How knowledge of adverse childhood experiences can help pediatricians prevent mental health problems.

Abstract

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

Adverse childhood experiences and their relationship to complex health profiles among child welfare–involved children: A classification and regression tree analysis

“…In fact, fewer than 11 percent of pediatricians in the sample reported familiarity with the ACE study conducted by Felitti and colleagues . Failing to ask about early adversities may be a missed opportunity to assist families in accessing services, as many children with high ACE scores or child welfare involvement are less likely to participate in early intervention programs and have unmet health needs . Findings from classification tree models may help health care providers and other child‐ and family‐serving providers, such as child welfare staff, understand the long‐term benefits to inquiring about adversity in childhood due to its association with children's health risk.…”

Brief Report: Examining the Association of Autism and Adverse Childhood Experiences in the National Survey of Children’s Health: The Important Role of Income and Co-occurring Mental Health Conditions

“…By comparison, the relationship between ACEs and ASD was largely unchanged after adjusting for intellectual disability. These findings suggest that the presence of co-occurring mental health conditions may help clinicians (a) identify youth with ASD who are likely to experience or have experienced adversity and (b) intervene, when possible, to reduce stressors via greater monitoring (Mitchell & O’Connor, 2013; Mitchell et al, 2016), medical homes models (Kogan et al, 2008), enhanced parent support and focused efforts to help families access social and financial resources (Flynn et al, 2015). …”

Methods to Assess Adverse Childhood Experiences of Children and Families: Toward Approaches to Promote Child Well-being in Policy and Practice

“…5–10 These advances inspire and require us to evolve models of care and use new measurement instruments to guide the design, delivery, and evaluation of health and human services, such as well-child care, early learning, social services, and other medical, public health, and social services. 11–15 …”

“…Despite these findings, a recent national survey suggests that the majority of pediatric providers are not knowledgeable about the science related to ACEs and many barriers exist to integrate knowledge about ACEs into practice, including lack of information on methods to assess and respond to information about ACEs for children and families. 12,15,26,27 Although studies confirm systematically higher rates of health status and school engagement problems among US children exposed to ACEs, they also document wide variations in outcomes among otherwise similar children who have equal exposure to ACEs. This raises questions about individual differences in sensitivity to ACEs and discerning appropriate approaches to discussing ACEs and interventions with families.…”

“…13,15,48,49 However, many questions and controversies exist, including whether and how to directly inquire about ACEs with children and youth in addition to ACEs of parents, ensuring assessment promotes trust and empowers families and children, other information to collect simultaneously, data protection and confidentiality, and feasibility and practice redesign implications. 12,27,50 Because assessing ACEs in clinical or community public health contexts is not yet well studied, we approached this study with neutrality as to the value, efficacy, and feasibility of ACEs assessment in practice.…”