April is National Child Abuse prevention month. The effects of child abuse and other traumatic events can follow children into adulthood and impact their mental and physical health. The Adverse Childhood Experiences (ACES) study exposed the heavy impact of these events, particularly child abuse, on well-being through the life span – from developing diseases to early death.1
As families often turn to their primary care providers in times of stress, PCPs are ideally situated to identify these traumatic events and provide support for children and families. This support begins with regular screening for traumatic events while informing families the importance of awareness to help mitigate the impact of the trauma.2 Screening forms like the Life Events Checklist (https://docassistillinois.org/tools/screening-tools/) are brief and easy to integrate into regular well-child checks.
After identification of a traumatic event, the PCP can take the next step to provide support for the family. This should include education about potentially traumatic events including the common nature of these events (“I see many children with similar experiences”) and the common physical and emotional reactions (“It is expected that you would feel distressed or unsafe”). Empathetically normalizing these reactions is an important part of caring for families during these times. With education on expected distress, it is important to recommend self-care to promote resilience and recovery. Encouraging families to support each other and engage in healthy activities, eating, and relaxation are effective ways to engage the natural support system.2 Some resources for this can be found on the Illinois DocAssist website: https://docassistillinois.org/tools/resources-for-your-patients/.
After a single event trauma, often times children will recover without further intervention. However, trauma is a risk factor for developing multiple mental health disorders including posttraumatic stress disorder, other anxiety disorders, major depressive disorder, and attention deficit hyperactivity disorder. If you have further questions about managing the mental health sequelae of a traumatic event or screening for trauma; the consultants at Illinois DocAssist are available by phone to assist primary care providers in developing a treatment plan.
Felitti, Vincent J. MD, FACP et al. Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults: The Adverse Childhood Experiences (ACE) Study. Am J Prev Med 1998; 14(4)
Cohen, Judith A. MD; Kelly J. Kelleher, MD; Anthony P. Mannarino, PhD. Identifying, Treating, and Referring Traumatized Children – The Role of Pediatric Providers. Arch Pediatr Adolesc Med. 2008;162(5):44