Tagged With "in person"
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Graduations, non-linear paths, & the importance of getting started
With graduation season upon us, I have been thinking a lot about one of my favorite graduation speeches. It’s the speech that Shonda Rhimes, creator of Grey’s Anatomy, gave in 2014 at Dartmouth College. She references the typical expected advice from a graduation speech: “Follow your dreams. Listen to your spirit. Change the world. Make your mark. Find your inner voice and make it sing. Embrace failure. Dream. Dream and dream big..." And then she says, “I think that’s crap.”
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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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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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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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A Conversation with Nadine Burke Harris: How Should Pediatricians Address Childhood Adversity?
Pediatrician Nadine Burke Harris is a masterful storyteller. I learned in a conversation with her at Wheelock College before her presentation for the Brookline, MA organization Steps to Success , that before she decided to become doctor, Dr. Burke Harris wanted to be an author. Only after the smashing success of her TED talk: How childhood trauma affects health across a lifetime , when she was approached by a literary agent, did she find her way to writing. Her newly released book The...
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A Guide to Providing Telehealth During the COVID-19 Crisis
Many of us in the mental health field are being thrust into unfamiliar territory as clinicians in the midst of the COVID-19 response. We either risk personal health (and the health of our clients) by seeing people in person, or needing to utilize technologies that we may be unfamiliar with. Further, those technologies have fluid legal/ethical standards (and is even more fluid at present to accommodate the pandemic), and which require different skill sets that in-person therapy. I am...
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A Guide to Providing Telehealth During the COVID-19 Crisis
ACEs in Pediatrics community manager's note: Although this post by Daren Casagrande is geared toward mental health providers, I thought it had material that could be useful to a wider swath of health care providers. Please comment below if you have any questions or suggestions. --- Laurie Udesky Many of us in the mental health field are being thrust into unfamiliar territory as clinicians in the midst of the COVID-19 response. We either risk personal health (and the health of our clients) by...
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A 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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A National Agenda to Address Adverse Childhood Experiences
What are ACEs and Why Do They Matter? In 2016 1 , nearly half of U.S. children – 34 million kids – had at least one Adverse Childhood Experience (ACE) and more than 20 percent experienced two or more. The new brain sciences and science of human development explain how ACEs can have devastating, long-lasting effects on children’s health and wellbeing. These events resonate well beyond the individual child to have far-reaching consequences for families, neighborhoods, and communities. ACEs...
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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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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 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 champion pediatricians talk about life and practice in a COVID-19 world
With the advent of the COVID-19 pandemic, healthcare providers everywhere are changing how they care for their patients. I asked a few members of the ACEs in Pediatrics community what they’re doing differently. Dr. R.J Gillespie, pediatrician at The Children’s Clinic in Portland, OR. Dr. R.J. Gillespie Gillespie says that, as much as possible, they’re switching to virtual visits, which allows them “to comfort and reassure our patients face-to-face as much as possible without risking their...
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ACEs Research Corner — June 2019
[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 posts the summaries of the abstracts and links to research articles that address only ACEs. Thank you, Harise!! -- Jane Stevens] Wickramasinghe YM, Raman S, Garg P, Hurwitz R. Burden of adverse childhood experiences in children attending paediatric clinics in South Western Sydney, Australia: 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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Association of Immigrant and Refugee Status with Risk Factors for Exposure to Violent Assault Among Youths and Young Adults in Canada [jamanetwork.com]
By Natasha Ruth Sanders, Juan Guan, Alison Macpherson, et al., March 4, 2020 Key Points Question: What is the risk of experiencing violent injury associated with immigrant and refugee status among youth and young adults in Canada? Findings: In this population-based cohort study including 22 969 443 person-years, the adjusted risk ratio of experiencing assault among immigrants was 0.41 and among refugees was 0.82 compared with nonimmigrant individuals. Risk of assault among immigrants was...
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Solano County's (CA) ACEs initiative, a robust community effort, makes room for input from all
In a house called “Johanna’s House” on a tree-lined side street in Vallejo, Calif., four women are filling out the adverse childhood experiences (ACE) survey given to them by Maria Guevara, the founder of Vallejo Together, an organization that serves homeless residents in Vallejo. The house was named for Johanna Dilag, a homeless woman who was found dead along with her dog.
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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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Study Finds Children Separated From Their Parents At The Border Experience High Levels Of Anxiety [texasstandard.org]
Texas’ southern border is ground zero in the nation’s immigration debate. We’ve covered concerns that the Trump administration’s family separation policy could have lasting traumatic effects on the migrant children separated from their parents at the border. A recent study looked at the health impact on kids who are part of families of mixed legal status, such as the roughly 1,800 kids in the Rio Grande Valley who had a parent deported by Immigration and Customs Enforcement last year. Tania...
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The Magic of Everyday Moments Video Series (Zero to Three)
How do you help parents and students of child development understand how they can best help young children thrive? Seeing is believing! Parents today know how important their children’s early experiences are in shaping how they...
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The Power of a Baby's Laugh
Peek-a-boo: A window on baby's brain By Anna Lacey BBC Health Check http://www.bbc.com/news/health-24553877 Baby laughter: What it reveals about your baby's brain Continue reading the main story Health Check A baby's first smile is an...
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The Power of Beliefs: What Babies Are Telling Us
Dr. Wendy Anne McCarty is a pioneer in prenatal and perinatal psychology and has worked with young families for over 40 years. She writes: "In 2002, I wrote a JOPPPAH article, The Power of Beliefs: What Babies are Teaching Us . In it I discuss how young babies already portray a sophisticated and established complex of beliefs and patterns of being in the world. I describe four clinical stories of babies in PPN-oriented BEBA therapy sessions who are expressing very difficult patterns based...
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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 for people with Developmental Disabilities Conference
Sponsored by the Family Resource Center-Parents Helping Parents May 12,2018 in San Jose,CA
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Trauma-informed groups rev up to address race, inclusion
Eighteen-year-old Kia Hanson has always enjoyed her time as a youth leader at the East Oakland Youth Development Center (EOYDC). She’s worked mostly with five- and six-year-olds since she began in 2016. Recently, she tapped into new skills, especially if the kids were having a meltdown. Kia Hanson “If they’re off, we ask them, ‘What’s wrong?’ ‘Do you want to talk about anything?’,” she explains. “Basically asking before assuming they’re mad at the world for no reason.” What made the...
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Upcoming ACEs webinar hosted by National Pediatric Practice Community(NPPC) team - CME/MOC credits available!
Healthy Spaces Webinar Series (Two 1-Hour Webinars) Communicating About ACEs with Patients and Families presented by: Leena Singh, DrPH, MPH - Director of the NPPC Karissa Luckett, RN, MSW - NPPC Pilot Site Coach April 17, 2019 9:00-10:00 AM (PT) 12:00-1:00 PM (ET) Learner Outcome: The learner will be able to identify two evidence based tools and/or strategies to utilize in the pediatric healthcare setting to improve child care when addressing health concerned among children &...
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Upstreamist in Action: In a Texas Clinic, Lawyers Are Health Care Providers [Health Begins]
Upstreamists are changemakers pioneering practices that improve health by blending medical and social care . In this series of profiles, HealthBegins highlights some of these bold leaders and their innovations, in settings large and small. Their stories show us that the journey upstream is not only necessary — it’s possible. The People’s partnership began in 2012, when two puzzle pieces clicked together. The clinic’s Chief Medical Officer, Dr. Louis Appel, a pediatrician with an interest in...
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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 I believe Gregory Williams, and his book, Shattered By The Darkness, will help save lives and revolutionize healthcare.
When you first hear about it, it sounds unlikely, fact that something that happened to someone in utero, at the age of two months, or four years, or any time in childhood, is what is killing them as an adult, or making them want to die, or making them want to hurt themselves or others. Yet the connection between childhood trauma and adult disease, mental illness, addiction, suicide, violence – most all of society’s ills – is as irrefutable as the myriad truths revealed about it in the...
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Why the Nation Should Screen All Students for Trauma Like California Does [theconversation.com]
By Sunny Shin, The Conversation, November 18, 2019 As the first person to hold the new role of Surgeon General of California, Dr. Nadine Burke Harris is pushing an unprecedented plan to implement universal screenings for childhood trauma within the state’s schools. Childhood trauma is defined by the National Institute of Mental Health as an “emotionally painful or distressful” event that “often results in lasting mental and physical effects.” Burke Harris’ plan is already more than a dream:...
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Why We Suck (at Self-Soothing & Self-Care): Dr. Dawn O'Malley
Without yoga and coffee, I'm kind of a jerk. These are my personal "puppy uppers and doggie downers" and prevent me from being cranky, quick to cry, and ready for conflict. Coffee and calming make life more manageable. Humans even seem tolerable. Without them I might veer into hating humans for being so needy which is not a great trait for a parent, partner or a professional. Or a self. My partner says coffee and exercise are acts of kindness, service as promote public safety. In other...
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Re: Medical Authorities with Academic Blinders look the other Way: Reject ACES
I can see this information used to discriminate against disadvantaged people. Pediatricians should not be collecting scores that can be used in a harmful way against children or parents. You are basically asking a parent to put a number on the chart associated with their name that represents the "parental risk factors" for child abuse and neglect that we all know about from the various medical textbooks we use. I was looking at Zitelli and the ACE questions are listed in the section as...
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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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Child Life specialists empower kids in hospitals, disasters and now the pandemic
In late May, Betsy Andersen’s 7-year-old son, Ezra, had a serious meltdown. He and his six-year-old sister Abby had been enjoying an online Zoom interaction with “Miss Eileen,” “Miss Savannah,” a couple of their colleagues, and a puppet. Betsy Andersen “I could see him trailing off and then he started crying,” says Andersen, who lives in Mundelein, Illinois. But before she swooped in, she heard Miss Eileen talking to him: “She was saying ‘Hey, I see you’re having some big emotions.” Speaking...
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Back-to-School in a Pandemic? Questions, Concerns, and Discussion with School Nurse, Robin Cogan
Robin is a brilliant, passionate, and vocal school nurse with almost two decades of experience as a New Jersey school nurse in the Camden City School District. She is the Legislative Co-Chair for the New Jersey State School Nurses Association and she joined us last week for A Better Normal community discussion about back-to-school (or not) plans families are facing this school year. Robin serves as faculty in the School Nurse Certificate Program at Rutgers University-Camden School of Nursing...
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The Resilient Beginnings Network Is Taking Grant Applications!
Interested SF Bay Area safety net organizations can apply for funding to participate in this three-year program on resilience and trauma-informed care.
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Wellness navigators in clinics screening for ACEs help prevent crises in patients' lives
A patient came into the Goleta location of the Santa Barbara Neighborhood Clinics pleading with people at the front desk to speak to Mayra Garcia, a wellness navigator at the clinic, despite not having an appointment. The clinic is part of a network of four clinics in the Santa Barbara region of California that serve mainly patients on Medi-Cal, the state’s Medicaid program, or patients who are uninsured. Mayra Garcia “She was crying. Her husband had been deported. She couldn’t pay the rent,...
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Asking the Right Questions: Implementing Behavioral Health Screening in a Pediatric Emergency Department
Jessica Williams wants you to know that depressed kids don’t have a “look”. As the lead social worker in charge of the behavioral health screening protocol at Nemours/Alfred I duPont Hospital for Children, it’s her job to educate clinicians, staff, and families about the one thing they can do to identify kids in crisis: ask them the right questions. “Kids that appear to be depressed, whatever you think that might look like, they might not actually be depressed,” she explains. “And sometimes...
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The Pandemics of Racism and COVID-19 [pediatrics.aappublications.org]
By Tina L. Cheng and Alison M. Conca-Cheng, Pediatrics, August 31, 2020 COVID-19 is a recent crisis. Racism is an enduring crisis which is inflamed in the presence of other crises. The Chinese word for "crisis” is composed of two characters, one signifying "danger" and the other, "opportunity." The pandemics of COVID-19 and racism present clear danger. Our duty is to make sense of the opportunity by learning, understanding, and taking action. In this issue of Pediatrics, Cheah et al.1...
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Plans of US Parents Regarding School Attendance for Their Children in the Fall of 2020 [jamanetwork.com]
By Emily Kroshus, Matt Hawrilenko, Pooja S. Tandon, et al., JAMA Pediatrics, August 14, 2020 Key Points Question What do parents plan to do about school attendance in the fall of 2020, and what factors are influencing these plans? Findings In this survey study of 730 US parents of school-aged children, 31% of parents indicated they will probably or definitely keep their child home this fall if schools open for in-person instruction. Factors associated with planning to keep children home were...
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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...