Children with Multi-Trauma Histories: Special Considerations for Care and Implications for Treatment Selection

The complex symptom profiles of young children with histories of trauma exposure underscore the importance of matching individual child characteristics and symptom needs with existing evidence-based treatment protocols. Children (N = 134) between the ages of 2–12 and their caregivers were administered the Child Behavioral Checklist, Trauma Symptom Checklist for Young Children, and the Trauma Symptom Checklist for Children-Alternate Version at baseline and end of treatment. ANCOVA analyses examined the relationships between the number of different types of trauma exposures, child gender, placement status, child age, type of treatment received, and end of treatment symptom scores. Child age at the start of treatment was found to influence externalizing and total problem scores at the end of treatment when baseline scale scores were held constant. Older children were found to have significantly higher levels of externalizing and total problem scores at the end of treatment compared to younger children in the sample. Significant improvements were found between baseline and termination outcome scores regardless of treatment type, however, results suggest that differences in severity of symptoms may vary by treatment type. Study findings suggest that latency age children and their caregivers may have differing trauma-related treatment needs compared to younger children and may benefit from an adjusted focus in treatment. The matching of individual child characteristics and need can help maximize emotional and behavioral outcomes and the addition of a cognitive-based treatment modality may be indicated for some children.