Part Two of a two-part series on Adverse Childhood Experiences (ACEs) examines the impact of advocacy and education campaigns. Read Part One for an overview on ACEs.

As World Health Day (April 7) approaches, policymakers are joining the upsurge of voices from medicine, education, and social services calling for childhood adversity to be made a key priority.

Earlier this year, Gov. Gavin Newsom proposed a budget that includes funding for universal ACEs screening for all children and adults receiving Medi-Cal -- further demonstrating California’s commitment to addressing childhood trauma. In 2017, the California legislature passed Assembly Bill 340 (AB340), which calls for the Department of Health Care Services to convene a trauma screening advisory group.

Newsom also recently appointed Dr. Nadine Burke Harris, founder of the Center for Youth Wellness (CYW) and a leader in the international movement to address childhood trauma, to be the state’s first Surgeon General – a historical move for the state and an important validation of the need for greater awareness of toxic stress.

Burke Harris’s work at CYW has helped inspire the adoption of policies across the country designed to prevent and mitigate trauma and toxic stress, bolster resiliency, and implement trauma-informed policies and practices in everything from schools to the justice system. From Trauma-Free New York to the Tennessee ACE Project and the Wisconsin Trauma Project, the movement for trauma-informed care is gaining steam among both Democrats and Republicans.

Opportunities to Make More Progress

These are huge steps in the right direction, but in order to make universal ACEs screening a reality, we also need to provide doctors the training and support they need to effectively screen their patients and connect them with the appropriate services.

Screening all children for adverse childhood experiences (ACEs) is crucial, because you cannot “see” toxic stress by looking at a child and if we want to effectively treat the frequent by-products of toxic stress, such as asthma, diabetes, hyperactivity, and many other associated conditions, we need to first rule out toxic stress as a cause.

That’s why CYW is working with pediatric clinicians across the country through its National Pediatric Practice Community on Adverse Childhood Experiences (NPPC) program, which provides practices with the resources, training and support they need to effectively understand and treat toxic stress.

"As a pediatrician starting a new screening program for ACEs, I have found the NPPC community invaluable … many of the issues that came up for us have been tackled by others already and we were able to learn from their experience instead of reinventing the wheel," said Dr. Lara Yoblonski of Phoenix Children’s Hospital. “Bringing about institutional and community change can be difficult but the NPPC community and Center for Youth Wellness have provided the resources and support we needed to launch into trying to address ACEs."

In addition to the training needed on the clinical side, physicians and policymakers also need to see a groundswell of support from the public. A big first step in building that support is an understanding of how ACEs affect us and our families. Visitors to the Stress Health website can take the ACE quiz, find out their score, and learn about steps they can take as a family to prevent and heal toxic stress.  The website also houses a popular science-based blog on ACEs and parenting and a national campaign to teach parent bloggers about the fundamentals of ACEs science.

“We know supportive relationships are the most powerful intervention to preventing and reversing the long-term effects of toxic stress in children,” says Jabeen Yusuf, Vice President, Strategic Engagement for CYW and Director of the Stress Health initiative. “That’s why we invited influential ‘mom bloggers’ from around the country to learn more and write about ACEs and ways to mitigate the damage they can cause. Parent and caregiver voices have to be a part of addressing ACEs as a public health crisis — we cannot do it without them.”

Finally, the field needs continued private investment in research and innovation of early intervention and the prevention of toxic stress. Philanthropic dollars have given CYW the chance to seed and innovate crucial projects that it hopes local and federal governments will continue to bring to scale.

By preventing and treating childhood trauma, we could save between $124 billion and $585 billion in lifetime costs for each year’s worth of new cases of childhood trauma, according to the Centers for Disease Control and Prevention. According to a separate report published by the advocacy group Safe and Sound, the financial economic burden incurred by the State of California for lifetime costs associated with child maltreatment in 2017 is $19.3 billion. If other states follow California’s lead in early and universal ACEs screening, we’ll have the best chance of erasing the long shadow of childhood trauma across our society and eventually the world.

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Original contribution by Diana Hembree, Science Writer at the Center for Youth Wellness.