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Pediatricians are encouraged to screen for adverse childhood experiences (ACEs). The current study developed and implemented a tool to screen for Child-ACEs at a pediatric resident clinic in San Bernardino, California. Development of the tool, named the Whole Child Assessment (WCA), was based on an iterative process that incorporated triangulation of references, patient data, and physician feedback. Implementation of the WCA occurred over the course of 6 improvement cycles that involved obtaining and responding to stakeholder feedback, streamlining paperwork and workflow, and providing physician education. Over the course of our study, we reviewed 1100 charts from well-child visits. We demonstrated that use of the WCA increased identification of multiple Child-ACEs compared with no screening and that reports of multiple Child-ACEs increased with age. These results suggest that use of the WCA provides an acceptable and feasible way to screen for Child-ACEs during routine pediatric practice.

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Results suggest that screening for C-ACE along with developmental and behavioral screening may help pediatric health care providers to identify children who are both at greatest risk for mental health problems and in need of help in accessing services. Incorporation of nutrition and exercise components into mental health interventions may increase enrollment and retention, as may targeting mental health interventions and referrals to parents with child behavior concerns. (PsycINFO Database Record