Abstract
Young children who experience abuse, neglect, domestic violence, and other interpersonal forms of trauma are at risk for developing complex psychological trauma. Timely referrals by child welfare services for trauma evaluation and intervention is critical, particularly during the developmentally-sensitive period of birth to three. However, few screening instruments exist that are feasible for implementation in child welfare services and none have reported psychometric data for children under three. The aim of this exploratory, retrospective study was to examine developmental differences in detection rates of two brief trauma screening scales, comparing outcomes for toddlers (age 1 and 2 years) and preschoolers (age 3 to 6 years), using the evaluation data from a statewide child welfare demonstration project. The sample included 151 children ages 1 to 6 participating in evidence-based trauma treatment with their caregivers. More than 80% of children, regardless of age group, met the cut-off on one of the screeners; children who met the cut-off on either screener were significantly more likely to have experienced domestic violence, physical abuse or poly-victimization. Implications for future research are discussed.
Similar content being viewed by others
References
Achenbach, T. M., & Rescorla, L. A. (2001). Manual for the ASEBA preschool forms & profiles. Burlington: University of Vermont, Research Center for Children, Youth, & Families.
Bartlett, J. D., Barto, B., Griffin, J. L., Fraser, J. G., Hodgdon, H., & Bodian, R. (2016). Trauma-informed care in the Massachusetts child trauma project. Child Maltreatment, 21(2), 101–112. https://doi.org/10.1177/1077559515615700.
Barto, B., Bartlett, J. D., Von Ende, A., Bodian, R., Noroña, C. R., Griffin, J., et al. (2018). The impact of a statewide trauma-informed child welfare initiative on children’s permanency and maltreatment outcomes. Child Abuse & Neglect, 81, 149–160. https://doi.org/10.1016/j.chiabu.2018.04.023.
Briere, J., Johnson, L., Bissada, A., Damon, L., Crouch, J., Gil, E., et al. (2001). Trauma symptom checklist for young children (TSCYC): Reliability and association with abuse exposure in a multi-site study. Child Abuse & Neglect, 25, 1001–1014. https://doi.org/10.1016/S0145-2134(01)00253-8.
Chadwick Trauma-Informed Systems Project. (2013). Creating trauma-informed child welfare systems: A guide for administrators (2nd ed.). San Diego: Chadwick Center for Children & Families.
Child Welfare Information Gateway (2016). Racial disproportionality and disparity in child welfare. Washington, D.C.: U.S. Department of Health and Human Services, Children’s Bureau. Retrieved from https://www.childwelfare.gov/pubPDFs/racial_disproportionality.pdf. Accessed 15 Nov 2017.
Cohen, J. A., & Scheeringa, M. S. (2009). Posttraumatic stress disorder diagnosis in children: Challenges and promises. Dialogues in Clinical Neuroscience, 11(1), 91–99.
Conradi, L., Agost, J., Tullberg, E., Richardson, L., Langan, H., Ko, S., & Wilson, C. (2011). Linking child welfare and mental health using trauma-informed screening and assessment practices. Child Welfare, 90(6), 129–147.
Cooper, J. L., Banghart, P., Aratani, Y. (2010). Addressing the mental health needs of young children in the child welfare system: What every policymaker should know. National Center for Children in Poverty. New York: Mailman School of Public Health. Columbia University. https://doi.org/10.7916/D8B56SPM.
Crandal, B. & Conradi, L. (2013). Review of child and adolescent trauma screening tools. San Diego, CA: Rady Children's Hospital, Chadwick Center for Children and Families. Retrieved from http://www.childsworld.ca.gov/. Accessed 15 Nov 2017.
D’Andrea, W., Ford, J., Stolbach, B., Spinazzola, J., & van der Kolk, B. A. (2012). Understanding interpersonal trauma in children: Why we need a developmentally appropriate trauma diagnosis. American Journal of Orthopsychiatry, 82, 187–200. https://doi.org/10.1111/j.1939-0025.2012.01154.x.
DeBellis, M. D., & Zisk, A. (2014). The biological effects of childhood trauma. Child & Adolescent Psychiatric Clinics North America, 23, 185–222. https://doi.org/10.1016/j.chc.2014.01.002.
Dehon, C., & Scheeringa, M. (2006). Screening for preschool posttraumatic stress disorder with the child behavior checklist. Journal of Pediatric Psychology, 31, 431–435. https://doi.org/10.1093/jpepsy/jsj006.
Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., et al. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The adverse childhood experiences (ACE) study. American Journal of Preventive Medicine, 14(4), 245–258. https://doi.org/10.1016/S0749-3797(98)00017-8.
Fraser, J. G., Griffin, J. L., Barto, B. L., Lo, C., Wenz-Gross, M., Spinazzola, R., et al. (2014). Implementation of a workforce initiative to build trauma-informed child welfare practice and services: Findings from the Massachusetts child trauma project. Children and Youth Services Review, 44, 233–242. https://doi.org/10.1016/j.childyouth.2014.06.016.
Hanson, R. F., Lang, J. M., Fraser, J. G., Agosti, J. R., Ake, G. S., Donisch, K. M., & Gewirtz, A. H. (2017). Trauma-informed care: Definitions and statewide initiatives. In J. R. Conte & J. B. Klika (Eds.), The APSAC handbook on child maltreatment, Fourth Edition. Thousand Oaks: Sage Publications, Inc..
Lang, J. M., Ake, G., Barto, B., Caringi, J., Little, C., Baldwin, M. J., & Connell, C. M. (2017). Trauma screening in child welfare: Lessons learned from five states. Journal of Child & Adolescent Trauma. https://doi.org/10.1007/s40653-017-0155-y.
Levendosky, A. A., Huth-Bocks, A. C., Semel, M. A., & Shapiro, D. L. (2002). Trauma symptoms in preschool-age children exposed to domestic violence. Journal of Interpersonal Violence, 17, 150–164. https://doi.org/10.1177/0886260502017002003.
Lewis-Beck, M. S., Bryman, A., & Liao, T. F. (2004). The SAGE Encyclopedia of Social Science Research Methods. Thousand, Oaks: SAGE Publications, Inc. https://doi.org/10.4135/9781412950589.
Lieberman, A. F., & Van Horn, P. (2007). Assessment and treatment of young children exposed to traumatic events. In J. Osofsky (Ed.), Young children and trauma (pp. 111–138). New York: Guilford Press.
Lieberman, A. F., Chu, A., Van Horn, P., & Harris, W. (2011). Trauma in early childhood: Empirical evidence and clinical implications. Development and Psychopathology, 23, 397–401. https://doi.org/10.1017/S0954579411000137.
Lieberman, A. F., Ghosh Ippen, C. & Van Horn, P. (2015). Don’t hit my mommy!: A manual for child-parent psychotherapy with young children exposed to violence and other trauma. Zero to three. Washington, D.C.
Loeb, J., Stettler, E. M., Gavila, T., Stein, A., & Chinitz, S. (2011). The child behavior checklist PTSD scale: Screening for PTSD in young children with high exposure to trauma. Journal of Traumatic Stress, 24(4), 430–434. https://doi.org/10.1002/jts.20658.
National Child Traumatic Stress Network (2010). Core clinical characteristics trauma detail form. Retrieved from http://www.nctsn.org
Osofsky, J.D., Lewis, M.L., & Szrom, L. (2018). The adverse childhood experiences of very young children and their parents involved in infant-toddler court teams: A policy brief from the Quality Improvement Center for Research-Based Infant-Toddler Court Teams. Retrieved from http://www.qicct.org/sites/default/files/ACES%20Policy%20Brief% 20%20v4%20%28003%29.pdf. Accessed 1 June 2018.
Rosner, R., Arnold, J., Groh, E.-M., & Hagl, M. (2012). Predicting PTSD from the child behavior checklist: Data from a field study with children and adolescents in foster care. Children and Youth Services Review, 34, 1689–1694. https://doi.org/10.1016/j.childyouth.2012.04.019.
Scheeringa, M.S. (2010). Young child PTSD and young child PTSD Screen. Retrieved from https://www2.tulane.edu/som/departments/psychiatry/ScheeringaLab/manuals-training.cfm. Accessed 15 Nov 2017.
Scheeringa, M., & Haslett, N. (2010). The reliability and criterion validity of the diagnostic infant and preschool assessment: A new diagnostic instrument for young children. Child Psychiatry & Human Development, 41(3), 299–331. https://doi.org/10.1007/s10578-009-0169-2.
Scheeringa, M.S., & Zeanah, C.H. (1994). PTSD Semi-Structured Interview and Observational Record for Infants and Young Children. New Orleans, LA: Department of Psychiatry and Neurology, Tulane University Health Sciences Center.
Scheeringa, M. S., Peebles, C. D., Cook, C. A., & Zeanah, C. H. (2004). Toward establishing procedural criterion and discriminant validity for PTSD in early childhood. Journal of the American Academy of Child & Adolescent Psychiatry, 40(1), 52–60. https://doi.org/10.1097/00004583-200101000-00016.
Shapiro, S. S., & Wilk, M. B. (1965). An analysis of variance test for normality. Biometrika, 52, 591–611.
StataCorp. (2015). Stata statistical software: Release 14. College Station: StataCorp LP.
Stover, C. S., & Berkowitz, S. (2005). Assessing violence exposure and trauma symptoms in young children: A critical review of measures. Journal of Traumatic Stress, 18(6), 707–717. https://doi.org/10.1002/jts.20079.
Taylor, N., Steinburg, A., & Wilson, C. (2006). The child welfare trauma referral tool. San Diego: Chadwick Center for Children and Families, Rady Children’s Hospital - San Diego.
U.S. Department of Health & Human Services, Administration for Children and Families, Administration on Children, Youth and Families, Children’s Bureau (2017). Child Maltreatment 2015. Retreived from http://www.acf.hhs.gov/programs/cb/research-data-technology/statistics-research/child-maltreatment.
Zero to Six Collaborative Group, National Child Traumatic Stress Network. (2010). Early childhood trauma. Los Angeles & Durham: National Center for Child Traumatic Stress.
Zero to Three. (2005). Diagnostic classification of mental health and developmental disorders of infancy and early childhood: Revised edition (DC: 0--3R). Washington, D.C.: Zero to Three Press.
Zero to Three (2016). DC:0-5™ Diagnostic classification of mental health and developmental disorders of infancy and early childhood: Revised edition. Washington, D.C., Zero to Three Press.
Acknowledgements
The authors wish to acknowledge Dr. Carolyn Schwartz and DeltaQuest Foundation, Inc. for statistical and conceptual support.
Funding
The study was supported by a grant from the Administration for Children and Families, Children’s Bureau (Grant No. 90C01057) to the Massachusetts Department of Children and Families.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of Interest
The authors declare that they have no conflicts to report.
Ethical Standards and Informed Consent
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation [institutional and national] and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study.
Additional information
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Fraser, J.G., Noroña, C.R., Bartlett, J.D. et al. Screening for Trauma Symptoms in Child Welfare-Involved Young Children: Findings from a Statewide Trauma-Informed Care Initiative. Journ Child Adol Trauma 12, 399–409 (2019). https://doi.org/10.1007/s40653-018-0240-x
Published:
Issue Date:
DOI: https://doi.org/10.1007/s40653-018-0240-x