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MNAAP Newsletter

Screening for Adverse Childhood Experiences, Psychosocial Risk, and Resilience

AndyBarnesbw150TomScottBy Andrew J. Barnes, MD, MPH, Assistant Professor, Developmental-Behavioral Pediatrics, Division of General Pediatrics and Adolescent Health, University of Minnesota and Tom Scott, MD, Clinical Professor, Developmental-Behavioral Pediatrics, Division of General Pediatrics and Adolescent Health, University of Minnesota

Although there are normative challenges during childhood – for example, separating from parents for daycare – many children experience frequent or ongoing stress that is overwhelming. Such stress, including Adverse Childhood Experiences (ACEs) and extreme poverty, can lead to modified gene expression, problems with cognitive and social-emotional development, and chronic health conditions. These negative outcomes are less likely for children with ample protective factors, whether internal (such as self-regulation) or external (such as a consistent, nurturing adult caregiver). These factors improve children’s capacity to succeed and develop well in the context of threat or challenge – i.e., resilience.

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Screening Instruments: Caring for the Whole Child

AndyBarnesBy Andrew Barnes, MD , MPH, FAAP, Assistant Professor, Developmental-Behavioral Pediatrics, Division of General Pediatrics and Adolescent Health, University of Minnesota

If you’ve ever wondered whether you’re seeing more children with disabilities in your clinic over the past 15 years, you are – from 2000-2010, this population of children grew the fastest since it started to be recorded in the U.S. This increasing prevalence was mostly due to neurodevelopmental differences and mental health conditions – up 20% in the past decade (while physical health disabilities were down 10%), rising fastest among families with higher socioeconomic status. We may be identifying some of these children better in our clinics because of improved standardized developmental screening, as recommended by the American Academy of Pediatrics in their 2006 policy statement. This policy (and other related policies relating to autism, social-emotional, and mental health screenings) recognize that early intervention is critical for children with developmental and behavioral needs, and that these conditions are best managed within a medical home that cares for the whole child.

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