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New research demonstrates that using the Whole Child Assessment (WCA), which was developed at Loma Linda University Health, improves identification of child-adverse childhood experiences (Child-ACEs) during a routine well-child doctor visit versus not using a screening tool.
Ariane Marie-Mitchell, MD, PhD, MPH, lead author of the study and a preventive medicine physician at Loma Linda University Health, said ACEs are a growing public health issue.
Literature - Development - Stress - Body - Risk
“There is strong literature showing that early Child-ACEs affect neurological development and can cause chronic stress in the body and an increased risk for many medical problems, including mental health issues and substance abuse, as they get older,” Marie-Mitchell said. “If we know that, we can prevent these poor outcomes either by reducing exposure to the adversity, or if its already occurred, we can offer support to the family and child so that outcomes improve.”
Pediatricians are encouraged to screen for ACEs, such as physical and sexual abuse, neglect, and household dysfunction such as parental separation, substance abuse, mental illness, domestic violence and incarceration. ACEs, however, can be difficult to bring up because of their sensitive nature.
Study - Month - Journal - Global - Pediatric
The study was published last month in the peer-reviewed journal Global Pediatric Health.
The WCA is a consolidated questionnaire a parent or caregiver of a child age 0-11 years old completes during a well-child visit with their doctor that incorporates questions about exposure to and risk of ACEs. The WCA was approved by the state of California in 2016 and has been found to have no negative impact on the length of a doctor’s visit.
Study - Tool - Childhood - ACEs - Resident
This study developed and implemented a tool to specifically screen for childhood ACEs at a pediatric resident clinic in Southern California. Development of the tool, which was later named the Whole Child Assessment, was based on an iterative process that incorporated triangulation of references, patient data and physician feedback.
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