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PACEs in Pediatrics

Tagged With "fetal origins of adult disease"

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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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Past child abuse may influence adult response to antidepressants [Reuters.com]

Samantha Sangenito ·
Antidepressants don’t work for everyone, and having a history of abuse during childhood may signal a low likelihood that the drugs will improve an adult’s symptoms of major depression, a recent study suggests. While there are few reliable predictors of which people will respond to specific antidepressants, lots of previous research links a history of trauma early in life with how well people tend to do on these drugs, researchers note in the journal Translational Psychiatry. "The presence of...
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Pediatricians screen parents for ACEs to improve health of their babies

Jane Stevens ·
The  Children’s Clinic , tucked in a busy office park five miles outside downtown Portland, OR, and bustling with noisy babies, boisterous kids and energetic pediatricians, seems ordinary enough. But, for the last two years, a quiet...
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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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Please stop saying parenting is hard for everyone & read Parenting with PTSD instead

Christine Cissy White ·
Sometimes, we feel anxious, intrusive, or afraid when changing or bathing or own babies. Sometimes, we feel sick to our stomachs and worried while potty training, nurturing, or disciplining our toddlers. Sometimes, we feel shame-filled and ill-equipped when talking about puberty, body parts, or sexuality because of how and where we were compromised by caregivers as children as in our bodies, homes, and families. P arenting is brutally hard for some. If affection, attention and intimacy have...
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Positive Childhood Experiences and Adult Mental and Relational Health in a Statewide Sample: Associations Across Adverse Childhood Experiences Levels [jamanetwork.com]

By Christina Bethell, Jennifer Jones, Narangerel Gombojav, et al., JAMA Pediatrics, September 9, 2019 Question : Are positive childhood experiences (PCEs) associated with adult depression and/or poor mental health (D/PMH) and adult-reported social and emotional support (ARSES) independent from adverse childhood experiences (ACEs)? Findings : In this cross-sectional study, adults reporting higher PCEs had lower odds of D/PMH and greater ARSES after accounting for ACEs. The associations of...
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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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Recently released research on ACEs; incarceration; separating families at the border

Laurie Udesky ·
Behavioral risk factor surveillance system state survey on exposure to adverse childhood experiences (ACEs): Who declines to respond? [Children and Youth Services Review] "A wealth of research has examined the prevalence and impact of adverse childhood experiences (ACEs) via various research methodologies. Some of these studies have also examined the presence of nonresponse bias, showing minimal nonresponse bias effects. More recently, many states and the District of Columbia have used the...
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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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Research roundup: ACEs among incarcerated women; testing technology to help reduce substance use; prenatal support as an intervention to prevent ACEs

Laurie Udesky ·
photo by Rhoda Baer/Wikimedia Common Life as she knows it: The effects of adverse childhood experiences on intimate partner violence among women prisoners [Child Abuse & Neglect] "Most incarcerated women suffer from adverse childhood experiences (ACEs), such as abuse (e.g., physical, sexual, emotional), neglect, (e.g., physical, emotional), and chaotic home environments (e.g., witnessing domestic violence), and adult intimate partner violence (IPV). Yet the majority of research on the...
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Research roundup of studies about ACEs and resilience

Laurie Udesky ·
photo /CreativeCommons How do parents' perception of their children's resilience match up with their ACE scores? What is the scientific evidence that separating children from parents causes trauma? How does a trusted adult and other supports counteract the impact of high ACE scores? Looking at the National Survey of Children's Health for answers about bullying
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Research roundup: Prospective ACE study and commentary about it; ways of asking about trauma; research on the power of internal resilience in juvenile offenders and a companion essay

Laurie Udesky ·
Association of Childhood Trauma Exposure With Adult Psychiatric Disorders and Functional Outcomes JAMA Open Prospective Study Delves Deeper Into Mental Health Effects of Childhood Trauma Psychiatry From Treatment to Healing: Inquiry and Response to Recent and Past Trauma in Adult Health Care Women's Health Issues Adverse Childhood Experiences and Psychological Distress in Juvenile Offenders: The Protective Influence of Resilience and Youth Assets Journal of Adolescent Health Adverse...
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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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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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Boston’s architect of community well-being: Pediatrician Renée Boynton-Jarrett

Christine Cissy White ·
She talks with parents about the relationship between childhood adversities they have experienced and how that may have an impact on parenting. “I frame things a bit more broadly than ACEs,” she said, “because I think it’s very important to reflect on a broader number of exposures than were covered in the original study, such as poverty or structural violence and racism.”
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Brittany S. Bruggeman and Zach Spoehr-Labutta: Partnering for resilience in Gainesville [Gainesville.com]

Samantha Sangenito ·
Pupils widen. The heart pounds. Stress hormones flood the body. Lungs expand, and every muscle sits on the verge of action. This describes the stress response, a normal reaction to a normal emotion. However, when a child experiences this response in a strong, frequent or prolonged way due to adversity, without the support of an adult, it can cause health consequences lasting into adulthood. This phenomenon is called toxic stress. As a pediatrician at UF Health, helping children grow and...
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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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Building trust is now a critical part of health care

Laurie Udesky ·
In a video clip , a hospital patient turns away in protest as a physician enters the room. “Why do you all keep coming in my room!” she asks in frustration. The physician moves a chair out of the way and sits down at eye level with the patient. “You’ve had to see so many people,” he acknowledges. “And I’m tired of it!” she yells. “I already know I have to get both of my legs cut off. That’s what they keep saying. I don’t have a choice!” “You don’t feel like you have a choice,” he repeats...
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CA announces robust perinatal depression prevention for Medi-Cal recipients

Laurie Udesky ·
Melinda Coates experienced a tumultuous pregnancy. “I was really mentally upset literally from day one (of the pregnancy),” she says. (Melinda Coates is a pseudonym. To protect her and her children’s privacy and safety, we are not using her real name.) Coates had hoped to get counseling last October, when she was seven months pregnant. That’s when she enrolled in the state’s Medi-Cal program, shortly after she and her abusive husband moved to California, “but nobody was able to get me in...
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CA announces robust perinatal depression prevention for Medi-Cal recipients

Laurie Udesky ·
Melinda Coates experienced a tumultuous pregnancy. “I was really mentally upset literally from day one (of the pregnancy),” she says. (Melinda Coates is a pseudonym. To protect her and her children’s privacy and safety, we are not using her real name.) Coates had hoped to get counseling last October, when she was seven months pregnant. That’s when she enrolled in the state’s Medi-Cal program, shortly after she and her abusive husband moved to California, “but nobody was able to get me in...
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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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California has Begun Screening for Early Childhood Trauma, But Critics Urge Caution [sciencemag.org]

By Emily Underwood, Science, January 29, 2020 On 1 January, California became the first U.S. state to screen for adverse childhood experiences (ACEs)—early life hardships such as abuse, neglect, and poverty, which can have devastating health consequences in later life. The project is not just a public health initiative, but a vast experiment. State officials aim to cut the health impacts of early life adversity by as much as half within a generation. But critics say the health benefits of...
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California healthcare providers adapt ACEs screening from in-person to virtual environment

Laurie Udesky ·
Dr. Amy Shekarchi, a pediatrician based in Los Angeles, CA, was helping to lead the rollout of ACEs screening among 50 health care providers at six clinics affiliated with the L.A. County Department of Health Services when the COVID-19 pandemic hit—days before she was set to launch the effort. “We had trained everybody in doing face-to-face [ACEs screening], and when COVID-19 happened we thought, let’s not throw the screening out. Everybody was ready,” says Shekarchi, who is the pediatric...
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California unveils ACEs Aware initiative to screen for trauma

Laurie Udesky ·
Will screening for adverse childhood experiences (ACEs) in California be mandatory? No, but it’s recommended. Will there be training for physicians and staff on how to screen? Yes. Who will be reimbursed for screening patients in California? Physicians who serve patients in the state’s Medi-Cal program — for now. For more answers to these and other questions that surfaced during a Dec. 4 webinar introducing Californians to a new statewide initiative, read on. Come January 1, California will...
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Can We Harness Pediatrician T. Berry Brazelton's Message of Hope?

Claudia Gold ·
Photo courtesy of Brazelton Touchpoints Center As our nation mourns the passing of renowned pediatrician T. Berry Brazelton, hearing his voice through the outpouring of articles, video clips, and conversations on social media feels like a balm for the soul. In these trying times, his simple shift from learning "what's wrong" to listening for "what's right" in a child and family seems very much needed. In his 50 years practicing pediatrics, he saw up close the ways parents can struggle. With...
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Caring adult relationships can make the difference for children in trauma [register-herald.com]

Alicia Doktor ·
Social workers, law enforcement officers and other children’s advocates gathered Wednesday for the first day of the West Virginia Children’s Justice “Handle With Care” Conference to learn more about child trauma, intervention and ways to help children become successful. In a state that leads the nation for opioid overdose deaths and babies born with Neonatal Abstinence Syndrome, West Virginia children are often witnesses to and victims of trauma. The West Virginia Defending Childhood...
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CHCS brief outlines foundational steps toward implementing trauma-informed care

Laurie Udesky ·
A newly-released brief by the Center for Health Care Strategies details some practical strategies and recommendations for health care organizations seeking to implement trauma informed practices. “It draws from the experiences of pilot sites in Advancing Trauma-Inform ed Care , a CHCS-led national initiative made possible through support from the Robert Wood Johnson Foundation.” Here is a related video CHCS-organized webinar entitled Implementing Trauma-Informed Care in Pediatric and Adult...
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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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Child abuse could leave 'molecular scars' on its victims [medicalxpress.com]

Alicia Doktor ·
Children who are abused might carry the imprint of that trauma in their cells—a biochemical marking that is detectable years later, according to new research from the University of British Columbia and Harvard University. The findings, based on a comparison of chemical tags on the DNA of 34 adult men, still need confirmation from larger studies, and researchers don't know if this tagging—known as methylation—affects the victims' health. But the difference in methylation between those who had...
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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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Course credit for "Childhood Adversity and Toxic Stress in Medical Care: Promoting Health and Healing Throughout the Lifespan"

Jane Stevens ·
Dr. Beth Grady, a pediatrician at South San Francisco Clinic, developed a course called: "Childhood Adversity and Toxic Stress in Medical Care: Promoting Health and Healing throughout the Lifespan". She did the presentation on June 15, 2016, and the webinar was posted on June 22, 2016. The termination date for the webinar is June 22, 2019. Instructions for earning 1 AMA PRA Category 1 Credit TM for this enduring material: Watch the video of the presentation, which can be accessed via this...
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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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Introducing NEW Becoming Trauma-Informed & Beyond Community

Christine Cissy White ·
Earlier this year @Dawn Daum wrote to us when she was ready to share ACEs science with people in the organization she works in to make a case for moving towards more trauma-informed care for the benefit of the staff and those they serve. She was frustrated because almost all the training and resources she found were geared towards schools, clinical staff or to organizations working with children and families rather than ACE-impacted adults in the workplace and who are...
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Kaiser family medicine clinic launches 4-question ACE survey pilot for adults

Laurie Udesky ·
In July, medical residents in family medicine at Kaiser Permanente in San Jose, CA, began screening adult patients for adverse childhood experiences (ACEs). But it’s an ACE survey with a twist: it’s shorter, not the 10-question survey of the original CDC-Kaiser Permanente ACE Study , according to Dr. Kathryn Ridout who is leading the pilot along with Dr. Francis Chu and Dr. Alec Uy . Why a shorter ACE survey? Dr. Kathryn Ridout “When we were doing our initial discussions with stakeholders in...
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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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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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Listening to Killers: Bringing Developmental Psychology into the Courtroom in Murder Cases

Former Member ·
    Only 1/1000 have an ACE score of 9 or 10.  In his new book, James Garbarino, shows us how we as society creates killers through overwhelming ACEs .  He is empathetic and shows lets us know the reality, most killers are...
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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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Medical students' ACE scores mirror general population, study finds

Laurie Udesky ·
A national survey published in 2014 revealed a disturbing finding. Compared to college graduates pursuing other professions, medical students, residents and early career physicians experienced a higher degree of burnout. Citing that article, a group of researchers at University of California at Davis School of Medicine wondered whether medical students’ childhood adversity and resilience played a role in their burnout, said Dr. Andres Sciolla, an associate professor of psychiatry and...
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“Motherless Children Have the Hardest Time”: Epigenetic Programming and Early Life Environment  [pediatrics.aappublications.org]

Alicia Doktor ·
The Blind Willie Johnson blues song “Motherless Children” highlights the maternal bonds that we all know are critical to emotional and cognitive development. Authors of previous work looking at infant stress response have found that these bonds begin in utero and can be influenced by both maternal and paternal influences and across multiple generations. 1 The observations of Barker et al 2 on the Dutch famine birth cohort of World War II were perhaps the first published observations of this...
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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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National Survey of Child and Adolescent Well-Being (Adverse Childhood Experiences in NSCAW # 20)

Former Member ·
Why We Should Assess for ACEs in kids in the child welfare system.  I don't know exactly how old this brief from the Administration on Children and Families from HHS is but the graphs say it all.  However I will add a few points:   1....
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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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New organization calls all pediatricians to end crisis that's "hiding in plain sight"

Laurie Udesky ·
When the question of screening patients for adverse childhood experiences (ACEs) was first raised a couple of years ago, Santa Barbara pediatrician Andria Ruth had mixed feelings about it.
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New Sesame Street Tools Help Build Resiliency [rwjf.org]

Alicia Doktor ·
The Robert Wood Johnson Foundation and Sesame Workshop share a common vision of giving all children—especially the most vulnerable among us—a strong and healthy start in life. We know that childhood experiences lay the foundation for children to grow into productive and successful adults, and promoting healthy behaviors and supporting families from the very beginning can help kids thrive. But it’s equally important to address challenges that can undermine their healthy development. That’s...
 
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