Identifying and Providing Services to Young Children Who Have Been Exposed to Trauma: For Professionals

Due to the particular developmental risks associated with young children's traumatic experiences, it is essential that vulnerable children be identified as early as possible after the trauma. Many community resources—including health systems, Early Intervention programs, child welfare agencies, Head Start, child care programs, and early education systems—play an important role in identifying children, and in linking them and their families with services.

Some of these systems now try to address possible traumatic experiences by including questions about specific traumas into their intake and/or assessment protocols. For example, both Head Start and Early Intervention intake protocols include questions about domestic violence in families. Other protocols may include targeted questions about accidents, loss of family members, and/or significant medical history.

The series NCTSN series "Young Children and Trauma: Service System Collaborations," features presentations by Network members on providing consultation to service systems. Access the free online series in the NCTSN Learning Center for Child and Adolescent Trauma.

For Mental Health Professionals

Behavioral Health Assessment
Assessment of trauma in young children must focus on the presenting problem in the context of the child's overall development. This information can be gathered though interviews with the parents/significant caregivers in the child's life, observation of the parent/caregiver-child interaction, and standardized assessment tools. Clinical assessment should include review of the specifics of the traumatic experience(s) including:

  • Reactions of the child and parents/caregivers
  • Changes in the child's behavior
  • Resources in the environment to stabilize the child and family
  • Quality of the child's primary attachment relationships
  • Ability of parents/caregivers to facilitate the child's healthy socioemotional, psychological, and cognitive development

Instruments for Assessing Traumatic Stress In Young Children

Below is a list of some of the standardized instruments used within the NCTSN to assess traumatic stress in young children.

  • Child Behavior Checklist (CBCL): Achenbach, and Rescorla (2001)―aged 1½–5
  • Posttraumatic Stress Disorder Semi-Structured Interview and Observation Record: Scheeringa and Zeanah (1994)―aged 0–4
  • Posttraumatic Symptom Inventory for Children (PT-SIC): Eisen (1997)―aged 4–8
  • Preschool Age Psychiatric Assessment (PAPA): Egger and Angold (1999)―aged 2–5
  • PTSD Symptoms in Preschool Aged Children (PTSD-PAC): Levendosky, Huth-Bocks, Semel, and Shapiro (2002)―aged 3–5
  • Traumatic Events Screening Inventory-Parent Report Revised (TESI-PRR): Ghosh et al. (2002)―aged 0–6
  • Trauma Symptom Checklist for Young Children (TSCYC): Briere et al. (2001)―aged 3–12
  • Violence Exposure Scale for Children-Preschool Version (VEX-PV): Shahinfar, Fox, and Leavitt (2000)―aged 4–10
  • Violence Exposure Scale for Children-Revised Parent Report (VEX-RPR): Shahinfar, Fox, and Leavitt (2000)―for parents of preschool-aged children aged 4–10

Instruments for Assessing Parenting Stress and Strengths

  • Life Stressor Checklist―Revised (LSC-R): Wolfe, Kimerling, Brown, Chrestman, and Levin (1996)
  • Parenting Stress Index (PSI): Abidin (1995)
  • Davidson Trauma Scale (DTS): Davidson (1996)

When conducting an assessment of a young child, it is also important to assess developmental delays (e.g., gross/fine motor, speech/language, sensory processing), which may indicate that the child could benefit from evaluation and/or services from another professional (e.g., occupational therapist, speech/language therapist, physical therapist). It is often helpful to consult and/or to work collaboratively with these professionals.

For Medical Professionals 

Screening/Assessment in Health Settings
Most young children are seen at regular intervals by providers in the pediatric health care system, enabling repeated opportunities for identifying early childhood trauma.

Medical providers can also play an important role in diminishing risks and in maximizing protective factors associated with young children's exposure to trauma. They can supply information to prevent accidents and can incorporate questions about stressful and traumatic experiences into their interviews with families.

Resources for Identifying Traumatic Stressors in Young Children

Online resources

Journal articles:

  • Cohen, J. A., Kelleher, K. J., & Mannarino, A. P. (2008). Identifying, treating, and referring traumatized children: The role of pediatric providers. Archives of Pediatrics and Adolescent Medicine, 162(5), 447-452.
  • Dehon, C., & Scheeringa, M. S. (2006). Screening for preschool posttraumatic stress disorder with the Child Behavior Checklist. Journal of Pediatric Psychology, 31(4), 431-435.

For Early Educators and Childcare Providers

Educators and childcare providers may inquire about children's safety; offer resources to reestablish safety for families; and, most importantly, support young children's learning through nurturing relationships, and through predictable expectations and routines in the classroom.

Resources for Educators

Online resources
   Center on the Social and Emotional Foundations for Early Learning
     For Teachers/Caregivers

 Head Start

    NCTSN

    Scholastic.com

Print resource

  • Rice, K. F., & Groves, B. M. (2005). Hope and healing: A caregiver's guide to helping young children affected by trauma. Washington, D.C.: Zero to Three Press.

For Family Court Judges and Staff

The more that family court judges know about child development and the effects of child trauma, the better equipped they are to make decisions regarding permanency planning for abused and neglected children, to improve the lives of children who have witnessed domestic violence, and to adjudicate custody and visitation cases.

Online resources
    NCTSN

    Safe Start Center

Multimedia resource
    Zero to Three

  • Helping Babies from the Bench: Using the Science of Early Childhood Development in Court (DVD): To access an order form to request this DVD, click here.

For Faith-Based, Community, and Mentoring Organizations

Community and faith-based organizations have in-depth knowledge of the resources and challenges in their communities. They play a vital role in linking families to resources that help stabilize and support them in the aftermath of trauma events. Advocating for families and increasing access to care can help families begin their recovery process.

Resources for Community Organizations