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PACEs in Pediatrics

Tagged With "EnACT! (Engagement in Action Framework)"

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For a pediatrician and former teacher ACEs awareness came from a punch in the face

Laurie Udesky ·
Dr. Kavitha Selvaraj did not learn about adverse childhood experiences (ACEs) from a class in medical school. Her first awareness of ACEs came after a student slugged her in the face when she was a new teacher in a school in Los Angeles. She had heard a chorus in the hallway urging her students she refers to as “J” and “N” to “Fight! Fight! Fight,” she writes in an essay in a recent issue of the journal Pediatrics . The two were trading punches. When she stepped in the middle to break it up...
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Graduations, non-linear paths, & the importance of getting started

Lori Chelius ·
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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Hearing in House Education and Labor Early Childhood Subcommittee addresses intersection of trauma and education

Dr. Nadine Burke Harris (l) and Karina Chicote, Churchill Fellow from western Australia meet after congressional hearing After watching the hearing on a monitor in the overflow room, Karina Chicote, a Churchill Fellow from western Australia, and I hustled to the hearing room in hopes of speaking to the lead witness, Nadine Burke Harris, MD, the first Surgeon General of the State of California. She was deep in conversation with others, including a young woman who wanted to tell her how...
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Helping Young Children Exposed to Trauma: A Systems Approach to Implementing Trauma-Informed Care [chdi.org]

Marianne Avari ·
By Alysse Loomis, Ph.D. Kellie Randall, Ph.D. Jason Lang, Ph.D., CHDI, June 2019. This IMPACT provides a summary of the research on the effects of early trauma exposure, discusses what Connecticut is doing across systems to support young children who have experienced trauma, and outlines a framework to expand Connecticut's robust system of trauma-informed care for older children to include younger children. There are more than 228,000 children under the age of six years old in Connecticut,...
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Hillary Clinton’s Comprehensive Agenda on Mental Health [The Briefing—Fact Sheets]

The first bullet under Early Diagnosis and Intervention of today’s release of Hillary Clinton’s mental health agenda is titled “ Increase public awareness and take action to address maternal depression, infant mental health, and trauma and stress in the lives of young children.” It states “We also know that infant mental health depends on children forming close and secure relationships with the adults in their lives, and that too many children are growing up in environments that cause them...
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How collaboration helps clinic in San Mateo County, CA, tackle ACEs in children

Laurie Udesky ·
Dr. Elizabeth Grady is a pediatrician at the South San Francisco Clinic, a community clinic of San Mateo Medical Center. She and Susana Flores , a senior public health nurse with San Mateo County Health, spoke with me about how the clinic and other health agencies in San Mateo have been able to craft ways to work together to prevent and heal toxic stress in children. Grady also talked about how she and Flores have been working with the Resilient Beginnings Collaborative (RBC), a group of...
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How do these pediatricians do ACEs screening? Early adopters tell all.

Laurie Udesky ·
Last week, three pediatricians — with a combined experience of 15 years integrating ACEs science into their practices — reflected on the urgency they felt several years ago that prompted them to begin screening patients for childhood adversity and resilience when there was practically no guidance at all. Along their journey , they accumulated a list of lessons learned for other pediatricians and family clinics to use. The three pediatricians participated in the ACEs Connection webinar,...
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Immigrant teens, parents explore ACEs, resilience in 5-week course with family doc

Laurie Udesky ·
Dr. Angela Bymaster, a family doctor in San Jose, Calif., was determined to find a way to teach ACEs science to her patients. Teens would come to the Washington Neighborhood Clinic clearly depressed by a range of problems at home that were contributing to risky sexual behavior and marijuana use, as well as preventable health problems like extreme obesity.
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In ACEs Connection webinar, physicians talk trauma, offer tips for helping pediatric immigrant patients

Laurie Udesky ·
Dr. Raul Gutierrez, a pediatrician in the San Francisco Bay Area, said he and his fellow clinicians see constant fear and its health consequences every single day among the largely immigrant and Latino population they serve. It’s all the result of anti-immigrant policies and the news cycle that feeds the fear. Dr. Raul Gutierrez “It is almost inescapable with the repercussions of immigration policy on the radio, television, social media and from friends and family,” Gutierrez told the 69...
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Interim report of the President’s opioid commission says its final report will address early intervention strategies for children with ACEs

On August 8, President Trump spoke to the opioid crisis in this country and declined to declare a national emergency as recommended by the “President’s Commission on Combating Drug Addiction and the Opioid Crisis.” Instead, the President emphasized the law and order aspects of the problem and the importance of preventing drug use in the first place since addiction is so hard to overcome. The Commission will make a final report in the fall. The recently released interim report makes eight...
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4 years after integrating ACEs science, Pueblo, CO clinic improves services for families; cuts ER costs, doctor stress

Laurie Udesky ·
Four years ago, Dr. Leslie Dempsey would never have talked about ACEs — adverse childhood experiences — with her patients. Now ACEs is a common topic. “Just as I don’t feel awkward asking someone if they smoke or do intravenous drugs, I don’t really feel awkward talking about their childhood traumas in a way that it relates to their health. It’s just integrated into obtaining background and social history,” she says. Dr. Leslie Dempsey Dempsey is a physician in obstetrics who oversees a team...
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A Community Approach to Trauma Sensitivity / Making a Difference Conference in MA in November

Christine Cissy White ·
The 6th Annual Making a Difference Conference for SESPs, Foster/Adoptive and Kinship Caregivers and their Professional Partners will be held in Marlborough, MA on November 14, 2017. The theme is A Community Approach to Trauma Sensitivity. There will be at least two talks will be about ACEs! Speakers/Topics: Keynote: Managing the Hearts and Souls of Many, Dana Royster-Buefort, M.Ed., C.A.G.S. Workshops Tackling ACEs by Building Resilient Communities , Renee D Boynton-Jarrett, MD, ScD . Note:...
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A Framework for Child Health Services: Promoting optimal health, development, and well-being for all children [chdi.org]

Alicia Doktor ·
CHDI and Connecticut Children’s Office for Community Child Health outlined a joint vision for improving child and population health in A Framework for Child Health Services: Promoting optimal health, development, and well-being for all children . This 2019 Framework builds on the original Framework for Child Health Services published in 2009. It highlights progress on implementing recommendations from the original Framework and puts forth new recommendations for integrating child health...
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A Guide to Providing Telehealth During the COVID-19 Crisis

Daren Casagrande ·
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

Daren Casagrande ·
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

Laurie Udesky ·
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 Message from the President of the Illinois Chapter, American Academy of Pediatrics

Elise Groenewegen ·
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 National Agenda to Address Adverse Childhood Experiences

Christina Bethell ·
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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ACE Fact Sheets to Give Your Doctors, Patients & Beyond (free downloads)

Veronique Mead ·
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 and Health Policy Brief

Former Member ·
The Illinois ACEs Response Collaborative is pleased to share three policy briefs on the impact of ACEs in the health, justice, and education systems including promising practices and recommended actions for change. These briefs were developed by members of the Illinois ACEs Response Collaborative—system leaders in Illinois who are working from an ACEs-informed lens to improve systems to prevent and mitigate trauma across generations. Rooted in social justice, these briefs are a call to...
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ACEs Research Corner — January 2020

Harise Stein ·
Research papers this month include links between ACEs and bullying, dropping out of high school, adult disability, and the effects of countering ACEs.
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ACEs Research Corner — July 2019

Harise Stein ·
[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] Wang X, Maguire-Jack K. Family and Environmental Influences on Child Behavioral Health: The Role of Neighborhood Disorder and Adverse Childhood Experiences . J Dev...
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ACEs Research Corner — June 2019

Harise Stein ·
[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 Research Corner — November 2019

Harise Stein ·
[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] Jackson DB, Chilton M, Johnson KR, Vaughn MG. Adverse Childhood Experiences and Household Food Insecurity. Am J Prev Med. 2019 Nov;57(5):667-674. PMID: 31522923...
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ACEs Research Corner — October 2019

Harise Stein ·
[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] Zhang L, Zhang D, Sun Y. Adverse Childhood Experiences and Early Pubertal Timing Among Girls: A Meta-Analysis. Int J Environ Res Public Health. 2019 Aug 13;16(16).
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ACEs Research Corner — September 2018

Harise Stein ·
[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 in CA — a Q and A with Dr. Dayna Long

Laurie Udesky ·
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

Jane Stevens ·
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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After WIC Offered Better Food Options, Maternal And Infant Health Improved (scienceblog.com)

A major 2009 revision to a federal nutrition program for low-income pregnant women and children improved recipients’ health on several key measures, researchers at UC San Francisco have found. The study is the first to analyze the health effects of the changes to the U.S. Special Supplemental Nutrition Program for Women, Infants and Children (WIC), which serves half of all infants and more than a quarter of all pregnant and postpartum women in the U.S. It comes amid renewed attention to poor...
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American Acad of Pediatrics Policy Statement - Immigration policies need to be trauma-informed [www.medpagetoday.com]

Leslie Lieberman ·
The American Academy of Pediatricians has made a bold statement about the proposed DHS policy to separate children from their parents and the use of detention - clearly linking these policies to their potential to traumatize children. To that end, children should never be separated from a parent unless it is for the child's safety, and the Department of Homeland Security should discontinue the use of family detention and use community-based alternatives to detention to treat immigrant...
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So you've screened for ACEs...Now what?

Margaret Wayne ·
Docs for Tots has partnered with the Center for Youth Wellness (CYW) to bring together diverse pediatric offices across Long Island and assist them in implementing universal ACEs screening. CYW, national experts on ACEs, has demonstrated that by addressing ACEs and building resilience through community resources, behavioral therapy, and support, the health outcomes of individuals can improve. A key goal of CYW is to have every pediatrician universally screening for ACEs in order to identify...
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Solano County's (CA) ACEs initiative, a robust community effort, makes room for input from all

Laurie Udesky ·
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

Carey Sipp ·
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]

Laurie Udesky ·
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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The CHIP Program Is Beloved. Why Is Its Funding in Danger? [nytimes.com]

Alicia Doktor ·
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)

Christine Cissy White ·
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 Relentless School Nurse: ACEs Impact Nurses More Than We Realized!

Robin M Cogan ·
I ran across this message on www.acesconnection.com and not only did it catch my attention, but it also made me want to dig deeper. Could it be true that nurses have a higher ACEs score than other healthcare professionals? It seemed true in this small survey, but was this a representation of a trend? If it was, the implications in nursing practice could be tremendous and concerning. What I found was that there is a grand canyon gap in research. The minimal studies that do exist confirm that...
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The Relentless School Nurse: Brandy Bowlen Shares Her Message - From Seat to Feet

Robin M Cogan ·
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: Full Disclosure: I am Fearful to Welcome Another September

Robin M Cogan ·
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: Pediatricians + School Nurses = Powerful Partners

Robin M Cogan ·
Pediatricians and school nurses are powerful partners when we intentionally collaborate to improve the continuity of care in the populations we serve. It is the intentionality of relationship building that can bear the most fruitful outcomes to improve the health and well-being of our most vulnerable population, our children. We are far more effective working in concert than in our silos. School communities are looking for guidance, answers, and action to address the explosion of...
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Toxic Childhoods [politico.com]

Alissa Copeland ·
Often times, a pediatrician or medical professional well-versed in the effects of ACEs or toxic stress can be the initial bridge to services, support, and building resilience for children, youth and families served by child welfare. It's exciting and encouraging to read about more and more pediatricians grounding their medical practice within ACEs framework. A toddler came into my examination room recently at Bayview Child Health Center in Bayview Hunters Point, an underserved, largely...
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Trauma education and mindfulness help youth living amid gun violence

Laurie Udesky ·
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 groups rev up to address race, inclusion

Laurie Udesky ·
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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Upstreamist in Action: In a Texas Clinic, Lawyers Are Health Care Providers [Health Begins]

Karen Clemmer ·
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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Webinar: How to Streamline ACEs Screening Using CHADIS

Leena Singh ·
The idea of adding an adverse childhood experiences (ACEs) screening tool to your practice’s workflow can be daunting – which tool, will you have time, does it add enough value? The Child Health and Development Interactive System (CHADIS) is helping to address this challenge by partnering with the National Pediatric Practice Community on ACEs (NPPC) to add an ACEs questionnaire into its system. Join this webinar to learn more about how this collaboration can help support your efforts to...
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Webinar Invitation: National Pediatric Practice Community on Adverse Childhood Experiences (ACEs)

Leena Singh ·
National Pediatric Practice Community on Adverse Childhood Experiences (ACEs) Dr. Nadine Burke Harris and the Center for Youth Wellness team invite you to attend the launch of the National Pediatric Practice Community on ACEs (NPPC) . NPPC is a network of medical providers focused on integrating ACEs screening and a toxic stress framework into pediatric medical practice. We will be kicking off the NPPC with an informational webinar on Monday, May 8th, 2017 at 12 noon (PST) . Webinar...
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What Our Children Need Us to Know, Right Now

Jondi Whitis ·
Teaching children how to better navigate crisis, right now.
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Why I believe Gregory Williams, and his book, Shattered By The Darkness, will help save lives and revolutionize healthcare.

Carey Sipp ·
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 screen if there are no services? (Barbara J. Howard - Pediatric News)

Former Member ·
  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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Wisconsin Dept of Health Services - Trauma-Informed Care News & Notes, Oct. 29, 2018

Scott A Webb ·
ACEs, Adversity's Impact Adverse childhood experiences increase prediabetes markers in adulthood How parenting affects antisocial behaviors in children Documentary broken places uses archival footage to tell stories of ACEs and resilience over time NYC's first lady urges reporters to tackle mental health issues A guide to toxic stress The quest to find biomarkers for toxic stress, resilience in children - A Q&A with Jack Shonkoff Parent-child bond predicts depression, anxiety in teens...
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