Addressing Pediatric Toxic Stress During Initial Attention-Deficit/Hyperactivity Disorder Evaluations

Assessing for adverse childhood experiences (ACEs)/toxic stress (TS) is vital to comprehensive care for pediatric patients; however, no current national guidelines for pediatric ACEs/TS screening exist. Because of the similarity in externalizing behaviors for attention-deficit/hyperactivity disorder (ADHD) and elevated ACEs/TS scores, ACEs and TS need to be addressed with patients and families when evaluating for ADHD. Implementation of a quality improvement program to standardize ACEs/TS screening during all initial ADHD evaluation visits in a private pediatric clinic resulted in increased provider awareness of ACEs/TS, with an overall screening rate of 71%. (c) 2023 Elsevier Inc. All rights reserved