Center for Injury Research and Prevention

Post-injury Traumatic Stress: Current Research

After the Injury – Child Injury Care – CIRP
A parent tip sheet from AfterTheInjury.org

Pediatric injury recovery is a challenging process for most injured children and their families and includes both physical and emotional/psychological health and recovery following an injury.

For two decades, the Child and Adolescent Reactions to Injury and Trauma (CARIT) research program has conducted studies examining the range of responses that children (and their parents) experience during pediatric injury recovery, including child and parent coping strategies. Our studies have found that psychological distress, including symptoms of posttraumatic stress disorder (PTSD), occurs in significant numbers of children and parents after unintentional injuries, interpersonal violence, and other difficult medical events.

Through the CARIT research program, the Center is adding to our understanding of how children and parents manage the emotional impact of pediatric injury, developing and testing screening tools and intervention methods to promote emotional healing, and testing ways to integrate these tools into medical care. Current research in pediatric injury recovery focuses on learning more about how children and parents interact as they cope with injury, disseminating web-based interventions for parents (www.AfterTheInjury.org) and clinicians (www.HealthCareToolbox.org), and developing innovative eHealth tools for children to help manage traumatic stress.

The Center is also examining the impact of pediatric disability on families. Physical disability, cognitive disability, and diminished quality of life can have short- or long-term effects on children. While severely disabling injuries can profoundly change a child and create a "new normal" that requires significant adaptation and re-integration into society, even seemingly minor function or life impairments following injury can also be very challenging.

Current Areas of Pediatric Injury Recovery Research

  • Understanding Children's and Parents' Responses and Coping After Injury -- Our studies stem from the experiences of children and parents who are dealing with acute injuries. Research at the Center is advancing the scientific foundation for interventions by understanding how children and parents react and cope after an injury.
  • Prospective Studies of Acute Child Trauma and Recovery (PACT/R) Data Archive -- Our Center leads this international collaboration archiving and organizing previously collected prospective data on PTSD, risk, and protective factors in children following injuries and other acute traumatic events - across multiple studies and countries. By making data available to researchers around the world, the PACT/R Archive will have a continuing impact on child trauma research and treatment. The Archive currently includes data from child trauma studies in the U.S., Australia, and Europe.
  • eScreen -- In collaboration with Radiant Creative, LLC, our team is developing and validating a new eHealth screening system, “eScreen”, for post-hospital pain, posttraumatic stress symptoms, and functional recovery in school age children that can guide follow-up care from parents and healthcare providers.
  • Pediatric Resuscitation Quality Improvement Project -- Working with researchers in the Emergency Department at CHOP and other community-based hospitals, this project will provide novel, practical methods for community Emergency Departments (EDs) to improve pediatric resuscitation performance with the resources they have at hand. Our team will create effective new quality improvement tools to assess and improve resuscitation care, including family-centered care. A web-based platform will engage the community of practicing clinicians and other experts in EDs nationwide in sharing their quality improvement tools and experiences.

Creating and Disseminating Information and Interventions

  • Trauma Informed Care Approach and Training – With support from the Violence Prevention Initiative, CIRP researchers are developing and testing frameworks for a systems-based approach to trauma-informed care for those who work with children. Our team works with doctors and nurses to develop and evaluate ways to incorporate prevention of traumatic stress and promotion of emotional recovery within pediatric medical settings. Our trauma-informed care training efforts grow directly from our research in this area.
  • Helping Parents Help Their Injured Child --  AfterTheInjury.org is CIRP's award-winning website that helps parents help their children recover emotionally from an injury. Our team has evaluated the site's impact on parent knowledge, and we continue to develop and evaluate ways to ensure that parents find the website when they need it.
  • Secondary Prevention of Traumatic Stress through Pediatric Trauma Care -- Our team works with doctors and nurses to develop and evaluate ways to incorporate prevention of traumatic stress and promotion of emotional recovery within pediatric medical settings. Our trauma-informed care training efforts grow directly from our research in this area.
  • The Cellie Coping Kit -- Originally designed for pediatric cancer patients by CHOP psychologists, the Cellie Coping Kit includes a stuffed toy named Cellie, coping cards, and a book for caregivers. The Cellie Coping Kit can be used at home, in the clinic or in the hospital and provides children with over 100 tips for dealing with numerous medically-related stressors, such as medical procedures, hospital visits, and feelings of fear and uncertainty. The Cellie Coping Kit is currently available for several medical conditions, including cancer (English and Spanish), sickle cell disease, and food allergy as well as injury. Our team is currently collaborating with colleagues at CHOP and the University of Kentucky to adapt the coping kit for eosinophilic esophagitis (EOE) and motility disorders of the gastrointestinal track.
  • Center for Pediatric Traumatic Stress (CPTS) --The Center for Pediatric Traumatic Stress (CPTS) at CHOP addresses medical trauma in the lives of children and families. The www.HealthCareToolbox.org website from CPTS provides a wealth of resources for health care professionals: a library of downloadable patient education handouts in English and Spanish for children, teens, and parents, and a set of interactive online courses in trauma-informed pediatric care that offer continuing education credit for nurses.