First post in a while folks - sorry! I've been having a few conversations recently with different colleagues, and thought I'd post my thoughts here to see what the AtoZ community has to say. (First, here's a blog post from a fellow school psychologist that goes into a bit more detail, if anyone is interested. I get many of my thoughts from this.) A big take away for me is that it’s important for various data consumers (& pushers) to understand what different assessments are measuring, at what unit of analysis, etc. Some things work on one level (e.g., large-scale research studies), but not at organizational or individual levels. My primary issue is that people are now attempting to use it (ACEs) as an individualized psychosocial assessment tool for clinical practice, rather than seeing it as a tool to measure some elements of trauma from a research perspective. Even at it’s most appropriate level, though, there are big problems/limitations: it doesn’t measure dimensionality of trauma experience (e.g., intensity, frequency, persistence) collect any other related info (e.g., age of trauma) attempt to measure the person’s past or present reaction & relationship to those events (e.g., present level of emotional functioning) assess other sources of trauma (from community, peer, etc.) assess other types of trauma (e.g., rape, bullying) In large part, that’s because this tool was created by Kaiser Permanente for a specific HMO use with a specific population in the mid-90s, and while it’s been researched since, a better, more comprehensive tool was never conceptualized or created to take its place once ACEs started being used beyond that limited, original use. Then……the issue is how it’s been used. Like a lot of educational fads, consultants & schools have now repackaged a variety of materials and jumped on the bandwagon of “trauma-informed” service-delivery, which by definition leaves out a wide swatch of causes that might contribute to students' psychosocial issues. These trauma-informed trainings, packages, & practices are often implemented as silo interventions and stock “cookbook” programs, rather than focusing on creating a system of response to students’ psychosocial needs more broadly. Many of these programs and approaches also have never been researched. One response to this critique is that while incorporating ACEs/trauma-informed practices might not be everything, it’s better than nothing, and at least addresses the trauma component. The problem is that it actually may do the opposite, especially when implemented in isolation: For example, when schools respond unilaterally to students’ emotional needs by assuming a common/singular source (e.g., all emotional outbursts are related to trauma) with pre-determined responses (e.g., these are the interventions you use for “trauma-related” behaviors), educators go down the wrong path, and then are likely to arrive at the wrong support structure for students. Maybe the biggest thing I’ve noticed in my career is that educators tend to take piecemeal approaches to education, rather than focusing on creating systems of support. They want to add on this reading program, then that math program, then this teacher accountability approach, then that trauma-informed program. It results in a series of disconnected packages that are incomplete, and therefor ineffective. Effective systems create processes to identify & respond to the specific needs of kids, teachers, & schools - they are the processes by which helpers arrive at identifying causes & solutions. By contrast, many of these pre-packaged programs skip the process, and jump straight to the conclusions, denying the individual circumstances & needs, which ironically is fully antithetical to the original purpose of “trauma-informed care” in the first place. In short, ACEs and resultant trauma-informed care has become another haphazard rebranding and prepackaging of actual best practices, which distracts people from focusing on a more comprehensive, effective approach - in my opinion. I’m not against the idea of measuring trauma, nor am I against the idea of training staff & implementing practices to support children’s needs related to trauma, but the specific way it’s come about (both from an assessment perspective (ACEs) and an intervention package (“trauma-informed” practices) has been problematic. What do you think?