Issues concerning the screening and assessment of adverse childhood experiences (ACEs) in healthcare settings have been subject to growing scrutiny in recent years, yet relatively little is known about practitioner perceptions and competencies related to such practices. This study examined practitioner knowledge, ability and concerns about the assessment of ACEs among parents and children in clinical settings and the acceptability of a newly validated measure (The Adverse Life Experiences Scale, ALES) for this purpose. Participants were (N = 144) healthcare practitioners (predominantly psychologists, nurses, social workers and psychiatrists). Measures were completed online, and the effects of family characteristics on practitioner perceptions were tested experimentally using case vignettes. Participants indicated moderate-to-high levels of knowledge and ability regarding the assessment of ACEs, and the ALES demonstrated high levels of acceptability across hypothetical cases involving various levels of risk. Practitioner concerns about such assessment were also found to be influenced by the level of risk indicated by case referral information. Specifically, concerns that assessment would be too upsetting or time-consuming were greater in response to a case with a high level of ACEs, compared to one with low-to-moderate ACEs (p < .05; large effect size). Practitioners demonstrated relatively high competencies regarding the assessment of ACEs and supported the use of the ALES for this purpose. Those families with the highest levels of ACEs may nonetheless be the least likely to receive such assessment in clinical settings.

中文翻译：

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临床环境中不良儿童经历的评估：从业者的能力和认知

近年来，有关在医疗保健机构中筛查和评估不良儿童经历 (ACE) 的问题受到越来越多的审查，但对从业者与此类实践相关的认知和能力知之甚少。本研究检查了从业者对临床环境中父母和儿童评估 ACE 的知识、能力和担忧，以及为此目的新验证的测量（不良生活经历量表，ALES）的可接受性。参与者是（N = 144) 医疗保健从业人员（主要是心理学家、护士、社会工作者和精神科医生）。测量是在线完成的，家庭特征对从业者感知的影响使用案例小插曲进行了实验测试。参与者表示在评估 ACE 方面的知识和能力处于中到高级水平，并且 ALES 在涉及不同风险水平的假设案例中表现出高度的可接受性。还发现从业者对此类评估的担忧受到病例转诊信息所指示的风险水平的影响。具体来说，与低到中等 ACE 的案例相比，在应对高水平 ACE 的案例时，对评估过于烦躁或耗时的担忧更大（p < .05; 大效应量）。从业者在评估 ACE 方面表现出相对较高的能力，并支持为此目的使用 ALES。然而，具有最高 ACE 水平的那些家庭可能最不可能在临床环境中接受此类评估。