CDC says physicians can play a role in mitigating childhood trauma

A pediatrician and his patient
Physicians, particularly pediatricians, should screen patients for adverse childhood experiences, the CDC advises. (Getty/shironosov)

Childhood trauma is linked to long-lasting negative health effects and physicians have a role to play in its prevention, according to the Centers for Disease Control and Prevention (CDC).

The CDC this week released a report on adverse childhood experiences (ACEs)—such as abuse or neglect, witnessing violence at home or growing up in a family with mental health or substance abuse problems—and linked those to later health issues that ranged from weight problems and heavy drinking to COPD and depression.

CDC officials said physicians, particularly pediatricians, can help mitigate the effects of childhood trauma by screening patients and referring them for help.

"Clinicians are busy and may or may not incorporate ACEs into their practice, but we think it's very important that they do,” said Anne Schuchat, M.D., the CDC’s principal deputy director, in a telebriefing. Pediatricians can evaluate children for childhood trauma and screen parents so that the problem is not passed from generation to generation, she said.

There are programs that both primary care doctors and pediatricians can use, said James Mercy, Ph.D., director of the CDC’s division of violence prevention and an author of the report.

In a viewpoint article in JAMA, the authors wrote about actions clinicians can take in their practices to help prevent childhood trauma and reduce its harms. Research shows many physicians do not routinely ask about or screen for such experiences, according to the authors. It’s important clinicians become educated about and recognize ACEs and learn strategies for prevention and care of patients who have experienced trauma, they said.

“Opportunities to identify ACEs in the clinical setting are more substantial than clinicians might think,” they wrote. For instance, a pediatrician can recognize when a child might be neglected or witnessing violence in the home. Or an emergency room physician might treat an adolescent after an assault, suicide attempt or drug overdose.