Exploring the Relationship between Adverse Childhood Experiences (ACEs) and Mental Health in Low Birthweight Children.

Low birthweight is associated with poor health, developmental, and social outcomes throughout the lifespan. Exposure to adverse childhood experiences (ACEs) is also associated with negative mental and physical health outcomes in adulthood. The aims of this study were to explore the relationship between low birthweight (LBW), exposure to ACES, and subsequent utilization of mental health service. Data analysis was conducted using a subset of data from children ages 6-17 years from the National Survey of Children's Health (NSCH) for 2018-2019 (n = 40,656). Welch ANOVA, Pearson's chi-square, and logistic regression investigated the relationship between LBW, ACEs, and mental health. LBW children in this sample had higher exposure to ACEs when compared to not low birthweight (NBW) children. LBW children also had a higher reported incidence of identified mental health (MH) issues. There was no significant association between birthweight and unmet MH service needs. LBW children with an ACE score or two or more were more likely to have an unidentified MH issue and/or an unmet MH service need. The results demonstrate LBW children experience higher levels of adversity. Children with ACE scores of two or more and those with unidentified MH issues have a higher likelihood of unmet MH needs. Professionals working in the health, education, and social service sectors can use this information to raise awareness of the increased vulnerability and more effectively meet the mental health needs of LBW children.

A Pilot Survey of Pediatric Occupational and Physical Therapy Providers' Confidence, Attitudes, Barriers, and Education Regarding Trauma-Informed Care.

AIM: Trauma-informed care (TIC) is a strengths-based organizational approach which recognizes the prevalence and impact of trauma on an individual's neurological, sensorimotor, and emotional responses and development. There is limited research on pediatric occupational therapy providers' (OTPs) and physical therapy providers' (PTPs) perceptions on incorporating TIC into their practice. This pilot study aims to describe the confidence, attitudes, barriers, and education of pediatric OTPs and PTPs regarding TIC. METHOD: OTPs and PTPs (n = 87) working in pediatric settings in the U.S. completed an electronic survey regarding their perceptions of TIC. RESULTS: OTPs reported higher confidence in TIC compared to PTPs. Most participants reported favorable attitudes toward TIC, yet no statistical significance was identified between the two professions' overall attitudes toward TIC. Collectively, participants reported lack of time and training as barriers. There was a statistically significant difference between how the two professions rated competency, training, and concern over clients' retraumatization. There was significant association between years of professional experience and TIC education. CONCLUSION: Preliminary findings indicate an overall agreement of OTPs and PTPs with principles of TIC and common barriers to TIC practice. There are implications to further integrate opportunities for TIC training into foundational education and professional practice.

Trauma-Informed Care in Pediatric Physical Therapy as a Standard Precaution: The Time Is Here.

In this special communication, an overview of the research on trauma, resilience, and action items for the pediatric physical therapist (PT) is addressed. The experiences of early childhood, positive and negative, impact overall development and well-being throughout the lifespan. Childhood trauma can include exposure to abuse, neglect, violence, racism, or medical procedures. These adverse childhood experiences are associated with poor physical and mental health outcomes that can extend into adulthood and can appear in the pediatric rehabilitative realm as caregivers who become labeled noncompliant. Trauma is common and impacts all children; however, some populations, such as children with disabilities, have greater risk for experiencing adversity. An individual's trauma history is not always visible, necessitating a standard approach. Pediatric PTs must take an intentional approach to address the detrimental effects of trauma on those we serve. Many organizations recommend adopting trauma-informed care as the standard of care for all populations.

Inter-Organizational Collaboration: The Process of Creating a Joint Statement.

BACKGROUND: Students with disabilities benefit from a team-based approach to support their needs. Individuals from occupational therapy (OT), physical therapy (PT), and speech-language pathology (SLP) partnered to form an interprofessional (IP) workgroup to address the topic of student-centered collaborative goal writing in the context of school-based practice. METHOD: This IP workgroup engaged in a collaborative process centered around a shared goal which integrated reflection and discussion sur¬rounding barriers to teaming, collaborative goal writing, and summarizing best practices from the healthcare and special education literature. This process required development of a shared goal, common language, and collaboration across professions and organizations. RESULTS: The workgroup process created a consensus document, the Joint Statement on Interprofessional Collaborative Goals in School-Based Practice, to provide guidance for school-based practitioners to support student success. Following inter-organizational expert review, the statement was endorsed by three professional organizations and disseminated to practitioners via their respective organizational websites. CONCLUSIONS: This paper outlines the innovative process used by an interprofessional, inter-organizational workgroup to develop and disseminate a consensus document outlining practical guidelines for interprofessional teams working in the educational setting. Additionally, this workgroup created associated professional development materials and presented them to OTs, PTs, and SLPs at a national level.

Transforming Interprofessional Education Through Integration with a University Core Curriculum.

BACKGROUND: Over the past several decades, enhanced health outcomes have been connected to effective collaboration among stakeholders. Academic institutions have looked to Interprofessional Education (IPE) to enable effective collaboration and improve health outcomes. However, these programs are not often integrated and aligned with general education/core curricula at their institutions. METHODS: IPE faculty engaged in a collaborative process of integrating IPE courses and outcomes with a new university-wide core curriculum for all undergraduate students. This initiative required revising and realigning IPE courses, updating pedagogy, and developing new teaching teams. RESULTS: This process produced a Core Framework, outcomes, essential criteria, and enhanced work across the institution to align IPE competencies to university student learning outcomes. The process also strengthened IP learning as a contributing partner to the overall goals and outcomes of a St. Louis University graduate. CONCLUSIONS: The paper describes the iterative process, initial outcomes and the transformation that has occurred during the development of shared goals, shared language, broadening the dialogue and understanding of IPE at the wider university level. Aligning IPE with the Core has strengthened the IPE courses to be more highly valued across the health professions and contributed to even stronger transformational learning experiences of the students and faculty.