ACE surveys often reveal solvable problems
that would have been left unchecked.
“They teach you in medical school to ask
open-ended questions, but it doesn’t always
work very well in the reality of the patients we
Medicine’s mission. For many communities, produce lasting changes in the brain and body,
including Immokalee, Federally Qualified especially in children.
Health Centers (FQHCs) are the primary
providers for patients with limited resources.
The College of Medicine and its clinical
The younger the person, the more sensitive
the brain is to chemicals such as cortisol, and the
more damaging toxic stress can be. One recent
see,” Kolb said. “But now they’ve already been training partner, Healthcare Network of study showed that excessive stress disrupts the
asked all these specific questions about their Southwest Florida, operate an FQHC at the architecture of the developing brain.
psychosocial health and environment. medical school’s Immokalee Health Education Site. The grant, part of the National Child
Most, if not all, of the health problems there Traumatic Stress Initiative, will support
“The psychologist gives me a heads-up:
‘Hey, you know, the father’s been incarcerated have sociological and/or psychological roots. “developing capacity and infrastructure for the
because he’s not legal here, they’re struggling Stress, and the way we respond to it, is a center to serve as a national resource regarding
with how they’re gonna put food on the table.’ normal part of life. A temporary spike in heart effective treatment and service approaches
And in my conversation with the mother, it rate, blood pressure, adrenaline and the stress for child trauma experienced by young and
turns out they don’t have a refrigerator. hormone cortisol is important for helping us preschool children, specifically those from
attain the strength, speed and alertness needed migrant farm-working families.”
“The oldest child is the caregiver for the little
ones, going after school to buy food, bring it to overcome obstacles ranging from annoying to home, prepare it and nowhere to put it because life-threatening. It’s part of our survival instinct. experiences, the grant landed in the right place.
In the right dose, cortisol provides energy and “At the beginning eight years ago the level of
there’s no refrigerator, so it spoils. They are
For trauma, and adverse childhood
wasting food and what little money they have. boosts the immune system. The AAP says stress need we saw here was kind of overwhelming,”
“Most of the time you don’t even think of becomes toxic when there is “strong, frequent, or Rosado said. “From a clinical and research
asking your patients, ‘Do you have a refrigerator prolonged activation of the body’s stress response perspective it was difficult to get a grasp on it
in your house?’” systems in the absence of the buffering protection because the needs were so big. Where do we
of a supportive, adult relationship.” go? Where do we fit in?
Mission-focused research
Addressing health-care needs in Florida’s
rural towns is a key part of the College of
When it doesn’t go away as it should, elevated
“Anytime we do anything, we make sure it’s in
levels of cortisol in the bloodstream, along line with the mission and the vision of this medical
with increased heart rate and blood pressure, school, and that’s why we’ve been successful.”
Seeking a model many can use
A
ll children at the Immokalee
interventions that they receive so we’ll be
November. Within the next year, able to tell if a kid came in with an elevated
Clinical Director Javier Rosado ACE score and they got treatment, what is the
hopes to have collected enough data to begin difference between that and a similar kid who
reporting findings that also will include: also came in with an elevated ACE score but
· What stressors are people reporting?
· How often are they happening?
“We want to find out – these kids who are
“We’ll also be reporting behavioral health
clinic have been screened since
they didn’t follow up with treatment.”
The Center for Child Stress & Health (med.
fsu.edu/child) already provides resources for
experiencing a greater number of adverse parent and patient education and for health- “I’m fortunate to have been here from very
childhood experiences, do they end up on more care providers. Rosado is confident the research early on and I have seen it grow,” Rosado said.
medications – what kind of medications? Do will show benefits, including cost savings, for “There’s not that many of us here, but we’ve
they come to the doctor more often? Less often? integrating pediatric behavioral health into been able to do it, and I know this can be
What kind of diagnoses do they have?” Rosado said. primary-care clinics. done in rural clinics throughout Florida and
elsewhere. We’ll be able to show them how.”
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