IDENTIFYING AND ADDRESSING CHILDHOOD TRAUMA IN PRIMARY CARE

Abstract

Nearly half of US children have experienced 1 or more adverse childhood experiences (ACEs). ACEs are associated with lasting physical and mental health problems. One way to prevent these outcomes is through early identification and intervention. The frequency and longevity with which families visit primary care makes it a nearly universal setting in which to screen for and help mitigate consequences of ACEs. However, primary care providers (PCPs) lack the time and training to address these concerns. Our Symposium will include 4 presentations on trauma in primary care and a discussant. Rebecca Ferro will compare clinical characteristics and treatment recommendations of patients with and without ACEs for whom PCPs sought psychiatric consultation or co-located social work services through Maryland’s Behavioral Health Integration in Pediatric Primary Care Program. Sheila Marcus, MD, will describe the frequency of trauma concerns among pediatric and perinatal patients for whom PCPs sought clinical consultation with the Michigan Collaborative Care Program. Joyce Harrison, MD, will describe the frequency and types of ACEs among young child patients for whom PCPs sought training and support through the Kennedy Krieger Institute Network for Early Childhood Tele-Education. Carol Vidal, MD, will describe findings from a survey of pediatricians and child and adolescent psychiatrists about their knowledge, attitudes, and training needs related to trauma-informed care. Larry Wissow, MD, will summarize the findings and discuss the implications for research, policy, and practice. Participants will learn about the frequency of ACEs in the context of primary care, models for supporting PCPs in meeting the mental health needs of pediatric patients with ACE histories, and PCP knowledge, attitudes, and perceived needs for training in trauma-informed care. There is a growing need for early identification and intervention for youth exposed to trauma. Primary care is an ideal setting to address ACEs, but there is a gap in knowledge, skills, and time to effectively address these concerns. This session will provide an opportunity to learn about characteristics of patients with ACEs presenting in primary care and approaches to supporting PCPs in meeting the needs of these patients.