Child Trauma Screening Questionnaire

Last Updated

August 27, 2021

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.

Pediatric Disorders

Mental Health

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)

Pencil
CTSQ Form

10 minutes

Required Training

No Training

Required Training Description

No training required.

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

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)

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