Patient selection: pediatric patient
Parameters:
(1) unmet social needs - 6 items
(2) adverse childhood experiences (ACE) - 6 items
Unmet social needs:
(1) lack of parental education
(2) parental unemployment
(3) lack of child care
(4) food insecurity
(5) housing insecurity and problems with bills (electric, heating, etc)
(6) need for legal aid
Adverse childhood experiences:
(1) separation from caregiver
(2) parental mental illness or substance abuse
(3) bullying
(4) witness to violence
(5) physical abuse
(6) sexual abuse
number of toxic stress risk factors =
= (number of unmet social needs) + (number of adverse childhood experiences)
Interpretation:
• minimum number of toxic stress risk factors: 0
• maximum number of toxic stress risk factors: 12
• The higher the number of toxic stress risk factors the greater the toxic stress.
In the ASK tool there is a 13th question about whether the child has someone that can make them feel better when the child is feeling sad.
