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California PACEs Action

How ACEs Screening Can Break the Silence on Sexual Abuse

 

Photo Credit: Photo by Marina Shatskih on Unsplash

 

The allegations raised in the recent documentaries about Michael Jackson and singer R. Kelly made headlines this past month, but they were soon buried in a flood of news about the Mueller report and new political scandals. Then, just days ago, we learned of a sting operation in New Jersey that led to the arrest of 16 men, from teachers to police officers and ministers, who were caught attempting to solicit sex from minors. All of these stories point to one emerging theme: sexual abuse is a national epidemic.

A federal study, published in 2005, reported that at least one in four girls (and one in six boys) in the United States is sexually abused by the age of 18. Parents may envision nameless monsters, but as more and more of us are learning, the sad reality is that children are usually abused by someone they know and trust.

Despite its prevalence, child abuse as an epidemic is just making its way into the national discourse. We’ve long known the possible consequences of such trauma — shame, fear, self-blame, PTSD, depression, suicidal thoughts, and substance abuse. Because sexual abuse can lead to health issues, it deserves a healthcare solution. Child abuse isn’t something we should publicize once in a while: It’s time to take action.

In childhood, sexual abuse is one of 10 adversities that studies have shown can result in toxic stress. Other such experiences include emotional or physical abuse, neglect or growing up in a home with a violent, incarcerated or mentally ill parent. The risks of toxic stress, still largely unknown to most of the public, are far-reaching. Without intervention or buffering from a caring adult, toxic stress can cause serious health problems starting in childhood, increasing the risk for seven of the ten leading causes of death in the United States.

As many as 34 million children are at risk of toxic stress nationwide. If we screened all kids for ACEs, early and often, we could dramatically improve the health of millions, save billions in health care dollars, and prevent endless cycles of abuse and trauma within generations of families.

The science is irrefutable. It is therefore imperative that we identify children at risk for toxic stress and get them screened through a simple, low-cost process. Armed with screening results, pediatricians can educate parents and give them greater guidance, support, and resources to protect their children and begin the healing process within their family.

The path to screening all children for childhood trauma is going to be long and winding but, as is so often the case, it starts in California. In 2017, former California Governor Jerry Brown signed a new bill into law, Assembly Bill 340, which created an advisory group to update and amend the EPSDT screening standards to include trauma screening for more than 5.7 million children on Medi-Cal.

Governor Gavin Newsom, built upon this momentum, proposing nearly $45 million in the state budget for ACEs screening and referrals for children and adults. These are the first statewide childhood trauma screening initiatives in the nation.

We need more states to follow California’s lead. There is no single preventive measure for sexual abuse or toxic stress. But if we educate more parents and providers about the warning signs and the risks of toxic stress, we can spark a national movement for universal ACEs screening and as a result, we will create a safer, healthier future for millions.

— Jabeen Yusuf is Vice-President of Strategic Engagements at the Center for Youth Wellness, whose mission is to build public awareness of the impact of childhood adversity and trauma, and leads the org's Stress Health initiative.

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Comments (5)

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Thank you Dr. Felitti. That's an excellent idea. We're actually collecting anonymous ACEs screening information on www.stresshealth.org and currently thinking about how to publish that information. One idea was to share that with our Stress Health Community of 2000 email subscribers and 95,000 Facebook followers but you make an excellent point about even broader distribution. We have also recently partnered with our local Bayview community newspaper to expand the distribution of our Stress Health Blog so they could be great partners in executing the idea you presented. Thank you for adding to this conversation. 

If you wish to "... educate more parents and providers about the warning signs and the risks of toxic stress", a good technique is to get a local newspaper to publish the 10-question ACE Questionnaire, asking readers to fill it out anonymously, and then pool and publish the pooled, anonymized data.  This attracts tremendous attention because the results are so contrary to conventional belief and expectation.  Meanwhile, readers might wish to google <ACE Study> on the Internet to see the relationships that are currently known but largely avoided.

Screening will hopefully lead to intervention, healing, rehabilitation, treatment, and recovery.  These five are not new concepts. Intervention, healing, rehabilitation, treatment, and recovery have been around for many decades and there are still hordes of hurting children and adults.  Legendary comedian Moms Mabley quipped, "If you always do what you always did, you will always get what you always got."

Let's take a lesson from public health and try primary prevention for a change...like a new kind of parenting education.  One that reaches everyone, everywhere, all the time.

Visit advancingparenting.org.

 

 

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