Abstract
The relationship between adverse childhood experiences (ACEs) and risky behavior, chronic illness, and premature mortality is well documented. Despite this evidence, screening for ACEs in primary care settings remains limited. Objections to widespread screening include concerns that the original ACE screening tool limited childhood adversities to family and household dysfunction. The purpose of this scoping review is to describe current knowledge for expanding ACEs categories and revising the formatting and scoring of the screening tool. With the assistance of a medical librarian, we used a two-step process to conduct a systematic search in three databases (CINAHL, OVID Medline, PsycINFO). Our aim was to focus on articles that expanded ACE categories and/or revised the scoring or formatting of the ACE tool. Eighteen articles (reporting 19 studies) met criteria. A minimum of two authors extracted the relevant characteristics of the studies independently and conferred to reach agreement. The majority of studies broadened ACEs to include community and systemic categories; three studies revised the formatting or scoring of the ACE tool. Exposure to community violence (ECV) was the most frequently added category (15), followed by economic hardship in childhood (EHC) (13); bullying (10); absence/death of parent or significant others (9); and discrimination (7). This evidence supports the expansion of ACE screening tools for assessment of childhood trauma and timely treatment.
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The research team would like to acknowledge and thank Mary M. Kreiger, MLIS, RN for her assistance with the literature search.
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The first author came up with the idea for the study and drafted an early version of the paper. Jee Hye Yoo conducted the search with the assistance of a medical librarian and the first author. All authors made substantial contributions to the manuscript by inputting or reviewing data in the tables, writing specific sections, and reviewing several versions of the manuscript. All authors approved the submitted version of the manuscript and are accountable for all aspects of the study.
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SmithBattle, L., Loman, D.G., Yoo, J.H. et al. Evidence for Revising the Adverse Childhood Experiences Screening Tool: a Scoping Review. Journ Child Adol Trauma 15, 89–103 (2022). https://doi.org/10.1007/s40653-021-00358-w
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DOI: https://doi.org/10.1007/s40653-021-00358-w