Developing Systems of Trauma-Informed Care

infant hand on blanket

Significant attention is now focused on the impact of early trauma and adversity on the lives of children, following groundbreaking information in the Adverse Childhood Experience Study conducted at Kaiser Permanente in Southern California from 1995 to 1997. Over 17,000 Health Maintenance Organization members from Southern California receiving physical exams completed confidential surveys regarding their childhood experiences and current health status and behaviors. Almost two-thirds of study participants reported at least one ACE, and more than one in five reported three or more ACEs. The ACE score (total sum of the different categories of ACEs) was used to assess cumulative childhood stress. Study findings indicated that as the number of ACEs increase, so do negative health and well-being outcomes across the life span. For more information about the original ACE Study and current work being conducted on ACEs, go to

The National Traumatic Child Stress Network (NCTSN) is funded by the Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, US Department of Health and Human Services and is focused on combining a knowledge of child development, expertise in child traumatic experiences, and dedication to evidence-based practices in order to change outcomes for young children impacted by trauma. For more information about NCTSN, including a brief Public Service Announcement about Child Trauma, go to

In addition, a variety of Trauma-informed Care Toolkits have been developed by multiple organizations and are organized and available through the ACES Connection website at the following link:


Resources to Prevent and Address Trauma

The National Child Traumatic Stress Network (NCTSN) has released their July 2017 eBULLETIN, which includes general information about:


and resources such as:

  • Once I Was Very Very Scared is a story developed by psychologist Chandra Ghosh Ippen and Erich Ippen, Jr. available in English, Spanish, Arabic and Turkish and designed to serve as a population-based intervention as not every child in need has access to a therapist. The story is available in book and in PDF version. PDF versions are free. Practitioners can access and download the stories and additional resources at:
  • New APA Guidelines for Treatment of PTSD approved by the APA Council of Representatives on February 24, 2017. This document may be useful for health care providers and their patients in considering treatment options as well as for policymakers and insurance administrators in making treatment coverage decisions.
  • New Article: Comparing Trauma Exposure, Mental Health Needs, and Service Utilization Across Clinical Samples of Refugee, Immigrant, and US-Origin Children by Theresa S. Betancourt, Elizabeth A. Newnham, Dina Birman, Robert Lee, Heidi Ellis, and Chris Layne. July 2017 Journal of Traumatic Stress.