Screening for Trauma in Pediatric Primary Care

Keeshin, Brooks; Byrne, Kara; Thorn, Brian L.; Shepard, Lindsay

doi:10.1007/s11920-020-01183-y

Cited by 24 publications

(21 citation statements)

References 15 publications

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“…116,117 The Pediatric Traumatic Stress Screening Tool in the Intermountain Care Process Model has been recently developed to screen for pediatric traumatic stress in the primary care setting, either as a universal screen or with targeted screening when traumas are known. 118 A limitation of ACE and SDoH screening tools is their lack of nuance: they identify risk factors that have been derived from epidemiological studies, not outcomes at the individual level. 129,130 Those outcomes are the result of the physiologic response to adversities.…”

Section: Screeningmentioning

confidence: 99%

Trauma-Informed Care

et al. 2021

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Most children will experience some type of trauma during childhood, and many children suffer from significant adversities. Research in genetics, neuroscience, and epidemiology all provide evidence that these experiences have effects at the molecular, cellular, and organ level, with consequences on physical, emotional, developmental, and behavioral health across the life span. Trauma-informed care translates that science to inform and improve pediatric care and outcomes. To practically address trauma and promote resilience, pediatric clinicians need tools to assess childhood trauma and adversity experiences as well as practical guidance, resources, and interventions. In this clinical report, we summarize current, practical advice for rendering traumainformed care across varied medical settings. INTRODUCTIONExperiences in childhood, both positive and negative, have a significant effect on subsequent health, mental health, and developmental trajectories. For many children and adolescents, traumatic experiences are all too common. Almost one-half of American children, or 34 million younger than 18 years, have faced at least 1 potentially traumatic early childhood experience. [1][2][3][4][5][6][7] Such traumas may include those originating outside the home, such as community violence, natural disasters, unintentional injuries, terrorism, immigrant or refugee traumas (including detention, discrimination, 6,8,9 or racism), and/or those involving the caregiving relationship, such as intimate partner violence, parental substance use, parental mental illness, caregiver death, separation from a caregiver, neglect, or abuse, originally defined as adverse childhood experiences (ACEs). 10 For many children, medical events, such as injury, medical procedures, and/or invasive medical treatments, can be traumatic. Given the robust science explaining the physiologic consequences of accumulated trauma experiences on the brain and body, [11][12][13][14] there have been calls for pediatric clinicians to address childhood trauma and child traumatic stress. 10,14-16 However,

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Section: Screeningmentioning

confidence: 99%

Trauma-Informed Care

et al. 2021

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“…This occurs because current sports injury prevention research methods primarily derive from extractive public health models, extrapolating from detailed self-report surveys and survivor testimonies to estimate problem size and scope 5. Developed to study accidental sports injuries, these methods may re-traumatise athlete-survivors of interpersonal violence through trauma reactivation 4 6 7. Further, this methodology does not guarantee anonymity or necessarily facilitate access to resources and treatment, which is an essential component of ethical trauma screening.…”

Section: Methodological and Ethical Challenges Of Studying Interperso...mentioning

confidence: 99%

Methodological and ethical limitations of interpersonal violence research in Sports and Exercise Medicine: advancing an athlete-centred approach

et al. 2023

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“…35 Because responses to adverse experiences vary widely, some argue that screening for trauma symptoms, rather than for traumatic experiences alone, is preferable because it would identify children who would most benefit from trauma-specific treatment. 36 Large-scale efforts are underway to improve trauma-informed care within primary care and pediatrics. 37,38 Applying updated treatment recommendations for trauma-related conditions remains prudent.…”

Section: Diagnostic Advancesmentioning

confidence: 99%

Key Updates to Understanding Roles of Childhood Trauma in Overall Health

Weleff

Potter

2023

AMA Journal of Ethics

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While adverse childhood experiences and trauma, including childhood abuse and neglect, have often been viewed from the lens of psychiatry, their influence on physical health, health behaviors, and factors that moderate health now garner more attention. This article reviews recent literature that has changed clinical and social viewpoints on child abuse and neglect and can be used as a primer to better understand (1) influences of child abuse and neglect on physical illness; (2) critical diagnostic advances relevant to persons who have experienced child abuse and neglect; and (3) ethical, research, and practical questions generated by these new understandings.The American Medical Association designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 Credit™ available through the AMA Ed Hub TM . Physicians should claim only the credit commensurate with the extent of their participation in the activity. Trauma's Roles in HealthIncreasing attention is being paid to the impact of child abuse and neglect on health. The rapidly growing knowledge base on long-term outcomes of those exposed to child abuse and neglect in the form of both trauma and adverse childhood experiences (ACEs), such as childhood economic hardship, 1 neglect, sexual abuse, emotional abuse, discrimination, racism, household dysfunction, exposure to violence, parental mental illness, and parental substance use has warranted this attention. 2 These types of maltreatment have often been viewed only from the lens of psychiatry, but it is now clear that, beyond their impact on mental health, these experiences affect biological mechanisms that influence physical health, 3,4 health behaviors, and other factors that moderate good health, making it a general concern for all of health care and for those invested in improving health outcomes at large. Given these wide-ranging health impacts, health care systems and individual practitioners must be prepared to evaluate childhood maltreatment-related health concerns. Many clinicians feel unprepared to do this sort of work, and it was likely absent from their training. 5 This article aims to review recent core literature that has broadened medicine's understanding of the forms of child abuse and neglect. It also

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Screening for Trauma in Pediatric Primary Care

Cited by 24 publications

References 15 publications

Trauma-Informed Care

Trauma-Informed Care

Methodological and ethical limitations of interpersonal violence research in Sports and Exercise Medicine: advancing an athlete-centred approach

Key Updates to Understanding Roles of Childhood Trauma in Overall Health

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