P0063 - Uniting Teachers and Pediatric Providers: the Interprofessional Fight Against ACEs

Background: One in six adults have experienced four or more Adverse Childhood Experiences (ACEs). Increased exposure to ACEs is associated with increased risk for chronic health problems that manifest during adolescence or earlier. Because these ACEs are deep-rooted in an adolescent’s childhood, they take a multidisciplinary approach to address. Only a low number of pediatric residents and attendings are formally trained on how to screen for or recognize ACEs, however they are front-line providers who identify and interact with these health issues. Teachers are adults who spend a maximum amount of time with children in multiple environments, and are attuned to how trauma manifests in students. They can be a valuable resource for pediatric providers on providing insight on adolescent development and behavior. Teachers are often in contact with not only the student but their family, and are often aware of trauma occurring in students lives. When teachers have previous professional development regarding ACEs, they can identify specific behavior patterns indicative of trauma and respond in a trauma-informed manner. This education and knowledge dissemination can help pediatric providers identify patients undergoing toxic stress. Integrating teacher viewpoints in pediatric provider education can assist in targeted history-taking. Early intervention on an interdisciplinary level can buffer the stress response that children who undergo ACEs experience.

Objectives: The purpose of this study was to interview teachers regarding their experience with trauma in their students and its manifestation in the classroom. These interviews are to be shaped into qualitative data for pediatric providers to use in their targeted history-taking around trauma and ACEs.

Methods: 25 teachers from two different low-income high school schools were interviewed. One school was a neighborhood public school, and one was a neighborhood magnet school. Data was organized into Atlas.ti. Researchers created structural codes based off of commonly used phrases, the codes varied from observed behaviors to trauma histories. The data was coded by 2 researchers.

Results: 100% of teachers interacted with students who had gone through one or more ACE. Teachers were able to identify uniquely how trauma manifested in the classroom, in the form of different demeanors, changes in personality traits, or specific behavior patterns. They understood the different ways in which toxic stress impacted their students. Teachers were able to identify how adults could interact with children in a culturally-sensitive and situational manner to minimize re-triggering of trauma and buffer their stress response.

Conclusions: Teachers are a crucial part of the interdisciplinary team that must work to reduce the impact of ACEs in children. By creating open communication for teachers to share their experiences with students who have experienced trauma, pediatric providers can broaden their knowledge-base surrounding the subject and augment their work with children with ACEs.