FSU MED Magazine Fall 2017, Vol. 13 | Page 17

the young girl who just took the ACE survey is screened for behavioral health concerns, and her results are passed in a folder for Kolb – or one of the other physicians – to review before the well-child exam begins. In clinical terms, a ‘‘yes’’ response means she has tested positive for toxic stress, setting in motion a chain of events that may help to improve the quality of her life. Thanks to the medical school’s research and clinical-care efforts, the physician will be able to introduce the patient to a clinical psychologist A tool that lets them talk Screening for childhood stress, which isn’t bound to provide an adequate response or resource and treatment. Yet most doctors’ in the exam room. As Kolb exits to see another patient, the required, allows physicians to learn things offices don’t have behavioral health specialists psychologist follows up with the young girl and happening in a child’s life that might otherwise on-site. They refer patients for treatment, which her caregiver. There may be resources available never come out during a routine exam. creates additional barriers for underserved to help mitigate some of the stressors in her populations like the one in Immokalee. life. Additional counseling may help reduce “If a doctor asks a person, ‘Have you ever been sexually abused?’ they probably are just “A lot of them are migrants – they travel a going to say no,” said Natalia Falcon-Banchs, lot; it’s hard for them to have that coordination an FSU College of Medicine clinical health of care,” said pediatrician Michelle Kolb, a don’t know how to access them,” said Catherine psychology fellow. “But if it’s written, they feel College of Medicine clerkship faculty member DeVito, the center’s case worker. “That’s where more comfortable giving an honest answer.” in Immokalee. “Most of our patients here don’t I come in. Sometimes it’s just basic needs, things have transportation.” like clothing; sometimes it could be something questions, physicians are legally and ethically But like all other children seen in this clinic, “Often the families aren’t aware of resources, or more serious, but they don’t know where to turn.” If a child answers affirmatively to certain stress related to other issues. Completing the Adverse Childhood Experiences survey prior to a primary care appointment. 15