Adverse Childhood Experiences (ACEs) Screening and Assessment in Health and Human Service Settings

The association between adverse childhood experiences (ACEs) and negative outcomes across physical, mental, and behavioral domains is well established. Health and human service settings offer unique contexts where problem identification/diagnostic processes and treatment efficacy would benefit from identification of ACEs early on in service delivery. Further, effective ACEs assessment within these settings provides a foundational gateway for needed referrals and intervention related to ACEs exposure. Barriers exist in ACEs assessment in health and human services settings, including provider training and knowledge, access to appropriate screening and referral sources, time burden, accuracy of ACEs reporting, and negative impacts of the screening process. This chapter describes why ACEs screening is important and beneficial, what the core components of ACEs screening may entail, who may be utilized for ACEs reporting, when ACEs should be assessed, and what methods should be used for effective ACEs assessment. Recommendations for effective ACEs assessment include: (1) developmental tailoring of assessment methods and questions; (2) triangulation of reporting sources of ACEs exposures; (3) universal screening and repeated evaluation of ACEs across time; (4) guidelines and training for ACEs assessment procedures, including what key features of ACEs should be evaluated on follow-up of a positive screen; and (5) interdisciplinary approaches to ACEs assessment and response to promote positive assessment experiences and support access to resources in the case of positive screens.