Study: Effective ACE screening builds trust, reveals vital patient information

Editor's Note

This recent study of five pediatric clinics in Los Angeles County, California, found that when clinic staff performed screening for adverse childhood experience (ACE), they were able to elicit important patient information and build trust, with no adverse events reported. The study, titled "Clinician and Staff Perspectives on Implementing Adverse Childhood Experience (ACE) Screening in Los Angeles County Pediatric Clinics," was published in Annals of Family Medicine in September 2023.

Among the findings:

• Adverse childhood experiences may include abuse, neglect, violence in the home, or separation from a parent. 
• ACEs can trigger toxic stress, which can lead to later poor health outcomes, including decreased physical and mental health, developmental delays, depression, asthma, obesity, smoking, cancers, and heart disease. 
• Routine ACE screening in pediatric/primary care settings can mitigate physical and mental health effects of ACEs in children and adults.
• Significant barriers to providing ACE screening include insufficient time for screening and response, lack of training, and lack of clarity about referral networks and resources that could be offered to patients. 

In order to better incorporate ACE screening into trauma-informed care, staff noted that clinics need to take steps to address time constraints and limited referral resources.