Utilizing Adverse Childhood Experiences (ACEs) Science to Inform Health Care in Urban Settings

Research has demonstrated that early life adversity, including specific adverse childhood experiences (ACEs), has cascading effects on development and long-term health outcomes. Pediatric primary care may be an ideal venue for addressing childhood adversity during the earliest years of life due to frequent well-child visits for preventive care and health supervision. Based on what is now known about ACEs and health, several large pediatric health-care systems and settings have begun to implement trauma-informed care, which seeks to address potentially traumatic childhood adversity through key principles and practices that recognize and respond to these experiences with routine screening and linkage to supports. The science of early childhood relational health and resilience also suggest that pediatric practice settings may be especially well-poised to offer primary prevention through integrated care with infant and early childhood mental health specialists to support safe, nurturing relationships between primary caregivers and their young children. This chapter reviews current knowledge regarding application of trauma-informed care within pediatric settings, describes several implementation pilots across the United States including our own, and offers “lessons learned” for those considering undertaking this important work.