When to Refer

Trauma Screening should include family education, additional follow-up as needed, resources and referrals to  community services. Concerns based on a screening should be followed by appropriate referrals for  formal assessment by a qualified early childhood behavioral/mental health specialist. The ACE Screening Clinical Algorithm helps a provider assess whether a patient is at low, intermediate or high risk of a toxic stress physiology, and how to incorporate ACE screening results into clinical care and follow-up plans.30 It is important to identify a family’s strengths when developing a plan for a family with young children experiencing or at risk for trauma. Trauma-informed care consists of education to help patients recognize and respond to the role past or present stressors may be playing in their current health conditions and to address toxic stress physiology as a core component of treating ACE-Associated Health Conditions.31

How to Refer

For young children and families identified as low risk and without associated health conditions, screenings should be followed by family education about the impact of toxic stress on the child and families’ health.30 Depending on family eligibility, a screening may also be followed by a referral to a local home visiting program, Early Head Start, or other services available in the community.  Other community or private services to be considered for referral include parenting groups, support groups, or stress management classes.33 The local county First 5, Help Me Grow, or a family resource line may be used to further assist with information about programs available in the community.

For young children and families identified as moderate to high-risk, with or without associated health conditions, referrals to behavioral and mental health treatment may be necessary. The referral process begins by discussing the results of the screening with the parent and getting parental consent for referral. Most county departments of behavioral/mental health operate resource lines or hotlines that can provide confidential mental health information, referrals to service providers, and crisis counseling at any day or time. Numbers for these hotlines are generally available on the behavioral/mental health website for each county.

Follow-Up After Referral

It is important to check in with the family after you recommend services to be sure that they understand the reason(s) the referral was made and to determine whether they were able to access the services.