Evidence for Revising the Adverse Childhood Experiences Screening Tool: a Scoping Review.

Area of Science:

• Public Health
• Psychology
• Sociology

Background:

• Adverse childhood experiences (ACEs) are linked to negative health outcomes, including chronic illness and premature mortality.
• Current primary care screening for ACEs is limited, partly due to the narrow scope of original tools focusing on family dysfunction.

Purpose of the Study:

• To review current research on expanding ACE categories beyond family dysfunction.
• To identify revisions in the formatting and scoring of ACE screening tools.

Main Methods:

• A systematic literature search was conducted across CINAHL, OVID Medline, and PsycINFO databases.
• The review focused on studies that expanded ACE categories or revised the ACE tool's format/scoring.
• Data from 19 studies (published in 18 articles) were independently extracted and verified by at least two authors.

Main Results:

• Most studies expanded ACEs to include community and systemic adversities.
• The most frequently added categories were exposure to community violence (15 studies) and economic hardship in childhood (13 studies).
• Other significant additions included bullying, parental absence/death, and discrimination; three studies revised tool formatting or scoring.

Conclusions:

• Evidence supports broadening ACE screening to encompass a wider range of childhood adversities.
• Expanded ACE assessments can lead to more comprehensive identification of childhood trauma.
• This facilitates timely and appropriate treatment interventions for affected individuals.