Feasibility of Assessing Parental ACEs in Pediatric Primary Care: Implications for Practice-Based Implementation

Adult health burden and costs in California during 2013 associated with prior adverse childhood experiences

“…Upstream efforts at screening for ACEs should begin in childhood as an approach to reduce exposure and continue into adult primary care to assure that disease prevention and management activities are cognizant of early life trauma. Numerous studies have explored the effectiveness of screening of childhood adversities in primary care, and have seen promising findings overall in improved outcomes related to healthcare costs, quality of care, feasibility, and reduced maltreatment prevalence [40][41][42][43]. However, careful consideration of clinical integration of screening for early life adversity is also important and requires ongoing research [44][45][46].…”

Parental Adverse Childhood Experiences and Offspring Development at 2 Years of Age

“…The feasibility of integrating parental ACE measures into pediatric primary care has recently been demonstrated in the extant study population. 20 This work is grounded in the notion that intergenerational pathways can be interrupted by promoting family resilience and positive parenting behaviors. In our study, the findings were at most suggestive that parental early life resilience buffered the observed effects of parental ACEs on offspring development; however, we did not measure current resilience, a construct more germane to pediatric-based intervention.…”

“…Parental ACE screening was implemented with 8 physicians at 1 site and subsequently spread to all practitioners by 2015; the screening procedure is described in detail elsewhere. 20 There were 1822 patients in the practice born during the study period of October 2012 to June 2014. The study cohort included 546 patients whose parent(s) were assessed for ACEs and 91.5% of whom were from 1 site, obviating the need to account for site-level effects in study analyses.…”

“…Although still uncommon in pediatrics, some primary care practices have begun to measure parental ACEs routinely in a transition toward trauma-informed care. These efforts have generated promising results regarding feasibility 20 but have been implemented with limited empirical evidence regarding intergenerational effects. As those working within pediatric practices search for and implement novel approaches to address family adversity, elucidating the developmental risks attributed to parental ACEs and the related mechanisms (eg, maternal depression) will inform prevention and mitigation strategies.…”

Physicians’ knowledge and practices regarding screening adult patients for adverse childhood experiences: a survey

“…Both patients and doctors report that < 10% of patients are asked about ACEs [23,24]. Patients indicate that they understand the relevance of ACEs and most do not object to being asked [23,25]. Indeed, among patients who have experienced sexual abuse, most would like to be asked about their experience if it is done sensitively and supportively [26,27].…”