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PACEs in Pediatrics

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New Video Explores “What is Trauma-Informed Care?”

Mariel Gingrich ·
In this new animated video, meet “Dr. Cruz,” who addresses these questions and shares what she has learned about caring for patients with exposure to trauma, including abuse, neglect, and violence.
Blog Post

Next "A Better Normal" community discussion series: April 3, 2020/ Maternal health and pediatrics in the time of COVID-19

Jane Stevens ·
Steve Sack • Star Tribune The "Better Normal" community discussion for Friday, April 3, 2020, features two wonderful staff members from ACEs Connection: Karen Clemmer, community facilitator for the Northwest, Far Northern California, Alaska and Hawaii; and reporter Laurie Udesky, who is also community manager for the ACEs in Pediatrics community on ACEsConnection.com. Karen Clemmer Join them at noon PT/ 1 pm MT/ 2 pm CT/ 3 pm ET and share your thoughts, ideas, questions, concerns, and...
Blog Post

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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Nominate a Trauma-Informed Care Champion: #TICchampion

Mariel Gingrich ·
Becoming a trauma-informed organization requires clear communication about the transformation process, and support from staff at all levels of an organization. Often these efforts are spearheaded by “trauma-informed care champions”— individuals committed to raising awareness regarding the health effects of trauma and toxic stress and improving care for people who have experienced trauma. This week, the Center for Health Care Strategies (CHCS) invites you to recognize people around you who...
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One way Childhood Trauma Leads to Poorer Health for Women [news.osu.edu]

By Jeff Grabmeier, Ohio State News, September 17, 2019 Researchers have long known that childhood trauma is linked to poorer health for women at midlife. A new study shows one important reason why. The national study of more than 3,000 women is the first to find that those who experienced childhood trauma were more likely than others to have their first child both earlier in life and outside of marriage – and that those factors were associated with poorer health later in life. The findings...
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Opinion: All Doctors Should Practice Trauma-Informed Care [calhealthreport.org]

By Bob Erlenbusch and Drew Factor, California Health Report, November 20, 2019 “Adverse childhood experiences are the single greatest unaddressed public health threat facing our nation today,” Dr. Robert Block, former president of the American Academy of Pediatrics, has been widely quoted as saying. According to the Adverse Childhood Experiences Study, conducted in the 1990’s by the Centers for Disease Control & Prevention and Kaiser Permanente, adverse childhood experiences are common,...
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Opinion: Screenings Alone Won’t Prevent Adverse Childhood Experiences—We Must Address Community Trauma [calhealthreport.org]

By Rachel A. Davis and Howard Pinderhughes, California Health Report, December 19, 2019 Earlier this month, California’s Surgeon General Nadine Burke Harris launched an ambitious campaign to reduce adverse childhood experiences, which can cause lifelong health problems. With more than 60 percent of Californians saying they were exposed to a traumatic childhood event, adverse childhood experiences are at crisis levels in the state. The ACEs Aware campaign will train and pay health care...
Comment

Re: The Relentless School Nurse: Full Disclosure: I am Fearful to Welcome Another September

Christine Cissy White ·
Robin: I appreciate your writing and perspective so much. I can feel your fear, and given all that you have experienced, personally and professionally, you know this fear too well. Thank you for helping educate the rest of us, and help us all "activate" as well and not be overwhelmed by fear. You are a force for good and I'm grateful for your work and have shared it on the main site and in Parenting with ACEs. Cis
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Re: The Relentless School Nurse: Full Disclosure: I am Fearful to Welcome Another September

Robin M Cogan ·
Cissy, Your message is appreciated more than I can express. I am so thankful that we connected on Twitter and now through Acesconnection.
Comment

Re: Pediatric Symposium at National ACEs conference offers lessons learned and the way forward

Former Member ·
More random thoughts about office ACEs screening.... Everyone needs to know their ACE score - but we don’t necessarily need to be getting ACE scores in the doctor’s office only because this could put a person on a list to be discriminated against in the future or experience the violence of forced psychiatry. The ACE study is a population study and tells us that with a certain amount of trauma exposure during childhood- there is a certain amount of increased likelihood for a problem for ex -...
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Re: ACOG Policy Statements on Drug Use During Pregnancy and what Is Actually Happening in the Real World

Former Member ·
ACOG Policy Statement on the Non-Medical Use of Prescription Drugs During Pregnancy Committee on Health Care for Underserved Women Number 538, October 2012 (Reaffirmed 2014) Below is the Link to the Complete ACOG Committee Statement: Non-Medical Use of Prescription Drugs During Pregnancy T he 4 P's of Screening Mothers for Drug use During Pregnancy P arents: Did any of your parents have a problem with alcohol or other drug use? P artner: Does your partner have a problem with alcohol or drug...
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Re: ACEs in Pediatrics Thoughts on Toxic Stress

Calista Scott ·
Yes, I totally agree. Maybe the answer is too simple. Perhaps because we have forgotten where it all starts ….at the bottom of the pyramid; not halfway up. We have to address basic needs before we can move on. Basic needs are essential. Skipping over basic needs causes stress which impacts the brain....then you've got a problem. Lack of an adequate supply of diapers infancy and toddlerhood causes distress for an infant and his mother. Here, you have already negatively impacted the back and...
Blog Post

Doctors are burning out and trite ‘wellness’ measures aren’t helping [CenterForHealthJournalism.org]

Samantha Sangenito ·
“I'm already beat. The trick is to not let the caring get to you.” These were the words recently uttered by one of my physician colleagues, referring to the stresses of caring for patients in the world of modern health care. The weariness was clear over the phone. Without missing a step, I responded, “I know. Of course.” It took me weeks to realize that it might be concerning that I immediately empathized with her sense of being submerged and overpowered by an uncaring health care system.
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Doctors, Is It O.K. if We Talk About Why Finger-Wagging Isn’t Working? [nytimes.com]

Marianne Avari ·
Doctors give a lot of very good advice. Over the years, my primary care doctors have suggested better eating habits, more exercise, improved sleep hygiene, not carrying such a heavy shoulder bag, even exercises to improve my posture. The problem is, I am not sure I have ever made any changes in my behavior as a direct result. That would not come as a surprise to Ken Resnicow, a professor at the University of Michigan School of Public Health. “Finger-wagging doesn’t work,” he said. “There’s...
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Dozens of stakeholders representing thousands of practitioners send public comments on Calif. ACEs-screening plan

Laurie Udesky ·
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. Claudia Gold: Empathy & Listening as ACE-Informed Practice

Christine Cissy White ·
"You are absolutely not doomed from having ACEs."
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DULCE helps pediatricians in Oakland, CA, prevent toxic stress in newborns

Laurie Udesky ·
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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Early Childhood Trauma Can Affect Your Health Later In Life (medicaldailytimes.com)

A recent survey has shown that half of people who live in New Hampshire have experienced a traumatic event at some point in their lives. Studies have shown that people who experience trauma early in their lives are more likely to have health problems later on down the road. Ten percent of people who did not have a traumatic experience in childhood were in poor health. Seventeen percent of people who had a traumatic experience had poor health. Traumatic experiences include things such as...
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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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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

Laurie Udesky ·
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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Hillary Clinton’s Comprehensive Agenda on Mental Health [The Briefing—Fact Sheets]

The first bullet under Early Diagnosis and Intervention of today’s release of Hillary Clinton’s mental health agenda is titled “ Increase public awareness and take action to address maternal depression, infant mental health, and trauma and stress in the lives of young children.” It states “We also know that infant mental health depends on children forming close and secure relationships with the adults in their lives, and that too many children are growing up in environments that cause them...
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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...
Blog Post

How do these pediatricians do ACEs screening? Early adopters tell all.

Laurie Udesky ·
Last week, three pediatricians — with a combined experience of 15 years integrating ACEs science into their practices — reflected on the urgency they felt several years ago that prompted them to begin screening patients for childhood adversity and resilience when there was practically no guidance at all. Along their journey , they accumulated a list of lessons learned for other pediatricians and family clinics to use. The three pediatricians participated in the ACEs Connection webinar,...
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HOW TO CALM SIBLING SQUABBLES (Futurity Research News from Top Universities)

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

Laurie Udesky ·
What are the reasons that parents or caregivers do not fully disclose their own or their young children’s ACEs when asked to fill out an ACE screening form in their child’s pediatrician’s office? That was one of the many questions raised in a recent webinar entitled Screening for Adverse Childhood Experiences in the Pediatric Primary Care Setting: Practical Considerations and Lessons Learned . Dr. Kavitha Selvaraj, an attending physician at the Ann & Robert H. Lurie Children’s hospital...
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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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Interim report of the President’s opioid commission says its final report will address early intervention strategies for children with ACEs

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

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

Laura Shamblin ·
I’d like to take this opportunity to address some of the objections to screening for ACEs that I have come across. It is true that some areas of research are still emerging, such as protocols, but in other ways we are twenty years behind using the information we have to make a positive difference in our patients lives and in training new physicians to be more comfortable addressing social and experiential determinants of health.
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A 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 Guide to Providing Telehealth During the COVID-19 Crisis

Daren Casagrande ·
Many of us in the mental health field are being thrust into unfamiliar territory as clinicians in the midst of the COVID-19 response. We either risk personal health (and the health of our clients) by seeing people in person, or needing to utilize technologies that we may be unfamiliar with. Further, those technologies have fluid legal/ethical standards (and is even more fluid at present to accommodate the pandemic), and which require different skill sets that in-person therapy. I am...
Blog Post

A Guide to Providing Telehealth During the COVID-19 Crisis

Daren Casagrande ·
ACEs in Pediatrics community manager's note: Although this post by Daren Casagrande is geared toward mental health providers, I thought it had material that could be useful to a wider swath of health care providers. Please comment below if you have any questions or suggestions. --- Laurie Udesky Many of us in the mental health field are being thrust into unfamiliar territory as clinicians in the midst of the COVID-19 response. We either risk personal health (and the health of our clients) by...
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A Health Problem and An Opportunity: Screening for Adverse Childhood Experiences [medium.com]

Dayna Long ·
By Dayna Long, Medium, May 19, 2020 A consensus of scientific research demonstrates that cumulative adversity, especially when experienced during critical and sensitive periods of development, is a significant contributing factor to some of the most harmful, persistent, and expensive health challenges facing our nation. Adverse Childhood Experiences (ACEs) are highly prevalent, experienced in all communities, and are likely to increase during the COVID-19 emergency [i] [ii] [iii] [iv] [v].
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A Kaiser pediatrician, wise to ACEs science for years, finally gets to use it

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

Elise Groenewegen ·
Dear Illinois ACE Connection members, Children and families from all demographic and socioeconomic backgrounds in Illinois experience trauma, adversity, and chronic stress. Social determinants such as where we live, work, and play, can further exacerbate positive or negative physical, emotional, and behavioral health issues. The critical factor that determines if a child, family, and/or community can manage trauma, adversity, and chronic stress successfully is resilience : the process by...
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ACE-Aha Moments & Parenting: Meet Aprel Phelps Downey

Christine Cissy White ·
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)

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 Research Corner — September 2018

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

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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Adolescent Suicide Up 87 Percent Over Last Decade; LGBT and American Indian/Alaskan Native Teens at Highest Risk [prnewswire.com]

By Trust for America's Health, October 29, 2019 Adolescent suicide deaths have spiked over the last decade and substance misuse including vaping is exacting a heavy toll on teens according to a report released today by Trust for America's Health (TFAH) and Well Being Trust (WBT). The report, Addressing a Crisis: Cross-Sector Strategies to Prevent Adolescent Substance Misuse and Suicide finds that, while progress has been made in reducing some risky behaviors, adolescent suicide and substance...
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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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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...
Blog Post

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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Announcing a New Parenting and ACEs Blog from Stress Health, an Initiative of the Center for Youth Wellness

Diana Hembree ·
Research shows that the right kind of support and care can mitigate the impact of toxic stress in children and help them bounce back.
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Announcing the Parenting with ACEs Monthly Chat Series!

Christine Cissy White ·
I'm thrilled to announce our NEW Live Chat series!!! Starting in May, once a month, we will have a live Chat Event. It will take online in the Parenting with ACEs Group the second Tuesday of the month at 10 a.m. PST (1 p.m. EST). We'll learn from our featured guests (below) about ACE-related issues. We'll have discussions and share experiences, stories, and resources with each other. Here is who and what we have scheduled for 2017. 2017 Monthly Chat Schedule / Time is Always: @ 10 AM PST (1...
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As California Moves to Screen Children for Childhood Trauma, Poverty Has To Be Part of the Equation

Jim Hickman ·
In California, we are coming full circle in recognizing the connection between poverty and health.
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Baltimore uses trauma research to improve life for poor parents and their children [WashingtonPost.com]

Samantha Sangenito ·
One day, when she was 14 and feeling ill, Daylesha Brown’s mother took her to a Baltimore hospital and did not return for her. Child Protective Services (CPS) placed her in a group home and she was forced to move to other homes for the next three years. “My mother, she pushed me away,” Brown, now 23, said softly. “I was always getting in trouble with my mother.” So last year when Brown discovered her daughter, Sa-Maji, had lead poisoning, a lingering problem in Baltimore where the rate of...
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