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PACEs in Pediatrics

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The Relentless School Nurse: Soap, Toothbrushes & Sleeping on Concrete Floors

Earlier in the year, I wrote a blog post about one of my newest students who was saving food that was served in school to bring home to her family. The 4-year-old girl, a recent immigrant from Guatemala, was storing food in her pants pockets instead of eating at school. Here is a link to the blog post: Pockets Filled With Chicken and Other Social Determinants of Health Yesterday, I was privileged to see this little girl welcome the guests for the end of year celebration as the students move...

The Youngest Child Separated From His Family at the Border Was 4 Months Old [nytimes.com]

By Caitlin Dickerson, The New York Times, June 16, 2019. T he text messages were coming in all day and night with only two data points: Gender and age. With each one that arrived, the on-call caseworker at Bethany Christian Services in Michigan had 15 minutes to find a foster home for another child who was en route from the border. On a brisk winter day in February 2018, Alma Acevedo got a message that caught her breath: “4 months. Boy.” Since the summer of 2017, the 24-year-old social...

After 5-year journey to integrate ACEs science, Santa Rosa, CA, pediatric clinic is trauma-informed, from head to toe

Dr. Meredith Kieschnick was among the first physicians in the U.S. to hear the term, "adverse childhood experiences". That was in 1998, early on in her career as a pediatrician, when the CDC-Kaiser Permanente Adverse Childhood Experiences Study (ACE Study) published its initial findings in the American Journal of Preventive Medicine . “I attended a conference at which (Dr. Vincent) Felitti spoke,” she recalls. Felitti, at that time director of the Health Appraisal Center at Kaiser Permanente...

Few doctors talk to patients about guns; experts say they want that to change [vcstar.com]

By Cheri Carlson, VC Star, June 15, 2019. Doctors and other health care providers often feel that they have a role in preventing firearm injury. But few talk to their patients about the risks. That’s what a group of physicians and researchers say prompted them to try to help. This month, a clinical guide to recognize patients' risk of firearm injury was published in the Annals of Internal Medicine’s “In the Clinic” series. Its authors came from the UC Davis Violence Prevention Research...

Social policies to prevent adversity -- see Open Access link (until July 1) to “A Critical Assessment of the Adverse Childhood Experiences Study at 20 Years”— in the American Journal of Preventive Medicine

The ACEs research by Drs. Felitti, Anda and colleagues focused attention on the important consequences of childhood adversity for adult health. Of course, as many in the resilience-building movement recognize, adversities affect children’s health and life trajectories as well. When we recognize the powerful impacts of harsh life circumstances for children and families, it becomes clearer that social policies to strengthen household and community resources are needed as well as...

Graduations, non-linear paths, & the importance of getting started

With graduation season upon us, I have been thinking a lot about one of my favorite graduation speeches. It’s the speech that Shonda Rhimes, creator of Grey’s Anatomy, gave in 2014 at Dartmouth College. She references the typical expected advice from a graduation speech: “Follow your dreams. Listen to your spirit. Change the world. Make your mark. Find your inner voice and make it sing. Embrace failure. Dream. Dream and dream big..." And then she says, “I think that’s crap.”

Dozens of stakeholders representing thousands of practitioners send public comments on Calif. ACEs-screening plan

Update: We posted this story on Tuesday evening and received a response from the Department of Health Care Services Wednesday that clarifies additional information. DHCS information Officer Katharine Weir said that subject to budget approval by the legislature and the governor: The reimbursement rate will be $29. Federally Qualified Health Centers will also be reimbursed for screening pediatric patients for trauma through Prop 56 funds and federal matching funds. In response to a question...

Trauma in adulthood can begin in the first 2 months of life [heraldnet.com]

By Paul Schoenfeld, HeraldNet, June 9, 2019. Last week, I attended the 30th annual International Trauma Conference in Boston. Several thousand mental health clinicians from around the world attended. It was sponsored by Dr. Bessel Van der Kolk, one of the world’s foremost researchers and clinicians in developmental trauma. He wrote an excellent book, “The Body Keeps the Score,” which I highly recommend. In the last 10 years, the field of neuroscience has blossomed. With new imaging...

Helping Young Children Exposed to Trauma: A Systems Approach to Implementing Trauma-Informed Care [chdi.org]

By Alysse Loomis, Ph.D. Kellie Randall, Ph.D. Jason Lang, Ph.D., CHDI, June 2019. This IMPACT provides a summary of the research on the effects of early trauma exposure, discusses what Connecticut is doing across systems to support young children who have experienced trauma, and outlines a framework to expand Connecticut's robust system of trauma-informed care for older children to include younger children. There are more than 228,000 children under the age of six years old in Connecticut,...

Why some practitioners of walk-and-talk therapy think it is especially helpful for teens [washingtonpost.com]

By Carolee Belkin Walker, Washington Post, May 29, 2019. Therapist Jennifer Udler was in the middle of a 50-minute session with a patient when it started to rain. Instead of being in her office, however, she and her teenage patient were outside, walking and talking about anxiety and stress — so they got soaked. But the torrent had an upside. When they made it back indoors, Udler said, “Hey, look at us! We’re fine! We’re a little wet, but, oh well! We got through it! Now you can use that next...

Infancy and early childhood matter so much because of attachment (theconversation.com)

We are born to connect. As human beings we are relational and we need biological, emotional and psychological connection with others . Attachment is the relational dance that parents and babies share together. You can think of this when you see a baby look at their parent and they catch each other’s eyes in a wonderful gaze: the parent smiles and the baby smiles and then the parent kisses and the baby coos. Or, when an infant cries to tell their parent they are hungry, and the parent picks...

ACEs research roundup: Toxic stress biomarker, mitigating ACEs in Scotland, ACEs and diabetes and more

Using hair cortisol to examine the role of stress in children's health inequalities at 3 years MHE Bryson, F Mensah, S Goldfeld, AMH Price - Academic Pediatrics , 2019 [HTML] How community resources mitigate the association between household poverty and the incidence of adverse childhood experiences A Blair, L Marryat, J Frank - International Journal of Public Health Developing an Indicator System to Measure Child Well-Being: Lessons Learned over Time KA Moore - Child Indicators Research,...

A community-based approach to supporting substance exposed newborns and their families

This information brief highlights a community-based approach to supporting families and newborns affected by substance use. MA EfC developed this brief to address the profound intersection between the Massachusetts opioid crisis, Federal mandates for the development of Plans of Safe Care for substance exposed newborns, and, the MA EfC focus on increasing social connectedness as a means to reduce child maltreatment.

Solano County's (CA) ACEs initiative, a robust community effort, makes room for input from all

In a house called “Johanna’s House” on a tree-lined side street in Vallejo, Calif., four women are filling out the adverse childhood experiences (ACE) survey given to them by Maria Guevara, the founder of Vallejo Together, an organization that serves homeless residents in Vallejo. The house was named for Johanna Dilag, a homeless woman who was found dead along with her dog.

So you've screened for ACEs...Now what?

Docs for Tots has partnered with the Center for Youth Wellness (CYW) to bring together diverse pediatric offices across Long Island and assist them in implementing universal ACEs screening. CYW, national experts on ACEs, has demonstrated that by addressing ACEs and building resilience through community resources, behavioral therapy, and support, the health outcomes of individuals can improve. A key goal of CYW is to have every pediatrician universally screening for ACEs in order to identify...

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