Trauma Identification Approaches NEW - Child Trauma and Wellbeing

Trauma Identification Approaches

There are many ways to learn about a child’s experience of trauma. Observation, conversation, or screening are all effective ways of identifying trauma.

One approach might be better suited to your organization’s capacity, preferences, and the types of services you provide, or you may find it helpful to combine some or all of these approaches.

To help you figure out which trauma identification approach(es) can be most beneficial to your organization, this page lays out some of the benefits and drawbacks of each approach.

Observation

Every child will react differently to trauma, but there are common signs you can look for. Noticing the signs of trauma through observation is a valuable skill for any professional working with children.

Benefits of Observation:

It’s relatively easy and inexpensive to train staff on this method.

Observation skills can be used by anyone in any sector.

Drawbacks of Observation:

Because trauma can look different depending on a child’s age, culture, gender, and personality, it can be easy to miss signs of trauma through observation.

Our own biases can influence what signs of trauma we notice or don’t notice, leading some groups of children to be over- or under-identified.

Snapshot from Practice

Mayra notices that one of the preschoolers in her class has been having more bathroom accidents lately and that he’s less joyful than usual. Remembering her training on common signs of trauma in young children, she speaks with her supervisor about next steps they can take to support him.

Conversation

Some providers are trained in structured clinical interview techniques, while others learn through experience how to develop rapport with children and caregivers. Talking with a child or their caregiver about stressful experiences is a great opportunity to understand the best way you can support them.

Benefits of Conversation:

It’s relatively easy and inexpensive to train staff on this method.

It presents a great opportunity to engage with families in a strength-based, culturally sensitive way.

It’s a practical way to talk more openly about trauma with families.

Drawbacks of Conversation:

It requires periodic coaching of staff to make sure skills continue to be guided by TIR principles.

It requires time to build trust with child and family before they open up.

Our own biases can influence what signs of trauma we notice or don’t notice, leading some groups of children to be over- or under-identified.

Snapshot from Practice

During a routine medical visit, Sonia complains about stomach aches and sleep problems. Knowing that this can be a symptom of trauma, her provider enquires about hobbies and school before asking her “Has anything scary or upsetting happened recently?”

Screening

Using a short, standardized questionnaire to identify if a child has experienced any potentially traumatic events and/or is showing signs of trauma can be very useful to identify children who need trauma supports.

There are two different ways of screening:

Benefits of Screening:

Universal screening ensures that all children and/or caregivers are asked the same questions, regardless of their situation, race, ethnicity, disability, or gender and sexual orientation.

Screening increases the chances of learning about a child’s traumatic experiences and reactions. That’s because children rarely disclose if not directly asked.

Drawbacks of Screening:

Screening requires more resources (time, money, staff) than other approaches.

Solely screening for trauma is not helpful to identifying children’s broader behavioral health needs. Organizations should also engage in general behavioral health screening.

The criteria used to identify which children should be screened (for selective screening) can lead to under- or over-identification of certain groups of children.

Snapshot from Practice

Doris and her children are spending their first night in a shelter. A staff member explains they’ve started using trauma screening as part of intake. This helps them better understand some of the difficulties the families they serve have experienced. That night, when Doris’ youngest has night terrors, shelter staff recognize this is likely a trauma symptom and provide trauma-informed and responsive supports to the family. Over the next few weeks, thanks to what Doris shared by completing the screener, the shelter staff refers the oldest child to therapy.

What is the Difference Between Screening and Assessment?

SCREENING	ASSESSMENT
Brief	Detailed, in-depth, comprehensive process
Identify if the youth experienced a traumatic event	Includes clinical interview, standardized measures, and/or observations
Identify reactions to events	Comprehensive history of trauma and needs/symptoms
Identify if the youth has specific mental health needs	Additional information to provide context (e.g., functioning, well-being, developmental context)
May lead to a referral for assessment	Conducted by a mental health professional
Conducted by front-line staff

Linking Trauma-Informed Screening and Assessment Practices Across Child-Serving Systems.
Presented by Lisa Conradi, Psy.D., Cassandra Kisiel, Ph.D., and Linzy Pinkerton, Ph.D. (2023)