Tagged With "Mary Vail Ware, Office for Victims"
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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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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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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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Boston’s architect of community well-being: Pediatrician Renée Boynton-Jarrett
She talks with parents about the relationship between childhood adversities they have experienced and how that may have an impact on parenting.
“I frame things a bit more broadly than ACEs,” she said, “because I think it’s very important to reflect on a broader number of exposures than were covered in the original study, such as poverty or structural violence and racism.”
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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 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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Leaders in SF public housing deal with their own and community trauma head on
Sengthong Sithounnolat, Jeris Woodson, Donald Greene, Ashley Blanco On a recent Saturday, 10 people gather around a table at the offices of Trauma Transformed in Oakland, Calif., where quotes from figures like Frederick Douglas, Nelson Mandela, and Coretta Scott King grace one wall as light streams in from a skylight above. The group is known as the Resident Warriors, which meets weekly. One participant talks of her recovery from addiction and her mother’s murder. Another mentions being...
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Maternal Depression and Intimate Partner Violence: Impacts on Children [aappublications.org]
Among the many adverse childhood experiences, one must consider are the effects of maternal depression and of mothers being the victim of physical or sexual violence. What is the toll of these on children? Neamah et al. ( 10.1542/peds.2017-3457 ) decided to evaluate this by looking at the strength of such an association on the cognitive development as well as physical growth of over a thousand toddlers between 18 to 36 months living in Tanzania. These children underwent developmental testing...
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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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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 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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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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Dr. Claudia Gold: Empathy & Listening as ACE-Informed Practice
"You are absolutely not doomed from having ACEs."
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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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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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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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Immigrant teens, parents explore ACEs, resilience in 5-week course with family doc
Dr. Angela Bymaster, a family doctor in San Jose, Calif., was determined to find a way to teach ACEs science to her patients. Teens would come to the Washington Neighborhood Clinic clearly depressed by a range of problems at home that were contributing to risky sexual behavior and marijuana use, as well as preventable health problems like extreme obesity.
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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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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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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.
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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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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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Teens Seen in ERs for Assault at Risk for Later Gun Violence: Study
Researchers suggest the emergency room might be best place to stop cycle of violence. MONDAY, April 6, 2015 (HealthDay News) -- New research suggests that the emergency room might be a good place to try to end the vicious cycle of gun violence...
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The CHIP Program Is Beloved. Why Is Its Funding in Danger? [nytimes.com]
WILMINGTON, Del. — Laquita Gardner, a sales manager at a furniture rental store here, was happy to get a raise recently except for one problem. It lifted her income just enough to disqualify her and her two young sons from Medicaid, the free health insurance program for the poor. She was relieved to find another option was available for the boys: the Children’s Health Insurance Program, known as CHIP, that covers nearly nine million children whose parents earn too much for Medicaid, but not...
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Those who separate immigrant children from parents might as well be beating them with truncheons
Many people who see reports of children separated from their parents might think that, because they’re not crying, that they’ve adjusted. Or, if they are crying, they’ll eventually stop and get over it. But, the reality is that those who participate in separating children from their parents and those who are caring for them in the detainment centers might as well be beating them with truncheons.
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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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Trauma-Informed Care — Reflections of a Primary Care Doctor in the Week of the Kavanaugh Hearing [NEJM.org]
Today, it was my third patient of the morning: a woman with a history of childhood sexual abuse and an abusive marriage. She shared with me her distress, her escalating nightmares and flashbacks over the past week. She held out her left arm to me, where for the first time since her adolescence, she had started cutting herself. And then my sixth patient struggled unsuccessfully to tolerate a Pap smear, as her anxiety became unbearable. Yesterday, it was my fourth patient, with a history of...
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Trauma-informed groups rev up to address race, inclusion
Eighteen-year-old Kia Hanson has always enjoyed her time as a youth leader at the East Oakland Youth Development Center (EOYDC). She’s worked mostly with five- and six-year-olds since she began in 2016. Recently, she tapped into new skills, especially if the kids were having a meltdown. Kia Hanson “If they’re off, we ask them, ‘What’s wrong?’ ‘Do you want to talk about anything?’,” she explains. “Basically asking before assuming they’re mad at the world for no reason.” What made the...
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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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Child Life specialists empower kids in hospitals, disasters and now the pandemic
In late May, Betsy Andersen’s 7-year-old son, Ezra, had a serious meltdown. He and his six-year-old sister Abby had been enjoying an online Zoom interaction with “Miss Eileen,” “Miss Savannah,” a couple of their colleagues, and a puppet. Betsy Andersen “I could see him trailing off and then he started crying,” says Andersen, who lives in Mundelein, Illinois. But before she swooped in, she heard Miss Eileen talking to him: “She was saying ‘Hey, I see you’re having some big emotions.” Speaking...
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New Model of Service Delivery and Supporting Toolkit for Identifying and Linking Systems of Care for Children and Youth
Service providers and the children, youth, and families whom they serve have long faced system barriers which often present more challenges than solutions. In today’s climate, the COVID-19 pandemic has further exacerbated many of these issues, forcing child and youth-serving providers to find unique ways to meet the needs of individuals and communities. For many reasons, the relevance and timing of the arrival of the Virginia HEALS model of service delivery could not have been more perfect.
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ACEs and Gynecological Problems - A Conversation Starter
Gynecological problems as a result of ACEs, and particularly of Childhood Sexual Abuse (CSA), are rarely discussed in books and articles about the ACEs. The author would like to see that issue become part of the ACEs conversation.
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Emergency departments look inward to deepen practices that support traumatized patients
An interdisciplinary team of clinicians from Brigham and Women’s Hospital had a bold idea in 2017. They would completely change the way things worked in their hospital’s emergency department so that the care provided to their patients was infused with a trauma-informed approach. That means recognizing how widespread trauma is and using a myriad of techniques to mitigate its harmful effects among patients, providers and staff. The realization of just how widespread trauma is came to light in...
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Wellness navigators in clinics screening for ACEs help prevent crises in patients' lives
A patient came into the Goleta location of the Santa Barbara Neighborhood Clinics pleading with people at the front desk to speak to Mayra Garcia, a wellness navigator at the clinic, despite not having an appointment. The clinic is part of a network of four clinics in the Santa Barbara region of California that serve mainly patients on Medi-Cal, the state’s Medicaid program, or patients who are uninsured. Mayra Garcia “She was crying. Her husband had been deported. She couldn’t pay the rent,...
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ACEs screening pilot in L.A. County pivots, troubleshoots barriers to remote visits
This story is part of an occasional series about California-based pediatricians who are incorporating ACEs screening into their practices. In the first installment published in May, which you can find here , Dr. Amy Shekarchi and other team members had just launched their ACEs screening by phone. A community health worker from a clinic affiliated with Los Angeles County’s Department of Health Care Services recently called a teenage patient to find out if she ever felt unsafe in her home or...
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Think beyond ACEs screening, advises California funders workgroup in new report
Californians have experienced an alarming epidemic of adverse childhood experiences. Between 2011 and 2017, 60 percent of Californians reported experiencing at least one type of childhood adversity; about 16 percent experienced four or more. People who experience four or more ACEs are 1.5 times as likely to have heart disease, 1.9 times as likely to have a stroke, and 3.2 times as likely to have asthma as people who have experienced no ACEs. (For more information about ACEs and ACEs science,...