The Child Trauma Screen is an assessment tool to identify children ages 6-17 who are experiencing symptoms of traumatic distress (Lang & Connell, 2018). It is short, free, and meant for use by a variety of professionals working with children. It is not meant to be comprehensive and screen for all possible symptoms or reactions, but rather a quick initial step to identify the most common reactions and exposures, for further follow up of clinical treatment or more comprehensive assessment. It is recommended to be conducted using an in-person interview, but it can also be used as a self-report measure, and also recommended to get both reports from the child and the caregiver or multiple caregivers. One concern I noted for the Child Trauma Screen is that all three of the studies listed on its hosted website which found it valid and reliable were all conducted by the creator of the screen (Child Health and Development Institute of Connecticut, Inc., 2021).
The context which I would use this assessment personally is within my practice as a Licensed Professional Counselor and Registered Play Therapist, specializing in treating trauma in children and adolescents. An ethical consideration is that if a child reports any abuse, I would need to report it to the Child Welfare office. Another consideration that I would prefer is to first have several sessions with the child to build rapport and safety before administering the screen, and I would also request that the parent leave the room. The child may not feel comfortable sharing in front of their parent for a variety of reasons, such as not wanting to upset them, fear over their reaction, or the parent instigating the abuse.
Reducing traumatic exposure for children and adolescents may ultimately not be possible, although developing better prevention and interventions to interrupt cycles of abusers could make a large difference. Still, trauma is present in nearly all of our lives (van der Kolk & McFarlane, 1996). In reducing the burden of trauma on children and adolescents, I believe we should instead focus on creating resilient support systems which help children process trauma in healthy ways and develop skills for self- and co-regulation of emotions.
See this image below depicting Bronfenbrenner’s Ecological Theory or socio-ecological model (Stanger, 2011). Using this theory, we could construct levels of systems, which all interact and influence each other, embedding resilience building factors into each level. Such a design might buffer negative mental health impacts for children after experiencing traumatic events.
Here is another image which shows the same concept but in a slightly different way which may be helpful (University of Minnesota, n.d.).
This same resource listed multiple ideas on how to apply this model in practical applications. I believe these would apply to reducing the burden of trauma on children, adults, families, communities, society, and so on.
- Promote individual and family solutions to support mental well-being (e.g., self-efficacy)
- Learn and teach others to manage stress and cope with adversity
- Provide health education to support parent-child/caregiver-child relationships
- Promote social connections – between family, neighbors, employees, etc.
- Expand youth development in schools
- Increase skill-based learning to promote adaptability, coping and resilience
- Coordinate mental health prevention efforts at the federal, state, and local levels
- Support local communities taking an active role in co-creating solutions
- Increase collaboration between service organizations to strengthen service coverage, access and the referral process for a more integrative, comprehensive approach
- Leverage the role of service providers to increase natural social support systems
- Fund mental health promotion research and community-based supports
- Promote equitable resource allocation
(University of Minnesota, n.d., par. 8).
References
Child Health and Development Institute of Connecticut, Inc. (2021). Child Trauma Screen. https://www.chdi.org/our-work/mental-health/trauma-informed-initiatives/ct-trauma-screen-cts/
Lang, J., & Connell, C. (2018). The Child Trauma Screen: A follow-up validation. Journal of Traumatic Stress, 31(4), 540-548.
Stanger, N. (2011). Moving “eco” back into socio-ecological models: A proposal to reorient ecological literacy into human developmental models and school systems. Human Ecology Review, 18, 167-173.
University of Minnesota. (n.d.). Mental health and well-being ecological model. Center for Leadership Education in Maternal & Child Public Health. https://mch.umn.edu/resources/mhecomodel/
Van der Kolk, B.A. & McFarlane, A.C. (1996). Traumatic Stress: The Effects of Overwhelming Experience on Mind, Body, and Society. New York, NY: The Guilford Press.