Childhood adversity is highly prevalent and associated with risk for poor health outcomes in childhood and throughout the life course. Empirical literature on resilience over the past 40 years has identified protective factors for traumatized children that improve health outcomes. Despite these empirical investigations of resilience, there is limited integration of these findings into proactive strategies to mitigate the impact of adverse childhood experiences. We review the state of resilience research, with a focus on recent work, as it pertains to protecting children from the health impacts of early adversity. We identify and document evidence for 5 modifiable resilience factors to improve children’s long- and short-term health outcomes, including fostering positive appraisal styles in children and bolstering executive function, improving parenting, supporting maternal mental health, teaching parents the importance of good self-care skills and consistent household routines, and offering anticipatory guidance about the impact of trauma on children. We conclude with 10 recommendations for pediatric practitioners to leverage the identified modifiable resilience factors to help children withstand, adapt to, and recover from adversity. Taken together, these recommendations constitute a blueprint for a trauma-informed medical home. Building resilience in pediatric patients offers an opportunity to improve the health and well-being of the next generation, enhance national productivity, and reduce spending on health care for chronic diseases.
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State-of-the-Art Review Article|
May 01 2017
Modifiable Resilience Factors to Childhood Adversity for Clinical Pediatric Practice Available to Purchase
Flora Traub, PA-C;
aDepartment of General Pediatrics, Boston University School of Medicine, Boston, Massachusetts; and
Address correspondence to Flora Traub, PA-C, MPP, Brigham and Women’s Hospital, Department of Medicine, 75 Francis St, Boston MA 02115, [email protected]
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Renée Boynton-Jarrett, MD
Renée Boynton-Jarrett, MD
aDepartment of General Pediatrics, Boston University School of Medicine, Boston, Massachusetts; and
bDivision of General Pediatrics, Boston Medical Center, Boston, Massachusetts
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Address correspondence to Flora Traub, PA-C, MPP, Brigham and Women’s Hospital, Department of Medicine, 75 Francis St, Boston MA 02115, [email protected]
POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.
FINANCIAL DISCLOSURE: The authors have indicated they have no financial relationships relevant to this article to disclose.
Pediatrics (2017) 139 (5): e20162569.
Article history
Accepted:
November 15 2016
Citation
Flora Traub, Renée Boynton-Jarrett; Modifiable Resilience Factors to Childhood Adversity for Clinical Pediatric Practice. Pediatrics May 2017; 139 (5): e20162569. 10.1542/peds.2016-2569
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