I work in a pediatric office as a therapist. I routinely ask about trauma, but not every primary care office has a person like myself on staff. However, I feel like it's important to point out that the ACEs tool is meant to be used with adults. It talks about experiences that have happened in the past. It has not been used with or normed with children. Asking about ACEs becomes a lot more complicated if a child discloses to you that they are currently happening, which I'm sure is one of the reasons many pediatricians may shy away from asking. It also is complicated because children do not have the ability or right to seek care for ACEs on their own. A child may disclose something and then be punished by the parent at home. In my clinic we do routinely screen for depression in children 10 and up. Nursing staff also ask if our patients feel safe at home. If either of these screenings are positive, I get involved with the family to figure out how we can best support them.
While I support the idea that we need to start identifying ACEs earlier in life, I also think we need to wait until we have evidence-based tools and protocols that are specifically geared toward children in order to prevent unintended negative consequences that may impact this very vulnerable population.