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*Repost from General Discussion Board

Hi, has anybody got any links to peer-reviewed journal articles where an individual's ACE score/questionnaire is used to inform practice?  I know it's fairly common practice now in some areas to enquire about ACEs, but I struggle to find any papers describing how that information is then used.  Would be good to find some examples where, say, a score of four leads to a more targeted intervention or response, for instance.

I have my doubts about the use of the ACE questionnaire for individuals, but I do see it being rolled out in various ways with no evaluation of whether it actually has any tangible benefit. I thought rather than just getting into debates about it on Twitter (which happened when I posted this:, which are fascinating but not of real practical use, I thought I'd try and do a proper, objective systematic review of the available evidence.  But, despite ACE screening being rolled out quite commonly, I've really struggled to find any studies to even include in my review so far.  Quite a few in the grey literature, but very few peer-reviewed ones.  Maybe that's an important finding in itself.


Last edited by Andrew Turner
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Have you joined the website NPPC ACEs? They have links to most of the relevant research there. 

I think your question shows a bit of a difference in thinking from those who are using ACEs screening. It is not as simple as an ACE of 4 needing a referral. That would be simple. It is possible that a person with an ACE of 6 has a good relationship with a caregiver, feels safe most of the time, has good school and church support, and no current medical or mental health issues. They don't currently need a referral but its good to keep the number in mind if future medical or mental health issues come up. It is also possible for a person with an ACE of 2 to have had loss of a primary caregiver, minimal school support, no buffering or mental health support and is having an increase in headaches and asthma. That person would warrant a referral. The website has a nice algorithm chart for use but I don't know that there is prospective research behind it. It is really incumbent on the doctor using the screening tool to be comfortable talking about not only ACEs and health outcomes but how caregivers and communities can also support resilience and protective and compensatory experiences. Parenting classes are also one of the most requested interventions and are not a medical intervention. 

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