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PACEs in Pediatrics

Tagged With "bags on head"

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

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

Christine Cissy White ·
Have you talked with friends, siblings or co-workers about Parenting with ACEs while going through the change? Do you have any fascinating facts to share about how your OBGYN prepared or supported you when thrown by midlife, hormonal shifts and emotional residue from traumatic stress? Me either. And it's a shame. A lot of people parent, go through menopause, and have survived a bunch of ACEs. Conversations and information shouldn't be so hard to find. But they are. T hat's the reason we...
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Report reveals how foster care, juvenile and adult justice systems traumatize youth, calls for policy shifts

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

Laurie Udesky ·
YWFC sponsored Sister Warriors meeting When she was 15 years old, Lucero Herrera was put in a rehab program by San Francisco’s Juvenile Court because she was getting drunk regularly. And in doing so, the court failed to explore the root of her drinking. Had they done so, she said, they would have found that anger and trauma were lurking underneath, driven by her ACEs: adverse childhood experiences. Lucero Herrera "Why did they put me in a drug program when I had an anger problem? I went...
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Building a Movement to Birth a More Just and Loving World [Groundswell March 2018]

Karen Clemmer ·
The National Perinatal Task Force: Building a Movement to Birth a More Just and Loving World - In my 20 years as a public health nurse, I've never seen race called out so clearly in a report like this. Data has shown disparities, however the data was presented in a tidy way — very apolitical, purposely written to not ruffle any feathers or point fingers - " persistent racial gap ". This report written by The National Perinatal Task Force is refreshingly honest and this is important. We need...
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Careful, It's Not Over Yet & Parenting with ACEs & PTSD

Christine Cissy White ·
Note: Dawn Daum & Joyelle Bran dt are the featured guests on the live chat held in the Parenting with ACEs Group on Tuesday, June 13th at 10 AM PST / 1 PM PST. The topic is Parenting with PTSD & ACEs. Dawn and Joyelle are artists, activists and parents. They met a few years ago and set about creating an online community for parent survivors to working to break the cycle of abuse. Here's a small sample of the work they have done and are doing: Wrote a resource about Parenting as an...
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Chicago healthcare providers start center for ACEs science education; aim to reach all medical, health students by 2025

Laurie Udesky ·
In 2017, Dr. Audrey Stillerman and three other women from the Chicago healthcare community founded the THEN Center . Its goal is lofty: By 2025, it wants every graduating student in medical and health sciences across the United States to apply core concepts of childhood adversity, neurobiology, resilience and health equity into their work. Dr. Audrey Stillerman Today, the THEN Center (The Collaborative Study of Trauma, Health Equity and Neurobiology) is well on its way. Its founders are...
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Childhood Stress and Adversity is Associated with Late-Life Dementia in Aboriginal Australians

Colette Ryan ·
This was just sent by the RACP “Paediatric Pot-Pourri”. It continues the developing and worrying themes presented at the recent NBPSA and CCCH satellites days before the RACP Congress. I cannot see any reason to imagine that these same outcomes do not also apply to those children living anywhere in the world where ACE’s are flooding into their lives. John Goldsmith “All paediatricians, particularly those with an interest in child development, are aware of the Adverse Childhood Experiences...
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Leaders in SF public housing deal with their own and community trauma head on

Laurie Udesky ·
Sengthong Sithounnolat, Jeris Woodson, Donald Greene, Ashley Blanco On a recent Saturday, 10 people gather around a table at the offices of Trauma Transformed in Oakland, Calif., where quotes from figures like Frederick Douglas, Nelson Mandela, and Coretta Scott King grace one wall as light streams in from a skylight above. The group is known as the Resident Warriors, which meets weekly. One participant talks of her recovery from addiction and her mother’s murder. Another mentions being...
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Montefiore to test out lower ACE score cut-off in pediatric patients

Laurie Udesky ·
photo/ CCO 1.0 Screening their pediatric patients for Adverse Childhood Experiences (ACEs) showed researchers at Montefiore Medical Center that their cut-off score of 4 for referring children and families for help was too high, says Dr. Dana Crawford, a pediatric psychologist and the director of the Trauma-Informed Care Program at Montefiore Medical Center in Bronx, NY. Dr. Dana Crawford Their analysis of the results not only confirmed what pediatricians had suspected, it helped them...
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Nadine Burke Harris debuts "The Deepest Well: Healing the Long-Term Effects of Childhood Adversity" in Philadelphia

Jane Stevens ·
Dr. Nadine Burke Harris debuted her book, The Deepest Well: Healing the Long-Term Effects of Childhood Adversity , at the Philadelphia Free Library this evening in a talk and book signing. This first stop in an ambitious book tour that crisscrosses the country reflects a mission that Burke Harris has pursued for nearly a decade: to spread the knowledge about the science of adverse childhood experiences, and about how people can use this knowledge to help solve our most intractable problems.
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NJ medical school program requires all first-year students to learn about ACEs science

Laurie Udesky ·
In 2015, Dr. Beth Pletcher, a pediatrician and associate professor specializing in genetics, was at the annual conference of the American Academy of Pediatrics in Washington D.C. when she heard two speakers that forever changed her work with medical students. Dr. Beth Pletcher “I went to two talks on adverse childhood experiences (ACEs) that were so mind-boggling to me that I decided on my drive back to New Jersey that I had to do something about it,”says Pletcher, director of the Division...
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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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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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Immigrant Kids Were Restrained to Chairs With Bags Over Their Heads at a Juvenile Hall in Virginia [motherjones.com]

By Samantha Michaels, Mother Jones, January 22, 2020 Antonio was tired of people calling him names. Staff members at the Virginia juvenile hall where he was held would call him pendejo and “onion head,” he said. After fleeing violence in Mexico at age 15 and arriving alone at the US border, he’d been sent to Shenandoah Valley Juvenile Center in 2016 and held alongside American teens while he awaited immigration proceedings. Shenandoah is one of two juvenile halls nationally that the Office...
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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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A Conversation with Nadine Burke Harris: How Should Pediatricians Address Childhood Adversity?

Claudia Gold ·
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 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 Aware Webinar: Trauma-informed practices to address stress from COVID19

Laurie Udesky ·
How can health care providers take care of themselves, their colleagues and their patients during this COVID-19 pandemic? First and foremost is recognizing how the pandemic can stir up trauma from the past, said Dr. Alicia Lieberman, a psychologist specializing in trauma. “COVID19 is reawakening traumatic reminders in many of us and in the families we work with. And that often makes it difficult for parents to protect themselves and their children,” she noted. Lieberman, the director of the...
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ACEs Research Corner — November 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] Jackson DB, Chilton M, Johnson KR, Vaughn MG. Adverse Childhood Experiences and Household Food Insecurity. Am J Prev Med. 2019 Nov;57(5):667-674. PMID: 31522923...
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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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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 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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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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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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Study unearths patterns in San Jose homeless population's ACE scores

Laurie Udesky ·
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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Teaching 6-Year-Olds About Privilege and Power (kqed.org)

On a sunny day in April, I drove to Head-Royce School in the hills of Oakland, California, to join circle time in Bret Turner ’s first-grade classroom. I had asked Turner if I could sit in on some lessons after reading an article he wrote describing how he teaches about some surprising topics -- like race and class -- in an elementary school classroom. I wanted to see what that looked like and what kind of conversations first-graders at this private school would have around such complicated...
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Teaching Parenting Skills At Doctor Visits Helps Children's Behavior [NPR.org]

Samantha Sangenito ·
As researchers have come to understand how poverty and its stresses influence children's brain development, they've begun untangling how that can lead to increased behavior problems and learning difficulties for disadvantaged kids. Rather than trying to treat those problems, NYU child development specialists Adriana Weisleder and Alan Mendelsohn want to head them off. They say they've found a way: Working with low-income parents when they bring babies and young children to the pediatrician.
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The quest to find biomarkers for toxic stress, resilience in children — A Q-and-A with Jack Shonkoff

Laurie Udesky ·
The JPB Research Network on Toxic Stress , led by Dr. Jack Shonkoff, is working on developing biological and behavioral markers for adverse childhood experiences (ACEs) and resilience that they believe will be able to measure to what extent a child is experiencing toxic stress, and what effect that stress may be having on the child’s brain and development. The JPB Research Network on Toxic Stress is comprised of scientists, pediatricians and community leaders, and is a project of the Center...
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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: 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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The School-to-Deportation Pipeline [tolerance.org]

Alicia Doktor ·
On a Saturday afternoon in Houston, Dennis Rivera-Sarmiento crossed a stage donning a green graduation gown. The 19-year-old was proud of this moment—one he wasn’t sure would happen. Just months before, a scuffle with a classmate near Stephen F. Austin High School threatened his future in the United States. Charged with assault, he was arrested by campus police, sent to county jail, then held in three different Texas immigration detention centers, including one located more than an hour from...
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TIC: News and Notes for the Week of March 18 2019

Scott A Webb ·
ACEs, Adversity's Impact Screening for adverse child experiences in primary care Linked: Adverse childhood experiences, health + addiction Adults with childhood traumas 11 times more likely to be involved in drugs and violence, report says Warning of overload in childhood trauma data Mental health issues increased significantly in young adults over last decade New student group to give hope to those with traumatic childhoods How anxiety leads to disruptive behavior Brain and Biology...
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To understand early childhood homelessness, we need more consistent federal data collection [childtrends.org]

Alicia Doktor ·
Homelessness in early childhood is a known risk factor for children’s health and well-being. Because high-quality early care and education (ECE) programs can buffer some of the negative effects of homelessness on a child’s development , federal ECE programs (such as child care subsidy, Head Start, and early intervention) have begun to prioritize these children for care. Unfortunately, ECE providers in the field often have difficulty identifying families eligible for child care slots that are...
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Top Organizations Encourage Appeals Court to Rule Against Trump Administration, End Detention of Migrant Children [Psychiatry.org

Jim Hickman ·
Contact: Nathan Carlile , Head of Firmwide Communications, Arent Fox LLP On behalf of a coalition of the nation’s leading organizations dedicated to the care, health, education, well-being, and welfare of children and families, Arent Fox LLP filed an amicus brief in the U.S. Court of Appeals for the Ninth Circuit in support of the Plaintiff in Jenny Lisette Flores, et al., v. William Barr, Attorney General of the United States, et al. Nearly thirty organizations steadfastly oppose the Trump...
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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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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. Hospitals May Often Miss Signs of Child Abuse (consumer.healthday.com)

Former Member ·
Less than half follow up on suspicious fractures among at-risk kids, study finds   MONDAY, July 13, 2015 (HealthDay News) -- Many U.S. hospitals may miss an opportunity to detect physical abuse in babies and toddlers, a new study reveals.  ...
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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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Re: Nobel Winner’s Research Shows Home Nurse Visits for New Moms Boost Children’s Cognitive Skills [The74Million.org]

Karen Clemmer ·
I love, LOVE this guy! Dr. Heckman is my public policy hero - I never thought I'd say that about an economist! Dr. Heckman is so well regarded, his research is impeccable, and the data has the potential to powerfully transform public policy with the end result of better lifelong outcomes for children and parents. AND in addition to cognitive skills, he recognizes " the importance of socioemotional skills, physical and mental health, perseverance, attention, motivation, and self-confidence .
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Child Life specialists empower kids in hospitals, disasters and now the pandemic

Laurie Udesky ·
In late May, Betsy Andersen’s 7-year-old son, Ezra, had a serious meltdown. He and his six-year-old sister Abby had been enjoying an online Zoom interaction with “Miss Eileen,” “Miss Savannah,” a couple of their colleagues, and a puppet. Betsy Andersen “I could see him trailing off and then he started crying,” says Andersen, who lives in Mundelein, Illinois. But before she swooped in, she heard Miss Eileen talking to him: “She was saying ‘Hey, I see you’re having some big emotions.” Speaking...
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ACEs and Gynecological Problems - A Conversation Starter

Dianne Couts ·
Gynecological problems as a result of ACEs, and particularly of Childhood Sexual Abuse (CSA), are rarely discussed in books and articles about the ACEs. The author would like to see that issue become part of the ACEs conversation.
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Leading Child Abuse Prevention Organizations Working to End Spanking

Robbyn Peters Bennett ·
The New York Foundling and The US Initiative to End Corporal Punishment Co-Sponsored by: American Professional Society on the Abuse of Children US Alliance to End the Hitting of Children Academy on Violence and Abuse Prevent Child Abuse America Stop Spanking Proudly Presents Preventing Abuse and Neglect in Our Lifetime A Virtual Conference Thursday, October 15, 2020 Friday, October 16, 2020 Join us to learn about... Latest research trends in corporal punishment How to implement a NoHitZone...
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ACEs Research Corner — November 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 posts the summaries of the abstracts and links to research articles that address only ACEs. Thank you, Harise!! -- Jane Stevens] Campbell KA, Gamarra E, Frost CJ, Choi B, Keenan HT. Childhood Adversity and Health After Physical Abuse. Pediatrics. 2020 Oct;146(4):e20200638. PMID: 32938778 From...
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A hospital builds awareness about trauma, deploys acts of empathy

Laurie Udesky ·
In late 2018, Roberta Azzo, an operations program manager at Bon Secours St. Francis Medical Center in Midlothian, Virginia, decided to take an all-hands-on-deck approach to infusing the hospital’s culture with a trauma-informed approach to care. This involves recognizing that trauma is widespread and that it can cause all kinds of troubled behavior, learning ways to de-escalate that behavior, and preventing practices that trigger patients and staff who have experienced trauma. The hospital...
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8 Categories of Adversity That Shape Health: Adverse Babyhood Experiences (ABEs), ACEs and ACEs+, ACREs, and More

Veronique Mead ·
As I've discovered since leaving my career as a family doctor, retraining as a somatic trauma therapist, and scouring the research for 20 years - adversity of all kinds, in all phases of our lives, and in past generations influences our health. As does discrimination. Like ACEs, these 7 additional categories of adversity shape health. They increase opportunities for prevention, identify early indicators of risk, and offer more tools for healing chronic illness and other effects of trauma.
 
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