Goldfinger, Jonathan – 2019
This slide presentation explains the relationship between adverse childhood experiences (ACEs) and childhood trauma and the role pediatricians can play in identifying and treating childhood trauma. It begins by identifying the original ACEs: physical, sexual, or emotional abuse, physical or emotional neglect, mental illness of parents, incarcerated relatives, divorce, mother was treated violently, and substance abuse. Additional adversities that have been identified using the PEARLS tool are then reviewed. Following slides discuss the prevalence ACEs in different racial groups, the cost of inaction to address ACEs in childhood, risk factors for children who experience 4 or more ACEs, clinical symptoms associated with toxic stress, the economic impact of ACEs in California, and key drivers for addressing ACEs and toxic stress. Provider challenges to universal ACEs screening are identified, as well as tools and materials for promoting universal screening and parent education. Ways to buffer the toxic stress response through six evidence-based domains are then reviewed and targeted interventions are recommended, including improving resilience to ACEs through pediatric medical homes. 13 references.
