Evaluation of an Early Risk Screener for PTSD in Preschool Children After Accidental Injury

OBJECTIVES: To evaluate the effectiveness and most powerful selection of predictors of an early screening tool for posttraumatic stress disorder (PTSD) in a sample of 87 children ages 2 to 6 years after unintentional injury.

METHODS: The examined screener was administered within 6 to 13 days post accident and consisted of an adapted version of the Pediatric Emotional Distress Scale (PEDS), the PEDS-ES (PEDS Early Screener), and questions on 5 additional risk factors (preexisting child behavioral problems, parental preexisting chronic mental or physical illness, pretraumatic life events in the family, parental feelings of guilt, parental posttraumatic stress). The PTSD Semi-structured Interview and Observational Record for Infants and Young Children served as criterion measure 6 months after the accident. A case was deemed positive when meeting criteria for full or partial PTSD.

RESULTS: Use of the PEDS-ES without the additional risk factors performed best, with good sensitivity (85%) and moderate specificity (63%) for full or partial PTSD.

CONCLUSIONS: The PEDS-ES allows for successful early screening of preschool-aged children after single accidental trauma. It may be used within a stepped-care model for early identification of individuals designated for possible secondary preventative interventions.