Experiences of childhood adversity are common, with more than 50% of adults reporting having experienced at least 1 adversity as children and more than 6% exposed to 4 or more adverse childhood experiences (ACEs).¹ There is currently a controversial debate in the medical field as to whether the ACEs questionnaire, which asks about abuse, neglect, and household dysfunction before age 18 years, should be administered as routine practice by pediatricians. While some argue that identifying and addressing ACEs can lead to support that may promote resilience and help decrease the well-established health burden of ACEs,² others caution against its limited evidence and effectiveness as a universal “screening tool” as well as its potential harms in terms of revictimization and increased patient stigma.^3,4 Although research on the potential benefits and consequences of universal screening for ACEs is in its infancy, the ACEs questionnaire has been rapidly adopted into pediatric care settings across North America. For example, $45 million has recently been allocated to state funding in California to increase ACEs screening and trauma-related training in pediatric care settings. Moreover, there are now 27 states that have statutes and resolutions associated with ACEs and trauma-informed approaches to care.

童年时期的逆境经历很普遍，超过50％的成年人报告说他们至少在儿童时期经历过1次逆境，而超过6％的成年人经历过4次或更多次不利的儿童时期经历（ACEs）。¹在医学领域，目前有争议的是，ACEs调查表是否应由儿科医生作为常规做法进行管理，该调查表询问18岁之前的虐待，忽视和家庭功能障碍。尽管有些人认为识别和解决ACE可以导致支持，这些支持可以增强适应力，并有助于减轻ACE的既定健康负担，[ ^2]其他人则警告其有限的证据和作为通用“筛查工具”的有效性，以及其在重新获得赔偿和增加患者耻辱感方面的潜在危害。^{3 ，4}虽然上的ACE普遍筛查的潜在益处和后果的研究还处于起步阶段，将ACE问卷得到了迅速采用到整个北美儿科护理设置。例如，最近已向加利福尼亚州拨款4500万美元，以增加ACEs筛查和儿科护理环境中与创伤有关的培训。此外，现在有27个州具有与ACE和创伤知情的护理方法相关的法规和解决方案。