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So you've screened for ACEs...Now what?


Docs for Tots has partnered with the Center for Youth Wellness (CYW) to bring together diverse pediatric offices across Long Island and assist them in implementing universal ACEs screening. CYW, national experts on ACEs, has demonstrated that by addressing ACEs and building resilience through community resources, behavioral therapy, and support, the health outcomes of individuals can improve. A key goal of CYW is to have every pediatrician universally screening for ACEs in order to identify risks early and empower families to take action to address toxic stress in their lives.

However, screening for ACEs can be difficult because the screen addresses topics that some professionals do not feel comfortable discussing. Specifically, it asks about past abuse and neglect. This is of particular concern for providers who have the responsibility of being mandatory reporters.

Q: Can I completely rule out abuse and neglect? When do I report?

Your professional judgment always takes precedence over what the screen states. As pediatricians, you are already checking in with how your patients’ home lives are. This means you would know if abuse or neglect were part of the child’s life in the past, and that you will know when to report, independent of ACEs screen. The ACEs screen is a screen for toxic stress and does not replace your professional judgment regarding abuse or neglect and your patients.

Q: If that’s the case, why screen at all?

Data shows us that the toxic stress that results from experiencing ACEs has long-term negative health outcomes. This can be especially harmful if a child experiences ACEs from birth to age five due to the impact on a child’s rapidly developing brain...

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Margaret, Thanks so much for posting this.  I think the more discussion about ways to address the questions posed in this post, the easier it will be for health care providers to move forward on implementing ACEs screening. 

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