Child Trauma Screening Questionnaire
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  2. Child Trauma Screening Questionnaire

Child Trauma Screening Questionnaire

Last Updated

Link to Instrument

https://www.healthcaretoolbox.org/sites/default/files/2021-03/Child-Trauma-Screening-Questionnaire-information.pdf

Acronym CTSQ

Area of Assessment

Stress & Coping

Assessment Type

Patient Reported Outcomes

Administration Mode

Paper & Pencil

Cost

Free

Actual Cost

$0.00

CDE Status

Not a CDE -- last searched 6/12/2023.

Populations

Pediatric Disorders
Mental Health

Key Descriptions

  • The CTSQ consists of 10 questions. 5 questions measure re-experiencing, and 5 questions measure hyper-arousal.
  • Scores range from 0-10. Scores of 5 and higher indicate child is at a high risk of developing PTSD.
  • The questionnaire consists of ten questions answered with the child’s response of ‘Yes’ or ‘No’. One point is assigned for every answer of ‘Yes.’
  • Periodicity: This instrument is not subject to practice effects, so it may be administered as frequently as needed. The developers recommend testing within the first two weeks of trauma exposure, then a re-screen at 4-6 weeks post-trauma.

Number of Items

10 items (5 questions measuring re-experiencing and 5 questions measuring hyper-arousal)

Equipment Required

  • Pencil
  • CTSQ Form

Time to Administer

10 minutes

Required Training

No Training

Required Training Description

No training required.

Age Ranges

Child

6 - 12

years

Adolescent

13 - 17

years

Instrument Reviewers

Martina Bailey, Doug Connelly, and Josee Pacheco (Master of Occupational Therapy students)

Faculty mentor: Danbi Lee, PhD, OTD, OTR/L

Division of Occupational Therapy, Department of Rehabilitation Medicine, University of Washington, Seattle

ICF Domain

Body Function

Measurement Domain

Cognition
Emotion
General Health

Professional Association Recommendation

None found -- last searched 6/12/2023.

Considerations

  • This instrument is not subject to practice effects, so it can be administered as frequently as needed.
  • It is recommended to be used within the first two weeks of trauma exposure, then a re-screen at 4-6 weeks post-trauma (Wu, 2020)
  • Languages: English, Arabic, Croatian

Pediatric Disorders

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Cut-Off Scores

Accidental injury: (Olsson et al., 2008; n = 79; mean age = 10.81 (2.42) years; length of hospital stay = 137.85 (216.33) hours; Mean Injury Severity Score = 9)

  • Scores of ≥ 5 indicate a positive screen for trauma symptoms
  • Sensitivity at 1 month = 85%, Specificity at 1 month = 75% 
  • Sensitivity at 6 months = 82%, Specificity at 1 month = 74%

Accidental injury: (Kenardy et al., 2006; n =135; mean age = 10.8 (2.3) years; length of hospital stay = 117.2 (176.3) hours; Mean Injury Severity Score = 9))

  • Scores of ≥ 5 indicate a positive screen for trauma symptoms
  • Sensitivity at 1 month = 85%, specificity at 1 month = 75%; Sensitivity at 6 months = 82%, specificity at 6 months = 74%

 

Normative Data

Accidental injury: (Olsson et al., 2008)

  • CTSQ scores of children with PTSD symptoms at 1 month post injury (Mean = 6.00, SD = 2.57) 
  • CTSQ scores of children with PTSD symptoms at 6 months post injury (Mean = 5.71, SD = 2.63)
  • CTSQ scores of children without PTSD symptoms at 1 month post injury (Mean = 3.24, SD = 2.38)
  • CTSQ scores of children without PTSD symptoms at 6 months post injury (Mean = 3.42, SD = 2.49)

 

Internal Consistency

Accidental injury: (Kenardy et al., 2006; n = 135)

  • Poor internal consistency: Cronbach’s alpha=0.69

 

Criterion Validity (Predictive/Concurrent)

Predictive Validity

Accidental injury: (Olsson et al., 2008)

  • Significant higher CTSQ scores of children with PTSD symptoms at 1 month and 6 months compared to children without PTSD symptoms

Scores of children on the CTSQ by presence of PTSD symptoms and time post-injury

PTSD Status

    1 Month (M(SD))

   6 Months (M(SD))

With symptoms

         6.00 (2.57)

        5.71 (2.63)

Without symptoms

         3.24 (2.38)

        3.42 (2.49)

 

t(77) = -3.54, p < 0.01

t(77) = -2.32, p < 0.5

 

  • Higher overall efficiency 1-month post-injury for those with a “both positive” profile on the CTSQ-HR24 (Heart rate 24 hours post-admission) compared to CTSQ alone (0.85 vs. 0.76)
  • Higher overall efficiency 6-months post-injury for those with a “both positive” profile on the CTSQ-EDHR (Heart rate in the Emergency Department) and CTSQ-HR24 compared to CTSQ alone (0.89 vs. 0.75 and 0.90 vs. 0.75, respectively)

 

 

 

 

Construct Validity

Convergent Validity

Accidental injury: (Kenardy et al., 2006; n = 135)

  • Adequate correlation with the Children’s Impact of Events Scale (CIES)(r = 0.56)

 

Content Validity

Scale adapted from the Trauma Screening Questionnaire (TSQ) that was an excellent predictor of PTSD in adult survivors of a rail crash. Questions were reworded for children and pilot tested for comprehension. (Kenardy et al., 2006)

Mental Health

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Standard Error of Measurement (SEM)

Internal displacement: (Sakhelashvili et al., 2018; n = 322; internally displaced children n = 161, mean age = 10.85 (0.9); non-internally displaced children n = 161, mean age = 10.94 (0.9))

  • SEM for entire group = 0.450; calculated from Sakhelashvili et al., 2018

 

Minimal Detectable Change (MDC)

Internal displacement: (Sakhelashvili et al., 2018) 

  • MDC for entire group = 1.25; calculated from Sakhelashvili et al., 2018

 

Cut-Off Scores

Internal displacement: (Sakhelashvili et al., 2018) 

  • Scores of ≥ 5 indicate a positive screen for trauma symptoms

 

Normative Data

Internal displacement: (Sakhelashvili et al., 2018)

  • CTSQ scores of internally displaced children: mean = 2.73, SD = 1.89.
  • CTSQ scores: of non-internally displaced children: of non-internally displaced children. mean = 2.6, SD = 2.28

 

Test/Retest Reliability

Internal displacement: (Sakhelashvili et al., 2018)

  • Poor test-retest reliability (Cronbach’s alpha = 0.65)

 

Internal Consistency

Internal displacement: (Sakhelashvili et al., 2018) 

  • Poor test-retest reliability (Cronbach’s alpha = 0.684)

Bibliography

Kenardy, J. A., Spence, S. H., & Macleod, A. C. (2006). Screening for posttraumatic stress disorder in children after accidental injury. Pediatrics, 118(3), 1002–1009. https://doi.org/10.1542/peds.2006-0406

Olsson, K. A., Kenardy, J. A., De Young, A. C., & Spence, S. H. (2008). Predicting children's post-traumatic stress symptoms following hospitalization for accidental injury: Combining the Child Trauma Screening Questionnaire and heart rate. Journal of Anxiety Disorders, 22(8), 1447–1453. https://doi.org/10.1016/j.janxdis.2008.02.007

Sakhelashvili, I., Eliozishvili, M., Oniani, N., Darchia, N., & Bruni, O. (2018). Sleep and psycho-behavioral problems in internally displaced children in Georgia. Sleep Medicine, 50, 42–47.  https://doi.org/10.1016/j.sleep.2018.05.013

Wu, J. (2020, February 14). Child trauma screening questionnaire. The National Child Traumatic Stress Network. https://www.nctsn.org/measures/child-trauma-screening-questionnaire

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