Adverse Childhood Experiences Part I: An Introduction
Substantial exposure to traumatic events impacts an estimated 50% to 75% of the population today. Trauma is linked to adversity, posttraumatic stress disorder, mental illness, interpersonal problems, substance abuse and chronic disease, which in turn drive up health care costs. The Adverse Childhood Experiences (ACEs) Study shows a connection between an individual’s physiologic stress response and subsequent neurologic alterations, as well as changes in metabolic and immune function and an increased risk of complex medical conditions.
Recent national, population-based data show that one-half of children in the U.S. have ACE exposure, and yet a national survey noted that the majority of health care professionals (HCPs) are not knowledgeable about ACEs and lack understanding of how to assess and respond to information about ACEs reported by children or family members.
This activity, part I in a series, will provide HCPs with an understanding of the science of ACEs and toxic stress. The importance of and rationale behind ACE screening will be reviewed along with opportunities to expand screening in the pediatric setting.
This activity is jointly provided by OptumHealth Education and UnitedHealthcare.
There was no commercial support received for this activity.
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This activity is designed to meet the educational needs of case managers, counselors, educators, nurses, nurse practitioners, pharmacists, pharmacy technicians, PAs, physicians, psychologists, social workers (all practice types), therapists and other HCPs who have an interest in the current science on ACEs and developmental pediatrics.
At the end of this educational activity, participants should be able to:
- Explain the current science on ACEs and their relationship to toxic stress.
- State the rationale for early detection and ACE screening along with the associated barriers.
- Demonstrate competence in interpreting the relationship between early life adversity and toxic stress to clinical outcomes in pediatric primary care.
- Identify opportunities for expanding ACE screening in the pediatric setting.
Rachel Gilgoff, MD, CCTP, FAAP
Clinical Innovations Lead
Center for Youth Wellness
San Francisco, CA
Leena B. Singh, DrPH, MPH
Director, National Pediatric Practice Community on ACEs
Center for Youth Wellness
San Francisco, CA
About the presenters
Dr. Rachel Gilgoff brings over 10 years of experience as a board-certified general pediatrician and child abuse pediatrician to this initiative. She has been a partner with the Center for Youth Wellness (CYW) for several years as part of the Bay Area Research Consortium (BARC). As part of BARC, she developed anticipatory guidance scripts for providers performing ACE screening and co-created “The Resiliency Clinic,” an integrated medical and mental health group pediatric clinic designed to protect children and families from toxic stress. Prior to working at CYW, she treated children suspected of being abused and/or neglected at the Center for Child Protection, UCSF Benioff Children’s Hospital Oakland. Dr. Gilgoff is dedicated to addressing health issues resulting from child stress and abuse and moving the field forward to incorporate trauma interventions into routine pediatric clinical practice.
Leena Singh is the Program Director for the National Pediatric Practice Community on ACEs at the Center for Youth Wellness. She has many years of experience in program management, clinical technical assistance, research, evaluation and training, and she has worked to address health issues affecting diverse and underserved youth at various agencies in the U.S. and abroad. She previously worked as a research associate at the Public Health Institute’s Center for Research on Adolescent Health and Development, providing research support for adolescent sexual health evaluation and policy work. In addition to her work at the Center for Youth Wellness, Ms. Singh is an adjunct professor of public health at California State University, East Bay. She received her Master of Public Health (MPH) degree from Columbia University and holds a Doctor of Public Health (DrPH) degree from the University of California, Berkeley.
Sarah Chart, RN
Disclosures of relevant financial relationships
In accordance with the ACCME Standards for Commercial SupportSM, OptumHealth Education (OHE) requires all those in the control of activity content to disclose their relevant financial relationships. An individual has a relevant financial relationship if such person (or his/her spouse/partner) has a financial relationship in any amount occurring in the last 12 months with a commercial interest whose products or services relate to the activity content. OHE ensures that the content is independent of commercial bias.
Ms. Chart and Ms. Gleason have indicated that they are employees of and own stock in UnitedHealth Group.
The remaining activity faculty or planners have no financial relationships to disclose.
In support of improving patient care, this activity has been planned and implemented by OptumHealth Education and UnitedHealthcare. OptumHealth Education is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE) and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
Credit designation statements
This activity was planned by and for the health care team, and learners will receive 1.00 Interprofessional Continuing Education (IPCE) credits for learning and change.
The participant will be awarded up to 1.00 contact hour(s) of credit for attendance and completion of supplemental materials.
The American Academy of Nurse Practitioners Certification Program (AANPCP) accepts credit from organizations accredited by the ACCME and ANCC.
This activity is approved for 1.00 contact hour ([0.10] CEU) in states that recognize ACPE.
Attending the full program will earn 1.00 contact hour.
Unique Activity Number(s): JA0007123-9999-19-008-L04-P/T
OptumHealth Education designates this live activity for a maximum of 1.00 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
The American Academy of Physician Assistants (AAPA) accepts credit from organizations accredited by the ACCME.
AAPC will honor 1-for-1 CEUs for any live event offering CME credit or AMA PRA Category 1 Credit™. A certificate of attendance or completion is necessary to show participation. The certificate will give the total CMEs possible for the offering. Physicians are advised to claim only the actual hours that they were present during the education. We ask that AAPC-certified members abide by this request also. One hour of instruction is worth 1 CEU.
Clock hours for Case Manager Certification have been approved for previous activities. This program has been submitted to The Commission for Case Manager Certification for approval to provide board certified case managers with 1.00 clock hour(s).
Counselors, psychologists, social workers and/or marriage and family therapists
This event is co-sponsored by R. Cassidy Seminars.
Participants must have attended the entire Web-based activity and completed an evaluation to receive a certificate. Partial credit is not available.
R. Cassidy Seminars is approved by the American Psychological Association (APA) to offer continuing education for psychologists. R. Cassidy Seminars maintains responsibility for this program. 1.00 CE hour.
R. Cassidy Seminars, ACE provider #1082, is approved as a provider for social work continuing education by the Association of Social Work Boards (ASWB) www.aswb.org, through the Approved Continuing Education (ACE) Program. R. Cassidy Seminars maintains responsibility for the program. Approval Period: April 15, 2018–April 15, 2021. Social workers should contact their regulatory board to determine course approval. Social workers participating in this course will receive 1 continuing education clock hours.
Counselors and/or marriage and family therapists
CA: The Board of Behavioral Sciences has deferred CE course approvals to APA and ASWB for its licensees. See those approvals under Psychologists and Social Workers.
IL: Illinois Dept. of Professional Regulation, Approved Continuing Education Sponsor, #168-000141, (1) hours.
OH: Provider approved by the Ohio Counselor, Social Worker and Marriage and Family Therapist Board for (1) clock hour, #RCST110701.
TX: Approved CE Sponsor through the Texas State Board of Examiners of Marriage & Family Therapists, Provider #151, 1 CE hour.
Other States: If your state is not specifically listed, nearly all state counselor and MFT boards accept either APA or ASWB approval, or are reciprocal with other state licensing board approvals, such as those listed below. Check with your board to be sure. The Ohio board includes counselors and MFTs.
If you require Americans with Disabilities Act (ADA) accommodations, please contact our office 14 days or more before the event. We cannot ensure accommodations without adequate prior notification.
Please note: Licensing boards change regulations often and, while we attempt to stay abreast of their most recent changes, if you have questions or concerns about this course meeting your specific board's approval, we recommend you contact your board directly to obtain a ruling.
A certificate of attendance will be provided to learners upon completion of activity requirements, enabling participants to register with licensing boards or associations that have not been preapproved for credits. To apply for credit types not listed above, participants should use the procedure established by the specific organization from which they wish to obtain credit.
- 1.00 ACPE - Pharmacists
- 1.00 ACPE - Pharmacy Technicians
- 1.00 AMA - Physicians
- 1.00 ANCC - Nurses
- 1.00 APA - Psychologists
- 1.00 Attendance - General Attendance
- 1.00 CCMC - General - Case Managers
These materials are intended ONLY for those that attended the live webcast on Tues., Feb. 5, 2019.
You must be logged into your account to participate in this activity. Get started by clicking “Begin/Continue” and viewing the “CE Info”; then follow the prompts at the bottom of the screen. At the end of the activity, you will be able to view, save or print your certificate of participation. A complete listing of all of your activities can be found under “My Account”, “My Activities.”