Tagged With "Gynecological Problems"
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A Kaiser pediatrician, wise to ACEs science for years, finally gets to use it
Dr. Suzanne Frank has known about the impact of childhood adversity on young lives for decades. She’s seen the fallout in the faces of young people huddled in beds at a children’s shelter where she worked years ago. She’s seen it as the regional child abuse services and champion for the Permanente Medical Group. And she’s seen it in hospital examination rooms where, as a member of the Santa Clara County’s Sexual Assault Response Team, she’s been called in to examine shell-shocked children...
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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 Research Corner — September 2018
[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
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
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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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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Announcing the Parenting with ACEs Monthly Chat Series!
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
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]
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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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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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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Teen Bullies And Their Victims Both Face A Higher Risk Of Suicide [NPR.org]
Bullying and cyberbullying are major risk factors for teen suicide. And both the bullies and their victims are at risk. That's according to a report from the American Academy of Pediatrics that urges pediatricians and family doctors to routinely screen teenagers for suicide risks. "Pediatricians need to be aware of the problem overall," says Benjamin Shain , a child and adolescent psychiatrist and lead author of the report published online Monday in the journalPediatrics. "They should be...
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The CHIP Program Is Beloved. Why Is Its Funding in Danger? [nytimes.com]
WILMINGTON, Del. — Laquita Gardner, a sales manager at a furniture rental store here, was happy to get a raise recently except for one problem. It lifted her income just enough to disqualify her and her two young sons from Medicaid, the free health insurance program for the poor. She was relieved to find another option was available for the boys: the Children’s Health Insurance Program, known as CHIP, that covers nearly nine million children whose parents earn too much for Medicaid, but not...
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The Decline of Empathy: A Hopeful Solution (www.claudiamgoldmd.blogspot.com)
Here is an excerpt from a recent blog post by Dr. Claudia M. Gold. Pediatrician T. Berry Brazelton was among the first to recognize the tremendous capacity of the newborn for complex connection and communication. Developmental psychologist Ed Tronick, drawing on this observation, designed the famous Still-Face Experiment to show the devastation, for both parent and baby, when they struggle to connect. Extensive research at the interface of developmental psychology, neuroscience, and...
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The quest to find biomarkers for toxic stress, resilience in children — A Q-and-A with Jack Shonkoff
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
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
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 ‘Unseen Wounds’ of Child Emotional Abuse [psmag.com]
As recent reports regarding actor Stephen Collins remind us, accusations of child sexual abuse reliably produce a reaction of intense horror. But a new study suggests that, if we are to seriously address the mistreatment of children...
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TIC: News and Notes for the Week of March 18 2019
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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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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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 and Responding to Children who Bite
Biting is a typical behavior often seen in infants, toddlers, and 2-year olds. As children mature, gain self-control, and develop problem-solving skills, they usually outgrow this behavior. While not uncommon, biting can be an upsetting and...
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What the ACEs Screening Movement Can Learn from the Healthcare Hotspotting Movement
No brief intervention or short-term infusion of services is a silver bullet that will overcome the long-term harm caused by structural racism, poverty, and multi-generational trauma.
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When Parents Have Experienced Adverse Childhood Experiences, What is the Effect on Their Children? [aappublications.org]
Our journal and others have published a myriad of studies on the deleterious effects of adverse childhood experiences (ACEs) on the developmental and physical well-being of infants and children. But what about the generational effect on offspring of parents who experienced ACEs growing up? Two studies we are early releasing this week shed some light on answering this question. First Racine et al. ( 10.1542/peds.2017-2495 ) present the results of their examination of maternal ACEs on the...
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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 screen if there are no services? (Barbara J. Howard - Pediatric News)
Why screen if there are no services? By: DR. BARBARA J. HOWARD OCTOBER 6, 2014 Behavioral Consult Do you remember the discussion of the ethical dilemma of Huntington’s disease you probably participated in during medical school? The...
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Re: Webinars
Excellent webinar Dr. Grady - I am so grateful to see the momentum behind the ACE study and the growing evidence of how we can intervene, rather than ignore the huge public health problem we have.
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Medical Authorities with Academic Blinders look the other Way: Reject ACES
Recently a family doc published a "Viewpoint" in the Journal of the American Medical Association suggesting restraint and caution in using the ACEs screening tool (Campbell TL. Viewpoint, Screening for Adverse Childhood Experiences (ACEs) in Primary Care: A Cautionary Note , JAMA Published Online: May 28, 2020, doi:10.1001/jama.2020.4365) because (1) there were no evidenced based treatments, (2) asking the questions would offend patients and parents, and (3) risk of labeling people with such...
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Re: Medical Authorities with Academic Blinders look the other Way: Reject ACES
Jeoffry, Although I have concerns about required screening for ACEs in a society and medical culture that has little understanding of trauma, still commonly believes the only effects of trauma are psychological, often tells individuals with “functional” diseases, mental health conditions, low income or who are discriminated against that it’s all in their heads, does not provide health insurance and mental health treatment for all – I believe it is important to move forward because of all...
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Re: Medical Authorities with Academic Blinders look the other Way: Reject ACES
Ms Mead I am so grateful for your heartfelt comments. It must have taken a lot of thought and energy to put together such an extensive essay. Your intimate passion and concern come through and I share it. I am glad you found a way (in spite of personal circumstances) to put your wisdom and caring to use. I would riff of your desire to see our society become "more trauma informed" to say I honestly think we live in a relatively brutal and unjust, selfish and violent society. Child abuse is...
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Re: Medical Authorities with Academic Blinders look the other Way: Reject ACES
Thank you for being so concerned and so passionate. As an advocate for good medicine and good therapy and for helping traumatized kids, I recognize some of your concerns, but others, in my experience, are not as significant as you think. (1) There is a lot of family violence, We have to do everything we can to prevent it and to treat its effects. (2) CYW is definitely not the government, Dr. BH may be part of government now but I see that as a great success in changing public policy to deal...
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Re: Medical Authorities with Academic Blinders look the other Way: Reject ACES
But, Alas, pediatricians are medical clinicians, not police. If they did not ask about language skills they may never uncover a hearing problem that could be treated. If they do not ask about home environment, they may overlook abuse -which they have the responsibility and skills to treat.This is not prejudice, punishment or stigmatization but caring outreach and risk assessment in the vast majority of circumstances.
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Re: Medical Authorities with Academic Blinders look the other Way: Reject ACES
You DO NOT NEED AN ACE SCORE to get a psychosocial history. You do not need to put a family at risk to do a psychosocial history and provide services to patients. I know. I have been doing it for 20 years. All this score can be used for when put in the medical record is to harm children, parents and families. If I were forced to get this score, I would tell all my patients that the government is forcing me to ask you questions that could put you at risk for having your children removed from...
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Re: ACEs screening is about building relationships, says early adopter
I have been thinking a lot about the current lively conversation. We have now known about the problem of the endemic of child abuse and neglect with the resulting traumatic stress contributing to mental and physical disease for a generation, but medicine has not yet dealt with it adequately. Taking a broad view I see we are having an enthusiastic dialogue among 3 groups of clinicians about how to deal with this problem and the 4th group. The fourth group is by far the largest - maybe 80 % of...
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ACEs and Gynecological Problems - A Conversation Starter
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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Re: ACEs and Gynecological Problems - A Conversation Starter
Thank you for your posts. It's scary when I hear people say "it's all about choices," as if babies and children have agency.
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Re: ACEs and Gynecological Problems - A Conversation Starter
Hi Dianne, Thanks so much for your comments, thoughts and questions, and being brave enough to share your personal history! It reinforces in my mind why it's so necessary that health care systems should be trained in trauma-informed practices. I recently interviewed a nurse practitioner, Annie Lewis-O'Connor about another project. But she founded and directs the C.A.R.E. clinic at Brigham and Women's Hospital in Boston. It's a trauma-informed clinic that serves girls and women who have...
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California ACEs Academy Event: The Repressed Role of Adverse Childhood Experiences in Adult Well-Being, Disease and Social Functioning: Turning Gold into Lead
Thursday, September 3, 2020 12:00pm - 1:00pm PDT | presented by Dr. Vincent J. Felitti *Priority will be given to Medi-Cal providers* The ACE Study reveals how typically unrecognized adverse childhood experiences are not only common, but causally underlie a number of the most common causes of adult social malfunction, biomedical disease, and premature death. Moreover, it enables one to see that the Public Health Problem is often an individual’s attempted Solution to childhood experiences...
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Health advocates highlight extreme COVID burnout, stark inequities and strong call for action
Dr. Elisa Nicholas, a pediatrician and chief executive officer of TCC Family Health Clinics in Long Beach, California, relays an example of how the COVID-19 pandemic has wreaked havoc on the lives of the clinics’ patients. Most had already been struggling financially prior to the pandemic. “Both the mother and father came down with coronavirus,” said Nicholas. “Their child was in on a telephone visit with one of our doctors. They did not have any way to get food. They had no money to pay for...
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ACEs screening pilot in L.A. County pivots, troubleshoots barriers to remote visits
This story is part of an occasional series about California-based pediatricians who are incorporating ACEs screening into their practices. In the first installment published in May, which you can find here , Dr. Amy Shekarchi and other team members had just launched their ACEs screening by phone. A community health worker from a clinic affiliated with Los Angeles County’s Department of Health Care Services recently called a teenage patient to find out if she ever felt unsafe in her home or...
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Think beyond ACEs screening, advises California funders workgroup in new report
Californians have experienced an alarming epidemic of adverse childhood experiences. Between 2011 and 2017, 60 percent of Californians reported experiencing at least one type of childhood adversity; about 16 percent experienced four or more. People who experience four or more ACEs are 1.5 times as likely to have heart disease, 1.9 times as likely to have a stroke, and 3.2 times as likely to have asthma as people who have experienced no ACEs. (For more information about ACEs and ACEs science,...
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A hospital builds awareness about trauma, deploys acts of empathy
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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Supporting Skagit County (WA) Families in Need
In 2012, retired from a career in maternity nursing, I joined an effort to start a food bank in our town of 900 people. Though small, we were prepared for most requests; that is, until the day a mother came in search of baby diapers. We had none, so one of our volunteers bought a package of diapers to give her the next time she came in. Soon after, more women came looking for diapers, including a mother-to-be who was expecting twins. She was going to need help. We felt empathy for her and...
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8 Categories of Adversity That Shape Health: Adverse Babyhood Experiences (ABEs), ACEs and ACEs+, ACREs, and More
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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Research article on ACEs and immune cell gene expression in children
Sharing our recent publication of pilot data on ACEs (assessed using the Whole Child Assessment) and immune cell gene expression in children age 5-11 years old
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Dr. Claudia Gold's Recent Blog Posts & Videos
Dr. Claudia Gold is an ACEs Champion who has as much medical expertise as she does empathy for parents, including and maybe especially for parents who are struggling. She recognizes the challenges and difficulties many parents experience but instead of shaming or punishing parents, she starts by listening to and learning from us. While this seems like the most practical, effective, and common-sense approach, to me, it is something many providers don't have the time, skill, inclination, or...