Asking Kids About Traumatic Stress- Our Research

February 22, 2013

As clinicians or researchers, we often turn to parents to tell us how their child is faring emotionally.  Parents are THE experts on their child, and are a great source of information about changes in a child’s usual behaviors.  But research and clinical experience have shown that parents may not always grasp a child’s emotional symptoms. After a scary event, it is crucial to ask children directly about their own traumatic stress reactions.

Until recently, there were no validated checklist or interview measures to do just that – ask children to tell us about their own reactions soon after a traumatic event.  An even bigger challenge was the gap in measures for Spanish-speaking children.  Many pediatric mental health measures are available only in English, or in informal translations that have never been subject to validation with Spanish-speaking children.

Our work is helping to address those gaps. We developed the first acute stress checklist for children (the Acute Stress Checklist for Kids, or ASC-Kids) in English, and then carefully created a Spanish version (Cuestionario de Estrés Agudo – Niños, or CEA-N) with input from bilingual mental health experts and from Spanish-speaking children. We also helped create the first Spanish language acute stress interview for children, working with colleagues who had validated an interview in English (the Diagnostic Interview for Children and Adolescents—Acute Stress Disorder, or DICA-ASD).

We recently published a paper in the Journal of Traumatic Stress reporting on a large multi-site study evaluating the ASC-Kids checklist and DICA-ASD interview for English-speaking and Spanish-speaking children. We worked with colleagues right here in Philadelphia, and at sites in Los Angeles and Miami, to enroll more than 200 children in each language (ages 8 to 17 years) in the study. All of the children had recently experienced a traumatic event such as an injury, accident, serious illness, or violence. 

What we found: Both the checklist and the interview appear to be reliable and valid tools to assess children in English or in Spanish.  While the interview allows a trained professional to assess a child’s symptoms in greater detail, the checklist can be administered quickly to children in situations where screening is needed. Either measure can help target support and intervention services to those children who need them.

Further English and Spanish resources to help children and parents after a traumatic event can be downloaded from www.HealthCareToolbox.org.