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How Psychologists Test Kids for PTSD

Fifteen percent of girls and six percent of boys in the U.S. develop post-traumatic stress disorder. Is your child among them?

Most parents assume their children haven’t developed post-traumatic stress disorder. The pathology is so strongly associated with war that it seems an unlikely diagnosis for a grade-schooler. It isn’t. Fifteen percent of girls and six percent of boys in the U.S. develop post-traumatic stress disorder. PTSD is most common in children who have experienced severe traumas, such as abuse, but many children who have not been victimized still wind up suffering from the disorder.
As it turns out PTSD is both predictable and unpredictable. Children living in New York City during 9/11 were more likely to suffer PTSD in the following years. This is a sad fact that many might have suspected. But kids who watched the towers fall on television were also more likely to develop the condition. That is to say that trauma does not necessarily emerge from first-hand experiences, which means it’s nearly impossible to insulate kids from the condition.
But how would you know if your kid had PTSD? In 2001, Edna Foa and colleagues at the University of Pennsylvania created a simple test that measures PTSD risk in children between the ages of 8 and 18. The questionnaire can be self-administered and, while it’s far from perfect, it’s an excellent screening tool that helps experts identify PTSD in kids.
Meet The Child PTSD Symptom Scale
Ask your child to write down the most distressing event he or she can remember, and note the length of time since the event. Then, ask your child to answer the following questions about the event with 0 (not at all or only at one time); 1 (once a week or less); 2 (2 to 4 times a week); 3 (more times a week/almost always). Ask, “How often are you…”:
  1. Having upsetting thoughts or images about the event that came into your head when you didn’t want them to
  2. Having bad dreams or nightmares
  3. Acting or feeling as if the event was happening again (hearing something or seeing a picture about it and feeling as if I am there again)
  4. Feeling upset when you think about it or hear about the event (for example, feeling scared, angry, sad, guilty, etc)
  5. Having feelings in your body when you think about or hear about the event (for example, breaking out into a sweat, heart beating fast)
  6. Trying not to think about, talk about, or have feelings about the event
  7. Trying to avoid activities, people, or places that remind you of the traumatic event
  8. Not being able to remember an important part of the upsetting event
  9. Having much less interest or doing things you used to do
  10. Not feeling close to people around you
  11. Not being able to have strong feelings (for example, being unable to cry or unable to feel happy)
  12. Feeling as if your future plans or hopes will not come true (for example, you will not have a job or getting married or having kids)
  13. Having trouble falling or staying asleep
  14. Feeling irritable or having fits of anger
  15. Having trouble concentrating (for example, losing track of a story on the television, forgetting what you read, not paying attention in class)
  16. Being overly careful (for example, checking to see who is around you and what is around you)
  17. Being jumpy or easily startled (for example, when someone walks up behind you)
We Tallied Up The Score. What’s It Mean?
Since each of the 17 items is rated on a scale from 0-3, the total scores ranges from 0 to 51. Yet clinical experience has shown that any score above 15 is cause for concern (Foa’s original work suggested an even lower cutoff score of 11). Of course, a score of 15 or above does not necessarily mean that your kid has PTSD. The symptom scale is a carefully-designed test that is best administered by a trained professional in a controlled setting. Your take-home version is by no means the last word. If you’re concerned about your child’s score, however, make sure to mention it to your doctor.
What If My Kid Actually Does Have PTSD?
The most effective treatment for PTSD in children is trauma-focused cognitive behavior therapy. One of the key features of TF-CBT is that, unlike other related forms of therapy, the child doesn’t go into a room alone with a therapist—the parents are involved in every stage of the the treatment. The therapy helps children build skills to cope with extreme anxiety, while teaching parents how to deal with their children during flashbacks, or episodes of irritability and aggression that can result from encountering a trigger.
“Since we have implemented trauma-focused CBT, the number of kids in the child protective services system needing in-patient psychiatric care has gone down enormously,” says Joan Kaufman of Yale University.