Tagged With "Approaches in Clinic Community Settings"
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A Pandemic Benefit: The Expansion of Telemedicine [nytimes.com]
By Jane Brody, The NY Times, May 11, 2020. Even if no other good for health care emerges from the coronavirus crisis, one development — the incorporation of telemedicine into routine medical care — promises to be transformative. Using technology that already exists and devices that most people have in their homes, medical practice over the internet can result in faster diagnoses and treatments, increase the efficiency of care and reduce patient stress. Without having to travel to a doctor’s...
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A tough childhood has a long-term effect on health [businesslive.co.za]
US-based pediatrician Nadine Burke-Harris had a glut of attention deficit hyperactivity disorder (ADHD) cases at the clinic where she worked in Bayview, a poor area in San Francisco. She felt in her bones that these cases didn’t come out of the blue, and were directly linked to high levels of toxic stress in the community. Toxic stress, experienced through consistent exposure to violence, abuse and the consequences of poverty and inequality, has a lasting effect on the brain, notably in the...
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AAP: Trauma-informed pediatric provider course set for April
The American Academy of Pediatrics just released the agenda for its 2018 trauma-informed pediatric course, which will be held in Houston from April 5-8. Among the participants are Boston-based pediatrician, social epidemiologist. community advocate and founding director of Vital Village , Renee Boynton Jarrett . She will convene a breakout session on early life trauma. RJ Gillespie , a pediatrician who has surveyed parents and children for ACEs and analyzed the data at the Portland,...
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ACE-Aha Moments & Parenting: Meet Aprel Phelps Downey
Aprel Phelps Downey What was your ACEs Aha moment? When did you first hear about ACEs and what impact did/does it have on you? How do ACEs impact you as a parent? How is your parenting impacted by past trauma? What’s been most helpful to you as a parent parenting with ACEs? What’s been most challenging for you as a parent parenting with ACEs? What has parenting taught you? What have you learned? How do you manage complex family relationships? What inspires/encourages and helps you? I know...
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ACE Fact Sheets to Give Your Doctors, Patients & Beyond (free downloads)
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 champion pediatricians talk about life and practice in a COVID-19 world
With the advent of the COVID-19 pandemic, healthcare providers everywhere are changing how they care for their patients. I asked a few members of the ACEs in Pediatrics community what they’re doing differently. Dr. R.J Gillespie, pediatrician at The Children’s Clinic in Portland, OR. Dr. R.J. Gillespie Gillespie says that, as much as possible, they’re switching to virtual visits, which allows them “to comfort and reassure our patients face-to-face as much as possible without risking their...
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ACEs Research Corner — February 2020
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 — July 2019
[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] Wang X, Maguire-Jack K. Family and Environmental Influences on Child Behavioral Health: The Role of Neighborhood Disorder and Adverse Childhood Experiences . J Dev...
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ACEs Research Corner — June 2019
[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...
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ACEs research roundup: Trauma response in an HIV clinic; ACEs and school nursing; protective factors and school outcomes; using the WCA
The association of trauma with the physical, behavioral, and social health of women living with HIV: Pathways to guide trauma-informed health care interventions YP Cuca, M Shumway, EL Machtinger, K Davis… - Women's Health Issues, 2019 Reflections on National Association of School Nurses’ (NASN’s) History NASN President's Inaugural Address LG Combe - 2019 Adverse childhood experiences and protective factors with school engagement A Robles, A Gjelsvik, P Hirway, PM Vivier, P High - Pediatrics...
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ACEs screening in CA — a Q and A with Dr. Dayna Long
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
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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All hands on deck (from a distance): remote care for traumatized moms and babies
Dear colleague, Coronavirus is forcing providers and allied professionals serving mothers and babies to make unprecedented decisions. Should pregnant women needing care go through our hospital quarantine entrance? Should moms deliver without partners, family or doulas present? Be sent home early before key screenings or jaundice treatment are completed? To make matters worse, our systems aren't ready for basic remote care of mothers and infants now "socially distanced". Prenatal, post-partum...
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Alternative IHEBA with ACEs for California (and Other) Pediatricians
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
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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An Editorial: Screening for Childhood Adversities in Prenatal Care: What Works and Why
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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Shifting the focus from trauma to compassion
photo: Rolf Schweitzer/CCO Dr. Arnd Herz, a self-described champion for ACEs science, would like nothing more than to witness a greater appreciation of how widespread adverse childhood experiences are. Herz, a pediatrician and director of Medi-Cal Strategy for the Greater Southern Alameda Area for Kaiser Permanente Northern California, would also like to encourage more people in health care to engage in a trauma-informed care approach, a change in practice that he says not only benefits...
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Solano County's (CA) ACEs initiative, a robust community effort, makes room for input from all
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
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]
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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Study indicates exercise sharpens the young adult brain [MedicalXpress.com]
Regular physical activity improves brain function even in young adults considered in their prime and at the height of cognitive ability, according to a new University of Otago study. A body of research already exists showing aerobic exercise...
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Study unearths patterns in San Jose homeless population's ACE scores
Photo by Terabass/ CC-SA-3.0 It was around 2010 that Dr. Angela Bymaster was seeing a disturbing pattern in the histories of her adult patients. She already knew that patients who saw her at the Valley Homeless Health Care Program in San Jose, CA, where she worked at the time, were homeless or recently homeless. What was most troubling to Bymaster was knowing that their current precarious existence could have been prevented. Dr. Angela Bymaster “Over and over and over again I was hearing the...
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Support, Connect and Nurture: Addressing the impact of ACEs in the pediatric medical home
Adverse childhood experiences (ACEs) can have a profound impact on children’s development, increasing risk for chronic disease and mental illness. The Support, Connect, and Nurture (SCAN) project was developed to address the impact of ACEs on the health and well-being of children and families in Pueblo, Colorado. Located at Southern Colorado Family Medicine Residency Clinic (SCFM) and in partnership with Catholic Charities Diocese of Pueblo, the SCAN intervention included the following...
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Supporting resilience in primary care pediatrics
Here is a powerpoint presentation by Dr. R.J. Gillespie of The Children's Clinic. Read here how The Children's Clinic is using ACEs science.
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Survey: Healthcare providers, community organizations weigh in on California's ACEs screening program
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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The Magic of Everyday Moments Video Series (Zero to Three)
How do you help parents and students of child development understand how they can best help young children thrive? Seeing is believing! Parents today know how important their children’s early experiences are in shaping how they...
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The Power of Beliefs: What Babies Are Telling Us
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 public health crisis facing homeless children [The Daily Beast]
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: Brandy Bowlen Shares Her Message - From Seat to Feet
Brandy Bowlen has transformed her school community by first taking a stand for her own health and well-being. This is not an easy feat for nurses. Eight years ago, when Brandy was a new school nurse, she found herself overwhelmed, overstressed and overweight. She became a warrior for self-care, connecting the importance that her professional persona would be most impactful if she presented herself as an example. Brandy shares her journey to wellness for herself and her school community.
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The Relentless School Nurse: The Ripple Effect - When Community Violence Comes to School
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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Trauma education and mindfulness help youth living amid gun violence
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 in adulthood can begin in the first 2 months of life [heraldnet.com]
By Paul Schoenfeld, HeraldNet, June 9, 2019. Last week, I attended the 30th annual International Trauma Conference in Boston. Several thousand mental health clinicians from around the world attended. It was sponsored by Dr. Bessel Van der Kolk, one of the world’s foremost researchers and clinicians in developmental trauma. He wrote an excellent book, “The Body Keeps the Score,” which I highly recommend. In the last 10 years, the field of neuroscience has blossomed. With new imaging...
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Traumatic Experiences Widespread Among U.S. Youth, New Data Show
[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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Understanding Motivation: Building the Brain Architecture That Supports Learning, Health, and Community Participation [developingchild.harvard.edu]
A healthy, engaged community depends on people achieving to the best of their potential, contributing actively to the economy and public well-being, and helping the next generation to thrive. A complex set of intertwined social and biological factors influences people’s motivation to participate actively and productively in schools, jobs, and communities–and to persevere in the face of setbacks. To unlock this puzzle and ensure that all people have the opportunity to develop motivation to...
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Update on bills re: childhood adversity in California Legislature
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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Upstreamist in Action: In a Texas Clinic, Lawyers Are Health Care Providers [Health Begins]
Upstreamists are changemakers pioneering practices that improve health by blending medical and social care . In this series of profiles, HealthBegins highlights some of these bold leaders and their innovations, in settings large and small. Their stories show us that the journey upstream is not only necessary — it’s possible. The People’s partnership began in 2012, when two puzzle pieces clicked together. The clinic’s Chief Medical Officer, Dr. Louis Appel, a pediatrician with an interest in...
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Validation of the Traumatic Events Screening Inventory for ACEs [pediatrics.aappublications.org]
OBJECTIVES: Our purpose in this study was to adapt and validate the Traumatic Events Screening Inventory (TESI) as a primary-care childhood adversity screening tool for children living in vulnerable neighborhoods using a community-partnered approach. METHODS: In this cross-sectional, descriptive study, we used a sample of 261 children (3–16 years old) who were seeking services at a Federally Qualified Health Center with colocated behavioral health services in Chicago and had a positive...
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Want to end ACEs? Ask a young student how.
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: Leveraging Advances in Science to Achieve Breakthrough Impacts at Scale for Young Children Facing Adversity
DATE: Thursday, February 21, 2019 TIME: 11:00-11:45am Jack P. Shonkoff, M.D., Director of the Center on the Developing Child at Harvard University, will address how new science is changing how we think about early childhood adversity and resilience – and how early experiences affect lifelong health and development. He will emphasize the need to address (and measure) individual differences in response to adversity and to intervention in very young children. He will also show how we can move...
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Webinar Series – Putting Trauma-Informed Care into Practice: Lessons from the Field
Health policymakers and practitioners increasingly recognize trauma as an important factor that influences health throughout the lifespan. By incorporating trauma-informed approaches to care into their practice settings, provider organizations can more effectively care for patients and support efforts to improve health outcomes, reduce avoidable hospital utilization, and curb excess costs. This two-part CHCS webinar series will explore innovative strategies for implementing a trauma-informed...
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Webinar—Trauma Informed Care: Implementation of the Adverse Childhood Experiences Questionnaire (ACE-Q) within an Urban, Pediatric Clinic [CFHA.net]
Sponsored by CFHA's Families and Health Special Interest Group Presented by Ruth Nutting, Phd, Amy Seery, MD and Vanessa Lohf, LBSW Thursday, September 21, 2017 at 2:00 PM EST REGISTER HERE Summary: Adverse childhood experiences (ACEs) are common within our population. Studies have shown that greater numbers of ACEs are strongly related to negative long-term physical and mental health outcomes. Recognizing that children often experience a gradual accumulation of ACEs, periodic screening...
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Webinars
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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Wellness and Resiliency Toolkit for Kids with Trauma
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 a Pediatrician Can Do for a Child Seeking Asylum—and What She Can’t
Asylum Seekers in Tlaquepaque, Jalisco Migrant Refuge Center, photo by Daniel Arauz CC BY 2.0 On a cool spring afternoon, in a clinic that serves refugee and immigrant families, I sit across from a teen-age girl. She is otherwise known as an unaccompanied alien child, or U.A.C. She left her home in Central America, crossed the southern border, and was detained for a week—in Texas, she thinks—in a facility where breakfast was a cold bean burrito, lunch was a cup of microwavable noodle soup,...
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What Our Children Need Us to Know, Right Now
Teaching children how to better navigate crisis, right now.
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What’s in the well? Pediatrician probes ACEs and the biology of toxic stress in kids [seattletimes.com]
Boot-strapping types who believe that surmounting a difficult childhood is mainly a matter of will may be perplexed by an anecdote near the beginning of Nadine Burke Harris’s new book, “The Deepest Well: Healing the Long-Term Effects of Childhood Adversity.” In it, the pediatrician describes a 7-year-old boy named Diego, who showed up at her Bay Area clinic looking like an undersized 4-year old. He had been referred by a school nurse for suspected ADHD . But Burke Harris also noted that her...
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When Parents Fear "It's All My Fault"
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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Who's integrating ACEs?
2015 article about Children's Clinic in Portland, OR, doing ACEs history on parents of four-month-old babies. 2014 article about pediatricians taking ACEs history on ACEsTooHigh.com. Center for Youth Wellness, San Francisco,...
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Why I believe Gregory Williams, and his book, Shattered By The Darkness, will help save lives and revolutionize healthcare.
When you first hear about it, it sounds unlikely, fact that something that happened to someone in utero, at the age of two months, or four years, or any time in childhood, is what is killing them as an adult, or making them want to die, or making them want to hurt themselves or others. Yet the connection between childhood trauma and adult disease, mental illness, addiction, suicide, violence – most all of society’s ills – is as irrefutable as the myriad truths revealed about it in the...
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Why Kids With ACEs Shouldn't Get a Pass on Chores
Don't worry that chores are too stressful for kids with ACEs, says trauma researcher Bob Sege, MD. “You don’t want to coddle them,” Sege said, “because the message they will get is that they are damaged goods. They need to know that the adversity they suffered is only one part of them; it’s not all of them.”