Limited Evidence to Support Screening for Adverse Childhood Experiences, Study Claims

There is limited evidence to support adverse childhood experiences screening in healthcare settings, according to a new critical appraisal by CDC-affiliated scientists and pediatricians. The appraisal, “Screening for Adverse Childhood Experiences:  A Critical Appraisal,” published in the December 2024 Pediatrics (published online Nov. 5), says that while it is important for healthcare professionals to assess for and respond to adverse and potentially traumatic experiences among their patients, there is not yet sufficient evidence on the potential benefits, challenges, and harms of adverse childhood experiences screening. Critical issues include difficulty in how to proceed and refer patients after adverse childhood experiences screening is conducted. No established threshold exists for screening results to determine when a patient needs to be referred to a specialist or considered for further care. Determining appropriate referrals and care is particularly difficult when the patient is not exhibiting any physical, emotional, or behavioral health symptoms.  Importantly, there is no existing research showing that adverse childhood experiences screening provides meaningful benefits to patients in terms of improved access to services or improved health outcomes.  Authors argue that more research on the impacts of adverse childhood experiences screening is needed before such screening is more widely implemented. They recommend that medical professionals should receive trauma-informed care training and implement a trauma-informed, relational health approach with all patients as the standard practice.

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The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults.