I think this topic would make for an excellent webinar or podcast or panel discussion. It's an important and complex issue and evokes lots of strong sentiments among many of us and for lots of different reasons.
While I don't favor screening for ACEs, because I don't trust most systems have dealt with bias towards those most likely to score high (people of color, women, poor people, those in the LGBTQ community), I do believe sharing information widely about ACEs is important. I believe the silence and avoidance, common to date, has been detrimental to many. I believe efforts that increase medical providers comfort having conversations about the way early life impacts adults health (for all of us, whether that means higher or lower health risks with higher or lower scores) is important - and hopefully will reduce judgments and increase listening, respect, and compassion when people understand that what many think of as self-created good health is often correlated with early adversity.
It seems beneficial, for example, for a doctor or nurse to know someone might be more likely to hit early menopause, or have a more complicated path through menopause, have accelerated aging, more complicated times during pregnancy, and early parenting, etc. etc. and may respond to kids, as parents, in ways related to childhood. These may be things that would improve a health provider's treatment, advice, or care. We, with high scores, might be more likely to have specific diseases but of course that doesn't mean we will have. We know those with lower scores are less likely to get many outcomes, but also, it doesn't mean that they won't have any. We simply know more about higher and lower risks of groups of people with specific ACE scores.
But, as Laura Porter says, ACE scores don't tell us anything on the individual level. I've heard her speak once and she also talked about "right fit" responses, an example of a criminal justice system where one probation officer had exceptionally good results with those with high ACE scores and then was able to train other probation officers who were less effective. Again, it wasn't to diagnose or asses a specific kid, but general info. used to improve the training of the probation officers less effective with some kids than other probation officers were. In essence, used to improve the skills of the probation officers. I find that fascinating.
My fear though is that the screening process will speed up referral to behavioral health or to the child welfare systems, etc. which can and sometimes have done more harm than good - especially to the same groups most likely to be impacted by high ACE scores. For me, until systems address bias and structural inequity, seems the priority since it's so relevant to those with high ACE scores.
For me, that's the blaring caution that I have. I worry that ACE scores will be another way to label people, or for insurers to somehow calculate risk of super utilizers without looking at wider context and co-existing issues and conditions. For me, that's my concern.
That said, I do believe the general public, providers, parents, and everyone should know more about ACEs and the information itself is powerful.
I have had great experiences at a doctor's office (which hasn't been my norm) when I could share openly with a provider. I write about that here. I wish I had learned more, earlier, not only about my own ACEs but about the presence and lack of ACEs in others. For me, the most shocking part about the ACEs study is how many people have no ACEs or one or two ACEs. It was not what I would have guessed or predicted, and it's not what I saw growing up in a family and community with lots of ACEs (meaning adverse childhood experiences and community environments).
Again, I think so many of us are thinking lots about all of this and how the research and information about ACEs is used, is important. I'm grateful for discussions and hearing the views of others.