Screening for ACES and Unmet Social NeedsDo Pediatricians Ask About Adverse Childhood Experiences in Pediatric Primary Care?
Section snippets
PS 85 Survey Administration
The AAP has conducted a PS of pediatricians 3 or 4 times each year since 1987 to inform policy, to develop new initiatives, and/or to evaluate current projects. Data collection for the PS 85 occurred between July and December 2013. The survey contained largely closed-ended questions asking about sociodemographic and practice characteristics, and it included questions about attitudes, training, and behaviors about child/adolescent and maternal MH. The questionnaire was pretested and approved by
Results
Examination of the 321 nontrainee pediatricians who exclusively practiced general pediatrics showed that 302 answered the majority of the ACEs questions and therefore were included in the analytic sample. Pediatricians were 46 years old on average, and 68% were women (Table 1). About half (51%) practiced in suburban settings, 53% worked in pediatric group practices, and 21% were in practice for less than 5 years. Almost two-thirds saw fewer than 100 ambulatory visits per week (65%), and the
Discussion
Our data suggest that most pediatricians surveyed have never heard of the original ACEs study and do not understand the epigenetic effects of ACEs. Nevertheless, most believe that childhood stressors can have a negative impact on children, that pediatricians can help influence parenting, and that positive parenting can influence children's trajectories. Even so, almost one-third of pediatricians in our sample do not usually ask about any ACEs, and only 4% ask about all of them, representing a
Acknowledgments
Supported in part by the American Academy of Pediatrics. NIMH P30 MH09 0322 (PI K. Hoagwood) supported Dr Storfer-Isser, Dr Hoagwood, and Dr Horwitz's participation in this research.
References (27)
- et al.
The impact of adverse childhood experiences on an urban pediatric population
Child Abuse Negl
(2011) - et al.
Adverse childhood experiences: translating knowledge into identification of children at risk for poor outcomes
Acad Pediatr
(2013) - et al.
Adverse childhood experiences and mental health, chronic medical conditions, and development in young children
Acad Pediatr
(2015) Postpartum depression effects on early interactions, parenting, and safety practices: a review
Infant Behav Dev
(2010)- et al.
Maternal postnatal depression and the development of depression in offspring up to 16 years of age
J Am Acad Child Adolesc Psychiatry
(2011) - et al.
Positive parenting predicts the development of adolescent brain structure: a longitudinal study
Dev Cogn Neurosci
(2014) - et al.
Is developmental and behavioral pediatrics training related to perceived responsibility for treating mental health problems?
Acad Pediatr
(2010) - et al.
Response rates to mail surveys published in medical journals
J Clin Epidemiol
(1997) - Center on the Developing Child at Harvard University. Excessive stress disrupts the architecture of the developing...
- et al.
The Effects of Childhood Stress on Health Across the Lifespan
(2008)
Compliance with well-child visit recommendations: evidence from the Medical Expenditure Panel Survey, 2000–2002
Pediatrics
Recommendations for Preventive Pediatric Health Care
The lifelong effects of early childhood adversity and toxic stress
Pediatrics
Cited by (153)
Adverse childhood experiences screening in healthcare settings: A focus on pediatric primary care
2024, Child Abuse and NeglectAdverse childhood experiences and adolescent handgun carrying
2023, Journal of Criminal JusticePositive Early Childhood Experiences and School Readiness among US Preschoolers
2023, Journal of Pediatrics“A multitude of things”: A qualitative analysis of practitioner perceived barriers to identifying and responding to childhood adversity
2023, Mental Health and Prevention
The authors declare that they have no conflict of interest.