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April 2016

Exploring Parents’ Adversities in Pediatric Primary Care

Author Affiliations
  • 1Division of General Pediatrics, Boston Medical Center, Boston, Massachusetts

Copyright 2016 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.

JAMA Pediatr. 2016;170(4):313-314. doi:10.1001/jamapediatrics.2015.4459

Recent attention focused on the effect of adverse childhood experiences (ACEs) provides important support for a life course perspective to health. However, the growing popularity of screening parents for ACEs requires consideration of its benefits and consequences. This Viewpoint explores potential issues associated with parental ACE screening. Although the focus of this Viewpoint is on parental ACE screening, similar and additional concerns (eg, possible need to involve child protective services) arise for child ACE screening. We also offer an alternative approach, grounded in evidence. Specifically, parents should be screened for current psychosocial issues like intimate partner violence, mental health problems, and substance use, all of which are common distal consequences of ACEs. Each has effective interventions. Education should be provided to all parents about how a prior adversity can affect their health, parenting behaviors, and relationships with their children. These discussions should occur in the context of trusting parent-clinician relationships; recognizing parents’ strengths; and encouraging safe, stable, and nurturing relationships with their children.