Assessing Acute Stress Symptoms in Children Bilingually

March 18, 2014

Childhood Trauma by the Numbers:

> 20 million US children suffer unintentional injuries annually, leading to:

> 8 million visits to a hospital Emergency Department (ED) and

> 200,000 children admitted for observation and/or treatment.

66% of urban adolescents and 40% of suburban adolescents report being victims of violence.

Thousands of youth are exposed to residential fires, natural disasters and other traumatic events each year.

Historically, a lack of validated assessment measures in Spanish has hampered accurate assessment of Spanish-speaking Latino children in the US. We are working to close this gap by developing and validating measures of acute traumatic stress symptoms in both English and Spanish for children. These measures help our Post-injury Care and Recovery (PICAR) team and others improve post-injury assessment of psychological and emotional reactions and reach a wider range of children and adolescents.

In a recently published paper with our colleagues at Children’s Hospital Los Angeles, we reported on the emotional impact of a variety of difficult and frightening events for children and adolescents. In this study we enrolled a large, multi-ethnic sample of nearly 500 English- and Spanish-speaking children in three US cities who had experienced a range of potentially traumatic events and conducted assessments in either English or Spanish. Many had been injured, while others had been through another kind of medical event that brought them to a hospital or had seen or experienced violence. We assessed acute traumatic stress symptoms, depression symptoms, and anxiety symptoms within a month of the acute event and found that these three types of reactions were associated with each other. In other words, children with greater acute stress also tended to report more severe depression and anxiety symptoms. 

We utilize this data to help us develop the tools that can help make trauma-informed care a reality and help increase our understanding of post-injury emotional and physical recovery.

Primary care providers and ED nurses and doctors are often among the first to see children exposed to acute traumatic events resulting in injury, which include traffic crashes, house fires, natural disasters, and violent mass trauma. Accurate early assessment of children’s acute stress reactions, as well as other psychological symptoms of depression or anxiety, can help clinicians serve the immediate needs of distressed children. This assessment can be a key element in trauma-informed pediatric healthcare.

Read more about the ASC-Kids checklist and the DICA-ASD interview for English-speaking and Spanish-speaking children.