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PACEs in Pediatrics

Tagged With "positive relationships"

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Healthy Spaces December 2019 Webinars

Aldina Hovde ·
Healthy Spaces: Promoting Healthy and Resilient Communities December 2019 Webinars The New Jersey Chapter, American Academy of Pediatrics (NJAAP) believes that all children deserve to feel safe and secure in their home, at school, and while at play. The Healthy Spaces program aims to address adverse childhood experiences (ACEs) through partnerships with pediatric/family healthcare teams, schools and communities. Preventing Child Abuse and Neglect (PCAN) Date & Time: Tuesday, December 10,...
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Hearing in House Education and Labor Early Childhood Subcommittee addresses intersection of trauma and education

Dr. Nadine Burke Harris (l) and Karina Chicote, Churchill Fellow from western Australia meet after congressional hearing After watching the hearing on a monitor in the overflow room, Karina Chicote, a Churchill Fellow from western Australia, and I hustled to the hearing room in hopes of speaking to the lead witness, Nadine Burke Harris, MD, the first Surgeon General of the State of California. She was deep in conversation with others, including a young woman who wanted to tell her how...
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Helping New Parents Make Room for Uncertainty

Claudia Gold ·
A new program for parents and infants, thanks to generous support from Mill Town Capital , is coming to Pittsfield, Massachusetts. The Hello It’s Me Project shines a spotlight on these tender new relationships, investing resources around the birth of a baby with the long-term goal of building a healthy community from the bottom up. When world-renowned child development researcher Dr. Ed Tronick spoke in the spring of 2018 for an audience of a wide variety of practitioners in Berkshire County...
Blog Post

Helping New Parents Make Room for Uncertainty

Claudia Gold ·
A new program for parents and infants, thanks to generous support from Mill Town Capital , is coming to Pittsfield, Massachusetts. The Hello It’s Me Project shines a spotlight on these tender new relationships, investing resources around the birth of a baby with the long-term goal of building a healthy community from the bottom up. When world-renowned child development researcher Dr. Ed Tronick spoke in the spring of 2018 for an audience of a wide variety of practitioners in Berkshire County...
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Heyman Oo integrates ACEs science as foundation of pediatric care

Sylvia Paull ·
Dr. Heyman Oo, a 34-year-old primary care pediatrician, first learned about the science of adverse childhood experiences in medical school at a grand rounds held around 2012 at Rady Children’s Hospital in San Diego, which she attended from 2009 to 2014. The presenter was none other than Dr. Nadine Burke Harris, a pediatrician who went on to become California’s first Surgeon General. The founder and former director of the Center for Youth Wellness drew millions of views for her TED talk on...
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How collaboration helps clinic in San Mateo County, CA, tackle ACEs in children

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

Laurie Udesky ·
Last week, three pediatricians — with a combined experience of 15 years integrating ACEs science into their practices — reflected on the urgency they felt several years ago that prompted them to begin screening patients for childhood adversity and resilience when there was practically no guidance at all. Along their journey , they accumulated a list of lessons learned for other pediatricians and family clinics to use. The three pediatricians participated in the ACEs Connection webinar,...
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How Does Trauma Affect a Person’s Interaction with Their Child? (www.nicabm.com) & Commentary

Christine Cissy White ·
Has anyone seen this video posted on the National Institute for the Clinical Application of Behavioral Medicine (NICAMB) blog? "According to Dr. Ruth Lanius, a parent's experience of trauma can impact their ability to form a close, intimate relationship with their child." Ruth Buczynski, PhD Those of us Parenting with ACEs sure know that's the truth. Developmental trauma impacts our ability to form close and intimate relationships with ourselves, other adults and our children. The video was...
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HOW TO CALM SIBLING SQUABBLES (Futurity Research News from Top Universities)

Former Member ·
    PENN STATE (US) —  New research suggests intervention strategies that can cultivate healthy and supportive sibling relationships.   The relationship between brothers and sisters is critical for learning life skills that...
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Researchers share learned lessons from screening for adverse childhood experiences in pediatric clinics

Laurie Udesky ·
What are the reasons that parents or caregivers do not fully disclose their own or their young children’s ACEs when asked to fill out an ACE screening form in their child’s pediatrician’s office? That was one of the many questions raised in a recent webinar entitled Screening for Adverse Childhood Experiences in the Pediatric Primary Care Setting: Practical Considerations and Lessons Learned . Dr. Kavitha Selvaraj, an attending physician at the Ann & Robert H. Lurie Children’s hospital...
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Infancy and early childhood matter so much because of attachment (theconversation.com)

We are born to connect. As human beings we are relational and we need biological, emotional and psychological connection with others . Attachment is the relational dance that parents and babies share together. You can think of this when you see a baby look at their parent and they catch each other’s eyes in a wonderful gaze: the parent smiles and the baby smiles and then the parent kisses and the baby coos. Or, when an infant cries to tell their parent they are hungry, and the parent picks...
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Intergenerational Impacts of Family Violence - Mothers and Children in a Large Prospective Pregnancy Cohort Study [thelancet.com]

By D. Gartland, R. Giallo, H. Woolhouse, F. Mensah, and S.J. Brown, August 18, 2019 Violence and other adversities commonly co-occur, yet are usually investigated individually. The primary objectives of this paper are to investigate: (i) the relationship between maternal exposure to violence (including childhood abuse and intimate partner violence) and postpartum mental and physical health; and (ii) the extent to which exposure to violence and poor maternal mental and physical health are...
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Interim report of the President’s opioid commission says its final report will address early intervention strategies for children with ACEs

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

Laurie Udesky ·
Four years ago, Dr. Leslie Dempsey would never have talked about ACEs — adverse childhood experiences — with her patients. Now ACEs is a common topic. “Just as I don’t feel awkward asking someone if they smoke or do intravenous drugs, I don’t really feel awkward talking about their childhood traumas in a way that it relates to their health. It’s just integrated into obtaining background and social history,” she says. Dr. Leslie Dempsey Dempsey is a physician in obstetrics who oversees a team...
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8 Myths About Screening For Adverse Childhood Experiences

Laura Shamblin ·
I’d like to take this opportunity to address some of the objections to screening for ACEs that I have come across. It is true that some areas of research are still emerging, such as protocols, but in other ways we are twenty years behind using the information we have to make a positive difference in our patients lives and in training new physicians to be more comfortable addressing social and experiential determinants of health.
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A Kaiser pediatrician, wise to ACEs science for years, finally gets to use it

Laurie Udesky ·
Dr. Suzanne Frank has known about the impact of childhood adversity on young lives for decades. She’s seen the fallout in the faces of young people huddled in beds at a children’s shelter where she worked years ago. She’s seen it as the regional child abuse services and champion for the Permanente Medical Group. And she’s seen it in hospital examination rooms where, as a member of the Santa Clara County’s Sexual Assault Response Team, she’s been called in to examine shell-shocked children...
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A Message from the President of the Illinois Chapter, American Academy of Pediatrics

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

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

Veronique Mead ·
I was first inspired to create a fact sheet summarizing the effects of adverse childhood experiences (ACEs) after reading a comment in “Got Your ACE score?” A reader wished she had a form to give her doctor that documented the vast body of evidence explaining how early trauma increases risk for chronic physical and mental health conditions and much more. I could relate.
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ACEs, biomarkers and the cost of adversity

Laurie Udesky ·
How useful and necessary are biomarkers in telling the story of how toxic stress from adverse childhood experiences and resilience can impact a child’s long-term health? In the introduction to an article in the journal BioEssays , Dr. Kathryn Ridout, a Kaiser Permanente San Jose psychiatrist, and her co-authors examine what is known about two biomarkers and quote data on child maltreatment and its economic burden over time that says it all. “When totaling the costs of health care, child...
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ACEs Research Corner — August 2019

Harise Stein ·
[Editor's note: Dr. Harise Stein at Stanford University edits a web site -- abuseresearch.info -- that focuses on the health effects of abuse, and includes research articles on ACEs. Every month, she's posting the summaries of the abstracts and links to research articles that address only ACEs. Thank you, Harise!! — Jane Stevens] Clemens V, Berthold O, Witt A, et. al. Child maltreatment is mediating long-term consequences of household dysfunction. Eur Psychiatry. 2019 May;58:10-18. PMID:...
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ACEs Research Corner — February 2020

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

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

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

ACEs Research Corner — March 2020

Harise Stein ·
Editor's note: Dr. Harise Stein at Stanford University edits a web site — abuseresearch.info — that focuses on the health effects of abuse, and includes research articles on ACEs. Every month, she's posting the summaries of the abstracts and links to research articles that address only ACEs science. Thank you, Harise!! -- Jane Stevens] Brown SM, Bender K, Orsi R, McCrae JS, Phillips JD, Rienks S. Adverse childhood experiences and their relationship to complex health profiles among child...
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ACEs Research Corner — September 2018

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

Laurie Udesky ·
Last year, the California Department of Health Care Services rolled out its plans for universal screening for trauma among its pediatric and adult Medicaid population. Beginning January 1, 2020, California physicians were able to receive an incentive payment of $29 for each pediatric patient screened for ACEs using the PEARLs ( Pediatrics Adverse Childhood and Resilience Study) tool. Dr. Dayna Long talked with ACEs Connection staff reporter Laurie Udesky about ACEs science, what led to the...
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Adverse Childhood Experiences (ACE) Study: Beyond Screening in Pediatrics

Claudia Gold ·
The evidence is clear. When bad things happen to us as young children, we are at significantly increased risk for not only mental health problems, but also a wide range of physical health problems including asthma, heart disease, and even early death. These "bad things" all involve disruptions in caregiving relationships. A national movement directed at screening for ACEs in pediatric practices has emerged from this work. My suggestion that the implication of the Adverse Childhood...
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After 5-year journey to integrate ACEs science, Santa Rosa, CA, pediatric clinic is trauma-informed, from head to toe

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

Andres F Sciolla, MD ·
Despite the landmark ACEs study in 1998, ACEs screening is uncommon in medical clinics - barriers include lack of time, ACEs resources, confidence in addressing sensitive topics, etc. Flanagan et al. developed a training program for clinicians that addressed the barriers, added resilience measures, and included clinic-specific adjustments. The study found that conversations on ACEs and resilience improved women’s trust in and relationship with their clinicians. After the training, clinicians...
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Anger overlooked as feature of postnatal mood disorders [sciencedaily.com]

Alicia Doktor ·
Women in the postpartum period should be screened for anger in addition to depression and anxiety, new research from the University of British Columbia suggests. Although anger has been recognized as an element of postpartum mood problems for some women, it has not been well studied and is not included in the widely used Edinburgh Postnatal Depression Scale screening tool. In a review of existing research, UBC nursing PhD student Christine Ou found anger to be a significant feature in...
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As California Moves to Screen Children for Childhood Trauma, Poverty Has To Be Part of the Equation

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

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

Tiffany Thomas-Turner ·
(Posted in the Commercial Appeal on December 5, 2018 ) Every child deserves to grow up with a strong connection to a caring adult and a loving family. But for one in four kids in Shelby County, a supportive relationship with a parent figure isn’t so easy to come by. The legacy of adverse childhood experiences (ACEs) — ranging from physical, emotional, or sexual abuse; physical or emotional neglect; the loss of a parent through illness, death, divorce, or incarceration; or domestic violence...
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Solano County's (CA) ACEs initiative, a robust community effort, makes room for input from all

Laurie Udesky ·
In a house called “Johanna’s House” on a tree-lined side street in Vallejo, Calif., four women are filling out the adverse childhood experiences (ACE) survey given to them by Maria Guevara, the founder of Vallejo Together, an organization that serves homeless residents in Vallejo. The house was named for Johanna Dilag, a homeless woman who was found dead along with her dog.
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Some 350 Florida Leaders Expected to Attend Think Tank with Dr. Vincent Felitti, Co-Principal Investigator of the ACE Study; Expert on ACEs Science

Carey Sipp ·
Leaders from across the Sunshine State will take part in a “Think Tank” in Naples, FL, on Monday, August 6, to help create a more trauma-informed Florida. The estimated 350 attendees will include policy makers and community teams made up of school superintendents, law enforcement officers, judges, hospital administrators, mayors, PTA presidents, child welfare experts, mental health and substance abuse treatment providers, philanthropists, university researchers, state agency heads, and...
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Strengths-based Approaches to Screening Families for Health-Related Social Needs in the Healthcare Setting [Center for the Study of Social Policy]

Laurie Udesky ·
How do you screen families to determine whether they have enough to eat or if they feel safe in their homes or communities without alienating them? In this new brief, authors Dr. Renee Boynton-Jarrett and JoHannah Flacks describe strength-based approaches to screening for health related social needs.
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The Academy of Pediatrics Calls to End Spanking, and APSAC agrees!

Janet Rosenzweig ·
The American Academy of Pediatrics (AAP) advises parents against the use of spanking as a disciplinary tool, citing multiple potential hards. APSAC agrees and offers alternatives for parents
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The Power of Beliefs: What Babies Are Telling Us

Kate White ·
Dr. Wendy Anne McCarty is a pioneer in prenatal and perinatal psychology and has worked with young families for over 40 years. She writes: "In 2002, I wrote a JOPPPAH article, The Power of Beliefs: What Babies are Teaching Us . In it I discuss how young babies already portray a sophisticated and established complex of beliefs and patterns of being in the world. I describe four clinical stories of babies in PPN-oriented BEBA therapy sessions who are expressing very difficult patterns based...
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The Relentless School Nurse: Pediatricians + School Nurses = Powerful Partners

Robin M Cogan ·
Pediatricians and school nurses are powerful partners when we intentionally collaborate to improve the continuity of care in the populations we serve. It is the intentionality of relationship building that can bear the most fruitful outcomes to improve the health and well-being of our most vulnerable population, our children. We are far more effective working in concert than in our silos. School communities are looking for guidance, answers, and action to address the explosion of...
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The Relentless School Nurse: When the Health Office Pass Includes Emotions

Robin M Cogan ·
The collaboration between school counselors and school nurses creates safe spaces for students at school. Building a coalition between school counselors and school nurses creates a safety net for our most complex and challenging students while benefiting the whole school community. Promoting connections through intentional relationship building, and ensuring a school environment that is physically, emotionally and psychologically safe changes the culture and climate. Read about an amazing...
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Trauma education and mindfulness help youth living amid gun violence

Laurie Udesky ·
Armon Hurst, 2nd from left, first row, Teens on Target, courtesy of YouthAlive! Eighteen-year-old Armon Hurst serves as vice president of the student body at Castlemont High School in Oakland, Calif. He has a 4.0 grade point average, is an avid baseball player, and is slated to go to college next year. But until a few years ago, Hurst would find himself waking from nightmares in the middle of the night. It was difficult to concentrate at school, and he wasn’t eating well. Armon Hurst “There...
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Trauma-informed groups rev up to address race, inclusion

Laurie Udesky ·
Eighteen-year-old Kia Hanson has always enjoyed her time as a youth leader at the East Oakland Youth Development Center (EOYDC). She’s worked mostly with five- and six-year-olds since she began in 2016. Recently, she tapped into new skills, especially if the kids were having a meltdown. Kia Hanson “If they’re off, we ask them, ‘What’s wrong?’ ‘Do you want to talk about anything?’,” she explains. “Basically asking before assuming they’re mad at the world for no reason.” What made the...
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Webinars

Jane Stevens ·
Childhood Adversity and Toxic Stress in Medical Care: Promoting Health and Healing Through the Lifespan . Beth Grady, MD, FAAP, South San Francisco Clinic, egrady@smcgov.org. 2016.
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What Exactly is a Toddler Tantrum?

Claudia Gold ·
Several years ago NPR had a story about temper tantrums, describing a study showing that the sounds children make during a tantrum indicate that they are primarily sad rather than angry. The written version of the story opens with description of tantrums as " the cause of profound helplessness among parents." I thought this was an interesting choice of words, as I have always thought of tantrums as representing a sense of helplessness in children. In fact, in my over 20 years of practicing...
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When Parents Fear "It's All My Fault"

Claudia Gold ·
Many of my colleagues in the field of early childhood mental health work with what are termed "high risk" populations. Children of drug addicted parents, victims of child abuse, and families in abject poverty. While the challenges these families face are daunting, I find myself feeling some envy for my colleagues whose clients are in such obvious distress that the need for intensive treatment of parent and infant is not in question. In my rural, small-town population things are not so clear.
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When Parents Have Experienced Adverse Childhood Experiences, What is the Effect on Their Children? [aappublications.org]

Alicia Doktor ·
Our journal and others have published a myriad of studies on the deleterious effects of adverse childhood experiences (ACEs) on the developmental and physical well-being of infants and children. But what about the generational effect on offspring of parents who experienced ACEs growing up? Two studies we are early releasing this week shed some light on answering this question. First Racine et al. ( 10.1542/peds.2017-2495 ) present the results of their examination of maternal ACEs on the...
Comment

Re: How can we help people understand that asking for help is a strength?

Ariane Marie-Mitchell ·
Hi John, Thank you for sharing your thoughtful post. I have a few thoughts to share based upon my experience of screening for ACEs in pediatric practice and related research: 1) The first opportunity in Pediatric practice comes not through referrals, but through the patient care encounter itself. There is an opportunity for the pediatrician to form a supportive relationship with the parent and child, which is wholistic and healing when understanding factors like ACEs becomes an expected part...
Comment

Re: How can we help people understand that asking for help is a strength?

Robert Schmitt ·
Thanks Dr. Marie-Mitchell your comments are helpful and correct. Larry Schmitt
Comment

Re: 10 ways to avoid ACEs (during the pandemic)

Elizabeth Meeker ·
Really appreciate the reframe on social distancing to social connection and physical distancing!
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