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Reply to "Misuse of ACE assessment"

Gosh, I'm surprised by the comments about not using the ACE screener with kids and not believing that these scores should be noted.  I agree with Courtney.  Dr. Nadine Burke-Harris is considered one of the foremost experts in the country on the topic of Adverse Childhood Experiences, along, of course, with Drs. Felitti and Anda.  Dr. Burke-Harris has developed free, teen-friendly screening instruments that can be downloaded from her site (see "Our ACE questionnaire" at the bottom of her website).  One has to ask permission to use them, but they are free to use once permission is granted.  Obviously, the parents of young children would fill it out for their children, but teens should be able to fill it out themselves.  It is the multiplicity of ACEs that is important, rather than the individual ACE.  School officials should advocate with pediatricians and other healthcare providers in their areas, including non-profit child-serving agencies, to perform screenings.  Drs. Felitti and Anda indicate that universal screening is one of the two most important elements of gaining traction over the deleterious effects of ACEs on our society, including, I believe, the current alarm over the opioid crisis.  This, after all, is the public health approach, which has far more successes than failures.  Mr. Finklehor's opinion is worthwhile, of course, but, while caution is always advisable in so important an area of science, we cannot ignore the high stakes that it represents out of fear that someone somewhere will misuse it.  That's why the HIPAA Act had to be passed in the first place.  Rather than limit healthcare to victims of ACEs, they should, in my opinion, be given priority for services.  ACEs can, after all, be transmitted multigenerationally, even if the premature mortality they often engender is not destiny.   I work for an agency, along with sister agencies, that screens teens, and it has not resulted in reported iatrogenic effects.  In my opinion, the reason why is precisely the one that Courtney referred to:  a sense of freedom and a lifting of the veil as to the reasons why they have previously felt so awful.     

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