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"The science of ACEs and resilience shines a light on the importance of the moment-by-moment relational experiences of children to their healthy brain, body and socio-emotional development, not only of our children, but our entire population.

The science requires a paradigm shift in how we think about child development, human health, social problems and the skills and requirements for our own well-being, which we can learn."-Dr. Christina Bethell, oral testimony.

At the CAHMI, we work to prioritize possibilities to advance child, family and whole-population health and well-being through policy, research, and practice.


The Prioritizing Possibilities National Agenda


With growing knowledge of the science of adversity comes an increased need to address childhood trauma. Promoting the development of positive health, such as resilience, engagement in life, and the safe, stable, and nurturing relationships is essential to child development and well-being. Given high rates of adversity, healing is prevention.


Addressing adverse childhood experiences and promoting social and emotional skills of the entire population is essential. In 2017, the CAHMI proposed the National Prioritizing Possibilities for Child and Family Health Agenda to address these issues. The National Agenda aims to transform the health care system through trauma-informed policy and practice.



Dr. Bethell is passionate about shifting the narrative from Adverse Childhood Experiences to Positive Childhood Experiences... read more about the power of PCEs by exploring the resources below!

Read about how Dr. Bethell's framework shaped the new American Academy of Pediatrics Policy Statement

Read about how Dr. Bethell envisions we can turn the pandemic in to a PCE!

Establishing the National Agenda


Over a four-year period, the Child and Adolescent Health Measurement Initiative (CAHMI) and Academy Health engaged more than 500 people across multiple sectors in a rigorous process to establish a national agenda to address ACEs. It began with the first-ever available national and state level data on ACEs, resilience, and family functioning from the 2011–12 National Survey of Children’s Health. To develop the agenda, a series of in-person meetings and listening forums were conducted along with several rounds of online crowdsourcing to identify goals and priorities across 10 stakeholder groups; educational sessions with stakeholders; and a range of research-in-action; coupled with community efforts.

From this process, the following emerged:


  • A special issue of Academic Pediatrics devoted to ACEs
  • Four overarching agenda priorities to address ACEs and promote child wellbeing in children’s health services;
  • Four specific areas of research that will advance these agenda priorities; and
  • Sixteen short-term actions and recommendations, each of which leverages existing research, policy, and practice systems and structures.

Payment for Progress: Investing to Catalyze Child and Family Well-Being Using Personalized and Integrated Strategies to Address Social and Emotional Determinants of Health


This report summarizes findings from a 2017-2018 conducted by the CAHMI and Academy Health and supported by the Children’s Hospital Association:  “Payment Transformation to Address Social and Emotional Determinants of Health for Children”. Over 18 months, the project engages stakeholders and experts in a process to take stock of current children’s health care payment models and identified requirements to advance both payment and care models that enable a focus on assessing and addressing children’s social and relational health risks and proactively promoting positive child and family health and resilience.  This work grew out of the CAHMI and AcademyHealth Prioritizing Possibilities National Agenda to Address Adverse Childhood Experiences and Foster the Social and Emotional Roots of Well-being.

From this report, three broad Priority Recommendations emerged and are delineated in the report as follows:

  1. Pay to Improve Child and Family Well-Being
  2. Support Enhanced and Personalized Well-Child Care
  3. Build Sustainable Capacity for Transformation

Read the report here!


Positive Health Partners


The CAHMI strives to be a partner in positive health with various organizations, institutions, and individuals. It is through partnership that advancements can truly be made in child health. Read more about some of our key partnerships below.


HOPE and the New Science of Thriving Summit


In March 2016, the CAHMI collaborated with the Children’s Hospital Association, the Center for the Study of Social Policy, Prevent Child Abuse America, and Health Resources in Action to coordinate and host a summit on “Hope and the New Science of Thriving,” with participants from many fields, including research, health care, health systems, policy, philanthropy, and more.


Read the summit proceedings here!


Center for Trauma-Informed Policy and Practice

The CAHMI’s director, Dr Christina Bethell, serves on the board of the Center for Trauma-Informed Policy and Practice. Read more about this work here!


Promoting Possibilities at the 2019 Congressional Hearing on Childhood Trauma


In 2019, Congress held its first-ever hearing on childhood trauma titled “Identifying, Preventing, and Treating Childhood Trauma: Pervasive Public Health Issue that Needs Greater Federal Attention.” Dr. Christina Bethell delivered expert testimony at this hearing.

Click here to read about and watch the full hearing!

Watch Dr. Bethell’s opening statement

Watch Dr. Bethell’s Q and A with Rep. Alexandria Ocasio-Cortez


Prioritizing Possibilities Resources:


View these resources to learn about how the CAHMI prioritizes possibilities for children, youth, and families through our work!

Research Papers and Reports:


Presentations, Webinars, and Media: