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PACEs in Pediatrics

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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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Parents’ Substance Abuse May Up Kids’ Risk of Medical & Behavioral Disorders [PsychCentral.com]

Samantha Sangenito ·
A new report finds that children whose parents or caregivers misuse alcohol or have a substance abuse problem face an increased risk of medical and behavioral problems. The study calls for pediatricians to take an active role in assessing a child’s risk and to support the family to get the help they need. Experts have known that children whose parents or caregivers misuse alcohol or use, produce or distribute drugs face an increased risk of medical and behavioral problems. In the new...
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Pediatricians Call For Universal Depression Screening For Teens [NPR.org]

Samantha Sangenito ·
Only about 50 percent of adolescents with depression get diagnosed before reaching adulthood. And as many as 2 in 3 depressed teens don't get the care that could help them. "It's a huge problem," says Dr. Rachel Zuckerbrot , a board-certified child and adolescent psychiatrist and associate professor at Columbia University. To address this divide, the American Academy of Pediatrics has issued updated guidelines this week that call for universal screening for depression. [For more of this...
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Pediatricians screening for ACEs at Loma Linda University

Ariane Marie-Mitchell ·
Attached is the Whole Child Assessment which is being used by pediatricians to screen for ACEs at Loma Linda University. For further questions about the development or use of the WCA, please contact Ariane Marie-Mitchell at Loma Linda University, amariemitchell@llu.edu .
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Positive Childhood Experiences offset ACEs: Q & A with Dr. Robert Sege about HOPE

Laurie Udesky ·
Tufts University medical professor Dr. Robert Sege directs the Center for Community-Engaged Medicine and is nationally known for his research on effective health systems approaches that address social determinants of health. He is also the principal investigator for the HOPE framework (Healthy Outcomes from Positive Experiences).The HOPE framework is based on research that shows how positive childhood experiences can mitigate the effects of adverse childhood experiences. Sege and colleagues...
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Power of Family Resilience to Protect Children From Bullying [sciencedaily.com]

By American Academy of Pediatrics, Science Daily, October 25, 2019 Studies show that children exposed to childhood trauma known as adverse childhood experiences (ACEs) are at increased risk of being bullied or bullying others. New research being presented at the American American Academy of Pediatrics (AAP) 2019 National Conference & Exhibition suggests that family resilience -- the ability to work together to overcome problems, for example -- reduces this risk. The research abstract,...
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Prevention: Bringing Baby Home Training of Facilitators

Carolyn Curtis ·
A friend of mine recently referred her grandchild and his pregnant wife to a Bringing Baby Home class, because she noticed that the wife had a horrible background of abuse and at times had difficulty functioning. What the grandmother noticed with this couple was a change in the family dynamics. the couple knows how to get along, the father is engaged in parenting, and the baby thriving. This is really starting at the root of the problem. 20 years ago, Drs. John and Julie Gottman worked with...
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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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Resource list -- Books

Jane Stevens ·
Brandt, Joyelle and Daum, Dawn -- Parenting with PTSD: the impact of childhood abuse on parenting , 2017. " Our Mission: 1. To build a supportive community for parenting survivors, normalize the PTSD responses they may be having, and share resources for healing from adverse childhood experiences (ACEs) or other traumatic events. 2. To educate professionals working in the fields of physical, mental, and social health about common triggers that arise for parents with PTSD, and the challenges...
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Resource list -- Handouts & tools

Jane Stevens ·
ACEs and Toxic Stress in Spanish -- A Spanish-language overview from AAP of "toxic stress, how it affects the body's systems, and how we can promote resiliency in children to help protect against toxic stress." ACE Surveys (different types of) -- A list of the original ACE study, adapted surveys, and expanded surveys. Circle of Parents -- " Circle of Parents ® provides a friendly, supportive environment led by parents and other caregivers. It’s a place where anyone in a parenting role can...
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RYSE gathering: To promote healing from trauma, institutions need to stop seeing youth as the problem

Laurie Udesky ·
A young man told clinical therapist Marissa Snoddy recently that when she calls him a leader, she got it all wrong. “He said, ‘I just came from Juvenile Hall,’ I’m not a leader.” But, she said, “We just kept giving him love. And we said, ‘You’re courageous for showing up and being here,’” The very fact that he was there, she explained, showed he was a leader. Snoddy related the anecdote recently for 80 people attending the Trauma and Learning Series launch led by Rising Youth for Social...
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Beyond Trauma: Building Resilience to ACEs (brochure)

Christine Cissy White ·
Wish you had a fairly easy and short way to share all about ACEs? Wish it was in-depth enough to share with teachers, doctors, nurses and therapists but not so long or jargony it puts family and friends to sleep? Here's the perfect thing to share when you've been all up in the faces with ACEs and want to back up your words before, during or after. This brochure is comprehensive but not so long that it remains in the "I'll get to it later," pile. Please feel free to print, forward, download...
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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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Building a Trauma-Informed Approach with Pediatric Physical Therapists

Jessica Barreca ·
In the profession of physical therapy (PT), the word "trauma" typically leads one to think of the physical manifestations of a catastrophic injury, subsequent emergency medical care, and lengthy rehabilitation services. However, the psychological aspects of trauma are not always as visible. Throughout an individual’s lifespan, PTs will provide services to restore function, manage pain, and increase physical activity. We provide education, hands-on care, and therapeutic exercise to improve...
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CA pediatrician develops, tests, gets state OK for whole-child assessment tool that includes ACEs

Jane Stevens ·
Over the last dozen years or so, many pediatricians, astounded by the ramifications of the science of adverse childhood experiences (ACEs) on the children they care for, began integrating this science into their practices. The most common approach has been to ask parents about ACEs using a questionnaire, and to use this information to counsel parents and identify resources for the family. Different practices have been using different questionnaires: Some ask parents for their ACE scores...
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CA pediatrician develops, tests, gets state OK for whole-child assessment tool that includes ACEs

Jane Stevens ·
[Editor's note: This blog was first posted in April 2017. Dr. Marie-Mitchell updated the assessment by modifying a few of the questions, so we are republishing with the new assessment, one in Spanish and one in English.] Over the last dozen years or so, many pediatricians, astounded by the ramifications of the science of adverse childhood experiences (ACEs) on the children they care for, began integrating this science into their practices. The most common approach has been to ask parents...
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CA to reimburse for only one of three ACEs screeners

Laurie Udesky ·
California health care providers will soon begin to learn how many of the 13.2 million California children and adults in the state’s MediCal program have been exposed to adverse childhood experiences (ACEs). But the state’s proposed decision to reimburse only one of three recommended options for screening children has drawn mixed reactions from pediatricians. “If we have mandated legislation that only looks at one screening tool, it really limits the opportunity to improve that screening...
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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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COVID-19 and our dialogue with death

Cristian Zanartu ·
[Editor's note: Dr. Cristian Zanartu, an internist and palliative medicine specialist, is currently volunteering at Bellevue Hospital during the pandemic.] I was angry. So angry. How come the smartest country in the world is acting like the dumbest? Why aren’t health authorities giving us clear guidelines now, before this starts? Like: how to quarantine, how to quarantine from a symptomatic loved one in the same household (we knew by late February from Chinese data that most spread happened...
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Developmental Delay Referrals Improve With QI Plan

Former Member ·
  Children with developmental delays stand a better chance of getting the early-intervention services they need if clinicians take the time to document screening efforts and follow-up with a simple telephone call, investigators say.   When a...
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10 Things Every Parent Should Know about Play

Former Member ·
  1.  Children learn through their play. Don’t underestimate the value of play. Children learn and develop: cognitive skills – like math and problem solving in a pretend grocery store physical abilities – like balancing...
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12 Things I Wish My Doctor Understood About Childhood Trauma

Anna Runkle ·
It doesn’t happen that often anymore, but one place where I almost always get triggered with my Childhood PTSD symptoms is when I visit the doctor. I could never even put this into words before. But now that I’m mostly healed from my Childhood PTSD symptoms, I want to express what I wish my doctors – all the doctors of my life – had understood about the effects of Childhood trauma, about me. Note: This is one of my most personal posts ever. Unless you’re someone who really prefers text, I...
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2017 Children's Mental Health Report

Lisa Frederiksen ·
Of the 74.5 million children in the United States, an estimated 17.1 million have or have had a mental health disorder — more than the number of children with cancer, diabetes and AIDS combined. Half of all mental illness occurs before the age of 14, and 75 percent by the age of 24. In spite of the magnitude of the problem, lack of awareness and entrenched stigma keep the majority of these young people from getting help. Children and adolescents struggling with these disorders are at risk...
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Iowa project aims to have all pediatricians, family docs screen for ACEs

Laurie Udesky ·
Dr. Amy Shriver is on a mission: to convince every pediatrician and family doctor in the State of Iowa to screen children for Adverse Childhood Experiences (ACEs). Dr. Amy Shriver The Des Moines-based Blank Children’s Hospital pediatrician is not alone. She’s part of Central Iowa ACES 360, a regional cross-sector coalition formed in 2011 that is working toward that ambitious goal. And they’re making substantial inroads. Central Iowa ACES 360 has just developed a one-hour trauma-informed...
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LGBTQ + Youth - a book reviewed in Journal of GLBT Family Studies

Dr. Lee-Anne Gray ·
LGBTQ youth are most vulnerable to the school to prison pipeline, which is a very severe ACE (Snapp et al, 2015.) To combat this problem, I wrote a clinical manual for educators and mental health clinicians. The book addresses the need for sensitive engagement with, and advocacy of, LGBTQ+ youth. LGBTQ+ Youth: A Guided Workbook to Support Sexual Orientation and Gender Identity was released in June 2018, endorsed by Jenny Finney Boylan, and #1 NEW RELEASE on Amazon in Teen and Young Adult...
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Marin Community Clinics in California screen babies for ACEs, provide support in effort to prevent trauma

Laurie Udesky ·
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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More American children and teens aren't just obese. They're morbidly obese. [Vox.com]

Samantha Sangenito ·
Public health researchers cheered an encouraging trend recently : Childhood obesity rates, which rose steadily through the 1980s and 1990s, seemed to have plateaued in the 2000s. But new research suggests a different, troubling problem lurking behind that plateau — a steep rise in the rates of severe obesity, particularly among older and minority children. The fraction of adolescents with severe obesity — a body mass index of 40 or greater — has more than doubled from 0.9 percent in 1999 to...
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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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National collaborative provides roadmap for doctors to ask about adult patients' ACEs, current trauma

Laurie Udesky ·
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

Susie Wiet ·
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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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...
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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...
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...
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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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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...
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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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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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