Tagged With "Chronic Illness"
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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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Pediatricians screen parents for ACEs to improve health of their babies
The Children’s Clinic , tucked in a busy office park five miles outside downtown Portland, OR, and bustling with noisy babies, boisterous kids and energetic pediatricians, seems ordinary enough. But, for the last two years, a quiet...
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Pediatricians screening for ACEs at Loma Linda University
Attached is the Whole Child Assessment which is being used by pediatricians to screen for ACEs at Loma Linda University. For further questions about the development or use of the WCA, please contact Ariane Marie-Mitchell at Loma Linda University, amariemitchell@llu.edu .
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Placebo Response in Antipsychotic Clinical Trials A Meta-analysis
Conclusions and Relevance The average treatment change associated with placebo treatment in antipsychotic trials increased since 1960, while the change associated with medication treatment decreased. Changes in randomized clinical...
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Please stop saying parenting is hard for everyone & read Parenting with PTSD instead
Sometimes, we feel anxious, intrusive, or afraid when changing or bathing or own babies. Sometimes, we feel sick to our stomachs and worried while potty training, nurturing, or disciplining our toddlers. Sometimes, we feel shame-filled and ill-equipped when talking about puberty, body parts, or sexuality because of how and where we were compromised by caregivers as children as in our bodies, homes, and families. P arenting is brutally hard for some. If affection, attention and intimacy have...
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Positive Childhood Experiences offset ACEs: Q & A with Dr. Robert Sege about HOPE
Tufts University medical professor Dr. Robert Sege directs the Center for Community-Engaged Medicine and is nationally known for his research on effective health systems approaches that address social determinants of health. He is also the principal investigator for the HOPE framework (Healthy Outcomes from Positive Experiences).The HOPE framework is based on research that shows how positive childhood experiences can mitigate the effects of adverse childhood experiences. Sege and colleagues...
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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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Beyond Trauma: Building Resilience to ACEs (brochure)
Wish you had a fairly easy and short way to share all about ACEs? Wish it was in-depth enough to share with teachers, doctors, nurses and therapists but not so long or jargony it puts family and friends to sleep? Here's the perfect thing to share when you've been all up in the faces with ACEs and want to back up your words before, during or after. This brochure is comprehensive but not so long that it remains in the "I'll get to it later," pile. Please feel free to print, forward, download...
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Building trust is now a critical part of health care
In a video clip , a hospital patient turns away in protest as a physician enters the room. “Why do you all keep coming in my room!” she asks in frustration. The physician moves a chair out of the way and sits down at eye level with the patient. “You’ve had to see so many people,” he acknowledges. “And I’m tired of it!” she yells. “I already know I have to get both of my legs cut off. That’s what they keep saying. I don’t have a choice!” “You don’t feel like you have a choice,” he repeats...
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CA announces robust perinatal depression prevention for Medi-Cal recipients
Melinda Coates experienced a tumultuous pregnancy. “I was really mentally upset literally from day one (of the pregnancy),” she says. (Melinda Coates is a pseudonym. To protect her and her children’s privacy and safety, we are not using her real name.) Coates had hoped to get counseling last October, when she was seven months pregnant. That’s when she enrolled in the state’s Medi-Cal program, shortly after she and her abusive husband moved to California, “but nobody was able to get me in...
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CA announces robust perinatal depression prevention for Medi-Cal recipients
Melinda Coates experienced a tumultuous pregnancy. “I was really mentally upset literally from day one (of the pregnancy),” she says. (Melinda Coates is a pseudonym. To protect her and her children’s privacy and safety, we are not using her real name.) Coates had hoped to get counseling last October, when she was seven months pregnant. That’s when she enrolled in the state’s Medi-Cal program, shortly after she and her abusive husband moved to California, “but nobody was able to get me in...
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CA pediatrician develops, tests, gets state OK for whole-child assessment tool that includes ACEs
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 about ACEs using a questionnaire, and to use this information to counsel parents and identify resources for the family. Different practices have been using different questionnaires: Some ask parents for their ACE scores...
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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 Is Giving Doctors Incentives To Ask Patients About Childhood Trauma [capradio.org]
By Sammy Caiola, Capital Public Radio, December 9, 2019 California health officials want children and adults on Medi-Cal to get screened for traumatic childhood events that can cause negative health effects down the line. Now the state has started giving doctors and nurses tools to do the screenings. People who experience adversity early in life have much higher chances of substance abuse, depression, or chronic diseases than their peers, according to national research. Gov. Gavin Newsom’s...
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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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Chronic Stress Exposure Among Young African American Children with Asthma: Racism is a Factor [annallergy.org]
By Bridgette L. Jones, Vincent Staggs, and Brianna Woods-Jaeger, Annals of Allergy, Asthma & Immunology, September 17, 2019 African American and Hispanic children are more likely to have a diagnosis of asthma and significantly higher disease related morbidity in comparison to non-Hispanic white children. Mortality rates are likewise higher as African American children are 8 times more likely than non-Hispanic white children to die from asthma 1. The cause of this striking health...
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COVID-19 and our dialogue with death
[Editor's note: Dr. Cristian Zanartu, an internist and palliative medicine specialist, is currently volunteering at Bellevue Hospital during the pandemic.] I was angry. So angry. How come the smartest country in the world is acting like the dumbest? Why aren’t health authorities giving us clear guidelines now, before this starts? Like: how to quarantine, how to quarantine from a symptomatic loved one in the same household (we knew by late February from Chinese data that most spread happened...
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Medical students' ACE scores mirror general population, study finds
A national survey published in 2014 revealed a disturbing finding. Compared to college graduates pursuing other professions, medical students, residents and early career physicians experienced a higher degree of burnout. Citing that article, a group of researchers at University of California at Davis School of Medicine wondered whether medical students’ childhood adversity and resilience played a role in their burnout, said Dr. Andres Sciolla, an associate professor of psychiatry and...
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Nadine Burke Harris debuts "The Deepest Well: Healing the Long-Term Effects of Childhood Adversity" in Philadelphia
Dr. Nadine Burke Harris debuted her book, The Deepest Well: Healing the Long-Term Effects of Childhood Adversity , at the Philadelphia Free Library this evening in a talk and book signing. This first stop in an ambitious book tour that crisscrosses the country reflects a mission that Burke Harris has pursued for nearly a decade: to spread the knowledge about the science of adverse childhood experiences, and about how people can use this knowledge to help solve our most intractable problems.
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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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New Member of Congress—Rep. Lauren Underwood (D-IL)—brings laser focus on toxic stress at hearing on immigration
At a March 6 hearing of the House Committee on Homeland Security, Rep. Lauren Underwood (D-IL) addressed the impact of family separation on the mental and physical health of children at the border. Her questions to Homeland Security Secretary Kirstjen Nielsen focused on the impact of toxic stress caused by family separation on short and long-term health outcomes for children. Sec. Nielsen was unfamiliar with the concept of “toxic stress.” Here’s a short description of the 6-minute exchange...
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New organization calls all pediatricians to end crisis that's "hiding in plain sight"
When the question of screening patients for adverse childhood experiences (ACEs) was first raised a couple of years ago, Santa Barbara pediatrician Andria Ruth had mixed feelings about it.
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Next "A Better Normal" community discussion series: April 3, 2020/ Maternal health and pediatrics in the time of COVID-19
Steve Sack • Star Tribune The "Better Normal" community discussion for Friday, April 3, 2020, features two wonderful staff members from ACEs Connection: Karen Clemmer, community facilitator for the Northwest, Far Northern California, Alaska and Hawaii; and reporter Laurie Udesky, who is also community manager for the ACEs in Pediatrics community on ACEsConnection.com. Karen Clemmer Join them at noon PT/ 1 pm MT/ 2 pm CT/ 3 pm ET and share your thoughts, ideas, questions, concerns, and...
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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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First health-related cost of ACEs study shows $113 billion price tag for California; just one ACE costs $28 billion
Researchers who have been looking for a way to quantify the health toll of ACEs in dollar terms, now have an example in a newly-released study of California. ACEs exacted a toll costing an estimated $113 billion annually, according to the study in the journal PLOS One that was commissioned by the Center for Youth Wellness. ACEs-associated cardiovascular disease was the condition that lead author Ted Miller dubbed “the giant in the room.” It accounted for $29.6 billion in spending, more than...
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Heyman Oo integrates ACEs science as foundation of pediatric care
Dr. Heyman Oo, a 34-year-old primary care pediatrician, first learned about the science of adverse childhood experiences in medical school at a grand rounds held around 2012 at Rady Children’s Hospital in San Diego, which she attended from 2009 to 2014. The presenter was none other than Dr. Nadine Burke Harris, a pediatrician who went on to become California’s first Surgeon General. The founder and former director of the Center for Youth Wellness drew millions of views for her TED talk on...
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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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How to Be More Resilient [nytimes.com]
As a psychiatrist, I’ve long wondered why some people get ill in the face of stress and adversity — either mentally or physically — while others rarely succumb. We know, for example, that not everyone gets PTSD after exposure to extreme trauma, while some people get disabling depression with minimal or no stress. Likewise, we know that chronic stress can contribute to physical conditions like heart disease and stroke in some people, while others emerge unscathed. What makes people resilient,...
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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 Kaiser pediatrician, wise to ACEs science for years, finally gets to use it
Dr. Suzanne Frank has known about the impact of childhood adversity on young lives for decades. She’s seen the fallout in the faces of young people huddled in beds at a children’s shelter where she worked years ago. She’s seen it as the regional child abuse services and champion for the Permanente Medical Group. And she’s seen it in hospital examination rooms where, as a member of the Santa Clara County’s Sexual Assault Response Team, she’s been called in to examine shell-shocked children...
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ACE Fact Sheets to Give Your Doctors, Patients & Beyond (free downloads)
I was first inspired to create a fact sheet summarizing the effects of adverse childhood experiences (ACEs) after reading a comment in “Got Your ACE score?” A reader wished she had a form to give her doctor that documented the vast body of evidence explaining how early trauma increases risk for chronic physical and mental health conditions and much more.
I could relate.
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ACEs Aware Webinar: Trauma-informed practices to address stress from COVID19
How can health care providers take care of themselves, their colleagues and their patients during this COVID-19 pandemic? First and foremost is recognizing how the pandemic can stir up trauma from the past, said Dr. Alicia Lieberman, a psychologist specializing in trauma. “COVID19 is reawakening traumatic reminders in many of us and in the families we work with. And that often makes it difficult for parents to protect themselves and their children,” she noted. Lieberman, the director of the...
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ACEs Screening
This is a collection of resources regarding screening for ACEs . This list aims to give a broad overview and is not all-inclusive. We welcome suggestions; if you have any, please comment below! This resource list is organized in alphabetical order. Pediatric Campus in Santa Rosa ACEs screeners, 2019 Description: ACEs screeners for 4m-11y and 12y-18y in English and Spanish are in the attachments below. Whole Child Assessment (WCA) , 2019 Description: The Whole Child Assessment (WCA) is a...
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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...
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Alternative IHEBA with ACEs for California (and Other) Pediatricians
If you are a pediatrician serving Medicaid managed care patients in California, then you are required to use the Staying Healthy Assessment or an alternative IHEBA (Individual Health Education Behavioral Assessment) at all well-child visits. The bad news is that getting approval to use an alternative IHEBA is a tedious process. The good news is that as of October 27, 2016 the Whole Child Assessment (WCA) is available for use in English and Spanish. Most importantly, the WCA has been...
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Alternative IHEBA with ACEs for California (and Other) Pediatricians
If you are a pediatrician serving Medicaid managed care patients in California, then you are required to use the Staying Healthy Assessment or an alternative IHEBA (Individual Health Education Behavioral Assessment) at all well-child visits. The bad news is that getting approval to use an alternative IHEBA is a tedious process. The good news is that as of October 27, 2016 the Whole Child Assessment (WCA) is available for use in English and Spanish. Most importantly, the WCA has been...
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Baltimore uses trauma research to improve life for poor parents and their children [WashingtonPost.com]
One day, when she was 14 and feeling ill, Daylesha Brown’s mother took her to a Baltimore hospital and did not return for her. Child Protective Services (CPS) placed her in a group home and she was forced to move to other homes for the next three years. “My mother, she pushed me away,” Brown, now 23, said softly. “I was always getting in trouble with my mother.” So last year when Brown discovered her daughter, Sa-Maji, had lead poisoning, a lingering problem in Baltimore where the rate of...
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Sharpening the global focus on ethnicity and race in the time of COVID-19 [thelancet.com]
By Neeraj Bhala, Gwnetta Curry, et al., The Lancet, May 8, 2020 Tackling injustices, including those that result from prejudice and racism globally, is essential in the response to the coronavirus disease 2019 (COVID-19) pandemic. Here, we focus on UK South Asian and Black and African-American populations, using internationally recognised terminology and definitions, and consider the UK and the USA as globally relevant examples. We recognise other minorities also need consideration in the...
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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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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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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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Traumatic Experiences Widespread Among U.S. Youth, New Data Show
[This is a media release from the Robert Wood Johnson Foundation.] New national data show that at least 38 percent of children in every state have had at least one Adverse Childhood Experience or ACE, such as the death or incarceration of a parent, witnessing or being a victim of violence, or living with someone who has been suicidal or had a drug or alcohol problem. In 16 states, at least 25 percent of children have had two or more ACEs. Findings come from data in the 2016 National Survey...
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Who's integrating ACEs?
2015 article about Children's Clinic in Portland, OR, doing ACEs history on parents of four-month-old babies. 2014 article about pediatricians taking ACEs history on ACEsTooHigh.com. Center for Youth Wellness, San Francisco,...
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Why screen if there are no services? (Barbara J. Howard - Pediatric News)
Why screen if there are no services? By: DR. BARBARA J. HOWARD OCTOBER 6, 2014 Behavioral Consult Do you remember the discussion of the ethical dilemma of Huntington’s disease you probably participated in during medical school? The...
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Re: ACE Fact Sheets to Give Your Doctors, Patients & Beyond (free downloads)
Dr. Mead, This is such a great collection of resources. I so appreciate you putting it all together.
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Re: ACE Fact Sheets to Give Your Doctors, Patients & Beyond (free downloads)
Thank you, Veronique, for your prolific and powerful post! Thank you for your creative initiative of developing two ACEs Fact Sheets. Thank you for streamlining the pathway for patients to be well-informed and prepared to advocate for their well-being during their doctors' visits. Thank you for lifting up our amazing ACEs Connection Cissy White. "In addition to the commenter who wished for an ACE form (thank you for being so courageous and clear about what you needed), I was also inspired to...