Researchers have proposed and tested a new method for assessing trauma in children, especially those in the juvenile justice system.
Until now, health care workers have relied upon the 54-question Trauma Symptoms Checklist for Children (TSCC). The method, used for decades, tests how trauma affects youth in hopes of developing the best treatment and support possible.
But interpreting the results can be very difficult as the work is done manually and involves a complex matrix from which to draw conclusions.
The new method, developed by a research team at Case Western Reserve University in Cleveland, changes neither the tool itself nor the questions involved, but rather how workers assess and, ultimately, apply the results.
“Ultimately, it is all about whether the tool is easy to interpret,” said study leader Fredrick Butcher, Ph.D., a research associate at the university’s Semi J. and Ruth W. Begun Center for Violence Prevention Research and Education.
“Some kids may have issues in several areas, but when you examine them together, you get a better sense of the severity of the issues they are having.”
The researchers focused on how six mental health factors associated with a child’s trauma (anxiety, anger, dissociation, depression, sexual concerns, and post-traumatic stress) were linked and scored.
They analyzed the TSCC test results of 2,268 children, aged eight to 17, from the Ohio Behavioral Health Juvenile Justice program, a program that diverts young people from incarceration to community-based agencies to work on behavioral, substance abuse, and mental health problems.
Each young person is assessed as they enter the program so that treatment can be targeted to their behavioral health needs, Butcher said.
Researchers found that traditional TSCC scoring works well to assess children’s trauma. But when looking at the total score alone, only a “muddied” picture emerges, one that doesn’t provide enough details to appropriately assess youth and target treatment.
On the other hand, Butcher and his team found that grouping the factors into two areas — one for anxiety, dissociation, and post-traumatic stress and the other for anger and depression — made analyzing the results easier and more accurate.
Social workers were given options on how to score the tests, from using a child’s total score to tallying anger and depression responses for one score and anxiety, post-traumatic stress, and dissociation responses for another.
Breaking down the scoring into two groups, Butcher said, can lighten the work burden on social workers and still provide enough useful information to design treatment programs.
“The alternative two-scale solution is not necessarily faster to score,” he said, “but it is much easier to interpret.”
Source: Case Western Reserve University