Addressing Adverse Childhood Experiences in Primary Care: Challenges and Considerations

Author:

Dubowitz Howard1,Finkelhor David2,Zolotor Adam3,Kleven Jennifer4,Davis Neal5

Affiliation:

1. Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland

2. Department of Sociology, University of New Hampshire, Durham, New Hampshire

3. Department of Family Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina

4. Department of Pediatrics, Gundersen Health System, La Crosse, Wisconsin

5. Pediatric Community Based Care, Intermountain Primary Children’s Hospital, Salt Lake City, Utah

Abstract

This article draws attention to the overlapping literature on social determinants of health and adverse childhood experiences, and the growing clinical interest in addressing them to promote children’s and parents’ health and well-being. We address important considerations and suggest solutions for leaders and practitioners in primary care to address social determinants of health/adverse childhood experiences. Priorities include: begin with a few prevalent conditions for which there are helpful resources; focus on conditions that are current or recent and where parents may be more apt to engage in services; focus initially on families with children aged <6 given the frequency of well-child visits and the especially strong relationships between primary care professionals and parents during this period; ensure training of primary care professionals and staff to help them play this role competently and comfortably; and have good referral processes to facilitate additional evaluation or help.

Publisher

American Academy of Pediatrics (AAP)

Subject

Pediatrics, Perinatology and Child Health

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4. The lifelong effects of early childhood adversity and toxic stress;Shonkoff;Pediatrics,2012

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