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ACEs (Adverse Childhood Experiences/Trauma) Pediatric Healthcare Toolkit

NCJ Number
Date Published
January 2018
63 pages

This tool kit provides knowledge and guidance intended to assist Maine's healthcare providers and their teams in identifying and providing appropriate services to children impacted by adverse childhood experiences (ACEs).


The urgency of this effort stems from the prevalence of ACE (one in four children in Maine have experienced ACE) and adverse long-term consequences of ACE. Children exposed to multiple ACEs have significantly higher rates of developmental delays, anxiety, depression, and other behavioral concerns. Adults who have experienced ACEs have higher rates of substance abuse, suicide, depression, and early death. Healthcare providers and their teams have the distinctive opportunity to understand, identify, and address persons with ACEs. Developmental screening with the Survey of Well-being of Young Children (SWYC) is one of the ways to assess childhood development and identify ACEs. This can lead to the provision of resources that can promote healthy development. After providing an overview of the nature and effects of ACEs, the toolkit discusses the context and tools for identifying children who have experienced ACEs. Contexts for ACE screening include outpatient settings and pediatric healthcare providers. Tools for screening and identifying ACEs are described, followed by a separate major section of the toolkit on the administration of the SWYC. A section on treatment resources discusses the process of helping children heal after exposure to ACE, agencies trained in evidence-based trauma treatment, and when to refer a child with ACE to a behavioral health clinician. The toolkit's concluding section reviews supporting resources available from the American Academy of Pediatrics (AAP) articles, the Center for Youth Wellness resources, and AAP/Defending Childhood Initiative posters.