Fundamentals of Adverse Childhood Experiences (ACEs) Screening and Response

CAFP's Family Medicine Initiative on Trauma-Informed Care (FIT) enduring activity consists of three separate accredited sessions designed to introduce clinicians to the concepts of toxic stress and Adverse Childhood Experiences (ACEs) as they relate to trauma-informed care. Session 1 introduces clinicians to the concepts of toxic stress and ACEs as they relate to trauma-informed care. Session 2 presents clinicians with best practices and practical strategies to use when responding to ACEs in their patients. And, Session 3 provides regional and state resources to use with patients.

This is part of CAFP's broader efforts to provide information and education on Adverse Childhood Experiences (ACEs) and Trauma Informed Care. See our website for updated information. 

It is expected that learners will complete each session. Learners who complete all three sessions can claim up to 1.50 AAFP Prescribed CME credits.


Adverse Childhood Experiences (ACEs) and toxic stress are public health crises. ACEs are stressful or traumatic events experienced by age 18, identified in the landmark Centers for Disease Control and Prevention (CDC) and Kaiser Permanente (KP) Adverse Childhood Experiences Study, to be strongly associated with increased health and social risks. Early detection and intervention can help prevent or reduce the health risks associated with ACEs.


Learners must register to participate in and receive credit for this online educational activity.  Read the target audience, learning objectives, and author disclosures.  Study the educational content online and choose the best answers to each question.  For information on applicability and acceptance of continuing education credit for this activity, please consult your professional licensing board.


CAFP policy and California state law requires that each learning activity have elements of cultural and linguistic proficiency included in the content. This activity includes discussions of special populations and tools to use for patient communications.


The California Academy of Family Physicians (CAFP) is committed to protecting the privacy of its members and customers. CAFP maintains safeguards to store and secure information it has about members and customers. The safeguards may be physical, electronic or procedural. For more information, contact


For questions regarding the content of this activity or for technical assistance, contact

The CAFP has made all reasonable efforts to ensure that information contained herein is accurate in accordance with the latest available scientific knowledge at the time of accreditation of this continuing education program. Information regarding drugs (e.g., their administration, dosages, contraindications, adverse reactions, interactions, special warnings, and precautions) and drug delivery systems is subject to change, however, and the learner is advised to check the manufacturer's package insert for information concerning recommended dosage and potential problems or cautions prior to dispensing or administering the drug or using the drug delivery systems.

Approval of credit for this continuing education program does not imply endorsement by CAFP of any product or manufacturer identified.

Any medications or treatment methods suggested in this CME activity should not be used by the practitioner without evaluation of their patient's condition(s) and possible contraindication(s) or danger(s) of use of any specific medication.


© 2022 California Academy of Family Physicians. All rights reserved. No part of this activity may be used or reproduced in any manner whatsoever without written permission except in the case of brief quotations embedded in articles or reviews.

Target Audience

This course is intended for family physicians and other primary care providers.

Learning Objectives

At the end of this course, you should be able to:

  • Describe how ACEs and toxic stress disrupt physiology and influence the development of chronic disease  
  • Summarize the principles of trauma-informed care as they relate to provider, staff and patient wellness
  • Formulate practical methods for responding to ACEs with trauma-informed care principles 
  • Identify best practices in the use of validated ACE screening tools
  • Reference regional, state, and national resources to use with patients
  • Apply your knowledge through a patient case

Additional Information

PDF icon ACEsFIT.FAQ-and-Resources.pdf252.78 KB
Course summary
Available credit: 
  • 1.50 AAFP Prescribed
  • 1.50 AMA PRA Category 1 Credit™
Course opens: 
Course expires: 

Anna Askari MD, MSBS

Anna Askari, MD, MSBS is an Outpatient Family Physician at OneMedical in Aliso Viejo, California. Anna received her medical degree from the Ohio State University College of Medicine and recently completed her residency at Eisenhower Health's Family Medicine Residency Program. Throughout her medical training, Anna has taken on leadership roles at both the AAFP and CAFP. Currently, she serves as Resident Director of the American Academy of Family Physicians and past Resident Member of the California Academy of Family Physicians (CAFP) Board of Directors and Foundation Board of Trustees. Anna has contributed to several publications, including CHEST and Journal of Cardiovascular Electrophysiology and received numerous awards, including the AAFP Award for Excellence in Graduate Medical Education and AAFP Family Medicine Interest Group Leadership Award.


Erika Roshanravan, MD

imageErika Roshanravan, MD is a family physician at CommuniCare Health Center, a Federally Qualified Health Center in Woodland, California. Erika also supervises and teaches University of California, Davis family medicine residents during their continuity clinic at CommuniCare. Erika received her Doctor of Medicine degree from the University of Berne School of Medicine (Berne, Switzerland) and completed her Family Medicine Residency at University of Washington. She is currently President of CAFP’s Sacramento Valley Chapter Board of Directors as well as Alternate Director for District 10 on the CAFP Board of Directors. Erika is fluent in German, Spanish, French and English and lives with her husband and three children in Davis, California.



Adia Scrubb, MD, MPP


Adia Scrubb, MD, MPP is an Oakland native and currently practicing full-scope Family Medicine at LifeLong Medical in East Oakland. She is serving on the California Surgeon General's ACEs Aware Clinical Implementation subcommittee.  Adia received her Doctor of Medicine degree from the David Geffen School of Medicine and PRIME Program at the University of California, Los Angeles (UCLA) and the Charles R. Drew University of Medicine and Science in Los Angeles. Adia earned a Master of Public Policy degree from UCLA’s Luskin School of Public Affairs and a Bachelor of Arts degree from University of California, Berkeley in Comparative Literature.



Brent Sugimoto, MD, MPH, AAHIVS, FAAFP


Brent K. Sugimoto, MD, MPH, AAHIVS, FAAFP is a family physician and HIV specialist. With a focus on care for adolescents and adults living with HIV at Kaiser Permanente in Oakland, California he worked to improve outcomes for this population. It was at Kaiser Permanente that Brent began efforts to screen and intervene for Adverse Childhood Experiences, which are over-represented in persons living with HIV. Brent is an educator and author of ACEs education for primary care, he serves on several of the California Surgeon General's ACEs Aware subcommittees, and he is currently the New Physician member on the AAFP Board of Directors. Brent is currently Chief Medical Officer for Decoded Health, a technology startup using artificial intelligence (AI) to achieve the Quadruple Aim. Brent received his MD from the University of California, San Francisco (UCSF), his MS as part of the University of California, Berkeley-UCSF Joint Medical Program, and his MPH from UC Berkeley. Brent lives with his husband and two children in Richmond, California.


Conflict of Interest Statements:

The Committee on Continuing Professional Development and CME will be responsible for mitigating any relevant financial relationships disclosed by an individual who may have influence on content, who have served as faculty, or who may produce CME/CPD content for the CAFP. Mitigation may include learner notification, peer review of content before presentation, requirement of EB-CME, changing topics, or even dismissing a potential faculty member.

It is the policy of the CAFP to ensure independence, balance, objectivity, scientific rigor, and integrity in all continuing education activities. All individuals with potential to influence the content of this program have submitted Disclosure of Interest declarations that have been reviewed according to policy. Learner notification of declarations is below. All individuals with relevant financial relationships with ineligible companies have been contacted by CAFP staff or CCPD members, and issues of conflict have been discussed and mitigated.

Faculty Disclosure:

Brent Sugimoto is founder and Chief Medical Officer of Decoded Health, a clinical automation software company. This relevant financial relationship has been mitigated.

All other faculty have no financial relationships with ineligible companies to disclose. Ineligible companies are those whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

CME Planners:

The following planners have no financial relationships with ineligible companies to disclose: Jerri Davis, Anita Charles

The AAFP has reviewed Family Medicine Initiative on Trauma Informed Care: Fundamentals of Adverse Childhood Experiences (ACEs) Screening and Response, and deemed it acceptable for AAFP credit. Term of approval is from 08/23/2022 to 08/23/2023. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Credit approval includes the following session(s):

  • 0.50 Enduring Materials, Self-Study AAFP Prescribed Credit(s) - Activity One: Trauma-Informed Care and ACEs Fundamentals
  • 0.50 Enduring Materials, Self-Study AAFP Prescribed Credit(s) - Activity Two: Tools for Trauma Informed Care
  • 0.50 Enduring Materials, Self-Study AAFP Prescribed Credit(s) - Activity Three: A Case for Trauma-Informed Care and Online Resources

Available Credit

  • 1.50 AAFP Prescribed
  • 1.50 AMA PRA Category 1 Credit™
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