Tagged With "Healthy Steps"
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Parenting Matters: Supporting Parents of Children Ages 0-8 (The National Academies Press 2016)
A study published by The National Academies of Sciences in 2016 resulting in 10 Recommendations to build support for parents... "Over the past several decades, researchers have identified parenting- related knowledge, attitudes, and practices that are associated with improved developmental outcomes for children and around which parenting- related programs, policies, and messaging initiatives can be designed. However, consensus is lacking on the elements of parenting that are most important...
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Parenting with PTSD One Liners & Parenting with ACEs Chat Reminder
Parents with PTSD from ACEs sharing what's hard about parenting while post-traumatically stressed: "Managing the terror around the possibility of everyone being a perp." "How to talk to children about why they won't meet X relative." “There was a point when I would feel completely overwhelmed by something as simple as having to make breakfast and school lunches at the same time.” "I didn't understand that not all parents reacted or were triggered the way I was." "was stone set on not...
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Report reveals how foster care, juvenile and adult justice systems traumatize youth, calls for policy shifts
YWFC sponsored Sister Warriors meeting When she was 15 years old, Lucero Herrera was put in a rehab program by San Francisco’s Juvenile Court because she was getting drunk regularly. And in doing so, the court failed to explore the root of her drinking. Had they done so, she said, they would have found that anger and trauma were lurking underneath, driven by her ACEs: adverse childhood experiences. Lucero Herrera "Why did they put me in a drug program when I had an anger problem? I went...
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Report reveals how foster care, juvenile and adult justice systems traumatize youth, calls for policy shifts
YWFC sponsored Sister Warriors meeting When she was 15 years old, Lucero Herrera was put in a rehab program by San Francisco’s Juvenile Court because she was getting drunk regularly. And in doing so, the court failed to explore the root of her drinking. Had they done so, she said, they would have found that anger and trauma were lurking underneath, driven by her ACEs: adverse childhood experiences. Lucero Herrera "Why did they put me in a drug program when I had an anger problem? I went...
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[Repost] Trauma-informed Care: It Takes More Than a Clipboard and a Questionnaire
California is about to launch an ambitious campaign to train tens of thousands of Medi-Cal providers to screen children and adults up to age 65 for trauma, starting on January 1, 2020. It is well-established that the early identification of trauma and providing the appropriate treatment are critical tools for reducing long-term health care costs for both children and adults. Research has shown that individuals who experienced a high number of traumatic childhood events are likely to die...
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Resource: Screening for adverse childhood experiences (ACEs) in pediatric practices
Now that we know that trauma early in life can have a significant impact on an individual’s health and wellness throughout their life, health care organizations are beginning to focus on providing more trauma-informed care. Screening for adverse childhood experiences (ACEs) in pediatric, clinical settings promotes early intervention and can be a tangible entry point for organizations interested in providing trauma-informed care. The Center for Community Health and Evaluation is a nonprofit...
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Review of Tools for Measuring Exposure to Adversity in Children and Adolescents [Journal of Pediatric Health Care]
photo/ Creative Commons " Exposure to childhood adversity can result in negative behavioral and physical health outcomes due to potential long-term embedding into regulatory biological processes. Screening for exposure to adversity is a critical first step in identifying children at risk for developing a toxic stress response. We searched PubMed, PsycArticles, and CINAHL for studies published between January 1, 2012, and December 31, 2016, as well as other sources, to identify potential...
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Book: Integrated Early Childhood Behavioral Health in Primary Care: A Guide to Implementation and Evaluation
Edited by Dr. Rahil Briggs, Integrated Early Childhood Behavioral Health in Primary Care: A Guide to Implementation and Evaluation , the book focuses the primary care environment as an ideal venue in which to promote preventive, two-generation, behavioral health efforts. The book, with a foreword from Dr. Jack Shonkoff and published by Springer in 2016, Outlines the implementation of integrated early childhood behavioral health programming into pediatric primary care, Explores the process of...
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Building a Movement to Birth a More Just and Loving World [Groundswell March 2018]
The National Perinatal Task Force: Building a Movement to Birth a More Just and Loving World - In my 20 years as a public health nurse, I've never seen race called out so clearly in a report like this. Data has shown disparities, however the data was presented in a tidy way — very apolitical, purposely written to not ruffle any feathers or point fingers - " persistent racial gap ". This report written by The National Perinatal Task Force is refreshingly honest and this is important. We need...
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CA pediatrician develops, tests, gets state OK for whole-child assessment tool that includes ACEs
[Editor's note: This blog was first posted in April 2017. Dr. Marie-Mitchell updated the assessment by modifying a few of the questions, so we are republishing with the new assessment, one in Spanish and one in English.] Over the last dozen years or so, many pediatricians, astounded by the ramifications of the science of adverse childhood experiences (ACEs) on the children they care for, began integrating this science into their practices. The most common approach has been to ask parents...
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CA to reimburse for only one of three ACEs screeners
California health care providers will soon begin to learn how many of the 13.2 million California children and adults in the state’s MediCal program have been exposed to adverse childhood experiences (ACEs). But the state’s proposed decision to reimburse only one of three recommended options for screening children has drawn mixed reactions from pediatricians. “If we have mandated legislation that only looks at one screening tool, it really limits the opportunity to improve that screening...
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California unveils ACEs Aware initiative to screen for trauma
Will screening for adverse childhood experiences (ACEs) in California be mandatory? No, but it’s recommended. Will there be training for physicians and staff on how to screen? Yes. Who will be reimbursed for screening patients in California? Physicians who serve patients in the state’s Medi-Cal program — for now. For more answers to these and other questions that surfaced during a Dec. 4 webinar introducing Californians to a new statewide initiative, read on. Come January 1, California will...
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Chicago healthcare providers start center for ACEs science education; aim to reach all medical, health students by 2025
In 2017, Dr. Audrey Stillerman and three other women from the Chicago healthcare community founded the THEN Center . Its goal is lofty: By 2025, it wants every graduating student in medical and health sciences across the United States to apply core concepts of childhood adversity, neurobiology, resilience and health equity into their work. Dr. Audrey Stillerman Today, the THEN Center (The Collaborative Study of Trauma, Health Equity and Neurobiology) is well on its way. Its founders are...
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Colorado Launches Two Generation Approach to Family Services [chronicleofsocialchange.org]
Colorado is testing a new approach to providing services to struggling families in an effort to address the intergenerational cycle of poverty, incarceration and foster care. Two Generation (2Gen) is a new initiative by the state recognizing that children and their parents are best served by recognizing the needs of the entire family unit. “CDHS embedded the 2Gen approach into all of our services, recognizing that our clients only succeed when their providers or children also get the support...
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“Landmark” Maternal Health Legislation Clears Major Hurdle [propublica.org]
Update, Dec. 13, 2018 at 8:15 p.m. ET: On Thursday evening, the Senate unanimously passed its version of the Preventing Maternal Deaths Act, sending it to the president to sign. Congress moved a big step closer on Tuesday toward addressing one of the most fundamental problems underlying the maternal mortality crisis in the United States: the shortage of reliable data about what kills American mothers. The House of Representatives unanimously approved H.R. 1318 , the Preventing Maternal...
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Lesson learned integrating ACEs science into health clinics: Staff first, THEN patients
Nearly two years ago, a team of colleagues at LifeLong Medical Clinics jumped at the opportunity to integrate practices based on ACEs science to prevent and heal trauma in their patients when it joined a two-year learning collaborative known as the Resilient Beginnings Collaborative (RBC). A few months after training began, the staff realized they had to put on the brakes.
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Montefiore Medical in Bronx screens 12,000+ kids for ACEs
Creative Commons/Flickr/Family drawing by Meggy ____________________________________ Since 2016, more than 12,000 children beginning at the age of 1-years-old have been screened for adverse childhood experiences (ACEs) at Montefiore Medical Center in Bronx, New York, according to Miguelina German, the director of Quality & Research in the Pediatric Behavioral Health Integration Program and project director of Trauma Informed Care at the center. Parents of infants are asked to fill out...
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New Health Resiliency Stress Questionnaire debuts for pediatricians, family practice, internal medicine...but anyone can use it
There's a new ACEs-resiliency survey in town! It came out of a conversation between two physicians having a conversation on a bus. Here's the story about how it was developed, and how to use it. Pilots were done in a pediatric clinic, internal medicine, addiction treatment center, group therapy, and psychiatric practice. It's now being used in two community clinics.
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NJ medical school program requires all first-year students to learn about ACEs science
In 2015, Dr. Beth Pletcher, a pediatrician and associate professor specializing in genetics, was at the annual conference of the American Academy of Pediatrics in Washington D.C. when she heard two speakers that forever changed her work with medical students. Dr. Beth Pletcher “I went to two talks on adverse childhood experiences (ACEs) that were so mind-boggling to me that I decided on my drive back to New Jersey that I had to do something about it,”says Pletcher, director of the Division...
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Opinion: Screenings Alone Won’t Prevent Adverse Childhood Experiences—We Must Address Community Trauma [calhealthreport.org]
By Rachel A. Davis and Howard Pinderhughes, California Health Report, December 19, 2019 Earlier this month, California’s Surgeon General Nadine Burke Harris launched an ambitious campaign to reduce adverse childhood experiences, which can cause lifelong health problems. With more than 60 percent of Californians saying they were exposed to a traumatic childhood event, adverse childhood experiences are at crisis levels in the state. The ACEs Aware campaign will train and pay health care...
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Doctors are burning out and trite ‘wellness’ measures aren’t helping [CenterForHealthJournalism.org]
“I'm already beat. The trick is to not let the caring get to you.” These were the words recently uttered by one of my physician colleagues, referring to the stresses of caring for patients in the world of modern health care. The weariness was clear over the phone. Without missing a step, I responded, “I know. Of course.” It took me weeks to realize that it might be concerning that I immediately empathized with her sense of being submerged and overpowered by an uncaring health care system.
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Documentary Wrestling Ghosts tracks a journey from trauma to resilience
When prompted by a life coach to comfort the child inside of her, Kim Montleon, a young mother at the center of the documentary film, Wrestling Ghosts , says emphatically: “I can’t do that; I’m afraid I won’t come back!” That’s the beginning of Montleon’s two-year struggle to dig deep into her own harrowing childhood trauma to find a way to heal so that she can nurture her young children. The documentary by filmmaker Ana Sofia Joanes was screened to more than 140 people on Saturday,...
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Dozens of Kaiser Permanente pediatricians in Northern California screen three-year-olds for ACEs
Since August 2016, more than 300 three-year-olds who visited Kaiser Permanente’s pediatric clinics in Hayward and San Leandro have been screened for adverse childhood experiences (ACEs), such as living with a family member who is an alcoholic or losing a parent to separation or divorce. But when the idea to screen toddlers and their families for ACEs was first broached at the Kaiser Permanente Hayward Medical Center, the staff were, in a word, “angsty,” says Dr. Paul Espinas, who led the...
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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...
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Dr. Claudia Gold: Empathy & Listening as ACE-Informed Practice
"You are absolutely not doomed from having ACEs."
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Draft Recommendation on Child Maltreatment: Primary Care Interventions
Dear ACEs Community, The United States Preventive Services Task Force (USPSTF) has released a Draft Recommendation Statement on Child Maltreatment: Primary Care Interventions. Opportunity for public comment expires on June 18, 2018 at 8:00 PM EST. View the full Draft at: https://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementDraft/child-maltreatment-primary-care-interventions1#consider Here's an excerpt from the recommendation: In 2013, the USPSTF found...
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Employing an Adaptive Leadership Framework to Childhood Adversity Screening [pediatrics.aapublications.org]
By Susannah Stein, Arin Swerlick, and Binny Chokshi, Pediatrics, January 2020 Providers of pediatric health care have been motivated and inspired by the research on childhood adversity, which has shown that in the early stages of life, critical neurodevelopmental pathways can be disrupted through exposure to adverse childhood experiences (ACEs) and resultant toxic stress.1,2 Early detection of ACEs and subsequent intervention has the potential to decrease the development of associated poor...
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Hearing in House Education and Labor Early Childhood Subcommittee addresses intersection of trauma and education
Dr. Nadine Burke Harris (l) and Karina Chicote, Churchill Fellow from western Australia meet after congressional hearing After watching the hearing on a monitor in the overflow room, Karina Chicote, a Churchill Fellow from western Australia, and I hustled to the hearing room in hopes of speaking to the lead witness, Nadine Burke Harris, MD, the first Surgeon General of the State of California. She was deep in conversation with others, including a young woman who wanted to tell her how...
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How can we help people understand that asking for help is a strength?
I keep thinking the best way to change our current problems with ACE issues is to make a national MANDATORY use of the ACE Survey at all pediatric practices. Yet, someone today said..."Is there any follow-up to the Portland pediatric story?" Are parents following through on getting counseling, etc. after sharing their ACE results? " Does anyone have that information? Because I was getting push back today from the CEO of a big, respected Corporate Wellness coaching firm. He found the ACEs...
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How collaboration helps clinic in San Mateo County, CA, tackle ACEs in children
Dr. Elizabeth Grady is a pediatrician at the South San Francisco Clinic, a community clinic of San Mateo Medical Center. She and Susana Flores , a senior public health nurse with San Mateo County Health, spoke with me about how the clinic and other health agencies in San Mateo have been able to craft ways to work together to prevent and heal toxic stress in children. Grady also talked about how she and Flores have been working with the Resilient Beginnings Collaborative (RBC), a group of...
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How do these pediatricians do ACEs screening? Early adopters tell all.
Last week, three pediatricians — with a combined experience of 15 years integrating ACEs science into their practices — reflected on the urgency they felt several years ago that prompted them to begin screening patients for childhood adversity and resilience when there was practically no guidance at all. Along their journey , they accumulated a list of lessons learned for other pediatricians and family clinics to use. The three pediatricians participated in the ACEs Connection webinar,...
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Immune Biomarkers of Early-Life Adversity and Exposure to Stress and Violence - Searching Outside the Streetlight [jamanetwork.com]
By Nicole R. Bush and Kirstin Aschbacher, JAMA Pediatrics, November 4, 2019 Evidence of an association between early-life adversity and heightened risk of chronic disease in adulthood has been found, but the optimal biomarkers for identifying vulnerable or resilient individuals remain unclear. Global trends, including widening socioeconomic disparities, the refugee crises, and climate change, increasingly sculpt trauma exposure and call for scalable early-risk identification and treatment...
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Interim report of the President’s opioid commission says its final report will address early intervention strategies for children with ACEs
On August 8, President Trump spoke to the opioid crisis in this country and declined to declare a national emergency as recommended by the “President’s Commission on Combating Drug Addiction and the Opioid Crisis.” Instead, the President emphasized the law and order aspects of the problem and the importance of preventing drug use in the first place since addiction is so hard to overcome. The Commission will make a final report in the fall. The recently released interim report makes eight...
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4 years after integrating ACEs science, Pueblo, CO clinic improves services for families; cuts ER costs, doctor stress
Four years ago, Dr. Leslie Dempsey would never have talked about ACEs — adverse childhood experiences — with her patients. Now ACEs is a common topic. “Just as I don’t feel awkward asking someone if they smoke or do intravenous drugs, I don’t really feel awkward talking about their childhood traumas in a way that it relates to their health. It’s just integrated into obtaining background and social history,” she says. Dr. Leslie Dempsey Dempsey is a physician in obstetrics who oversees a team...
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A Conversation with Nadine Burke Harris: How Should Pediatricians Address Childhood Adversity?
Pediatrician Nadine Burke Harris is a masterful storyteller. I learned in a conversation with her at Wheelock College before her presentation for the Brookline, MA organization Steps to Success , that before she decided to become doctor, Dr. Burke Harris wanted to be an author. Only after the smashing success of her TED talk: How childhood trauma affects health across a lifetime , when she was approached by a literary agent, did she find her way to writing. Her newly released book The...
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A fast, easy way for pediatricians to screen kids for ACEs...and other health issues
Last November, the California Department of Managed Care gave its stamp of approval to a new version of Whole Child Assessment 2.0 , a tool that screens for children’s adverse childhood experiences (ACEs). It was recommended as part of recently passed legislation calling for trauma screening for children in California. But the Whole Child Assessment 2.0 (WCA) does more. It also queries patients about other critical safety and health issues, including whether they have enough to eat, whether...
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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].
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ACEs, biomarkers and the cost of adversity
How useful and necessary are biomarkers in telling the story of how toxic stress from adverse childhood experiences and resilience can impact a child’s long-term health? In the introduction to an article in the journal BioEssays , Dr. Kathryn Ridout, a Kaiser Permanente San Jose psychiatrist, and her co-authors examine what is known about two biomarkers and quote data on child maltreatment and its economic burden over time that says it all. “When totaling the costs of health care, child...
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ACEs Research Corner — January 2020
Research papers this month include links between ACEs and bullying, dropping out of high school, adult disability, and the effects of countering ACEs.
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Announcing the Parenting with ACEs Monthly Chat Series!
I'm thrilled to announce our NEW Live Chat series!!! Starting in May, once a month, we will have a live Chat Event. It will take online in the Parenting with ACEs Group the second Tuesday of the month at 10 a.m. PST (1 p.m. EST). We'll learn from our featured guests (below) about ACE-related issues. We'll have discussions and share experiences, stories, and resources with each other. Here is who and what we have scheduled for 2017. 2017 Monthly Chat Schedule / Time is Always: @ 10 AM PST (1...
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Some 350 Florida Leaders Expected to Attend Think Tank with Dr. Vincent Felitti, Co-Principal Investigator of the ACE Study; Expert on ACEs Science
Leaders from across the Sunshine State will take part in a “Think Tank” in Naples, FL, on Monday, August 6, to help create a more trauma-informed Florida. The estimated 350 attendees will include policy makers and community teams made up of school superintendents, law enforcement officers, judges, hospital administrators, mayors, PTA presidents, child welfare experts, mental health and substance abuse treatment providers, philanthropists, university researchers, state agency heads, and...
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Strengths-based Approaches to Screening Families for Health-Related Social Needs in the Healthcare Setting [Center for the Study of Social Policy]
How do you screen families to determine whether they have enough to eat or if they feel safe in their homes or communities without alienating them? In this new brief, authors Dr. Renee Boynton-Jarrett and JoHannah Flacks describe strength-based approaches to screening for health related social needs.
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Study unearths patterns in San Jose homeless population's ACE scores
Photo by Terabass/ CC-SA-3.0 It was around 2010 that Dr. Angela Bymaster was seeing a disturbing pattern in the histories of her adult patients. She already knew that patients who saw her at the Valley Homeless Health Care Program in San Jose, CA, where she worked at the time, were homeless or recently homeless. What was most troubling to Bymaster was knowing that their current precarious existence could have been prevented. Dr. Angela Bymaster “Over and over and over again I was hearing the...
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Survey: Healthcare providers, community organizations weigh in on California's ACEs screening program
In January, California took a historic leap forward to promote universal ACEs screening of the state’s 13 million adults and children in the Medi-Cal program. The eventual goal is to promote ACEs screening for all patients, but this is a first step in dealing with a major issue that ACEs science has identified: that many children will develop serious health problems later in life because the healthcare system is not currently set up to detect the roots of those problems. The term ACEs, which...
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The Academy of Pediatrics Calls to End Spanking, and APSAC agrees!
The American Academy of Pediatrics (AAP) advises parents against the use of spanking as a disciplinary tool, citing multiple potential hards. APSAC agrees and offers alternatives for parents
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The Family Environment and Adolescent Well Being (Research Brief Child Trends)
Adolescence is an important developmental phase along the path to adulthood, years during which youth become increasingly independent from their families. 1 Yet parents and other family members still play a critical role in the promotion of...
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The Relentless School Nurse: Do Kids Yoga With Nurse G!
I am continuously inspired by the generosity of spirit that is being shared during this complicated and unprecedented time. There are artists, musicians, storytellers, and teachers creating opportunities for families to bring some structure to our very unstructured day. You can find a variety of classes, concerts, and virtual gatherings through social media. One shining example that I wanted to share is the story of 'Kids Yoga with Nurse G'. I am continuously inspired by the generosity of...
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The Relentless School Nurse: When the Health Office Pass Includes Emotions
The collaboration between school counselors and school nurses creates safe spaces for students at school. Building a coalition between school counselors and school nurses creates a safety net for our most complex and challenging students while benefiting the whole school community. Promoting connections through intentional relationship building, and ensuring a school environment that is physically, emotionally and psychologically safe changes the culture and climate. Read about an amazing...
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Trauma education and mindfulness help youth living amid gun violence
Armon Hurst, 2nd from left, first row, Teens on Target, courtesy of YouthAlive! Eighteen-year-old Armon Hurst serves as vice president of the student body at Castlemont High School in Oakland, Calif. He has a 4.0 grade point average, is an avid baseball player, and is slated to go to college next year. But until a few years ago, Hurst would find himself waking from nightmares in the middle of the night. It was difficult to concentrate at school, and he wasn’t eating well. Armon Hurst “There...
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We Must Step Forward on Behalf of the Children at our Border [fsg.org]
By Lauren Smith, FSG, June 26, 2019. Everything I have learned in my almost three decades as a pediatrician and public health advocate caring for children and families tells me that what we are doing to migrant children at the border is morally and medically wrong. It goes against all that we know about how children should be treated. It is also not who we aspire to be as a nation. We are and must be better than this. Recent detailed reports of the appalling conditions in the detention...