Trauma Screening in Child Welfare: Lessons Learned from Five States

The Child Trauma Screen: A Follow‐Up Validation

“…This follow‐up study provides additional support for the reliability and validity of CTS scores with a large clinical sample of children as well as descriptive statistics representing a general sample of children seeking outpatient behavioral health services. Results were generally consistent with our hypotheses and results from a previous study with a smaller sample (Lang & Connell, ) Rates of PTE exposure and PTSD symptoms were consistent across studies as were internal consistency and convergent validity with an established measure of PTSD, which were good to excellent. Agreement between child and parent report was only modest, consistent with what has been reported in prior research.…”

“…The CTS may be particularly useful in settings in which longer measures are not feasible and when screening large numbers of children. For example, the CTS is already being used in child welfare (Lang et al., ) and juvenile justice systems and could be useful in pediatric primary care, schools, and domestic violence shelters as well as a range of behavioral health settings. The CTS may also serve to complement existing broadband behavioral health screening measures, which rarely include items about trauma exposure or PTSD symptoms and therefore may under‐identify youth suffering from traumatic stress.…”

Reconsidering Our Domestic Violence System

“…Gains have been made within North Carolina's child welfare system, where trauma exposure is more routinely assessed and addressed. A recent study found domestic violence to be the primary form of trauma exposure for children in North Carolina's child welfare system [1]. Some programs are becoming more responsive to the impact of domestic violence given the toll it takes on overall results of maternal and child health programs.…”

“…Consider possible cases, like the police officer who discovers the 3-year-old cowering in her closet; the sheriff's deputy who serves a defendant at his job as a pastor; the judge who is asked to decide custody and visitation arrangements in a domestic violence protective order hearing; and the juvenile court counselor whose assessment of a 12-year-old suggests the youth is consumed with protecting his siblings from his mother's abusive boyfriend. There is the child protective services worker [1] who interviews an abused parent who refuses to relocate to a shelter, and the domestic violence shelter that does not have the capacity to shelter all siblings, or whose rules prohibit sheltering a 14-year-old male child. Consider the nurse who is told by a mother that her husband forbids vaccinations or follow-up medical visits for the children, and the ER doctor who treats a child for a broken arm and observes injuries on the child's parent.…”

“…A deeper chasm of consensus exists when children are involved (and when victims and perpetrators are parents). And children are very often involved [1].…”