At the Cobbs Creek Clinic in West Philadelphia, Dr. Roy Wade relies on some of the same tools every pediatrician uses for exams — blood pressure cuffs, a stethoscope, and, of course, tongue depressors.

He also uses particular questions to get at something that few doctors try to measure: childhood adversity.

Wade is working on his own screening tool, a short list of questions that would give every young patient at the clinic an "adversity score." The list will include indicators of abuse and neglect (which pediatricians already are on the lookout for) and also check for signs of poverty, racial discrimination or bullying.

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