CE Credit

Addressing Adverse Childhood Experiences through Trauma-Informed Care


Welcome to the training on Addressing Adverse Childhood Experiences through Trauma-Informed Care provided by the Texas Health and Human Services Commission (HHSC) and the Texas Department of State Health Services (DSHS).

Credit hours: 1.50 CE


The goal of this module is to equip Texas Health Steps providers and other health-care professionals to recognize adverse childhood experiences (ACEs), the resulting trauma and toxic stress, screen for health consequences, and provide culturally sensitive trauma-informed care for children and adolescents.

Target Audience

Texas Health Steps providers and other interested health-care professionals.

Specific Learning Objectives

After completing the activities of this module, you will be able to:

  1. Specify the nature of adverse childhood experiences (ACEs), their impact on short- and long-term health, and the providers’ role in addressing them. 
  2. Apply ethical guidelines for reporting suspected abuse and neglect. 
  3. Assess the steps required to provide culturally sensitive trauma-informed care to children, adolescents, and caregivers affected by ACEs.

Please note this module expires on 3/9/2021.

This module was released on 3/9/2018.

Accreditation Statement


Browser Requirements


Anticipatory Guidance

  • Texas Health Steps Anticipatory Guidance Resource List
    Comprehensive list, includes AAP’s Bright Futures, a resource for a variety of screening tools and forms; Connected Kids: Safe, Strong, Secure, a resource for anticipatory guidance; and the United Way’s Ages and Stages website. Also includes patient education resources.
  • Acutely Traumatized Children: Identifying and Managing Posttraumatic Stress
    Provides practical suggestions and resources to enable providers to apply the surveillance, trauma-informed anticipatory guidance, and evaluation (STAGE) approach to caring for traumatized children and their parents within the constraints of real-world pediatric practice.

General Resources

Practice Resources for Identifying, Screening, and Referral

School Resources

  • ACES Too High website
    Go-to website for background, news, and information about the ACE Study, developmental neurobiology — how severe stress and trauma affect a child’s developing brain and nervous system, and epigenetics, specifically, how our genes turn off and on in response to our experiences and social environment.
  • National Child Traumatic Stress Network (NCTSN) Resources for School Personnel web page
    Effective resources for educators and school personnel that include information on bullying and cyber bullying, psychological first aid, speaker series, and the Child Trauma Toolkit for Educators. Some materials available in English and Spanish.
  • The Trauma Informed Care Project resources web page
    Publications, links, videos, and books from an organizational structure and treatment framework focused on understanding, recognizing, and responding to the effects of all types of trauma. In addition, the project emphasizes physical, psychological, and emotional safety for both consumers and providers, and helps survivors rebuild a sense of control and empowerment.

Children and Youth with Special Health-Care Needs

Cultural Sensitivity

  • Culturally-Sensitive Trauma-Informed Care web page
    Part of the Children’s Hospital of Philadelphia Health Care Toolbox website; features key component explanations and provider materials that include questions to ask patients and care delivery tips.

Foster and Adoptive Families

  • Healthy Foster and Adoptive Families Cope with Trauma: A guide for pediatricians
    A webinar and downloadable guide from the AAP to support adoptive and foster families by strengthening the abilities of pediatricians to identify traumatized children and educate families and empower them to respond to a child’s behavior in a manner that acknowledges past trauma but promotes the learning of new, more adaptive reactions to stress. Includes a Coding Tips sheet and Visit Discharge Form for evaluations involving screening and anticipatory guidance related to trauma and other mental health/developmental concerns.
  • Cenpatico U
    Provides extensive trauma training to caseworkers, foster families, child-placing agencies, residential treatment centers, and others within the child welfare system, using the National Child Traumatic Stress Network (NCTSN) Child Welfare Trauma Training Toolkit.

Historical Trauma

Maternal PTSD and Depression

Medical Trauma


Treatment Resources

  • 2-1-1 Texas
    A free, confidential information and referral phone line answered 24/7 by nationally certified specialists with access to a comprehensive database of community organizations, government agencies, and nonprofits in Texas.
  • AAP’s Mental Health Initiatives website
    Dedicated to transforming systems and practices, building clinician skills, disseminating tools, and enhancing community resources for mental health/substance abuse care.
  • Behavioral Health Treatment Services Locator
    Sponsored by the federal Substance Abuse and Mental Health Services Administration (SAMHSA) to assist in finding alcohol and drug abuse treatment or mental health treatment facilities and programs around the country.
  • California Evidence-Based Clearinghouse for Child Welfare (CEBC)
    Provides a searchable database of programs for professionals serving children and families involved with the child welfare system. Program descriptions include a CEBC Scientific Rating, citations and summaries of relevant peer-reviewed research on the program, program description, and training and contact information.
  • Evidence-Based Child and Adolescent Psychosocial Interventions
    Outlines evidence-based child and adolescent psychosocial interventions and includes traumatic stress as one of the presenting problems. Published by and updated twice a year by AAP’s Pediatrics journal.
  • National Registry of Evidence-based Programs and Practices (NREPP)
    SAMHSA’s searchable online database of mental health and substance abuse interventions. NREPP is one way that SAMHSA is working to improve access to information on evaluated interventions and reduce lag time between the creation of scientific knowledge and its practical application in the field.
  • Psychological First Aid Field Operations Guide (PFA)
    Developed by the NCTSN and the National Center for PTSD, PFA is an evidence-informed approach for assisting children, adolescents, adults, and families in the aftermath of disaster and terrorism. The website offers free online training and downloadable first aid manuals in English, Spanish, Japanese, and Chinese.
  • Seeking Safety
    A model of counseling to help improve coping skills, originally developed for trauma, substance abuse, and/or post-traumatic stress disorder (PTSD). It is also applied broadly to increase coping and stabilization.
  • Trauma-Focused Cognitive Behavioral Therapy for Children Affected by Sexual Abuse or Trauma (TF-CBT)
    An issue brief from the Child Welfare Information Gateway that explores research and practice on trauma-focused cognitive-behavioral therapy (TF-CBT), an evidence-based treatment approach shown to help children, adolescents, and their parents overcome trauma-related difficulties.
  • Trauma-Informed Treatment: Best Practices
    A downloadable PowerPoint presentation by James A. Peck, PsyD at the 2009 Los Angeles County Annual Drug Court Conference.

The medical definitions provided in this module were obtained from the American Psychiatric Association, the Centers for Disease Control and Prevention, the U.S. National Library of Medicine, and WebMD.

  • Early Childhood Materials focused on trauma and justice
    Links to multiple resources, including-audience specific resources such as military deployment and homelessness, from the federal Substance Abuse and Mental Health Services Administration (SAMHSA).
  • Partnering with Parents: Apps for Raising Happy Healthy Children, a colorful, parent-friendly booklet designed to look like a smartphone app.
  • NCTSN Resources for Parents and Parents web page
    A wealth of resources for birth parents, adoptive parents, resource or foster parents, grandparents, caregivers, and all others who care for children and teens.
  • Parenting After Trauma: Understanding Your Child’s Needs
    Part of the AAP’s Helping Foster and Adoptive Families Cope with Trauma guide, explains how trauma can impact children and provides tips for making them feel safe in their new home. Pediatricians can copy and provide this handout to foster and adoptive parents. An AAP clearinghouse of topic-specific resources and articles for parents, including information on emotional wellness, resilience, and coping with trauma.
  • Triple P - Positive Parenting Program
    Multi-level system of family intervention developed through more than 30 years of clinical research trials. It aims to prevent severe emotional and behavioral disturbances in children by promoting positive and nurturing relationships between parent and child. It also offers training for organizations and practitioners as well as self-help and parent resources.
  • Sesame Street in Communities
  • Videos for children and other resources aimed at educating and helping children deal with ACEs like divorce and incarceration of a loved one.