Social Ecological Screening

When providing care through a trauma-informed lens, screening for medical traumatic stress allows health care providers to briefly assess risk status or distress / symptoms (such as individual or family risk or protective factors) and provide children and families with the appropriate level of care. In some cases, it will be appropriate to refer to a mental health provider.

The PPPHM helps guide interpretation of screening results. Ideally, screening is done universally with all ill or injured children and their families. Many screening measures are designed to be administered by frontline providers, or for self-administration by children or parents.

Find a trauma informed screening for:

PPPHM Screening

Primary Care Providers

Healthcare providers working in primary care settings – as well as subspecialists who see children with chronic medical conditions - have a unique relationship with their patients and families. By seeing a child and family over time, these providers often develop a deeper level of knowledge and trust with their patients. Parents and caregivers often cite their pediatricians as their most trusted provider for information and advice.

This unique position provides pediatricians the opportunity to screen children and families for traumatic stress related to injury or illness as well as adverse childhood experiences, within the context of a well-child visit or ongoing care. In fact, traumatic stress experts have suggest the value of pediatricians asking a basic screening question at all well-child visits: "Since the last time I saw you, has anything really scary or upsetting happened to you or your family?" (Cohen, J. A., Kelleher, K. J., & Mannarino, A. P. (2008). Identifying, treating, and referring traumatized children: the role of pediatric providers. Archives of pediatrics & adolescent medicine, 162(5), 447-452).

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Trauma Informed Screening Tools for Healthcare Providers

DEF Protocol: The DEF Protocol provides a trauma-informed framework to guide healthcare providers through screening patients and families for distress, emotional support and family needs throughout their recovery from injury or illness.

Psychosocial Assessment Tool (PAT) is a brief parent report screener of psychosocial risk in pediatric health. Using a social ecological framework, PAT allows for identification of a family's areas of risk and resiliency across multiple domains (e.g., family structure and resources, family problems, social support, child problems, acute stress, sibling problems).

Distress Thermometer (DT): uses a graphic representation of a thermometer, generating a 1-10 uni-dimensional rating of how distressed the respondent has felt in the past week. The DT may also be used with a problem list of practical problems (e.g. housing, insurance), family problems (e.g., dealing with partner, children), emotional problems (e.g.., worry, sadness), spiritual/religious concerns (e.g., relating to God, loss of faith) and physical problems (NCCN®, 2003).

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Trauma Informed Screening Tools for Mental Health Providers

DEF Protocol: The DEF Protocol provides a trauma-informed framework to guide healthcare providers through screening patients and families for distress, emotional support and family needs throughout their recovery from injury or illness.

Psychosocial Assessment Tool (PAT) is a brief parent report screener of psychosocial risk in pediatric health. Using a social ecological framework, PAT allows for identification of a family's areas of risk and resiliency across multiple domains (e.g., family structure and resources, family problems, social support, child problems, acute stress, sibling problems).

Distress Thermometer (DT): uses a graphic representation of a thermometer, generating a 1-10 uni-dimensional rating of how distressed the respondent has felt in the past week. The DT may also be used with a problem list of practical problems (e.g. housing, insurance), family problems (e.g., dealing with partner, children), emotional problems (e.g.., worry, sadness), spiritual/religious concerns (e.g., relating to God, loss of faith) and physical problems (NCCN®, 2003).

The SEEK Parent Questionnaire: The SEEK Parent Questionnaire: screens for the targeted problems. The PQ screens for common problems that are risk factors for child maltreatment: 1) maternal depression, 2) alcohol and substance abuse, 3) intimate partner (or domestic) violence, 4) harsh parenting, 5) major parental stress, and, 6) food insecurity. It was developed for parents to complete, voluntarily, before selected well-child visits. Parents can do so while waiting and then hand the PQ to the health professional at the start of the visit. It takes about 2 minutes to complete. The PQ has 15 items on one side of one page. It has a yes/no format that is easy to use by both parents and professionals. The PQ is completed at selected checkups, such as at the 2, 9 and 15-month, and the 2, 3, 4, and 5-year visits.

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