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PACEs in Pediatrics

A Health Problem and An Opportunity: Screening for Adverse Childhood Experiences [medium.com]

 

By Dayna Long, Medium, May 19, 2020

A consensus of scientific research demonstrates that cumulative adversity, especially when experienced during critical and sensitive periods of development, is a significant contributing factor to some of the most harmful, persistent, and expensive health challenges facing our nation. Adverse Childhood Experiences (ACEs) are highly prevalent, experienced in all communities, and are likely to increase during the COVID-19 emergency [i] [ii] [iii] [iv] [v]. ACEs and the potential resulting toxic stress physiology are strongly associated, in a dose-response fashion, with some of the most common and serious health conditions facing our society today, including nine of the 10 leading causes of death in the United States.

On these key facts, many of us in the scientific community agree that next step is to identify and implement the best ways to interrupt the intergenerational effects of trauma and create a healthier future for the next generation. I want to recognize and applaud the recent article in the American Journal of Preventive Medicine, authored by Robert Anda, Laura Porter, and David Brown for its role in stimulating dialogue, among the ACEs and trauma-informed community, as we push toward reducing the incidence of ACEs in half within one generation.

It will take more than one method of intervention to wrestle this public health crisis down and ensure that resilience (and the buffering supports that encourage it) wins the day. For the purpose of this piece, I’m going to focus on California’s ACEs Aware Initiative (which I serve on as an advisor), clinical interventions, and address some concerns raised by Anda, Porter, and Brown.

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