ACEs /Toxic Stress Screening Services

Programs that provide pediatric screening services that seek to identify situations in which young children are being exposed to adverse childhood experiences (ACEs) such as physical or emotional abuse, chronic neglect, domestic violence, parental mental illness or a substance use disorder, exposure to violence, and/or the accumulated burdens of family economic hardship. Moderate, short-lived stress responses can promote emotional growth, but toxic outcomes may result when a child experiences strong, frequent and/or prolonged adversity or trauma without adequate support from adults to help them cope. Screening helps to identify possible risk factors for future medical and mental health conditions, increases communication with families, provides resources to promote resiliency and mitigate the impact of ACEs, and monitors for stress-related health problems in at-risk patients and family members. Screening is also a means to identify children who would benefit from preventive measures that promote positive environmental influences and, if need be, therapeutic interventions. Routine anticipatory guidance encourages positive parenting, strengthens support for families, builds resilience and helps develop the buffers required to avoid toxic stress. Targeting the caregiver's stressors and improving the caregiver's capacity to provide safe, stable and nurturing relationships may mitigate any toxic stress response in children.