Tagged With "home visiting"
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Dozens of Kaiser Permanente pediatricians in Northern California screen three-year-olds for ACEs
Since August 2016, more than 300 three-year-olds who visited Kaiser Permanente’s pediatric clinics in Hayward and San Leandro have been screened for adverse childhood experiences (ACEs), such as living with a family member who is an alcoholic or losing a parent to separation or divorce. But when the idea to screen toddlers and their families for ACEs was first broached at the Kaiser Permanente Hayward Medical Center, the staff were, in a word, “angsty,” says Dr. Paul Espinas, who led the...
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Dozens of stakeholders representing thousands of practitioners send public comments on Calif. ACEs-screening plan
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
"You are absolutely not doomed from having ACEs."
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Early Bird registration ends Feb 2 for the AAP Trauma Informed Pediatric Provider Course
Early bird registration ends soon for the 2019 AAP Trauma Informed Pediatric Provider (TIPP) Course scheduled March 2-5, 2019 in San Antonio, TX. Learn from other pediatric healthcare providers about the recent science, evidence base and treatments of adversity, resiliency and toxic stress. AAP Past-President, Dr. Colleen Kraft, will deliver the keynote presentation Pediatricians as Leaders in Addressing Toxic Stress and Trauma in Children . For more information, a schedule of speakers and...
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Explore NPPC’s New ACEs Screening Resources Website
Join the National Pediatric Practice Community on ACEs (NPPC) on Wednesday, April 25 at 12:00 PM PST for a Q&A session and a “sneak peek” of its new member website, which provides a wide range of resources to help pediatric practices make the case and implement screening for adverse childhood experiences (ACEs). NPPC is an initiative of the Center for Youth Wellness.
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Free play is great for kids. Now pediatricians say so (sacbee.com)
The award for best line ever in a medical report: “Play is not frivolous.” It’s not new, the idea that free play helps children develop in remarkable ways. Multiple studies have found that play builds social skills and creativity and develops the ability to solve problems and to collaborate. What is new is that a clinical report published in August by the American Academy of Pediatrics specifically calls on pediatricians and family doctors to start taking play, well, seriously – in fact to...
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GunderKids: Design of a clinical care management program for parents with substance abuse and their newborn children with a focus on preventing child abuse [Health Innovations]
Photo/CreativeCommons "In response to an increased need to care for babies born to mothers with substance abuse issues, we developed GunderKids, a care management program that provides integrated medical care beyond standard-of-care, well-child appointments for these socially complex families. Methods: The program incorporates frequent visits to the pediatrician and the care team, which includes pediatric nurses, a pediatric social worker, and a child psychologist. Enrollment is volun- tary.
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Heyman Oo integrates ACEs science as foundation of pediatric care
Dr. Heyman Oo, a 34-year-old primary care pediatrician, first learned about the science of adverse childhood experiences in medical school at a grand rounds held around 2012 at Rady Children’s Hospital in San Diego, which she attended from 2009 to 2014. The presenter was none other than Dr. Nadine Burke Harris, a pediatrician who went on to become California’s first Surgeon General. The founder and former director of the Center for Youth Wellness drew millions of views for her TED talk on...
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Home Gun Safety Queries in Well-Child Visits [jamanetwork.com]
By Carole H. Stipelman, Greg Stoddard, Kyle Bata, et al., JAMA Pediatrics, October 28, 2019 Firearms are a leading cause of death in US children, and the rate of suicide by firearms in people aged 10 to 19 years has increased since 2008.1 In the United States, 4.6 million children (approximately 7%) live in households with at least 1 gun that is stored loaded and unlocked.2 Safe storage of guns and ammunition may decrease the occurrence of self-inflicted or unintentional firearm injury to...
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HOPE, Engagement, and COVID19
As children grow and develop, engaging with the larger community around them provides a sense of “mattering” — a sense that their participation in the community really does matter. The emergency conditions now in effect provide numerous opportunities to children and teens to pitch in. Here are a few ideas . . .
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How collaboration helps clinic in San Mateo County, CA, tackle ACEs in children
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.
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 "Sesame Street" is helping kids learn to cope with trauma [abcnews.go.com]
Big Bird and his " Sesame Street " buddies are taking on a new mission: helping kids learn to cope with stress and trauma. Sesame Workshop, the nonprofit offshoot of the long-running children's program "Sesame Street," launched the powerful new initiative, which was designed with the help of psychologists, the same week that the nation was rocked by the deadliest mass shooting in modern U.S. history. The initiative includes materials for parents, caregivers and social workers, as well as...
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How Supportive Parenting Protects the Brain
Photo credit: Caroline, Flickr The other day, a mother of a 15-month-old walked into Andrew Garner’s office, oozing frustration. “Is it normal for them to never sit still?” she asked. Garner, a pediatrician in Westlake,...
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Researchers share learned lessons from screening for adverse childhood experiences in pediatric clinics
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
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
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 fast, easy way for pediatricians to screen kids for ACEs...and other health issues
Last November, the California Department of Managed Care gave its stamp of approval to a new version of Whole Child Assessment 2.0 , a tool that screens for children’s adverse childhood experiences (ACEs). It was recommended as part of recently passed legislation calling for trauma screening for children in California. But the Whole Child Assessment 2.0 (WCA) does more. It also queries patients about other critical safety and health issues, including whether they have enough to eat, whether...
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A Message from the President of the Illinois Chapter, American Academy of Pediatrics
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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A Pandemic Benefit: The Expansion of Telemedicine [nytimes.com]
By Jane Brody, The NY Times, May 11, 2020. Even if no other good for health care emerges from the coronavirus crisis, one development — the incorporation of telemedicine into routine medical care — promises to be transformative. Using technology that already exists and devices that most people have in their homes, medical practice over the internet can result in faster diagnoses and treatments, increase the efficiency of care and reduce patient stress. Without having to travel to a doctor’s...
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AAP Federal Affairs Update
One week from today is Tuesday, Nov. 4: Election Day. Now is the time to speak up for children at the ballot box by casting your vote ! This year, all 435 members of the U.S. House of Representatives and 36 members of...
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ACEs Aware: On Jan. 1, 2020, Medi-Cal Providers Can Receive Payment for ACEs Screenings
ACEs and toxic stress represent a public health crisis that has been, until recently, largely unrecognized by our state’s health care system and society, but there’s hope. Together, we can screen for ACEs, respond with trauma-informed care, and significantly improve physical and mental health across the state. All Medi-Cal providers are encouraged to get trained today . Beginning on January 1, 2020, eligible Medi-Cal providers can receive a $29 payment for conducting qualifying ACEs...
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ACES Aware Webinar: Dec 13th, 12-1pm PT - Public Comments about soon-to-be-released Request for Proposal
The Department of Health Care Services and the California Office of the Surgeon General are hosting a webinar of the Trauma-Informed Care Implementation Advisory Committee’s Provider Education and Engagement Subcommittee. Subcommittee members will discuss a draft Request for Proposal (RFP) released for public comment as part of the ACEs Aware initiative. The draft RFP invites external organizations to apply for grants to support provider training activities, provider engagement activities...
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ACEs Aware Webinar: Trauma-informed practices to address stress from COVID19
How can health care providers take care of themselves, their colleagues and their patients during this COVID-19 pandemic? First and foremost is recognizing how the pandemic can stir up trauma from the past, said Dr. Alicia Lieberman, a psychologist specializing in trauma. “COVID19 is reawakening traumatic reminders in many of us and in the families we work with. And that often makes it difficult for parents to protect themselves and their children,” she noted. Lieberman, the director of the...
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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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American Academy of Pediatrics Friends of Children's Fund Update
Dear Friend of Children, At this time of year, we pause and give thanks for colleagues and friends like you who care deeply and passionately about the health and well-being of children. We sincerely thank you for your past support of the American...
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Announcing a New Parenting and ACEs Blog from Stress Health, an Initiative of the Center for Youth Wellness
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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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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Support, Connect and Nurture: Addressing the impact of ACEs in the pediatric medical home
Adverse childhood experiences (ACEs) can have a profound impact on children’s development, increasing risk for chronic disease and mental illness. The Support, Connect, and Nurture (SCAN) project was developed to address the impact of ACEs on the health and well-being of children and families in Pueblo, Colorado. Located at Southern Colorado Family Medicine Residency Clinic (SCFM) and in partnership with Catholic Charities Diocese of Pueblo, the SCAN intervention included the following...
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Survey: Healthcare providers, community organizations weigh in on California's ACEs screening program
In January, California took a historic leap forward to promote universal ACEs screening of the state’s 13 million adults and children in the Medi-Cal program. The eventual goal is to promote ACEs screening for all patients, but this is a first step in dealing with a major issue that ACEs science has identified: that many children will develop serious health problems later in life because the healthcare system is not currently set up to detect the roots of those problems. The term ACEs, which...
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Teens Seen in ERs for Assault at Risk for Later Gun Violence: Study
Researchers suggest the emergency room might be best place to stop cycle of violence. MONDAY, April 6, 2015 (HealthDay News) -- New research suggests that the emergency room might be a good place to try to end the vicious cycle of gun violence...
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Texas Lawmakers Want To Send Fewer Moms To Prison [npr.org]
For the eight-and-a-half years she spent in prison, Kristan Kerr looked forward to one thing every month: a visit from her daughter, Chloe. Visit by visit, she watched Chloe grow from a toddler to nearly a teenager. "I just watched her grow all the way up," Kerr says. "One visit, she couldn't read, and then the next visit she was reading something to me." Convicted for aggravated robbery in 2011 – she was the driver — Kerr says she wasn't making good choices back then, and it meant missing...
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The Psychosocial Profile: A History-Taking Aid
Can Fam Physician. 1985 Apr; 31: 864–868. 1. The psychosocial history helps to distinguish functional primary care complaints from organic ones. 2. As many as 1/2 - 3/4 of patient visits to primary care clinics have...
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The Relentless School Nurse: Brandy Bowlen Shares Her Message - From Seat to Feet
Brandy Bowlen has transformed her school community by first taking a stand for her own health and well-being. This is not an easy feat for nurses. Eight years ago, when Brandy was a new school nurse, she found herself overwhelmed, overstressed and overweight. She became a warrior for self-care, connecting the importance that her professional persona would be most impactful if she presented herself as an example. Brandy shares her journey to wellness for herself and her school community.
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The Relentless School Nurse: Do Kids Yoga With Nurse G!
I am continuously inspired by the generosity of spirit that is being shared during this complicated and unprecedented time. There are artists, musicians, storytellers, and teachers creating opportunities for families to bring some structure to our very unstructured day. You can find a variety of classes, concerts, and virtual gatherings through social media. One shining example that I wanted to share is the story of 'Kids Yoga with Nurse G'. I am continuously inspired by the generosity of...
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The Relentless School Nurse: Full Disclosure: I am Fearful to Welcome Another September
School is about to begin and for the first time in my 18 years as a school nurse, I am fearful to welcome another September. I work in an urban district where community gun violence is sadly commonplace, but that is not my fear. I travel throughout the city from school to school where drug dealing is an open-air exercise, but that is not my fear. Emergencies are often solitary experiences because school nurses work independently, but that is not my fear. Families facing deportation from...
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The Relentless School Nurse: How Are We Treating Our Children?
School nursing is filled with challenging moments, some are more emergent than others. Imagine this scenario: A preschool student whose family is displaced, enters school with no physical exam or immunizations has a seizure at school. The student is admitted to the hospital, and upon discharge, is released with multiple referrals to specialists and diagnostic studies. The family, undocumented and homeless, has no insurance. The mother's employer will not provide proof of income because she...
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The Relentless School Nurse: Soap, Toothbrushes & Sleeping on Concrete Floors
Earlier in the year, I wrote a blog post about one of my newest students who was saving food that was served in school to bring home to her family. The 4-year-old girl, a recent immigrant from Guatemala, was storing food in her pants pockets instead of eating at school. Here is a link to the blog post: Pockets Filled With Chicken and Other Social Determinants of Health Yesterday, I was privileged to see this little girl welcome the guests for the end of year celebration as the students move...
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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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Those who separate immigrant children from parents might as well be beating them with truncheons
Many people who see reports of children separated from their parents might think that, because they’re not crying, that they’ve adjusted. Or, if they are crying, they’ll eventually stop and get over it. But, the reality is that those who participate in separating children from their parents and those who are caring for them in the detainment centers might as well be beating them with truncheons.
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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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Trauma-Informed Care May Ease Patient Fear, Clinician Burnout [jamanetwork.com]
By Bridget M. Kuehn, JAMA Network, January 29, 2020 For many sexual assault survivors whom Anita Ravi, MD, MPH, sees as a New York City–based family physician, the prospect of even basic medical care can be frightening. Some have put off Papanicolaou tests and mammograms for years or even decades. To help them, Ravi has adopted a trauma-informed approach that works to restore patients’ trust and give them a greater sense of control over their visit. This may include asking permission before...
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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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Update on bills re: childhood adversity in California Legislature
Below is an updated table of bills that address childhood adversity in the Legislature in 2019. The list is not exhaustive, so please email Kelly Hardy with Children Now if you think a bill is missing and/or if you have any questions. Email: khardy @childrennow.org . Here are key dates for the remainder of the legislative session: July 10 = last day for bills to pass out of policy committees July 12 – August 12 = Summer recess August 30 = last day for fiscal bills to pass out of committee...