Citation

Wickramasinghe Y, Raman S, Garg P, Jain K, Hurwitz R. J. Paediatr. Child Health 2019; ePub(ePub): ePub.

Affiliation

Department of Community Paediatrics, South Western Sydney Local Health District, Sydney, New South Wales, Australia.

Copyright

(Copyright © 2019, John Wiley and Sons)

DOI

10.1111/jpc.14368

PMID

30604573

Abstract

AIM: There is strong evidence that adverse childhood experiences (ACE) are associated with poor short-, medium- and long-term health outcomes. In South Western Sydney, we trialled a modified ACE checklist in community paediatric clinics. Our aim was to design the best version of the ACE checklist for routine clinical use to serve as both a clinical and quality indicator.

METHODS: We trialled two versions of the modified ACE checklist based on a pre-existing tool in child development (CD) and vulnerable child (VC) clinics over a 6-month period in 2012 (V1) and 7-month period in 2017 (V2). We analysed clinical and demographic data and correlated with ACE scores. We asked clinicians about the use of the ACE checklist and modified the checklist based on clinicians' recommendations.

RESULTS: In phase 1, V1 was trialled in CD clinics only; 77 children were assessed, of whom 38 children (49%) had ACE score of ≥1, and 8 (10%) had a score of ≥4. In phase 2, of 279 children assessed, 178 (64%) had ACE ≥1, and 78 (28%) had ACE ≥4. In both phases, clinicians found the checklist simple to use and helpful in identifying especially vulnerable children.

CONCLUSIONS: The ACE checklist helps clinicians and managers identify the burden of exposure to trauma, violence and abuse of children attending paediatric clinics, both to facilitate intervention and aid service development. This version of the ACE checklist has the potential to be used across a variety of populations and settings as a clinical and quality indicator.

© 2019 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

Language: en

Keywords

adverse childhood experiences; child abuse and neglect; clinical indicator; quality improvement; trauma