The following is a summary of “Routine screening for adverse childhood experiences (ACEs) still doesn’t make sense,” published in the February 2024 issue of Pediatrics by McLennan et al.

Calls for routine screening of Adverse Childhood Experiences (ACEs) often emerge from a genuine concern about their prevalence and profound societal impact. However, the proposition of universal screening needs to adequately address the complexities inherent in determining whether the benefits of such programs outweigh the potential harms. Despite the compelling urgency to address ACEs, there still needs to be robust evidence from randomized controlled trials demonstrating the efficacy and effectiveness of ACEs screening initiatives.

Researchers of ACE screening often operate under the assumption that identifying these risk factors will inherently lead to improved outcomes for individuals and communities. However, this assumption overlooks critical nuances and complexities associated with translating population-level data into actionable individual interventions. It is essential to recognize that while there is a clear association between ACEs and adverse health and social outcomes at a population level, this does not directly imply causation nor guarantee that screening programs will lead to improved outcomes at an individual level.

Moreover, implementing routine ACEs screening raises ethical concerns, including the potential for stigmatization, overmedicalization, and the diversion of limited resources from evidence-based interventions. Instead of focusing solely on identification through screening, resources may be more effectively utilized by investing in high-quality prevention interventions aimed at reducing the occurrence of ACEs in the first place. Additionally, prioritizing evidence-based treatment services for individuals already affected by ACEs is crucial, irrespective of whether their health and social conditions are directly attributed to these adverse experiences.

In conclusion, while addressing ACEs cannot be overstated, routine screening must be implemented cautiously, carefully considering the balance between potential benefits and harms. Investing in rigorous evaluation of prevention and treatment interventions is paramount to effectively mitigating the long-term impacts of ACEs on individuals and society.

 Source: sciencedirect.com/science/article/pii/S0145213424000917