in Children and Adolescents Definition A significant number of children in American society are exposed to traumatic life events A traumatic event is one that threatens injury death or the physical integrity of self or others and also causes the victims to feel horror terror or helpless ID: 425741
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Slide1
Trauma in Children and AdolescentsSlide2
Definition
A significant number of children in American society are exposed to traumatic life events.
A traumatic event is one that threatens injury, death, or the physical integrity of self or others and also causes the victim(s) to feel horror, terror, or helplessness at the time it occurs.
Traumatic events can include sexual abuse, physical abuse, domestic violence, community and/or school violence, medical trauma, motor vehicle accidents, acts of terrorism, war experiences, natural and human-made disasters, suicides, or other traumatic losses. Slide3
Statistics
In community samples, more than two-thirds of children report experiencing a traumatic event by age 16 years.
A child has
a
39 to
85 percent estimated rate of witnessing community violence.
The estimated rate of victimization can be as high as 66
percent.A youths’ exposure to sexual abuse is estimated to be between 25 and 43 percent.Slide4
StatisticsChildren and adolescents make up a substantial proportion of the nearly 2.5 billion people affected worldwide by disasters in the past decade.
It is more common than not for a child or adolescent to be exposed to more than one single traumatic event.
Children exposed to chronic and pervasive trauma are especially vulnerable to the impact of subsequent trauma.Slide5
Signs and Symptoms
Children and adolescents vary in the nature of their responses to traumatic experiences; however, nearly all children and adolescents express some kind of distress or behavioral change in the acute phase of recovery from a traumatic event. Slide6
Symptoms May Include:
Preschoolers:
Thumb sucking, bedwetting, clinging to parents, sleep disturbances, loss of appetite, fear of the dark, regression in behavior, withdrawal from friends and routines.
Elementary-school children:
Irritability, aggressiveness, clinginess, nightmares, school avoidance, poor concentration, withdrawal from activities and friends.
Adolescents:
Sleeping and eating disturbances, agitation, increase in conflicts, physical complaints, delinquent behavior, poor concentration.Slide7
Recovery
The majority of children and adolescents manifest resilience in the aftermath of traumatic experiences. This is especially true of single-incident exposure.
Youths who have been exposed to multiple traumas, have a past history of anxiety problems, or have experienced family adversity are likely to be at higher risk of showing symptoms of posttraumatic stress.Slide8
Recovery
Research has provided evidence about predictors of trauma recovery, although there are no perfect predictors. Recovery can be impeded by:
Individual and family factors
The severity of ongoing life stressors
Community stress
Prior trauma exposure
Psychiatric comorbidities
Ongoing safety concerns
Poverty and racism
Caretaker responses to traumaSlide9
RecoveryOn a positive note, individual, family, cultural, and community strengths can facilitate recovery and promote resilience. Social, community, and governmental support networks are critical for recovery, particularly when an entire community is affected, as when natural disasters occur.Slide10
TreatmentA
substantial minority of children develop severe acute or ongoing psychological symptoms.
Most children and adolescents with traumatic exposure or trauma-related psychological symptoms are not identified and, consequently, do not receive any help. Those who do receive a wide variety of treatments.Slide11
TreatmentLiterature has focused largely on adults until recently and limited empirical data is available on the application of treatments with children and adolescents with traumatic
exposure.
Cognitive–behavioral therapy (CBT) techniques have been shown to be effective in treating children and adolescents who have persistent trauma
reactions.
Most evidence-based, trauma-focused treatments include opportunities for the child to review the trauma in a safe, secure environment under the guidance of a specially trained mental health
professional.Slide12
Role of Mental Health Professionals
Mental health professionals have an important role in facilitating the recovery of children, adolescents, and families when traumatic events occur. Opportunities include:
Working with first responders and community organizations that serve families with children
W
orking with existing clients who experience trauma
R
eaching out to help children and families affected by trauma in their community
Developing and implementing research studies to determine effective, evidence-based treatmentsPsychologists and other mental health providers can also register with the American Psychological Association’s (APA) Disaster Response Network or volunteer their services through their local chapter of the American Red CrossSlide13
Role of Assessments
Using standardized, well-established measures helps to ensure efficient assessment and diagnosis, as well as provides critical information for treatment design.
Enables tracking of symptom progression in the recovery process and return-to-baseline functioning.
Aids in the identification of co-morbid conditions.
Facilitates broad screening for traumatic exposures upon intake or in community and agency settings.Slide14
Assessments of Trauma and Child Abuse
Trauma
Symptom Checklist for Young
Children
™ (TSCYC™
)
Trauma
Symptom Checklist for Children™ (TSCC
™
)
Trauma Symptom Checklist™ Software Portfolio (TSC
™
-SP)
Checklist for Child Abuse
Evaluation (CCAE)
Child Sexual Behavior
Inventory (CSBI
™
)
House-Tree-Person and Draw-A-Person as Measures of Abuse in Children: A Quantitative Scoring
System (H-T-P/D-A-P)Slide15
Assessments of DepressionReynolds
Child Depression
Scale
™
-2nd Ed. and Short Form (RCDS
™
-2 and RCDS
™-2:SF)Reynolds
Adolescent Depression
Scale, 2
nd
Ed. and Short Form (RADS-2
™
and RADS-2
™
:SF)
Clinical
Assessment of
Depression™ and Scoring Program (CAD
™
and CAD
™
SP)
Adolescent
Psychopathology
Scale™
and
Short Form (APS
™
and APS-SF
™
)
Personality
Assessment
Inventory
®
- Adolescent (PAI
®
-A)
Reynolds Depression Screening Inventory
™
(RDSI
™
) Slide16
Assessments of Anxiety/Irritability
Adolescent Psychopathology Scale
™
and Short Form (APS
™ and APS-SF™
)
Personality Assessment Inventory
®- Adolescent (PAI®-A)
Clinical
Assessment of
Behavior
™
(CAB
™
)
Slide17
Assessments of Behavioral Disturbance(Sleep disruption, acting out, loss of appetite, somatic complaints, etc.)
Emotional
Disturbance Decision
Tree
™
(EDDT
™
)Eyberg
Child Behavior
Inventory
™
(ECBI
™
)
Sutter-
Eyberg
Student Behavior
Inventory-Revised
™
(SESBI-R
™
)
Clinical
Assessment of
Behavior
™
(
CAB
™
)
Pediatric
Behavior Rating
Scale
™
(PBRS
™
)
Personality Assessment Inventory
®
-Adolescent
(PAI
®
-A)
Revised
Behavior Problem Checklist-PAR
Edition (RBPC)
Children’s
Aggression
Scale
™
(CAS)
Reynolds Adolescent Adjustment Screening Inventory
™
(RAASI
™
)Slide18
Assessments of Interpersonal Relationships
Parenting
Stress
Index
™, 4th
Ed. (PSI
™
-4)Stress Index for Parents of Adolescents™ (SIPA
™
)
Clinical Assessment of Interpersonal Relationships
™
(CAIR
™
) Slide19
Risk AssessmentsPsychosocial Evaluation & Threat Risk Assessment
™
(PETRA
™
)Structured Assessment of Violence Risk in Youth
™
(SAVRY
™)Suicidal Ideation Questionnaire (SIQ)
Adolescent & Child Urgent Threat Evaluation
™
(ACUTE
™
)
Firestone Assessment of Violent Thoughts
™
-Adolescent (FAVT
™
-A)Slide20
References and Resources
2008 Presidential Task Force on Posttraumatic Stress Disorder and Trauma in Children and Adolescents
http://www.apa.org/pi/families/resources/children-trauma-update.aspx
Coping With a Disaster or Traumatic Event: Information for Individuals and Families
http://www.bt.cdc.gov/mentalhealth/general.asp
Post-Traumatic Stress Disorder (PTSD)
http://www.nimh.nih.gov/health/publications/post-traumatic-stress-disorder-ptsd/index.shtml
Treatments That Work
http://www.nctsnet.org/resources/audiences/parents-caregivers/treatments-that-work
Topic Specific Resources: Trauma and Justice
http://
www.samhsa.gov/children/earlychildhood_trauma.asp
How
Children Cope With Trauma and Ongoing Threat
http://www.nasponline.org/resources/crisis_safety/ongoingthreat.aspx