Implementing Standardized Screening for Adverse Childhood Experiences in a Pediatric Resident Continuity Clinic

Area of Science:

• Pediatrics
• Child Mental Health
• Public Health

Background:

• Childhood adversity, or adverse childhood experiences (ACEs), is linked to poor mental health and chronic medical conditions in children and adults.
• Recognizing ACEs and implementing interventions can enhance children's resilience.
• A standardized screening tool was implemented to assess patient exposure to adversity.

Purpose of the Study:

• To increase the screening rate for ACEs from 0% to 80% in children during annual well-child visits within one year.
• To evaluate the effectiveness of a standardized ACEs screening tool in a general pediatrics clinic.

Main Methods:

• A standardized ACEs screening tool was implemented in a general pediatrics clinic.
• Educational lectures, simulation, and process changes were utilized to promote screening.
• Surveys were administered to resident physicians and faculty regarding their experiences with ACEs screening.

Main Results:

• Over one year, 1,206 patients were screened for ACEs, increasing screening rates from 0% to 60%.
• Provider comfort in discussing abuse and familiarity with resources for children exposed to ACEs remained unchanged.
• The study demonstrated successful implementation of ACEs screening in a resident-led clinic.

Conclusions:

• A standardized ACEs screening tool can be effectively implemented in a resident-led pediatric clinic.
• This approach successfully identifies children with high-risk ACE scores.
• Further education and implementation may enhance provider comfort with ACEs screening.