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Inside the NICHD with Dr. Valerie Maholmes

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Dr. Maholmes oversees the Pediatric Trauma and Critical Illness Branch (PTCIB) at the NICHD. In this Inside the NICHD feature, she speaks about her work. Listen to Dr. Maholmes talk about the connection between childhood adversity and health.


Audio recording (MP3 - 2 MB)


Dr. Maholmes: I think we’re getting to the point where there are some common aspects of abuse and neglect that we all agree on are important. I think we also are now coming to understand that some of the challenges, in terms of youth behavior and even adult functioning, might have as origins in early experiences of maltreatment. And that’s work that we’re exploring a bit more in depth, but there are some papers coming out now which show those links to, of early adversity to some health outcomes.

One of the papers by Widom and her colleagues at John Jay College of Criminal Justice delves into that, and one of the areas that she looked at was cardiovascular problems. So, we know that there are certainly stressors in the lives of people who have had these kinds of experiences, but to look at how this work impacts their physical functioning and physiological functioning, or how, rather, these early experiences affect that functioning, is really highly significant. And as we start to look at health disparities, what we hope will happen now is that in screening in hospital settings or pediatric settings, that those kinds of questions will be asked, whether or not children have had these kinds of early experiences, so that we can understand how to better provide treatment for children and families, and that treatment might be treating the medical condition, but we also then might be able to combine that with the psychosocial intervention or treatment that might help address perhaps some of the stress and the emotional issues from having had those early experiences.

… Well, and I think that as we―now kind of moving from child development and behavior to pediatric trauma and critical illness―I think that what we hope that this new branch will be able to do is to illuminate what those risk factors are for those kinds of traumatic experiences. There will be some, of course, that we won’t, where we won’t be able to do that, but if we can really shed light on what some of those early warning signs are and risk factors for families that might be at risk for doing harm to children or exposing them to violence and injury, then we might be able to prevent that. So it’s going to take the collaborative effort of many disciplines to be able to bring that to bear.


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