A multipronged approach to mitigate childhood adversity and build resiliency

Reviewed by Emily Henderson, B.Sc.May 4 2021

A hot topic symposia session during the Pediatric Academic Societies (PAS) 2021 Virtual Meeting will discuss a multipronged approach to addressing childhood adversity and promoting resilience - at the clinical, systems, community and educational levels.

The effect of adverse childhood experiences (ACEs) on health outcomes across the lifespan is well recognized among pediatric practitioners. Increasing the ability of healthcare providers to recognize and respond to ACEs can buffer the long-term negative physical and mental health impacts of adversity and increase patient-centered care.

In the era of COVID-19, employing a trauma-informed approach to care is of even graver importance because the reverberations of the overactivity of the biological stress response during this time will affect populations both in the near and distant future. Understanding the biological impact of stress and childhood adversity and recognizing ways in which to mitigate this impact and build resiliency is key. Our panel will serve this function."

Binny Chokshi, MD

For pediatric practitioners, there are multiple ways to address ACEs. This symposium will review approaches at the patient, systems (clinic/hospital), community and education level. It will also highlight the importance of interdisciplinary collaborations in moving this work forward.

At the patient level, the session will review the experience of Atrium Health Levine's Children's Hospital as a pilot site for the National Pediatric Practice Community of the Center for Youth Wellness. Shivani Mehta, MD, MPH, will discuss the facilitators and barriers to ACE screening implementation in both the academic and community primary care pediatric settings and review the use of resource referrals as a key intervention in promoting wellbeing and resilience.

At the clinic and hospital level, the Substance Abuse and Mental Health Services Administration delineates a framework to guide the creation of trauma-informed systems. Anita Shah, DO, MMS, MPH, will review the experience of Cincinnati Children's Hospital Medical Center in developing a trauma-informed strategic plan with multidisciplinary partners.

Community partnerships can be critical in securing resources to build resilience and preventing childhood adversity. Nia I. Bodrick, MD, MPH, FAAP, will highlight two exemplary community partnerships, the Early Childhood Innovation Network and the Building Communities Resilience National Coalition.

Lastly, education on ACEs and trauma-informed care is essential in assuring the sustainability and integration of approaches to confront adversity. Heather Forkey, MD, will describe the Pediatric Approach to Trauma, Treatment, and Resilience (PATTeR) program, supported by the American Academy of Pediatrics. The PATTeR program has trained over 400 pediatricians and clinic team members about childhood adversity and trauma-informed care.