Adverse Childhood Experiences

Adverse childhood experiences (ACEs) describe stressful or traumatic events of abuse, neglect, or household dysfunction early in life and have been shown to increase lifelong risk for many of the leading causes of morbidity and mortality in the US.  Our understanding of how ACEs impact lifecourse health is evolving rapidly, and it is already abundantly clear that the toxic stress of ACEs exerts substantial influence over our physiology and health outcomes. With well over half of us in California having histories of ACEs, it is also clear that ACEs are widespread and have a large impact on population health that the health care system is just beginning to grapple with. Our AAP Chapter is committed to raising awareness of ACEs among pediatricians and the public, which is why we have launched our ACEs Committee. The ACEs Committee members are experts and practitioners dedicated to sharing advances in knowledge and practice relevant to ACEs in pediatrics. Stay tuned to this page for updates on our work.

Publications

AAP-CA2 ACEs Bulletin – Volume 1 (August 2019)

AAP-CA2 ACEs Bulletin – Volume 2 (October 2019)

AAP-CA2 ACEs Bulletin – Volume 3 (November 2019)

Resources Specific to COVID-19

ACEs Aware supports health care providers, their teams, and all those on the front lines of administering care and interventions as California addresses stress and anxiety related to COVID-19.

NEW: ACEs Aware Webinar May 27 at 12PM
Primary Care & Telehealth Strategies for Addressing the Secondary Health Impacts of COVID-19. The recording will soon be available Here

Questions to ask during TeleHealth or in-person visits:

  1. These circumstances are difficult for everyone in different ways (for complex children add: but particularly stressful for families with children who have more complex medical needs and conditions).  What are the things that are most difficult for you/your family/your child?
  2. What do you do when you feel really overwhelmed/anxious/scared/frustrated? Do you have any outlets that are helpful when you feel like you just need to hit the “pause” button for a few minutes and calm yourself down?
  3. What are the specific things that you worry most about right now?  Are these new since the COVID 19 pandemic or have they always been there but gotten worse since the coronavirus? Why?
  4. What are you doing to take care of yourself, even small little things that help recharge your battery?
  5. What types of behaviors are you noticing in your child(ren) that may be different than usual? Do they concern you?  What do you think is causing these changes?

Managing Stress

Recommended Apps

MEDITATION Apps
Headspace is currently free for health care providers, educators, and those who are unemployed.

Ten Percent Happier has free COVID-related resources

CLINICAL Apps
PFA Mobile is the VA’s app designed to assist responders who provide psychological first aid (PFA) to adults, families, and children.

PTSD Coach (Also from the VA) was designed for those who have, or may have, posttraumatic stress disorder (PTSD). This app provides you with education about PTSD, information about professional care, a self-assessment for PTSD, and more.

TalkSpace offers app-based therapy for patients. Plans start at $65/week

 

GENERAL resources

NCTSN Learning Center for Child and Adolescent Trauma

As part of the National Child Traumatic Stress Network (NCTSN), the Learning Center for Child and Adolescent Trauma offers Free Online Education with 300+ free CE certificates, 50+ speakers, 200+ online webinars and 90,000+ members. Visit/Register

AAP Policy statement on Childhood adversity

Early Childhood Adversity, Toxic Stress, and the Role of the Pediatrician: Translating Developmental Science Into Lifelong Health

Committee on Psychosocial Aspects of Child and Family Health, Committee on Early Childhood, Adoption, and Dependent Care, and Section on Developmental and Behavioral Pediatrics, Andrew S.Garner, Jack P. Shonkoff, Benjamin S. Siegel, Mary I. Dobbins, Marian F. Earls, Laura McGuinn, John Pascoe, David L. Wood

Related professional society statements on childhood adversity

American Psychological Association Statement on Responding to Children and Trauma

Update for Mental Health Professionals – Produced by: 2008 Presidential Task Force on Posttraumatic Stress Disorder and Trauma in Children and Adolescents

American College of Cardiology/American Heart Association Statement on Childhood Adversity and Heart Disease

On behalf of the American Heart Association Council on Epidemiology and Prevention; Council on Cardiovascular Disease in the Young; Council on Functional Genomics and Translational Biology; Council on Cardiovascular and Stroke Nursing; and Council on Quality of Care and Outcomes Research. Originally publiced 30 Jan 2018.

The resilience project

ACEs and Toxic Stress

The landmark Adverse Childhood Events (ACE) study was a collaboration between the Centers for Disease Control and Prevention (CDC) and Kaiser Permanente’s Health Appraisal Clinic in San Diego – led by Vincent Felitti, MD and Robert Anda, MD,MS.

The Resilience Project (Resources)

Resources designed to help pediatricians and families who are dealing with children and youth exposed to violence.

patter project

Pediatric Approach to Trauma, Treatment and Resilience

The Pediatric Approach to Trauma, Treatment and Resilience (PATTeR) Project is desinged to educate pediatricians about the trauma-informed approach in pediatric care. 

us preventive services task force recommendations

USPSTF Recommendations on Primary Care Interventions to Reduce Child Maltreatment

Final Recommendation Statement – Child Maltreatment:Interventions

Meet the ACEs Team

Our Adverse Childhood Experiences Committee is available to assist practices with specific concerns. Please contact the Chapter if you have any questions. Chapter2@aap-ca.org      (818) 422-9877

Committee Chair – Adam Schickendance, MD

Ruby Kalra, MD, FAAP

Jenifer L. Lipman, MSN, EdD
Stephanie Marcy, PhD

Ariane Marie-Mitchell, MD, PhD, MPH

Adwoa Osei, MD, FAAP

Danielle Shaw, MD, FAAP

Denise M. Nunez, MD
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