PEARLS screening tool

Aim 1 under the CARE Study encompasses seeks to advance the evidence base for the PEARLS tool, a California ACEs assessment screener. Upon adding a three-year follow-up point to the original PEARLS cohort, we will leverage our expertise to enhance scientific value by adding toxic stress biomarker data and will examine individual and contextual resilience-promoting factors in diverse, low-income, child-caregiver cohorts.  

PEARLS findings

The original cohort’s results identified three profiles of allostatic load, including one normative biologic measure profile arising from children with low ACEs and low caregiver stress.  

Importantly, children with high ACEs but low caregiver stress did not show the same metabolic dysregulation that children with high ACEs and high caregiver stress reported. The existence of this potential resilience pathway encourages further exploration in this study.  

Discovery research goals

We are poised to expand existing predictions regarding longitudinal child health outcomes and address critical gaps in ACEs science.  

This discovery research focuses on three components: 

1. Examine longitudinal associations between cumulative childhood adversity and biologic (both metabolic and inflammatory) and health (psychosocial, behavioral, physical) outcomes in early childhood.  

2. Identify contextual protective factors (social supports, parent-child relationships, exposure to pilot interventions) that may buffer against risk from adversity on outcomes in early childhood.  

3. Determine if candidate stress-sensitive biomarkers (IGF-BP1-leptin, HA1c, hs-CRP, immune cytokines, telomere) predicts longitudinal health outcomes among at-risk children.