Date of Award

Spring 5-22-2021

Document Type

Doctor of Nursing Practice Final Manuscript

Degree Name

Doctor of Nursing Practice



First Advisor

Martha G. Fuller, PHD, PPCNP-BC


Background: Evidence links adverse childhood experiences (ACEs) to health issues later in life. Most research has been conducted in adults but there is a lack of recent research on the impact of ACEs in the pediatric population particularly in relation to mental health conditions. Utilizing the Pediatric ACEs Screener (PEARLS) health care providers can screen for ACEs at earlier ages.

Purpose: The aim of this evidence-based project is to determine if there is an increase of newly diagnosed mental health related disorders when using PEARLS compared to not using PEARLS in the previous months before implementation.

Methods: ACEs were identified using PEARLS at well-child visits. Regardless of scores, participants received verbal or written education on reducing stressors related to ACEs. Behavioral health outcomes were obtained via chart audits.

Results: A total of 2,037 PEARLS were administered. Of that, 1949 screened negative for ACEs and 88 (4.3%) screened positive. Screening for ACEs identified that patients who screened positive who had a higher frequency of having a behavioral health diagnosis.

Implications for Practice: Screening for ACEs exposure in pediatrics can provide early detection and timely interventions to reduce the adverse impacts of ACEs.

Conclusion: Implementing of ACEs screening in a pediatric population was simple but did not result in an increase in identification of behavioral health diagnoses.

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