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PACEs in Pediatrics

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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 Aware: On Jan. 1, 2020, Medi-Cal Providers Can Receive Payment for ACEs Screenings

Gail Kennedy ·
ACEs and toxic stress represent a public health crisis that has been, until recently, largely unrecognized by our state’s health care system and society, but there’s hope. Together, we can screen for ACEs, respond with trauma-informed care, and significantly improve physical and mental health across the state. All Medi-Cal providers are encouraged to get trained today . Beginning on January 1, 2020, eligible Medi-Cal providers can receive a $29 payment for conducting qualifying ACEs...
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ACES Aware Webinar: Dec 13th, 12-1pm PT - Public Comments about soon-to-be-released Request for Proposal

Gail Kennedy ·
The Department of Health Care Services and the California Office of the Surgeon General are hosting a webinar of the Trauma-Informed Care Implementation Advisory Committee’s Provider Education and Engagement Subcommittee. Subcommittee members will discuss a draft Request for Proposal (RFP) released for public comment as part of the ACEs Aware initiative. The draft RFP invites external organizations to apply for grants to support provider training activities, provider engagement activities...
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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 — October 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] Zhang L, Zhang D, Sun Y. Adverse Childhood Experiences and Early Pubertal Timing Among Girls: A Meta-Analysis. Int J Environ Res Public Health. 2019 Aug 13;16(16).
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ACEs research roundup: preschool suspensions; trauma inquiry; foster youth; school success

Laurie Udesky ·
Adverse childhood experiences and preschool suspension expulsion: A population study , Child Abuse & Neglect S Zeng, CP Corr, C O'Grady, Y Guan The state of the science on trauma inquiry , Women's Health A Lewis-O'Connor, A Warren, JV Lee, N Levy-Carrick A Positive Youth Development Approach to Improving Mental Health Outcomes for Maltreated Children in Foster Care: Replication and Extension of an RCT of the Fostering Healthy Futures Program , American Journal of Community Psychology...
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ACEs Screening

Morgan Vien ·
This is a collection of resources regarding screening for ACEs . This list aims to give a broad overview and is not all-inclusive. We welcome suggestions; if you have any, please comment below! This resource list is organized in alphabetical order. Pediatric Campus in Santa Rosa ACEs screeners, 2019 Description: ACEs screeners for 4m-11y and 12y-18y in English and Spanish are in the attachments below. Whole Child Assessment (WCA) , 2019 Description: The Whole Child Assessment (WCA) is a...
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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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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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Allentown Headstart program focuses on kids dealing with trauma [whyy.org]

Alicia Doktor ·
In a space that used to be an abandoned state hospital, Lora Lesak has created an early childhood classroom filled with natural light and comfortable chairs — a room designed to feel like a home. As director of Developmental Health Services for Allentown’s Community Services for Children, she says that’s exactly what children who’ve experienced trauma need. “We have gotten children that have needed to remain in the hospital for two weeks to be weaned of substances — whether it’s cocaine,...
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Alternative IHEBA with ACEs for California (and Other) Pediatricians

Ariane Marie-Mitchell ·
If you are a pediatrician serving Medicaid managed care patients in California, then you are required to use the Staying Healthy Assessment or an alternative IHEBA (Individual Health Education Behavioral Assessment) at all well-child visits. The bad news is that getting approval to use an alternative IHEBA is a tedious process. The good news is that as of October 27, 2016 the Whole Child Assessment (WCA) is available for use in English and Spanish. Most importantly, the WCA has been...
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Alternative IHEBA with ACEs for California (and Other) Pediatricians

Ariane Marie-Mitchell ·
If you are a pediatrician serving Medicaid managed care patients in California, then you are required to use the Staying Healthy Assessment or an alternative IHEBA (Individual Health Education Behavioral Assessment) at all well-child visits. The bad news is that getting approval to use an alternative IHEBA is a tedious process. The good news is that as of October 27, 2016 the Whole Child Assessment (WCA) is available for use in English and Spanish. Most importantly, the WCA has been...
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America’s Workplaces Are Hostile to Families [BillMoyers.com]

Jane Stevens ·
  Childbearing gets a little more bearable for working women this year, with various new state and city policies to accommodate the needs of pregnant and parenting workers. In several states, including Delaware, Illinois, Minnesota and West...
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American Academy of Pediatrics Friends of Children's Fund Update

Former Member ·
Dear Friend of Children, At this time of year, we pause and give thanks for colleagues and friends like you who care deeply and passionately about the health and well-being of children. We sincerely thank you for your past support of the American...
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An Early Childhood Development Expert Explains How Trauma and Stress Can Derail a Kid’s Life [sarasotamagazine.com]

By Cooper Levey-Baker, Sarasota, December 19, 2019 Mimi Graham has spent her life fighting for kids. She began her career in the late 1970s as a Head Start administrator before moving into the world of academia to study child development and advocate for public policies that improve the health of mothers and children. Today, she’s the director of Florida State University’s Center for Prevention & Early Intervention Policy, a position in which she advises government agencies and...
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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 Resources for Families Coping After Natural Disasters

Andrea Cody ·
In the aftermath of recent hurricanes and wildfires, the Sesame Street in Communities team wanted to reach out to provide information on our available resources to help families cope in the aftermath of natural disasters, and other traumatic experiences. Bilingual videos, articles, printables and more, are all available for free on our website at www.sesamestreetincommunities.org . Here are the links to a few topic pages that may be most useful to you as you work with families in the...
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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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Study Examines Links Between Early ACEs and Outcomes in Middle Childhood

Janie Ginocchio ·
"Adverse experiences in infancy and toddlerhood: Relations to adaptive behavior and academic status in middle childhood", will be published in the August issue of the journal Child Abuse and Neglect . The study, conducted by University of Arkansas for Medical Sciences researchers Lorraine McKelvey, Nikki Edge, Glenn R. Mesman, and Leanne Whiteside-Mansell, along with Arizona State University researcher Robert H. Bradley, collected and analyzed interview data from a sample of low-income...
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Survey: Healthcare providers, community organizations weigh in on California's ACEs screening program

Laurie Udesky ·
In January, California took a historic leap forward to promote universal ACEs screening of the state’s 13 million adults and children in the Medi-Cal program. The eventual goal is to promote ACEs screening for all patients, but this is a first step in dealing with a major issue that ACEs science has identified: that many children will develop serious health problems later in life because the healthcare system is not currently set up to detect the roots of those problems. The term ACEs, which...
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Texas Lawmakers Want To Send Fewer Moms To Prison [npr.org]

Marianne Avari ·
For the eight-and-a-half years she spent in prison, Kristan Kerr looked forward to one thing every month: a visit from her daughter, Chloe. Visit by visit, she watched Chloe grow from a toddler to nearly a teenager. "I just watched her grow all the way up," Kerr says. "One visit, she couldn't read, and then the next visit she was reading something to me." Convicted for aggravated robbery in 2011 – she was the driver — Kerr says she wasn't making good choices back then, and it meant missing...
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The prevalence of adverse childhood experiences, nationally, by state, and by race or ethnicity [ChildTrends]

Laurie Udesky ·
Infographic courtesy of the RYSE Center, Richmond, California Using data from the 2016 National Survey of Children's Health , this report analyzed the prevalence of 8 specific adverse childhood experiences (ACEs) nationally and across states. The researchers also looked at ACE prevalence differences by race/ ethnicity and geographical regions. The most common ACEs were those associated with economic hardship and divorce or separation of a parent or guardian. Researchers found that black and...
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The public health crisis facing homeless children [The Daily Beast]

Laurie Udesky ·
photo/ creativecommons The People Serving People homeless shelter in Minneapolis, Minnesota is the largest family shelter in the state. It has 99 rooms, a technology center, a licensed preschool. And on the first floor, it has a full-service medical clinic. “For families in crisis, one of the biggest barriers to accessing health care is transportation,” said Martha Trevey, a nurse practitioner working with Healthcare for the Homeless, which runs the People Serving People clinic. “Here, they...
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The Relentless School Nurse: Full Disclosure: I am Fearful to Welcome Another September

Robin M Cogan ·
School is about to begin and for the first time in my 18 years as a school nurse, I am fearful to welcome another September. I work in an urban district where community gun violence is sadly commonplace, but that is not my fear. I travel throughout the city from school to school where drug dealing is an open-air exercise, but that is not my fear. Emergencies are often solitary experiences because school nurses work independently, but that is not my fear. Families facing deportation from...
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The Relentless School Nurse: The Ripple Effect - When Community Violence Comes to School

Robin M Cogan ·
Elizabeth (Liz) Clark, MSN, RN NCSN is a school nurse's school nurse. Her leadership skills were honed as President of the CO Association of School Nurses. She served on the national level as the CO NASN Director, completing her term in 2017. Liz has a prominent presence on Twitter and uses the social media platform to elevate school nursing practice. Liz is a natural teacher and you can find her sharing the most recent peer-reviewed articles with colleagues to promote health and learning. A...
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The Relentless School Nurse: What Happened at School Today?

Robin M Cogan ·
Welcome to a new feature on the Relentless School Nurse website: "What Happened at School Today?" The idea for this view from different health offices is the result of discussions with school nurses across the country who wanted to share their practice settings. Last year, Abby Pelletier and I shared pictures taken from our perspective health offices. I am in an urban NJ school and she is in rural NH, so the differences were quite distinct. "What Happened at School Today?" will feature...
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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 Care as a Universal Precaution: Beyond the Adverse Childhood Experiences Questionnaire [jamanetwork.com]

By Nicole Racine, Teresa Killam, and Sheri Madigan, JAMA Pediatrics, November 4, 2019 Experiences of childhood adversity are common, with more than 50% of adults reporting having experienced at least 1 adversity as children and more than 6% exposed to 4 or more adverse childhood experiences (ACEs). There is currently a controversial debate in the medical field as to whether the ACEs questionnaire, which asks about abuse, neglect, and household dysfunction before age 18 years, should be...
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Traumatic Experiences Widespread Among U.S. Youth, New Data Show

Jane Stevens ·
[This is a media release from the Robert Wood Johnson Foundation.] New national data show that at least 38 percent of children in every state have had at least one Adverse Childhood Experience or ACE, such as the death or incarceration of a parent, witnessing or being a victim of violence, or living with someone who has been suicidal or had a drug or alcohol problem. In 16 states, at least 25 percent of children have had two or more ACEs. Findings come from data in the 2016 National Survey...
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U.S. campaigns/organizations

Jane Stevens ·
U.S. Commission to Eliminate Child Abuse and Neglect Fatalities  - Entity created under the  Protect our Kids Act to give recommendations to Congress on how to address child maltreatment fatalities. Site has an overview of the group's work...
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Unprecedented childhood trauma hearing in U.S. Congress on July 11 to feature data from new state fact sheets on ACEs prevalence, impacts

A hearing of unprecedented scope and depth (this link will take you to a list of witnesses and all of their statements plus an overview memo on the hearing from committee staff) on ACEs science and childhood trauma — " Identifying, Preventing, and Treating Childhood Trauma: A Pervasive Public Health Issue that Needs Greater Federal Attention " — will be held today in the House Committee on Oversight and Reform. You can watch the live stream at 10:00 am ET through this link . Nine witnesses...
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Upcoming ACEs webinar hosted by National Pediatric Practice Community(NPPC) team - CME/MOC credits available!

Leah Medoff ·
Healthy Spaces Webinar Series (Two 1-Hour Webinars) Communicating About ACEs with Patients and Families presented by: Leena Singh, DrPH, MPH - Director of the NPPC Karissa Luckett, RN, MSW - NPPC Pilot Site Coach April 17, 2019 9:00-10:00 AM (PT) 12:00-1:00 PM (ET) Learner Outcome: The learner will be able to identify two evidence based tools and/or strategies to utilize in the pediatric healthcare setting to improve child care when addressing health concerned among children &...
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Update on bills re: childhood adversity in California Legislature

Kelly Hardy ·
Below is an updated table of bills that address childhood adversity in the Legislature in 2019. The list is not exhaustive, so please email Kelly Hardy with Children Now if you think a bill is missing and/or if you have any questions. Email: khardy @childrennow.org . Here are key dates for the remainder of the legislative session: July 10 = last day for bills to pass out of policy committees July 12 – August 12 = Summer recess August 30 = last day for fiscal bills to pass out of committee...
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Want to end ACEs? Ask a young student how.

Dominic Cappello ·
Adverse childhood experiences (ACEs) are a huge threat to our students, diminishing their capacity to learn and succeed. In all thirty-three counties of New Mexico, an epidemic of trauma exists, spreading like a virus as it is passed down generation after generation. We know from the research that our students suffer when they endure ACEs in the form of abuse, neglect, hunger, and living with parents who misuse substances, are violent, and have untreated mental health challenges. We know in...
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Webinar: Crossroads of Adverse Childhood Experiences (ACEs) and Developmental Disabilities

Kim Slouf ·
Physicians, nurses, psychologists, social workers, child life professionals, and other patient service providers are invited and encouraged to join a webinar entitled: "Crossroads of Adverse Childhood Experiences (ACEs) and Developmental Disabilities" Increased levels of toxic stress, which can be caused by recurrent or chronic exposure to adverse childhood experiences (ACEs), can impair neurodevelopment, behavior, and overall health of a child (Substance Abuse and Mental Health Services...
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Webinar: Cultivating Our Best Selves in Response to COVID-19 | Tuesday, March 17 at Noon PDT

Elaine Miller Karas ·
How to use the skills of the Community Resiliency Model (CRM) for self and others to be the calm in the storm as we face the unknown. Free Webinar Tuesday, March 17 at Noon PDT Speakers: Elaine Miller-Karas, LCSW Linda Grabbe, PhD, FNP-BC, PMHNP-BC Zoom Webinar Registration Link: https://zoom.us/j/715837300 Additional ways to join are listed at the bottom of this post. About the webinar leaders: Elaine Miller-Karas is the Executive Director and co-founder of the Trauma Resource Institute and...
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Webinar — Moving to universal ACEs screening: Findings from a CA advisory group on screening children for trauma

Leah Medoff ·
On April 23rd, 2019 from 12:00pm-1:30pm PST the National Pediatric Practice Community on ACEs (NPPC) , an initiative of the Center for Youth Wellness, will be hosting a webinar to support efforts to screen all children for adverse childhood experiences (ACEs) and additional adversities. This webinar will summarize the findings of a state advisory group assigned to review tools and protocols for screening children for trauma, and provide an introduction to two tools the advisory group...
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Wellness and Resiliency Toolkit for Kids with Trauma

Heidi Beaubriand ·
I'm excited to share a booklet created for youth in Oregon foster care at a Wellness camp this summer. Youth were provided with these quick, easy and effective (and evidence based) "Mindful Moments" exercises in their Wellness Toolkits and they were practiced throughout the day at camp so that they could be remembered in times of stress and dysregulation. The exercised are designed to quickly bring them back to a state of calm. The youth really enjoyed them, and found them easy and...
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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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Why screen if there are no services? (Barbara J. Howard - Pediatric News)

Former Member ·
  Why screen if there are no services? By: DR. BARBARA J. HOWARD OCTOBER 6, 2014 Behavioral Consult Do you remember the discussion of the ethical dilemma of Huntington’s disease you probably participated in during medical school? The...
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Why We Suck (at Self-Soothing & Self-Care): Dr. Dawn O'Malley

Christine Cissy White ·
Without yoga and coffee, I'm kind of a jerk. These are my personal "puppy uppers and doggie downers" and prevent me from being cranky, quick to cry, and ready for conflict. Coffee and calming make life more manageable. Humans even seem tolerable. Without them I might veer into hating humans for being so needy which is not a great trait for a parent, partner or a professional. Or a self. My partner says coffee and exercise are acts of kindness, service as promote public safety. In other...
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Wisconsin Dept of Health Services - Trauma-Informed Care News & Notes, Oct. 29, 2018

Scott A Webb ·
ACEs, Adversity's Impact Adverse childhood experiences increase prediabetes markers in adulthood How parenting affects antisocial behaviors in children Documentary broken places uses archival footage to tell stories of ACEs and resilience over time NYC's first lady urges reporters to tackle mental health issues A guide to toxic stress The quest to find biomarkers for toxic stress, resilience in children - A Q&A with Jack Shonkoff Parent-child bond predicts depression, anxiety in teens...
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Working with UCSF, California Surgeon General Aims to Cut Adverse Childhood Experiences by Half [ucsf.edu]

By Rebecca Wolfson, University of California San Francisco, February 18, 2020 Nadine Burke Harris, MD, California’s first surgeon general, has a bold goal: cut adverse childhood experiences and toxic stress in half within one generation. She spoke about her vision and her groundbreaking work to reduce adverse childhood experiences across the state during a speech at the UC San Francisco Parnassus Heights campus. The lecture at Cole Hall on Feb. 13 was part of Chancellor Sam Hawgood’s health...
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2020 Pediatric Brain Health Summit

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