Background and Objectives: Whereas adverse early life experiences (ACEs) correlate with cognitive, emotional and physical health at the population level, existing ACEs screens are only weakly predictive of outcomes for an individual child. This raises the possibility that important elements of the early-life experiences that drive vulnerability and resilience are not being captured. We previously demonstrated that unpredictable parental and household signals constitute an ACE with cross-cultural relevance. We created the 5-item Questionnaire of Unpredictability in Childhood (QUIC-5) that can be readily administered in pediatric clinics. Here, we tested if combined screening with the QUIC-5 and an ACEs measure in this real-world setting significantly improved prediction of child health outcomes. Methods: Leveraging existing screening with the Pediatric ACEs and Related Life Events Screener (PEARLS) at annual well-child visits, we implemented QUIC-5 screening in 19 pediatric clinics span