The Deepest Well: Healing the Long-Term Effects of Childhood Trauma and Adversity—A Transformative Guide to Understanding Childhood Trauma and Health

by Nadine Burke Harris

If it wasn’t for the ACE scores, no one would have suspected that Lila and her brother were at such high risk for so many health and developmental problems. Possibly they might have gotten some attention if they’d started to show behavioral problems in preschool, but even in that case, it’s likely they would have been diagnosed with ADHD and been funneled down the medication path. If they had never manifested any behavioral symptoms, chances are—even if they developed asthma, or an autoimmune disease, or any of the other significant immunological consequences of toxic stress—the underlying problem would likely have gone undetected and untreated. Guthrie had shown that the only way to radically move the needle on patient outcomes is to screen universally, because otherwise you are relying on chance: The chance that Lila’s symptoms would get bad enough that her doctor asked more questions. The chance that this particular doctor had heard about ACEs and knew to ask those questions in the first place. How much damage could be done while you were waiting for the right questions to be asked, the right tests to be run? Guthrie knew. His sister-in-law knew. They saw what happened when PKU was not tested across the board, when the opportunity for early intervention was lost. That is why an ounce of screening is better than a pound of cure.