A project designed and implemented by the New Hampshire Pediatric Improvement Project and funded by the New Hampshire Children’s Health Foundation as part of its Childhood Adversity Systems Change Project has been featured in the Journal of Family Trauma, Child Custody & Child Development.
The Childhood Adversity Screening in Primary Care Project was designed to provide clinician training on trauma-informed care and help five New Hampshire pediatric practices operationalize team-based care to address ACEs.
A Trauma Informed Pediatric Practice recognizes the impact of adverse childhood experiences on children and families, routinely screens for trauma exposure and related symptoms using evidence-based assessments, and collaborates with and refers families to child-serving systems in the local community.
Pediatric practices received support including coaching, training, and tools to plan and pilot ACEs screening over a 15-month period. Despite the co-occurring COVID-19 pandemic, the five clinics conducted 1195 screens with 142 (12%) families indicating a level of risk. Significant increases in clinician knowledge and confidence with these screening and response processes were noted. Increases in clinic self-assessment scores were observed.
While screening children for trauma and connecting them with resources to help them overcome it seems to make good sense, structural barriers stand in the way of wide-spread adoption by clinicians. Lessons learned included shortening the intervention period to 12 months and the importance of building local referral relationships.
The article outlines the project and offers recommendations for advancing ACEs screening.