Employing an Adaptive Leadership Framework to Childhood Adversity Screening.

Abstract

* Abbreviation: ACE — : adverse childhood experience Providers of pediatric health care have been motivated and inspired by the research on childhood adversity, which has shown that in the early stages of life, critical neurodevelopmental pathways can be disrupted through exposure to adverse childhood experiences (ACEs) and resultant toxic stress.1,2 Early detection of ACEs and subsequent intervention has the potential to decrease the development of associated poor health and psychosocial outcomes3; therefore, many pediatric medical homes are starting to discuss and implement screening for childhood adversity. As providers start to consider how screening for ACEs will fit into their clinic workflow, we recommend approaching this task through an adaptive leadership framework. This unique leadership approach focuses on 6 specific behaviors of leaders to guide organizations and individuals through periods of change and uncertainty (Fig 1).4,5 At the root of the adaptive leadership framework is (1) identifying the change required as an adaptive challenge, one that can provoke emotion or incite conflict or disagreement and for which there is usually no established best practice.4,5 Leaders are encouraged to (2) step back to reflect on the conflict that may be created, (3) create safe environments to uncover barriers to change, … Address correspondence to Binny Chokshi, MD, Division of Adolescent and Young Adult Medicine, Children’s National Health System, 111 Michigan Ave NW, Suite 400, Washington, DC 20011. E-mail: bchokshi{at}cnmc.org