. Smith PhD of Yale University. Diaper Need is an ACE. Add diaper need to the WCA. Calista Scott, MSN, Director Diaper Bank of Skagit County (WA) Member of the National Diaper Bank Network http://www.nationaldiaperbanknetwork.org
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Dozens of stakeholders representing thousands of practitioners send public comments on Calif. ACEs-screening plan

Laurie Udesky ·
Update: We posted this story on Tuesday evening and received a response from the Department of Health Care Services Wednesday that clarifies additional information. DHCS information Officer Katharine Weir said that subject to budget approval by the legislature and the governor: The reimbursement rate will be $29. Federally Qualified Health Centers will also be reimbursed for screening pediatric patients for trauma through Prop 56 funds and federal matching funds. In response to a question...
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Dr. Claudia Gold: Empathy & Listening as ACE-Informed Practice

Christine Cissy White ·
"You are absolutely not doomed from having ACEs."
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DULCE helps pediatricians in Oakland, CA, prevent toxic stress in newborns

Laurie Udesky ·
On a recent day in early March, Laura Lopez met a former patient of hers in the waiting room of Highland Hospital’s pediatric clinic in Oakland, CA. The patient had forgotten her Medi-Cal card and called Lopez asking for help. But in the brief conversation, Lopez, a family specialist with the DULCE program, learned about some dire changes in the patient’s life. Laura Lopez “Without me even asking, she shared with me that she had separated from her partner, that she needs to apply for food...
 
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