Tagged With "Approaches in Clinic Community Settings"
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Latest ACEs science research from PubMed, May 7, 2019
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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Launching a Revolution [hsph.harvard.edu]
By Madeline Drexler, Harvard Public Health, Winter 2020 In 2007, pediatrician Nadine Burke Harris, MPH ’02, set out on an idealistic mission: to deliver quality medical care to one of San Francisco’s poorest and most underserved neighborhoods—Bayview-Hunters Point, in the isolated southeastern corner of the city. Before Burke Harris arrived on the scene, only one pediatrician was serving the neighborhood’s 10,000 children. The community’s plight was starkly apparent in its ZIP code. In 17 of...
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Little kids and 'toxic stress': we can solve this [cnn.com]
All children have incredible potential, most with parents, teachers and other adults in their lives who want the best for them. Unfortunately, many schools, particularly those that serve children with the greatest need, face obstacles that limit children's educational success -- rote curriculums, insufficient support for teachers and scant extracurricular options, to name a few. Educators, parents and policymakers have long acknowledged such obstacles, but we now know that there is another...
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Love in the time of Coronavirus: HOPE-informed thoughts for parents
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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Marin Community Clinics in California screen babies for ACEs, provide support in effort to prevent trauma
When Marin Community Clinics (MCC) first considered screening their patients for adverse childhood experiences (ACEs) they already had decided that if they were going to prevent children from acquiring ACEs, they had to take a radical approach.
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Modifiable Resilience Factors to Childhood Adversity for Clinical Pediatric Practice / Abstract Link
I learned about a new research paper entitled, "Modifiable Resilience Factors to Childhood Adversity for Clinical Pediatric Practice" co-authored by Flora Taub and Renée Boynton-Jarret (pictured above). It was just published in Pediatrics which is the official journal of the American Academy of Pediatrics). Here's the link to the abstract. I'm not going to pretend I subscribe to Pediatrics. I don't. However, I have been interested in the work of Renée Boynton-Jarret ever since writing a...
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Nadine Burke Harris debuts "The Deepest Well: Healing the Long-Term Effects of Childhood Adversity" in Philadelphia
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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National collaborative provides roadmap for doctors to ask about adult patients' ACEs, current trauma
How do you ask patients about current and past trauma? And how do you respond to their disclosures? Those are two key questions that members of a national collaborative who are among the early adopters of trauma-informed care practices have answered in a recent article in the journal Women’s Health Issues. Dr. Edward Machtinger To Dr. Edward Machtinger, the lead author of the paper entitled, “ From treatment to Healing: Inquiry and response to recent and past trauma in adult health care” ,...
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New Health Resiliency Stress Questionnaire debuts for pediatricians, family practice, internal medicine...but anyone can use it
There's a new ACEs-resiliency survey in town! It came out of a conversation between two physicians having a conversation on a bus. Here's the story about how it was developed, and how to use it. Pilots were done in a pediatric clinic, internal medicine, addiction treatment center, group therapy, and psychiatric practice. It's now being used in two community clinics.
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New organization calls all pediatricians to end crisis that's "hiding in plain sight"
When the question of screening patients for adverse childhood experiences (ACEs) was first raised a couple of years ago, Santa Barbara pediatrician Andria Ruth had mixed feelings about it.
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NJ medical school program requires all first-year students to learn about ACEs science
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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NPPC News and Resources
As 2019 comes to a close, we wish you a peaceful and healthy holiday season. As trauma-informed healthcare practitioners, this is also a time to acknowledge that the holidays can trigger loneliness and anxiety -- so please take time to care for yourself and perhaps provide extra support for your patients and families. As always, below you’ll find other news, webinars and resources we hope you find helpful for your ACEs screening efforts. Medi-Cal Funding Available for ACEs Screening Starting...
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NPPC shares lessons learned and results from ACEs screening pilot sites
For Dr. Mercie Digangi, a pediatrician at Kaiser Southern California in Downey, CA, ACEs screening provided a crystal clear before-and-after in how she changed treatment plans for her pediatric patients, she explained to attendees of a December 2 webinar organized by the National Pediatric Practice Community on ACEs (NPPC) and cosponsored by ACEs Connection. Dr. Mercie Digangi One case that turned ACEs screening into a never-go-back moment for her was a three-year-old who was speech-delayed.
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Oxytocin Blunts Social Vigilance in the Rhesus Macaque (But this is the end of the last Talk I just listened to).
I'm listening to Van Der Kolk, MD (My Hero!!!!) tell us what he has to say about Stephen J. Suomi's talk: "Thanks Steve, I am really delighted that these presentations are being video taped and the reason why I...
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Parent Handouts: Understanding ACEs, Parenting to Prevent & Heal ACEs (English)
Please see the main post for these parent handouts in the ACEs Connection Resources Center. These two flyers ( Understanding ACEs and Parenting to Prevent & Heal ACEs ) can be downloaded, distributed, and used freely. One is brand new and the other is a revision. Both flyers were made with generous support from Family Hui, a Program of Lead for Tomorrow. Translations of these flyers are in progress and will be shared by Family Hui and updated on ACEs Connection when available.
Comment
Re: Kenneth Ginsburg, M.D., M.S. Ed on “Using Trauma Informed Care and a Strength Based Approach to Reach Teenagers and Build Resilient Kids and Communities,” Tuesday October 28th 6-8 PM
He is great and he has a book called " Building Resilience in Children and Teens: Giving Kids Roots and Wings" In fact I was going to post something from Healthychildren.org on resilience. I will just post it here. Building Resilience in Children The world can be a frightening place. As a parent, I am constantly aware of choices that I make to minimize my perception of fear and uncertainty. Death, illness, divorce, crime, war, child abductions, tsunamis, and terrorism — both here and abroad...
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Re: Mr. Rogers, Trauma-Informed Care, and the Limits of Information
Dr Gold- I so appreciate everything that I've read of your writing! My only comment is that ACE screening/listening and relational practice are not mutually exclusive, but ideally complementary. The question to me is, how do we teach this skill set such that all pediatric providers are capable of using?
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Re: ACEs in Pediatrics Thoughts on Toxic Stress
I actually mean in the pediatric clinic we are receiving requests to join performance improvement projects in our office on issues that are actually the result of toxic stress but I was asking "How do we get our colleagues to better understand that addressing toxic stress may actually be the most effective way to positively affect all these health care outcomes?"
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Re: Fighting Compassion Fatigue with CONNECTION
I'd love to learn more about the activity that you presented. I am working in a community health clinic in Los Angeles and am training the staff in each department on The Basics of ACEs Science and Resilience. We aim to prevent burnout, CF, and STS but also are working on improving the quality of life for our staff. The larger vision is to integrate this approach with staff so that when we introduce the patient care side, they will have already experienced it for themselves. I'd love to...
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Re: 12 Things I Wish My Doctor Understood About Childhood Trauma
Thank you, Anna. Patients' stories are so helpful to all of us clinicians. My colleagues and I are teaching students and residents about ACEs and how to talk to adults about ACEs. We are also working on a set of competencies that we hope will be adopted into medical school curricula all over the country. Physicians are starting to learn - but there is a long way to go!
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Re: 12 Things I Wish My Doctor Understood About Childhood Trauma
Re: 12 Things I Wish My Doctor Understood About Childhood Trauma
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Doctor-patient role-playing featured in ACEs Connection webinar
On an ACEs Connection webinar on Monday, Dr. Andrew Seaman, an assistant professor at Oregon Health & Science University, showed how he navigates his students through the science of adverse childhood experiences (ACEs). And, in an unusual twist for a webinar, Seaman and O’Nesha Cochran, a peer mentor with the Mental Health Association of Oregon, role-played doctor-patient interactions to show how to develop the skills to communicate with patients with high ACE scores. About 90 people...
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Doctor-patient role-playing featured in ACEs Connection webinar
On an ACEs Connection webinar on Monday, Dr. Andrew Seaman, an assistant professor at Oregon Health & Science University, showed how he navigates his students through the science of adverse childhood experiences (ACEs). And, in an unusual twist for a webinar, Seaman and O’Nesha Cochran, a peer mentor with the Mental Health Association of Oregon, role-played doctor-patient interactions to show how to develop the skills to communicate with patients with high ACE scores. About 90 people...
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Doctors and teachers could team up to reduce stress in schools [reuters.com]
(Reuters Health) - - Partnerships between teachers and doctors could help students and school staffers better deal with “toxic stress,” suggests a former teacher turned doctor. Pediatricians can help build resilience in both children and teachers to counter the effects of traumatic childhood experiences, poverty and violence, Dr. Kavitha Selvaraj of the Ann and Robert H. Lurie Children’s Hospital in Chicago writes in the journal Pediatrics. “Before I was a pediatrician, I was a teacher, and...
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Dozens of Kaiser Permanente pediatricians in Northern California screen three-year-olds for ACEs
Since August 2016, more than 300 three-year-olds who visited Kaiser Permanente’s pediatric clinics in Hayward and San Leandro have been screened for adverse childhood experiences (ACEs), such as living with a family member who is an alcoholic or losing a parent to separation or divorce. But when the idea to screen toddlers and their families for ACEs was first broached at the Kaiser Permanente Hayward Medical Center, the staff were, in a word, “angsty,” says Dr. Paul Espinas, who led the...
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Dozens of stakeholders representing thousands of practitioners send public comments on Calif. ACEs-screening plan
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. Nadine Burke Harris Presents at SCVMC-Pediatric Grand Rounds
Dr. Nadine Burke Harris presented today at Santa Clara Valley Medical Center during Pediatric Grand Rounds to a full room (standing room only) of pediatricians, nurse practitioners, physicians assistants, public health professionals and allied medical staff. With the show of hands, many of us in the room were familiar with ACEs science and the health impacts of toxic stress. With ease, Dr. Burke Harris dove into great detail of our bodies response to toxic stress and the multitude of...
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DULCE helps pediatricians in Oakland, CA, prevent toxic stress in newborns
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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Employing an Adaptive Leadership Framework to Childhood Adversity Screening [pediatrics.aapublications.org]
By Susannah Stein, Arin Swerlick, and Binny Chokshi, Pediatrics, January 2020 Providers of pediatric health care have been motivated and inspired by the research on childhood adversity, which has shown that in the early stages of life, critical neurodevelopmental pathways can be disrupted through exposure to adverse childhood experiences (ACEs) and resultant toxic stress.1,2 Early detection of ACEs and subsequent intervention has the potential to decrease the development of associated poor...
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Even Infants Need Mental Health Care, so new Chicago Clinic Caters to Those 5 and Under [chicagotribune.com]
By Peter Nickeas, Chicago Tribune, September 20, 2019 In and around Chicago’s Little Village neighborhood, long-standing causes of friction like gun violence and poverty have for some families combined with newer fears of immigration crackdowns and deportation of loved ones — and mental health professionals hope to address toxic stress that can have long-term effects on the lives of very young children. Aiming to rectify the shortage of mental health care available to infants and children...
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Family Resilience And Connection Promote Flourishing Among US Children, Even Amid Adversity [healthaffairs.org]
Flourishing and its predictors and links to health outcomes are well documented in adults, including among those facing adversities. Less is known about flourishing and its correlates among children, especially those who face circumstances such as adverse childhood experiences (ACEs), chronic illness, or poverty. Studies show that flourishing is distinct from an absence of physical or mental illness and other adversities; that flourishing can and does exist amid these circumstances; and that...
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Few doctors talk to patients about guns; experts say they want that to change [vcstar.com]
By Cheri Carlson, VC Star, June 15, 2019. Doctors and other health care providers often feel that they have a role in preventing firearm injury. But few talk to their patients about the risks. That’s what a group of physicians and researchers say prompted them to try to help. This month, a clinical guide to recognize patients' risk of firearm injury was published in the Annals of Internal Medicine’s “In the Clinic” series. Its authors came from the UC Davis Violence Prevention Research...
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Finding the Right Words About COVID-19 [chcf.org]
By Kate Meyers, California Health Care Foundation, March 26, 2020 Health care organizations in California and around the US are working incredibly hard to prepare for or respond to a surge of patients suffering from symptoms related to COVID-19. Appropriately, preparation has focused on trying to ensure adequate numbers of health care professionals and sufficient supplies and equipment in the right places at the right times as the demand grows. That focus on numbers and logistics is...
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First health-related cost of ACEs study shows $113 billion price tag for California; just one ACE costs $28 billion
Researchers who have been looking for a way to quantify the health toll of ACEs in dollar terms, now have an example in a newly-released study of California. ACEs exacted a toll costing an estimated $113 billion annually, according to the study in the journal PLOS One that was commissioned by the Center for Youth Wellness. ACEs-associated cardiovascular disease was the condition that lead author Ted Miller dubbed “the giant in the room.” It accounted for $29.6 billion in spending, more than...
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For a pediatrician and former teacher ACEs awareness came from a punch in the face
Dr. Kavitha Selvaraj did not learn about adverse childhood experiences (ACEs) from a class in medical school. Her first awareness of ACEs came after a student slugged her in the face when she was a new teacher in a school in Los Angeles. She had heard a chorus in the hallway urging her students she refers to as “J” and “N” to “Fight! Fight! Fight,” she writes in an essay in a recent issue of the journal Pediatrics . The two were trading punches. When she stepped in the middle to break it up...
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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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Heyman Oo integrates ACEs science as foundation of pediatric care
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
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.
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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Immigrant teens, parents explore ACEs, resilience in 5-week course with family doc
Dr. Angela Bymaster, a family doctor in San Jose, Calif., was determined to find a way to teach ACEs science to her patients. Teens would come to the Washington Neighborhood Clinic clearly depressed by a range of problems at home that were contributing to risky sexual behavior and marijuana use, as well as preventable health problems like extreme obesity.
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Researchers share learned lessons from screening for adverse childhood experiences in pediatric clinics
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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In ACEs Connection webinar, physicians talk trauma, offer tips for helping pediatric immigrant patients
Dr. Raul Gutierrez, a pediatrician in the San Francisco Bay Area, said he and his fellow clinicians see constant fear and its health consequences every single day among the largely immigrant and Latino population they serve. It’s all the result of anti-immigrant policies and the news cycle that feeds the fear. Dr. Raul Gutierrez “It is almost inescapable with the repercussions of immigration policy on the radio, television, social media and from friends and family,” Gutierrez told the 69...
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Integrating Healthcare and Early Childhood Systems Requires Capacity and Expertise [chapinhall.org]
By Angeline Spain, Angela Sander, and Amanda Brownd, Chapin Hall at the University of Chicago, 2020 Pediatric well-child visits represent a critical, often untapped opportunity to ask families about unmet social care needs and connect them with early childhood and other community services. Innovating in this space to address social determinants of health, early childhood organizations are increasingly building healthcare partnerships with the goal of increasing family access to services and...
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Interactive training on nature and health for health care providers, Oakland, Ca
October 27, 2018 8:45 AM 5:00 PM PDT Calling all health care providers! Save the date! Saturday October 27th, 2018 Join The Center for Nature and Health and Primary Care Clinic, UCSF Benioff's Children's Hospital: When: Saturday, October 27th, 2018, 8:30 a.m.–5:00 p.m. (Outdoor time included!) Where: CHORI Library, 5700 Martin Luther King Jr. Way, Oakland, Ca Register now: www.bitly.com/ucsf- nature2018 Featured speakers: Daphne Miller, MD, Physician and author Jose Gonzalez, Founder, Latino...
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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
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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A Conversation with Nadine Burke Harris: How Should Pediatricians Address Childhood Adversity?
Pediatrician Nadine Burke Harris is a masterful storyteller. I learned in a conversation with her at Wheelock College before her presentation for the Brookline, MA organization Steps to Success , that before she decided to become doctor, Dr. Burke Harris wanted to be an author. Only after the smashing success of her TED talk: How childhood trauma affects health across a lifetime , when she was approached by a literary agent, did she find her way to writing. Her newly released book The...
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A fast, easy way for pediatricians to screen kids for ACEs...and other health issues
Last November, the California Department of Managed Care gave its stamp of approval to a new version of Whole Child Assessment 2.0 , a tool that screens for children’s adverse childhood experiences (ACEs). It was recommended as part of recently passed legislation calling for trauma screening for children in California. But the Whole Child Assessment 2.0 (WCA) does more. It also queries patients about other critical safety and health issues, including whether they have enough to eat, whether...
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A Kaiser pediatrician, wise to ACEs science for years, finally gets to use it
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
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...