Gillespie Robert J
Pediatr Ann. 2019 Jul 1;48(7):e257-e261. doi: 10.3928/19382359-20190610-02.
Addressing adverse childhood experiences (ACEs) in primary care pediatric practice is riddled with potential pitfalls that prevent most providers from implementing ACE or toxic stress screening in their practices. However, the growing body of literature and clinician experience about ACE screening shows how this practice is also ripe with possibilities beyond just the treatment of trauma-related diagnoses and for the prevention of intergenerational transmission of toxic stress. This article reviews the current state of screening for ACEs and toxic stress in practice, describes how pediatricians and clinics have overcome pitfalls during implementation of practice-based screening initiatives, and discusses possibilities for the future of primary care-based screening. [Pediatr Ann. 2019;48(7):e257-e261.].
在初级保健儿科实践中应对儿童期不良经历(ACEs)充满了潜在的陷阱,这使得大多数医疗服务提供者无法在其实践中开展ACE或毒性应激筛查。然而,关于ACE筛查的文献和临床医生经验日益增多,表明这种实践不仅在治疗与创伤相关的诊断以及预防毒性应激的代际传递方面有着丰富的可能性。本文回顾了目前实践中ACEs和毒性应激筛查的现状,描述了儿科医生和诊所如何在实施基于实践的筛查举措过程中克服陷阱,并讨论了基于初级保健筛查的未来可能性。[《儿科年刊》。2019年;48(7):e257 - e261。]