Who and When to Screen
The ACEs Aware initiative recommends that all children are screened annually for ACEs to assess risk of toxic stress. Adults should be screened at least once in adulthood. Although ACEs, by definition, occur in childhood and therefore do not change, patient comfort with disclosure of these experiences may change over time, so re-screening for adults may be considered.
As discussed in Stage 1 Step 4, many clinics start screening for ACEs with a pilot project and adjust and expand it over time. For an overview of approaches to ACE screening implementation, review No One Size Fits All: Different Approaches to Piloting ACE Screening and Toxic Stress Treatment.