University of Wisconsin–Madison Medical College of Wisconsin

Adverse Childhood Experiences: Perceptions, Practices, and Possibilities

Hannah T. Sherfinski, BS; Paige E. Condit, MD; Samantha S. Williams Al-Kharusy, MD; Megan A. Moreno, MD, MSEd, MPH

WMJ. 2021;120(3):209-217.

Download full text pdf.


Background: Adverse childhood experiences are negative life events occurring in childhood that can have long-term health effects. Many health professionals do not receive formal education surrounding childhood trauma, and few providers screen for adverse childhood experiences.

Objective: This scoping review examines how current literature describes the perceptions, attitudes, and practices of health professionals and trainees regarding childhood trauma, identifies educational opportunities aiming to increase awareness for child trauma, and discusses screening for adverse childhood experiences.

Methods: PubMed, PsycInfo, and Google Scholar were used to find articles. Key search terms included “adverse childhood experiences” or “ACEs,” combined with terms such as “screening implementation,” “Education, Professional” (Medical Subject Headings [MeSH]), “Education, Medical, Graduate” (MeSH), “Curriculum” (MeSH), “Health Knowledge, Attitudes, and Practices” (MeSH), and “Attitude” (MeSH).

Results: A large proportion of providers and trainees are unaware of the effects of adverse childhood experiences. Training opportunities can increase knowledge about adverse childhood experiences and promote trauma-informed care practices. However, the long-term effects of these trainings remain largely unexplored. Barriers such as a lack of time, resources, comfort, or consensus regarding how to ethically screen impede broader efforts to implement systematic screenings for adverse childhood experiences.

Conclusions: Adverse childhood experiences are a public health concern. However, health professionals and trainees are undereducated about their pervasive effects. Further research is needed on how to better educate health professionals about adverse childhood experiences and trauma-informed care. Adverse childhood experiences screenings could promote the early identification of childhood trauma, yet the ethics and effectiveness of screening must be further studied.

Author Affiliations: University of Wisconsin School of Medicine and Public Health ((UW SMPH), Madison, Wisconsin (Sherfinski); Department of Pediatrics, UW SMPH (Condit, Williams Al-Kharusy, Moreno).
Corresponding Author: Hannah T. Sherfinski, Master of Public Health Program, 610 Walnut St, 740 WARF, Madison, WI 53726; phone 608.263.4889; email
Acknowledgements: The authors would like to thank Dipesh Navsaria, MPH, MSLIS, MD, for serving as faculty advisor for the Applied Practice Experience project, part of the Master of Public Health (MPH) program at the University of Wisconsin-Madison. They are also grateful for the direction of Barbara Duerst, MS, MPH, University of Wisconsin-Madison MPH program.
Funding/Support: None declared.
Financial Disclosures: None declared.
Share WMJ