Using lifecourse theory to better understand (and alter) health trajectories

A Pop Health 795 student writes about an article focusing on pediatric screening to prevent adverse childhood events. They make some interesting observations about the measurement of different types of childhood trauma (beyond the number or severity of exposures):

The studies in this article list 10 different types of ACEs including 5 types of family dysfunction, physical abuse, verbal abuse, sexual abuse and others. They then look at the effects of the number of different types of traumatic experiences as opposed to the number of incidents of each type of trauma. The finding are a series of increased risks of medical and mental problems that range from childhood hyperactivity and smoking to suicide and shortened lifespan. The idea is being further expanded into parenting, where the ACE score of a parent is related to parenting styles and their child’s behavior.

 untitled To prevent childhood trauma, pediatricians screen children …

acestoohigh.com

When parents bring their four-month-olds to a well-baby checkup at the Children’s Clinic in Portland, OR, Drs. Teri Pettersen, R.J. Gillespie and their 15 other …

I thought this article did a great job at emphasizing the need to look at health from a life-course perspective, and it was interesting that the studies looked at experiencing different types of traumatic events without looking at the number of incidents or magnitude of any single type in the scoring process. In thinking about that type of design and the development of resilience, I wondered if those who experienced multiple types of trauma also experienced more instances of trauma overall, or if experiencing multiple types presented an additional and at time insurmountable challenge to the body. In other words, are there too many unique types of stress for the body to adapt to in those who experience multiple types of trauma? The other thing to note here is that the study of ACEs began in the 90s, and yet here we are in 2014 when this was written looking at them as a revolutionary shift in how we approach healthcare. Hope everyone enjoys the read!

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3 thoughts on “Using lifecourse theory to better understand (and alter) health trajectories

  1. Fantastic article. Thank you for sharing.
    I’v been fortunate to have had the opportunity to attend the 2014 Children, Youth, and Family Summit that took place in Chippewa Falls, WI. It was here that I first learned about ACEs and the vast impacts screening for ACEs has on children and their families. I found this experience to be both thought provoking and prospective gaining. Recently, I was made aware that there is going to be a follow-up Summit that specifically looks at “Adverse Childhood Experiences and Building Resiliency as a path to Hope and Healing” that will be taking place on October 27th, 2016 from 8:30 am – Noon in Chippewa Falls, WI. For more specifics about the time/location of this event go to: https://form.jotform.com/62364146323148. By following this link you can also pre-register, which is required for attendance. If you have any questions or concerns about this opportunity you can call 715-726-7816. Or you can also reach out to me (jmkalscheur@wisc.edu) if that number does not prove to be useful.

    I have inquired about video/webinar options for attending this conference at a distance, but have not heard back yet. Will keep you posted if I hear back from them.

    If you are interested and available to attend, I would highly recommend it. I think this is a topic of intervention that will continue to grow in popularity among health care practices across multiple delivery systems (i.e. clinical, public health and social services) as more professionals understand its usefulness and impact on health, as well as become more confident in implementing screening strategies within their practices.

    Lastly, registration is likely going to be closed sooner than later, so do not delay in signing up if you are interested! Registration is Free!

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  2. This article was really interesting! It is so important to be able to ask these questions with parents to understand the background, rather than just focus on the symptoms and prescribe medicine. I really like the quote, “This is a culture shift. We’re here to support families.” Changing the norm, whether the norm for a provider or the norm of a parent, is a long process but a much needed process. The article talks about how difficult is is to get psychiatrists and other medical professionals to understand how important it is to prevent childhood adversity. If a provider isn’t used to asking questions about social problems, I would think that it would be hard to start and keep asking these hard questions, especially with the limited time they often have to see a patient. This article really shows how important it is to patients to feel like their physician is interested in their lives, rather than just the medical problem. Screening for ACEs has so much potential, but comes with many challenges to implement the new process.

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  3. As a Nursing student, this article really resonates with me. Using ACE screening is a great way of reminding providers to look beyond the surface. Once we are given the ACE score, we can make targeted referral to other services such as mental health, social work, etc. I think the ACE screening is a valuable tool. It is a way of normalizing the socioecological lens, looking beyond the individual child and putting greater emphasis on the social conditions and the overall impact of the physical and social environment. My hope is that we can continue to promote resiliency at a community-based level through creative social programs while we screen at an individual level.

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