This document includes the following materials developed by the Office of the California Surgeon General for both pediatric and adult patients: ACE Screening Clinical Workflow, ACEs and Toxic Stress Risk Assessment Algorithm, and ACE-Associated Health Conditions. (ADA Version)

This ACEs Aware-developed workflow provides tips and sample scripts for approaching conversations with patients about ACEs and toxic stress. It covers how to introduce the ACE screening purpose and tool to patients/caregivers, review screening results and the treatment plan with them, and following up on the treatment plan.

The “ACEs Aware Clinical Team Toolkit: Preventing, Screening, and Responding to the Impact of ACEs and Toxic Stress” offers clinicians and practices comprehensive information and resources. This toolkit is composed of a series of fact sheets that are designed to be read individually.

This is an ACEs Aware-developed sample school letter from a pediatrician to a school regarding a patient’s toxic stress symptoms and treatment plan.

The Department of Health Care Services approves specific tools to be used and questions to be asked for both pediatric and adult screenings.

This fact sheet explains why providers should screen for ACEs and describes the tools that should be used to screen children, adolescents, and adults for ACEs.

An ACEs Aware-developed tool for patients to use in developing a self-care plan to enhance well-being and decrease stress — for adults.

An ACEs Aware-developed tool for patients to use in developing a self-care plan to enhance well-being and decrease stress—for children and families.

This exam room poster gives an overview of what ACEs are, what they mean for our health, and how we can heal from them. Developed in collaboration between ACEs Aware and NumberStory.org.

Background information and examples of motivational interviewing.

The training toolkit is an education tool for pediatricians, residents, medical home teams, and others to better understand the effects of exposure to violence and how to approach the issue in the pediatric medical home setting.

Handout for parents about caring for themselves and children.

A consumer resource featuring information related to psychological issues affecting your daily physical and emotional well-being.

An American Psychological Association (APA) fact sheet series, “How psychologists can help,” provides insight into how psychologists can help patients manage a range of chronic health conditions.

The User Guide outlines how the Center for Youth Wellness Adverse Childhood Experiences Questionnaire is used at Bayview Child Health Center (BCHC-CYW).

Provider handout that includes helpful information on how to discuss ACEs with parents.

Provider handout on ways to approach families when screening for ACEs.

Provider handout on identifying parents ACEs and provide support to them and the entire family as a whole.

Provider handout that describes the definition and importance of ACEs.

Provider handout that describes the definition of toxic stress.

Patient handout on children’s sleeping habits.

Patient handout that provides tips on ways to reduce children’s effects of toxic stress.

Patient handout on ways to improve children’s mental health.

Patient handout on toxic stress, how it can cause health issues and how parents can incorporate positive parenting.

Patient handout on promoting exercise to children.

Patient handout for families about maintaining supportive relationships.

Patient handout about nutrition tips for children.

Patient handout about using mindfulness as a tool to reduce toxic stress.

A Centers for Disease Control and Prevention fact sheet on how children benefit when parents have safe, stable, nurturing relationships.

This Centers for Disease Control and Prevention web page provides information on how much sleep is recommended by age group and habits for improving sleep.

A brief describing the importance of safe, stable, nurturing relationships, written for a lay audience.

Helpful tips for positive and effective parenting at different ages.

“How childhood trauma affects health across a lifetime.”

With 12 natural touch points in the first 3 years of life, pediatric well baby visits make up the most frequent point of contact with the healthcare system for families with young children , providing an opportune space to address the caregiver and family context and provide behavioral health early intervention, connect families to resources, support early child development, and mitigate intergenerational trauma and the harmful effects of toxic stress.

Reviews of best rated 2019 meditation apps for adults.

Article on the AAP Parenting website about self-care for mothers.

Connect with a trained crisis counselor to receive free, 24/7 crisis support via text message.

The NAMI HelpLine can be reached at 1-800-950-NAMI (6264) or info@nami.org Monday through Friday, 10 am – 6 pm ET.

The NAMI HelpLine is a free, nationwide peer-support service providing information, resource referrals and support to people living with a mental health conditions, their family members and caregivers, mental health providers and the public. HelpLine staff and volunteers are experienced, well-trained and able to provide guidance.

Overview of treatments and practices for healing from trauma.

Trained expert advocates are available 24/7 to provide confidential support to anyone experiencing domestic violence or seeking resources and information. Help is available in Spanish and other languages.

An initiative of the Center for Youth Wellness, this network brings together pioneering pediatric practitioners interested in integrating ACEs screening and response into clinical care; it includes a comprehensive resource center with monthly newsletters, a podcast series, office hours, and training and technical assistance available.

Tips for ACEs-Related Coding, decision-making inputs worksheet for clinics seeking to start screening for ACEs, screening workflow, readiness assessment.

Connect with a trained staff member from a sexual assault service provider in your area that offers access to a range of free services. Crisis chat support is available at Online Hotline. Free help, 24/7.

If you or someone you know is in crisis—whether they are considering suicide or not—please call the toll-free Lifeline at 800-273-TALK (8255) to speak with a trained crisis counselor 24/7.

The National Suicide Prevention Lifeline connects you with a crisis center in the Lifeline network closest to your location. Your call will be answered by a trained crisis worker who will listen empathetically and without judgment. The crisis worker will work to ensure that you feel safe and help identify options and information about mental health services in your area. Your call is confidential and free.

ACEs Aware-developed resource on using a tiered clinical response framework to determine the patient education, level of intervention, and additional supports that may be needed for patients at different levels of risk for toxic stress.

Find a therapist near you.

This practice paper examines ACEs and ACE screening with immigrant youth, including qualitative research conducted with adolescent health providers and adolescents to understand their perspectives on this topic, and offers recommendations for adolescent health providers to effectively implement ACE screening with immigrant youth in primary care settings. This paper is a companion document to the authors’ practice paper entitled Screening Adolescents for Adverse Childhood Experiences (ACEs): Incorporating Resilience and Youth Development.

This practice paper examines ACEs and ACE screening with adolescents, including qualitative research conducted with adolescent health providers and adolescents to understand their perspectives on this topic, and offers recommendations for adolescent health providers to effectively implement ACE screening with adolescents.

The Department of Health Care Services approved specific tools to be used and questions to be asked for both pediatric and adult screenings. These tools are available in multiple languages for providers to use today.

Motivational techniques and skills for health and mental health coaching/counseling, published in 2013. Also see detailed examples and rationales for motivational interviewing strategies and techniques (2008).

This locator can help you find community outpatient, inpatient and residential treatment facilities, including affordable mental health services in your area

Article about applying the principles of motivational interviewing to everyday patient interactions  to elicit “behavior change” that contributes to positive health outcomes and improved patient–physician communication.

Positive Parenting Program—tips for caregiving through 16 years, with additional, formal (paid) online and in-person courses.

Tips on positive parenting.