Benefits of Screening for ACEs

Screening can mitigate toxic stress and improve health outcomes

Doctor with small child

Why screen

Routine and universal Adverse Childhood Experiences (ACEs) screening helps clinical teams provide more effective and equitable health care. Screening results can be used to provide targeted clinical interventions, as well as offer greater compassion, patience, and the opportunity for relational healing.

ACE screening has been successfully integrated into a wide range of clinical settings, including pediatric primary care, adult primary care, family medicine, and women’s health and prenatal care.

Leading health care and public health organizations, such as the National Academies of Science, Engineering, and Medicine, Centers for Disease Control and Prevention, and American Academy of Pediatrics, now recommend screening for ACEs.

Why screen children and adolescents for ACEs?

Children are uniquely vulnerable to the effects of an overactive stress response because their brains and bodies are still developing. While the plasticity in the brain during early childhood and adolescence is a source of vulnerability to ACEs, there is also an opportunity for effective intervention and treatment. Annual ACE screening:

  1. Routine screenings for children can capitalize on critical opportunities for prevention, early detection, and intervention.
  2. ACE screening can prevent and reduce the accumulation of exposures to adversity and the risk for negative health outcomes.
  3. Screening improves clinical assessment for and treatment of childhood health conditions.

Why should adult patients be screened for ACEs?

Over the past 20 years, studies have demonstrated the impact of exposure to ACEs on adult morbidity and mortality. There are several critical ways that screening for ACEs can benefit adult patients:

  1. ACE screening can improve clinical assessment, patient education, and treatment planning for chronic health conditions.
  2. ACE screening helps providers and patients address behavioral pathways to ACE-Associated Health Conditions.
  3. ACE screening can validate and empower patients and contribute to improved family health.

Why screen patients for ACEs who are seeking reproductive health care?

ACE screening is especially relevant in reproductive health care settings. In addition to the value of screening adults for ACEs, there are several ways that screening pregnant women and their partners for ACEs can support their and their child’s health:

  1. ACE screening helps identify risks to reproductive health.
  2. ACE screening promotes a positive cycle of health by reducing the intergenerational transmission of ACEs and toxic stress.
  3. ACE screening supports the provision of trauma-informed reproductive health services.

To start screening your patients for ACEs, learn how to get certified.

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END USER SUBLICENSE AGREEMENT

PLEASE READ CAREFULLY: This End User Sublicense Agreement (the “Agreement” or “Sublicense”) is a legally binding agreement between you (an individual or an entity, hereinafter “You” or “Sublicensee”) and the Department of Health Care Services (“DHCS”) for the use of the Pediatric ACEs and Related Life-events Screener (“PEARLS”) for children and adults up to the age of 21.

BY WAY OF DOWNLOADING, COPYING, ACCESSING, OR OTHERWISE USING THE PEARLS TOOL, YOU ARE AGREEING TO BE LEGALLY BOUND BY THE TERMS OF THIS AGREEMENT. IF YOU DO NOT AGREE TO BE BOUND BY THE TERMS OF THIS AGREEMENT, THEN YOU HAVE NO RIGHTS TO THE PEARLS TOOL AND MAY NOT DOWNLOAD, COPY, ACCESS, OR OTHERWISE THE PEARLS TOOL.

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    1. The PEARLS Tool. The PEARLS tool is a unique tool that assess for both Adverse Childhood Experiences (“ACEs”) such as abuse, neglect, and household challenges, and related events, such as discrimination, food insecurity, and community violence, thought to be risk factors for toxic stress. The PEARLS tool was made in the course of research under the auspices of the Children’s Hospital Research Center at Oakland (“BCHO”) and the University of California, San Francisco. BCHO has licensed the PEARLS tool to DHCS and provided DHCS with the right to sublicense the PEARLS tool.
    2. Sublicensee Attestation. By agreeing to this Agreement, You attest that You are a provider of health care services to Medi-Cal beneficiaries, a Medi-Cal Managed Care Plan, a Medi-Cal beneficiary, a parent or guardian of a Medi-Cal beneficiary, or an Electronic Health Records (“EHR”) vendor.
    3. The Sublicense. Subject to the terms of this agreement, DHCS hereby grants to Sublicensee a non-exclusive, royalty-free, non-assignable, non-transferable sublicense (the “Sublicense”) to the PEARLS tool. Under the Sublicense, Sublicensee may use the PEARLS tool as directed, and may save, download, print, copy, reproduce, or distribute the PEARLS tool to facilitate such use.
    4. Use in a Remote Patient Portal. The PEARLS tool was developed as a screener of risk for toxic stress and has been tested for safe, reliable screening when used during in-person (i.e., synchronous) visits. The questions and responses of the PEARLS tool may be administered using the EHR as structured data fields to facilitate record and follow-up. Because the PEARLS tool was never studied under asynchronous screening formats, DHCS cannot provide recommendations regarding its use in a remote patient portal. This includes information around safety and adequate windows of response. Sublicensee acknowledges that DHCS is not responsible for providing any recommendations regarding the use of the PEARLS tool in a remote patient portal, and that DHCS is not responsible for overseeing implementation and use of the PEARLS tool in a remote patient setting. This includes information around safety and adequate windows of response.
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