Why engage in research? 

Early-life trauma and related adversities are prevalent and associated with negative health and achievement outcomes. These adverse childhood experiences (ACEs) are especially common in economically disadvantaged communities of color.  

Learn more about our research

What we hope to learn 

While there has been tremendous growth in knowledge about ACEs and their impact on health across the life course, two gaps in ACEs knowledge severely limit trauma identification and effective resilience-promoting interventions: 

  1. Which biologic pathways are most affected by ACEs during early childhood and may help identify those children at greatest risk for future poor health?  
  2. How may child and family resilience be bolstered across the care continuum to mitigate the negative health effects of ACEs?  

To address these critical gaps, the “Collaborative Approach to building Resilience in Everyone” (CARE) program builds upon our existing California-based, child ACEs, longitudinal studies. From these studies, we have collected rich measurements of demographic information, health outcomes, and health-biomarker data. 

Pediatric ACEs and related life events screener  

Together, we developed the Pediatric ACEs and Related Life Events Screener (PEARLS) tool for pediatric primary care; built a comprehensive, pediatric cohort ACEs study with biomarker and health data; developed and implemented resilience-promoting caregiver-child interventions across care settings in California; and have systematically identified intervention components that work in real-world practice. 

Early findings  

Our preliminary results have already identified ACE-related differences in biomarkers of toxic stress and in health outcomes. These results indicate two potentially significant findings for children exposed to trauma:

  • Resilience-promoting interventions may improve caregiver-child relationships and behavioral outcomes
  • These interventions may have a biologic impact in the short term, providing the potential for improvement in long-term health outcomes. 

Extant caregiver-child interventions are highly variable, often lack empirical support, and predominantly rely on grant funding. Our project interventions have a proven track record of improving parenting skills, the caregiver-child relationship, and child behavioral outcomes. This demonstrates that biologic impact would provide an evidence-based to refine care strategies and move reimbursement policy towards providing ongoing-sustainable supports for such programs.