New Test Spots Risk for PTSD in Injured Kids10/04/13
FRIDAY, Oct. 4 (HealthDay News) -- A simple, short mental health
test already used for pediatric patients has been found effective
at predicting post-traumatic stress disorder (PTSD) risk among
preschoolers seriously injured by such things as a burn or car
"The most important point is that until now we had no evidence-based method to identify preschool-age children for their risk of long-term psychological problems early after accidents," said the study's lead author, Markus Landolt, head of pediatric psychology at University Children's Hospital Zurich.
Such problems can manifest as repetitive nightmares or the
"replaying" of the initial trauma, anxiety, aggressive behavior,
temper tantrums and problems with concentration, according to the
The Swiss effort centers around the "Pediatric Emotional
Distress Scale" questionnaire (PEDS). This test was retooled into
the PEDS-Early Screener (or PEDS-ES), designed to sift through
parent-provided information and zero in specifically on long-term
PTSD risk among injured preschoolers.
The result: By establishing an optimal scoring method,
investigators achieved an 85 percent success rate at picking up
PTSD risk, and a 63 percent success rate at specifically predicting
the onset of either full or partial PTSD.
"This study now presents convincing data that early identification is possible even at this young age," Landolt said, "and therefore offers the possibility for early treatment of those children who are in need of support."
The study appears in the October print issue of
The authors pointed out that accidents are a very common feature
of childhood. For example, they noted that in 2011, more than 10
percent of American children under the age of 6 had at least one
accidental trauma requiring hospital treatment.
"(And) studies with children injured by burns or road traffic accidents revealed that around 10 to 20 percent develop longer-term behavioral and psychological problems after accidents," Landolt said.
To reduce the risk of long-term complications, the authors
stress that time is of the essence when it comes to identifying
at-risk children and getting them into preventive treatment.
Ideally, they say, the whole process should unfold during a
one-to-two week window following an initial trauma.
To that end, the investigators set out to assess the
effectiveness of the PEDS-ES diagnostic tool, which covered 21
measures of problem behaviors. They administered it between 2010 to
2012 to the caregivers of 87 children, all between 2 and 6 years
old, who had just suffered a traumatic traffic or burn injury
within the previous two weeks.
Follow-up parental interviews were conducted six months later to
screen for PTSD among the children. At that point, 23 percent of
the patients were diagnosed with either a full or partial PTSD.
Beyond predicting the onset of the majority of such cases six
months before they were firmly diagnosed, the PEDS-ES questionnaire
was also successful in identifying the specific degree of PTSD
severity that developed in the at-risk children.
The study team therefore concluded that clinicians should be
encouraged to use the PEDS-ES test as a fast and easy way to
identify PTSD risk among injured youngsters.
"For the first time, it is now possible for first responders -- such as pediatricians, nursing staff or emergency psychologists -- to assess young children accurately with regard to their risk of long-term psychological and behavioral problems," Landolt said. "This is an important prerequisite to provide appropriate early treatment and thus reduce the number of preschool-age children suffering from psychological and behavioral problems after an accident."
Another expert, Dr. Glen Elliott, chief psychiatrist of the
Children's Health Council, emphasized the importance of accurate
screening for PTSD among very young injured patients.
"For many years, PTSD was completely ignored among children," he said. "There was an assumption that children are imminently resilient, and of course children don't often complain in a way that an adult would, or in the same way. Often because they lack the language to really describe it. So it tended to be missed."
"But clinicians now recognize and accept the problem," Elliot added. "And if we know which kids are likely to have an issue, then we can focus our intervention. ...There's no question that it's easier to work with a child shortly after he has been traumatized to prevent PTSD than to deal with PTSD once it's already been established."
For more on children and PTSD, visit the
American Academy of Child & Adolescent
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