Summer 2018: Mitigating ACEs at Vanderbilt Medical Center

“It’s easier to build strong children than to repair broken men.” – Frederick Douglass

Adverse childhood experiences (ACEs) come in many shapes and forms, including neglect, abuse, and household dysfunction. But how influential are they in a child’s health outcomes? Research has repeatedly shown that ACEs can significantly affect brain health enough to contribute to cognitive impairment, risky behavior in adult life, and long term risks of disease and mental illness. Therefore, we move onto the next question: How do we mitigate ACEs? That’s when I come in.

ACEs can range from being parenting related, to environmental.

This summer, I’m working alongside Dr. Seth Scholer, a pediatrician at Vanderbilt University Medical Center Children’s Hospital. Dr. Scholer has spent over a decade conducting research regarding ACEs, and how to successfully assess and alleviate them through pediatric primary care. With funding from the state of Tennessee, my research this summer has mostly focused on a randomized control trial (RCT) in which we hope to demonstrate that a brief parenting intervention can reduce unhealthy parenting tactics, thus nurture brain health in the clinic’s patients.

The utilization of an ACEs Screening Tool can improve health outcomes of children by identifying and addressing ACEs early in life.

My personal research project this summer is definitely simpler than an RCT, but has its own challenges. All previous research utilizing ACEs screening tools have taken place in pediatric clinics associated with research institutions such as Vanderbilt. However, the next step from here is employing a screening tool state-wide, which requires additional research that addresses how to implement the screening tool in private medical practices.

Therefore, I have been implementing an ACEs Algorithm and screening tool at a private pediatric primary care clinic for my summer research project. The screening tool is a quick survey that measures a child’s household/environmental stressors, and the degree to which their parent(s) use healthy discipline strategies. The ACEs Algorithm helps health-care providers interpret their patients’ scores, and points out when children are at low-high risk of ACEs. This is the first research study of its kind, and it requires working hands-on with the doctors and nurses at the private clinic to maximize the efficiency and effectiveness of the screening tool. Overall, this project has been a great opportunity to work along the front lines of ACEs research.

Health care providers use this ACEs Algorithm to interpret a child’s parenting-related ACEs and environmental ACEs (or other childhood stressors), after their caregiver completes a short ACEs Screening Survey. I worked with Dr. Scholer on the development of this algorithm throughout the summer, and this image is our final result.

As a Psychology major with minors in Neuroscience and Health Studies, this research experience perfectly fits the little niche formed from the intersection of my three fields of study. A typical day for me involves lots of patient/provider interaction and data management, with some manuscript and literature review writing stuck in between. This has helped me build concrete clinical research skills that are hard to learn in a classroom. Furthermore, I’m ecstatic about my ability to work within a research topic that is having a direct impact on people’s lives.