Adverse Childhood Experiences and Trauma-Informed Care.

Adverse childhood experiences (ACEs) refer to the abuse, neglect, and traumatic experiences in childhood that directly affect long-term adolescent and adult health. Understanding the ACE Pyramid and the physiological stress response has guided research toward a better understanding of the long-term mental and physical health consequences from psychological impacts early in life. Trauma-informed care becomes critical for pediatric clinicians to operationalize in practice. The four R's approach-realize, recognize, respond, and resist re-traumatization-can be used by pediatric providers as guidance. The trauma-informed care approach includes the realization of how ACEs affect health, the recognition of pediatric clinical symptom presentation and screening protocols for ACEs, and the health care provider's ability to respond and not re-traumatize patients when delivering evidence-based care. As recent events have triggered worldwide mental and emotional trauma in youth, clinicians must start operationalizing trauma-informed care into practice, as future presentations of trauma are expected.