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Child Trauma Screen (CTS)

Overview

The Child Trauma Screen (CTS) is a free screening measure for child trauma exposure and PTSD symptoms.  It was empirically developed and intended to be used by people with or without clinical training in a range of child-serving settings.

Author/Publisher Details

Date(s)

2017, 2018, and 2021

Description

The CTS is a free 10-item screening measure of trauma exposure and PTSD symptoms for children age 6-17 (age 3-6 is in development) intended for use by clinical or non-clinical staff in any child-serving setting, including behavioral health, pediatrics, schools, child welfare, juvenile justice, and other programs.   The CTS can be administered as an interview or self-report and both child- and caregiver report versions are available.  It is recommended that staff administering the CTS have brief training in trauma screening, which can be delivered internally if there is expertise in child trauma (online training in trauma screening is under development). The CTS is currently available in English, Spanish, Portuguese, and Chinese.

Access
The CTS is available at no cost for non-commercial purposes.  It is available at www.chdi.org/cts

Scoring and Interpretation

  • The 6 reaction/PTSD symptom items are summed to create a reaction score.
  • A cutoff score of 6 or greater indicates a high likelihood of PTSD diagnosis and is recommended for making referrals for trauma-focused assessment/treatment.

Psychometrics

The CTS has been evaluated in three psychometric studies, including two of children in behavioral health clinics (2017, 2018) and one in a pediatric primary care clinic (2021). The three samples of children (cumulative N=367) were diverse by race/ethnicity, gender, and age (from 6 to 18). For example, children in the initial validation study were 55% male, 33% Black, 31% Hispanic, 27% Caucasian, and 8% other race/ethnicity.  Internal reliability of the PTSD reaction items was a = .78 (child report) and a = .82 (caregiver report).  Convergent validity with a longer, established PTSD measure was r = .90 (child report) and r = .97 (caregiver report). The CTS demonstrated good divergent validity with other measures of general mental health, anxiety, depression, and ADHD (from r = .06 to .28).  The CTS demonstrated excellent predictive ability to identify children with a likely PTSD diagnosis using a receiver operating characteristic (ROC) analysis, for child report (AUC=.93; sensitivity: .88, specificity: .88, correct classification:  87.5%) and caregiver report (AUC: .99; sensitivity: 1.00, specificity: .84, correct classification:  87.5%).  The two additional studies with diverse populations of children have similar psychometrics.

Key/Core References   
  • Lang, J. M., & Connell, C. M. (2017). Development and validation of a brief trauma screening measure for children: The Child Trauma Screen. Psychological trauma: theory, research, practice, and policy, 9(3), 390. https://doi.org/10.1037/tra0000235
  • Lang, J. M., & Connell, C. M. (2018). The Child Trauma Screen: A follow‐up validation. Journal of traumatic stress, 31(4), 540-548. https://doi.org/10.1002/jts.22310
  • Lang, J. M., Connell, C. M., & Macary, S. (2021). Validating the Child Trauma Screen Among a Cross-Sectional Sample of Youth and Caregivers in Pediatric Primary Care. Clinical Pediatrics, 60(4-5), 252-258. https://doi.org/10.1177/00099228211005302

Manual   

A manual is not available but more information about administering the CTS and a FAQ are available at www.chdi.org/cts.  An online training is under development.