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Volume 22
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10.3390/ijerph22111644
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Article

Adverse Childhood Experiences (ACEs) Screening in Pediatric Primary Care: Is “Social Drivers of Health (SDoH) Screening” Sufficient?

by
Sylvia Zielinski
1,*,
Jocelyn Valdez
2,
Juliana James
2,
Jennifer Gates
2,
Bhavik Patel
2,
Tre DeVon Gissandaner
3,4,
Rachel Feurstein
5,
Ryan Levy
5,
Wanda Vargas
5 and
Evelyn Berger-Jenkins
1
1
New York-Presbyterian, Columbia University Irving Medical Center, New York, NY 10032, USA
2
Mailman School of Public Health, Columbia University, New York, NY 10032, USA
3
New York State Psychiatric Institute, Columbia University, New York, NY 10032, USA
4
School of Medicine, University of Missouri-Kansas City, Kansas City, MO 64108, USA
5
Division of Population and Community Health, New York-Presbyterian, New York, NY 10032, USA
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2025, 22(11), 1644; https://doi.org/10.3390/ijerph22111644
Submission received: 31 August 2025 / Revised: 9 October 2025 / Accepted: 27 October 2025 / Published: 29 October 2025
(This article belongs to the Special Issue Mental Health Services in Primary Care Settings: Challenges, Opportunities and Best Practices)
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Abstract

Adverse childhood experiences (ACEs) are established predictors of long-term health risks. While pediatric practices increasingly screen for social drivers of health (SDOH) and other family psycho-social stressors, routine ACEs screening is not recommended due to lack of evidence for long-term benefit and concerns over stigmatization, re-traumatization, and non-standardized follow-up protocols. We piloted routine ACEs screening in Pediatric Primary Care practices that already routinely screen for SDOH, maternal depression and intimate partner violence (IPV). This retrospective chart review (2016–2020) explored the extent to which these family psycho-social screenings could serve as a relative proxy for ACEs identification. Among 1492 participants (738 children aged 0–5 and 690 caregivers mean age 30.3 ± 6.9), ACE and SDOH screening results were significantly associated (p < 0.002), particularly with housing insecurity (p < 0.014). However, 51.7% of individuals who reported a positive ACE screen were not flagged by the SDOH measure (false negatives), indicating relatively poor sensitivity. The negative predictive value for negative SDOH screens and negative ACEs was higher at 86%. These findings suggest that SDOH screening misses over half of true positives, and therefore reliance on SDOH screening alone may underestimate ACE exposure in pediatric primary care.
Keywords: ACES; SDOH; trauma; screening; pediatric primary care ACES; SDOH; trauma; screening; pediatric primary care
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MDPI and ACS Style

Zielinski, S.; Valdez, J.; James, J.; Gates, J.; Patel, B.; Gissandaner, T.D.; Feurstein, R.; Levy, R.; Vargas, W.; Berger-Jenkins, E. Adverse Childhood Experiences (ACEs) Screening in Pediatric Primary Care: Is “Social Drivers of Health (SDoH) Screening” Sufficient? Int. J. Environ. Res. Public Health 2025, 22, 1644. https://doi.org/10.3390/ijerph22111644

AMA Style

Zielinski S, Valdez J, James J, Gates J, Patel B, Gissandaner TD, Feurstein R, Levy R, Vargas W, Berger-Jenkins E. Adverse Childhood Experiences (ACEs) Screening in Pediatric Primary Care: Is “Social Drivers of Health (SDoH) Screening” Sufficient? International Journal of Environmental Research and Public Health. 2025; 22(11):1644. https://doi.org/10.3390/ijerph22111644

Chicago/Turabian Style

Zielinski, Sylvia, Jocelyn Valdez, Juliana James, Jennifer Gates, Bhavik Patel, Tre DeVon Gissandaner, Rachel Feurstein, Ryan Levy, Wanda Vargas, and Evelyn Berger-Jenkins. 2025. "Adverse Childhood Experiences (ACEs) Screening in Pediatric Primary Care: Is “Social Drivers of Health (SDoH) Screening” Sufficient?" International Journal of Environmental Research and Public Health 22, no. 11: 1644. https://doi.org/10.3390/ijerph22111644

APA Style

Zielinski, S., Valdez, J., James, J., Gates, J., Patel, B., Gissandaner, T. D., Feurstein, R., Levy, R., Vargas, W., & Berger-Jenkins, E. (2025). Adverse Childhood Experiences (ACEs) Screening in Pediatric Primary Care: Is “Social Drivers of Health (SDoH) Screening” Sufficient? International Journal of Environmental Research and Public Health, 22(11), 1644. https://doi.org/10.3390/ijerph22111644

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