?s re ACE and Physical Health and War Zones

We in Maine are seeking an inquiry tool to use with young children in pediatric practices that serve our New Mainers, primarily from Somalia.  We have checked out the WHO ACE questionnaire - length appears to be formidable especially when trying to focus in the pediatric setting.  I recall having seen a shorter series of questions focused on this particular population but can't locate that at this time.  I realize that with very young children, the family would be the informant.  Any ideas where I can locate this?  Many thanks.

Hi Sue,

You may want to check out this site that includes more measures for children:

http://www.childrenandwar.org/measures/

Hi Chris,

I will pass the Macksoud CTWQ along to this pediatrician.  I continue to look for the earlier questions that I saw.  Teaches me to always mark these sites and not "assume" that I will find it a second time!  Thanks!

Thanks much!  I have sent this along to the pediatrician.  It still isn't the summary list of quick questions - so I am going to keep searching!  But this was relevant and may be of interest.  Thanks so much, Chris.

Hi Sue,

Coincidentally I just ran across this podcast on refugees (incl Somali). Not sure if it can be helpful to you or anyone else but thought I'd share.

Peeling the Fear from the Past: Building Community Capacities for Healing Refugee Trauma as a Human Rights Strategy - Dr. Patricia Shannon, Minneapolis (2011)

http://www.socialwork.buffalo.edu/podcast/reviews.asp?ep=76

Hi Sue,

I'm wondering if you've seen the 10-question questionnaire. It's not focused on children per se though. http://acestoohigh.com/got-your-ace-score/

Here's the print-friendly version: http://www.theannainstitute.org/Finding%20Your%20ACE%20Score.pdf

Please let me know more details if you can, if this is not the one. 

Hi Chris,

The tool/questions that I am seeking would augment the ACEs questionnaire and deal exclusively with topics related to the experiences of war.  I recently saw 5-6 questions specific to this but can't recall the source.  I believe that these questions were also more adult-oriented, but thought at the time that we could modify them for the interview with parents as to the impact of their experiences, and their child's (if any directly) experiences, as related specifically to the child.  Thanks.

Hi Sue,

The following two seem to be what're coming up in the research:

Macksoud's CTWQ includes a version for parents and a version for children.

http://www.childrenandwar.org/wp-content/uploads/2009/03/Childhood-...

Mollica’s Harvard Trauma Questionnaire has been previously adapted for this use as well. It is available for purchase. http://hprt-cambridge.org/?page_id=42

Please let me know if neither of these seems to be what you recalled.

Thank you Chris. My first question is a wondering (and thanks for your confirmation that I did get it right) as I have been thinking about the implications of this for GPs/physical health services...and the epidemic of health issues that are knocking in ever increasing numbers at our services doors...and I wonder and strongly suspect that most of them dont get it..largely put down to aging population...lots of wonderings here really..I understand the early intervention side of things....its more about adults who are now experiencing serious health issues...

Q2..wow, I love this group....

Somewhere, where I can just launch into my questions without having to explain ACE or implications ...beforehand..what a blessing

You're welcome, Debra! Dr. Felitti mentioned in his last webinar that there is a lot of resistance to this information. Dr. Sandra Bloom has said the same thing. Here is a good quote of hers that I have posted before: 

“We now know a great deal about the impact of trauma and despite this, training programs, degree programs, teacher preparation courses, etc., are still woefully deficient in conveying the research data to the people who need to know it,” said trauma expert Sandra Bloom, M.D. “Trauma training is not about the seemingly simple problem of giving people information. The real problem is that the material is challenging, threatening, and it may elicit resistance to change and denial within individuals and within entire systems. Any effort to [improve trauma services] will have to contend with this resistance if efforts are to be in any way successful,” said Bloom.” --The Damaging Consequences of Violence and Trauma. (2004). National Association of State Mental Health Program Directors. http://www.nasmhpd.org/docs/publications/archiveDocs/2004/Trauma%20...

 

Yes, I agree with you this site/forum is quite a blessing. :)

1) My understanding is that folks who grow up with high ACE scores and that don't participate in high-risk coping behaviors still run the risk of living shorter lives by 20 years. Reducing exposure to adverse experiences is key. Early screeing w/ interventions (e.g., home visitations to educate parents about healthier parenting styles) is one example of interrupting the adversity cycle.

2) War zones are environments of adverse experiences/toxic stress. CPTSD is common among these populations. You might find the WHO ACE questionnaire worth looking at:

http://www.who.int/violence_injury_prevention/violence/activities/adverse_childhood_experiences/en/

If we continue to live in a world that subjects people to adverse experiences at any age we are not headed in the right direction.

I hope this information is helpful. No questions are ever too silly here. :)

Thanks Chris

At the risk of being a proverbial   (I feel like a kid with a stack of pressies in front of her), in the ACE stuff did they find people with high ACEs and low/no physical health issues....and if so what were the mitigating factors...I guess I am wondering about impact of dealing with ACE early, or role of love/support/connection in peoples' lives and if these in any way mitigated the long term consequences...Spring has dawned here downunder..perhaps that may explain the awakening in my wonderings :-)

And the resistance here (NZ) is also huge...it seems unbelievable to me that there is no connection of all of the dots...and I agree..to connect them requires us to see and know (both within ourselves and others) the terrifying capacity of humanity to harm

I believe the "role of love/support/connection in peoples' lives" lowered people's ACE scores in general. If one has a high ACE score then there are strong chances one is not the recipient of a loving/safe home environment. Having one supportive adult in a child's life does help a child to be more resilient. I don't know the details on that research; perhaps someone else does. Everything in an environment is highly variable. So, sadly, this can all be quite complex. It would be true that whenever adverse experiences can be removed from one's environment that would bode, hopefully, for a better future. But age and previous experiences all play a part. It's a fact that some expereiences are highly damaging.

On another note, you may want to know about the posted video on Dr. Richard Benjamin. He is in Australia/NZ http://acesconnection.com/video/dr-richard-benjamin-on-ticp . You may also like the video on Psychic Trauma http://acesconnection.com/video/psychic-trauma-brain-mind-community (there are parts you may want to fast-forward through ;))