Are you screening for ACEs in schools? How are you responding?

Hi Leslie,. I know that Monroe County NY, included ACEs questions into their Youth Behavioral Risk Survey administered in schools.  Elizabeth Meeker, a member of ACN, posted info about it and I posted the information and tool in the ACEs and Education group (https://www.pacesconnection.com/...ming-trauma-informed).  We at ACEs Connection Network would love to hear of others that are asking about ACEs in schools so we can collate the information and make it accessible to others. Thanks!

Hi Leslie, 

Unfortunately, I don't have any information for you on schools with experience administering the ACE survey. I am, however, very interested in the prospect of a youth informed ACE survey! I work for an organization that mostly serves young children ages 5-13, and a youth based survey would be a great addition to our assessment process...

~Jackie

We administer this version in some schools in NYC - copied below in English and Spanish.

Counselors ask students the questions and record their answers as an interview rather than a survey format. If students report symptoms/distress or interest in meeting with a counselor, then we follow up with them and their families to complete a further assessment and offer additional support to meet the identified needs.

Many students take advantage of at least short-term counseling as a result of this process. Another outcome is that students know who to go to when something overwhelming happens because the counselor has already broken the ice on these topics that are difficult to bring up.

Schools we partner with were reluctant to include the question about sexual abuse so we didn't ask that in the first couple of administrations but we are working to include it this school year.  

ACE Questionnaire- ENGLISH

Directions: Please circle yes or no.
 
1. Did you ever live with a parent or guardian who got divorced or separated after you were born?
YES          NO

1. Did you ever live with a parent or guardian who died?
   YES NO
2. Did you ever live with a parent or guardian who served time in jail or prison after you were born?
   YES NO
3. Did you ever see or hear any parents, guardians, or any other adults in your home slap, hit, kick, punch, or beat each other up?
   YES NO
4. Were you ever the victim of violence or witnessed any violence in your neighborhood?
   YES NO
5. Did you ever live with anyone who was mentally ill or suicidal, or severely depressed for more than a couple of weeks?
   YES NO

1. Did you ever live with anyone who had a problem with alcohol or drugs?
   YES NO
2. Have you been treated or judged unfairly due to race/ethnicity?
   YES NO
3. Since you were born, how often has it been difficult to get by on your family's income, for example, was it hard to cover the basics like food or housing?

1: Very Often            2: Somewhat Often          3: Not Very Often          4: Never

National Survey of Children's Health (2011/2012). Data query from the child and adolescent health measurement initiative, data resource center for child and adolescent health website [Online query]. Retrieved from www.childhealthdata.org

Sacks, V., Murphey, D., & Moore, K. (2014). Adverse childhood experiences: National and state level prevalence [Research Brief]. Retrieved from http://www.childtrends.org/wp-...xperiences_FINAL.pdf

ACE Questionnaire- SPANISH

Directions: Please circle yes or no.

1.¿Alguna vez viviste con un padre que se divorció o separó después de que naciste?
Sí         NO

2.¿Alguna vez viviste con un padre que murió?
Sí         NO

1. ¿Alguna vez viviste con un padre que pasó tiempo en la cárcel o prisión después de que naciste?
   Sí NO

4.¿Alguna vez viste o escuchaste alguno de tus padres u otros adultos en su casa dar una bofetada, golpear, patear, golpear, o se golpearon el uno al otro?
Sí         NO

5.¿Alguna vez fuiste la víctima de la violencia o viste violencia en su barrio?
Sí         NO

6.¿Alguna vez viviste con alguien que tenía problemas de salud mental o tendencias suicidas, o severamente deprimido por más de un par de semanas?
Sí         NO

7.¿Alguna viviste con alguien que tenía un problema de alcohol o drogas?
Sí         NO

1. ¿Ha sido tratado injustamente debido a tu raza/etnicidad?
   Sí NO
2. Desde que naciste, ¿Con que frecuencia tu familia ha tenido dificultad para mantenerse económico de tu hogar, por ejemplo, las veces que ha sido difícil de cubrir los aspectos básicos como comida o vivienda?
   
   1: Siempre 2: A Menudo    3: Pocas Veces       4: Nunca

National Survey of Children's Health (2011/2012). Data query from the child and adolescent health measurement initiative, data resource center for child and adolescent health website [Online query]. Retrieved from www.childhealthdata.org

Sacks, V., Murphey, D., & Moore, K. (2014). Adverse childhood experiences: National and state level prevalence [Research Brief]. Retrieved from http://www.childtrends.org/wp-...xperiences_FINAL.pdf

I train school districts who are interested in becoming trauma informed. Many of them are interested in using ACES screening tools.  Some of them would love to pilot a screening tool.  I will be looking for the tool mentioned by Gail above. As for mechanisms, we are looking at building it into the RTI process district wide. I'm very interested in following this discussion. 

Melissa Sadin posted:

I train school districts who are interested in becoming trauma informed. Many of them are interested in using ACES screening tools.  Some of them would love to pilot a screening tool.  I will be looking for the tool mentioned by Gail above. As for mechanisms, we are looking at building it into the RTI process district wide. I'm very interested in following this discussion. 

Melissa,

Implementing TIC into the RtI process sounds interesting.  Is this a "universal screening" approach or at some other level of the RtI pyramid?  Can you clarify what type and amount of staff/admin training and competency assurance occurs before universal screening is implemented? 

-Denise

Denise,

we are implementing at all levels of the RTI process. The RTI teams are trained with the IEP teams. We will be using the ACES survey in the IEP evaluation process with the social workers. The RTI team is being trained in recognizing trauma and then administering a survey as a part of  tier 2 initially. 

Universal screening is part of a two year roll out. We are basically starting with tier 3 and training out. 

Thanks for the clarification, Melissa.  What then will be the responses/intervention to the ACEs survey results, at the different levels of RtI intervention?

At all tiers we are organizing wrap around services for the families. This is obviously dependent upon the level of ACES understanding in the local mental health agencies in the different states. In my town, we are working on trauma informing all first responders and county youth agencies. Starting with those that are already or should be hooked into the schools. 

At more individual and intensive levels, that depends on the child, the need, and the age. 

I'm very curious about how the ACEs survey is used on a universal design level as well as with the Special Education process.  As a school psychologist, I take the task of identifying children with disabilities seriously, with full awareness that children often struggle with focus and emotional regulation-two big areas for which kids are referred- that may be secondary to ACEs events in their lives.  I also would be interested in finding out about the increase in the percentage of children who have higher ACEs scores- saw something on the blog about a comparison between now and an earlier cohort, but can't easily get back to. Thanks for any thoughts on these issues.

Mary - I'm doing my dissertation on trauma and schools.  I have research on the dose response relationship between trauma and behavioral problems.  I also have access to research on the connection between ACES and ADHD, behavior problems, and learning.

Send me a private message if you are interested in any of this.

Melissa

Hi, Leslie -- This health clinic that's part of a high school in Santa Rosa is giving the ACE survey to every teen who visits the clinic. Apparently, it's produced a huge change in their understanding of these kids and how they help them. Here's the story -- https://acestoohigh.com/2015/10/06/customizing-the-aces-screen-for-the-specific-experiences-of-high-school-students/ 

I believe that there was some thought to screening kids for ACEs in some schools in New Haven, CT, but that idea was abandoned. In the trauma-informed schools that I've done stories on, the general feeling is that if the administration, staff & teachers have been thoroughly trained in being trauma-informed, that kids don't need to be screened because the teaches, staff & admins are so attuned to their kids, and their own stress responses, that they don't need it, and it might stigmatize a kid.

There have been some suggestions that a better way to get at understanding what kids are experiencing, and as a first necessary step to helping the entire family, is to have their parents or caregivers fill out ACEs and resilience  surveys. 

Hi Leslie- 

In the fall of 2015 the Buffalo Public School District in collaboration with the University at Buffalo's Institute on Trauma and Trauma Informed Care added  ACE questions to the Youth Risk Behavior Survey distributed to the districts high school students. Currently the Institute on Trauma and Trauma Informed Care is analyzing the data to provide the district with a better understanding about the level of trauma Buffalo students have experienced, so that the district can identify areas where teachers and administrators may need training. 

More info on the project and the Institute on Trauma and Trauma Informed Care is below. 

http://www.buffalonews.com/cit...nce-at-home-20151216

http://socialwork.buffalo.edu/...a-informed-care.html

In the healthcare field the though seems to be that we are not allowed to ask because we are mandated reporters and they don't want us uncover actionable things as there is no statute of limitation on sexual abuse of children. How does the educational system differ? I end up vaguely talking about the ACE's and then talking generally about resources for anyone experiencing them.