Fam Med. Confirmatory factor analysis (CFA) with varimax rotation is then used to specify the number of factors. An ED based screening tool for child abuse consisting of 8 questions for injured children younger than 14 years old was developed. Only the "Escape Form" is appropriate for use in children of all ages; the usefulness of this instrument is limited by the physical abuse and neglect focus (omitting sexual and psychological abuse screening) an… Disparate PedHITSS items and CTSPC subscales (eg, the PedHITSS threaten item and CTSPC sexual abuse subscale) were weakly and nonsignificantly correlated, providing evidence of discriminant validity. Provides information on the individual, relational, community, and societal factors that contribute to the risk of child maltreatment. sexual abuse. Following recoding, responses were summed within subscales.15 A total scale score was also calculated for the full CTSPC (range 0-550), and the full CTSPC with the addition of the two sexual abuse items (range 0-554). Outlines the legal definition of child abuse and neglect; the different types of abuse and neglect; and the signs and symptoms of abuse and neglect, including human trafficking. An ED based screening tool for child abuse consisting of 8 questions for injured children younger than 14 years old was developed. For Children & Adolescents (Ages 0 – 19) – Pediatric ACEs Screening and Related Life-events Screener (PEARLS), developed by the Bay Area Consortium on Toxic Stress and Health (BARC), a partnership between the Center for Youth Wellness, University of California, San Francisco (UCSF), and UCSF Benioff Children’s Hospital Oakland. Sensitivity and specificity findings indicate that any positive answer on the PedHITSS (a score of one, using regular or dichotomous scoring) maximizes sensitivity (the probability of correctly classifying a participant as a member of the abused subsample) while also demonstrating good specificity (the probability of correctly classifying a participant as a member of the nonabused subsample; Table 4). WebMD Citation files in RIS format are importable by EndNote, ProCite, RefWorks, Mendeley, and Reference Manager. Subsequent to demographic analyses, it was discovered that three participants in the nonabused subsample reported their child had experienced sexual abuse; these children were removed from further analyses (N=419). The STAR Center resources focus on early childhood screening. First, inherent to the administration of the measure, the PedHITSS was completed by a parent or guardian. duPont Hospital for Children. Pediatrics 2008. Baby Pediatric Symptom Checklist 12-question tool to screen children 1 - 18 months of age; Part of SWYCEmotion Screening NIH Toolbox (requires iPad; ages 3-to-adult; age-dependent variables) Family Psychosocial Screen Parental depression, Substance abuse, Domestic violence, Parental history of abuse, Social supports Mental Health Screening & Assessment Tools for Primary Care American … University of North Carolina, Chapel Hill, NC, USA. For each measure, a brief description, sample items, versions, and references are provided. A Novel Screening Tool for Assessing Child Abuse: The Medical Somatic Dissociation Questionnaire–MSDQ. 2021 © Society of Teachers of Family Medicine. A number of good screening tools designed for a variety of settings, ages, and purposes are available (e.g., Ages and Stages Questionnaire, 3rd edition, Parents’ Evaluation of Developmental Status with Developmental Milestones, and Child Development Inventory). Screening for intimate partner violence in a pediatric primary care clinic. 2008;121(1):e85-e91. 526-543. Autism Speaks offers the Modified Checklist for Autism in Toddlers-Revised (MCHAT-R) to screen children between 16 and 30 months for the signs of a possible Autism Spectrum Disorder (ASD) diagnosis. Leetch AN, Leipsic J, Woolridge DP. ISPCAN Child Abuse Screening Tool Children's Version (ICAST-C): Instrument development and multi-national pilot testing. The Screening Tool Finder is not exhaustive, and other screening tools may be available. 1 Introduction. In this EM Cases main episode podcast on Pediatric Physical Abuse Recognition and Management Dr. Carmen Coombs and Dr. Alyson Holland discuss the 6 B's of child abuse, the TEN-4 FACE decision rule, the Pittsburgh Infant Brain Injury Score, disclosure tips, screening … Future research investigating the use of the PedHITSS in clinical settings should include follow-up interviews by behavioral health providers to fully assess the extent of abuse. Child Abuse Negl. Responses were then recoded such that responses range from 0 to 25.15 The two sexual abuse items utilize a unique 3-point Likert scale ranging from 0 (never) to 2 (more than once). For best results, it is recommended that users review available instruction manuals prior to administering, scoring, and analyzing results of the scoring tools. The availability of the assessment tool was also a consideration. Diagnostic Accuracy. Scale scores were calculated by summing responses, with scores ranging from 0 to 20; higher scores indicate more frequent abusive behavior. However, while the PedHITSS measures abusive acts committed against children, it does not assess neglect nor, conversely, parental warmth and engagement. You should use screening questions to routinely ask about abuse and neglect. 16 Days of Action toolkit. This study was conducted to assess the psychometric properties and diagnostic accuracy of the 5-item PedHITSS, a novel screening tool for detecting physical and sexual abuse in children. No personally identifying information was collected. Our primary interest was assessment tools that had been validated and have some level of evidence to support their use with children. Social desirability bias can impact any sensitive survey like screening for child abuse; however, research shows that 87% of mothers wished their children’s primary care physician screened for child abuse.7 To minimize the socially desirable response affect, we recommend HITSS tool be administered in an electronic format (eg, computer or tablet given to the parent/guardian of the child while waiting in the exam room). Objectives: The aim of this study was to describe characteristics of commercial sexual exploitation of children/child sex trafficking (CSEC/CST) victims and to develop a screening tool to identify victims among a high-risk adolescent population. Reliability and validity of the ‘Extended-Hurt, Insult, Threaten, Scream’ (E-HITS) screening tool in detecting intimate partner violence in hospital emergency departments in Hong Kong. Welcome to Health Care Toolbox, brought to you by the Center for Pediatric Traumatic Stress (CPTS), a multidisciplinary center co-located at the Children’s Hospital of Philadelphia and Nemours A.I. Developed by the National Institute on Drug Abuse, NIDAMED resources include an online screening tool, a companion quick reference guide, and a comprehensive resource guide for clinicians. 2012. U.S. Department of Health & Human Services, Philosophy and Key Elements of Family-Centered Practice, Family-Centered Practice Across the Service Continuum, Creating a Family-Centered Agency Culture, Public Awareness & Creating Supportive Communities, Developing & Sustaining Prevention Programs, Evidence-Based Practice for Child Abuse Prevention, Screening & Assessment in Child Protection, Differential Response in Child Protective Services, Responding to Child Fatalities and Near Fatalities, Collaborative Responses to Child Abuse & Neglect, Supporting Families With Mental Health and Substance Use Disorders, Introduction to Family Support and Preservation, Resources for Managers of Family Support and Preservation Services, Transition to Adulthood and Independent Living, Recruiting and Retaining Resource Families, Working With Children, Youth, and Families in Permanency Planning, Working With Children, Youth, and Families After Permanency, Resources for Administrators and Managers About Permanency, Children's Bureau Adoption Call to Action, For Adoption Program Managers & Administrators, For Expectant Parents Considering Adoption and Birth Parents, Administering & Managing Child Welfare Agencies & Programs, Evaluating Program and Practice Effectiveness, índice de Títulos en Español (Spanish Title Index), National Foster Care & Adoption Directory, The Children's Bureau Legacy: Ensuring the Right to Childhood, Child Welfare Information Gateway Podcast Series, Episode 61: Thriving Families, Safer Children - A National Commitment to Well-Being, Part 1, Episode 60: What Did Child Welfare Learn From 2020 – Child Welfare as Public Health, Episode 59: What Did Child Welfare Learn from 2020 - upEnding Systemic Racism, Episode 58: What Did Child Welfare Learn from 2020 - Caseworker Care, Episode 57: Connecting Cross-Border Families, Episode 56: Prevention Training for Home Visitors, Episode 55: National Adoption Month - Engage Youth, Listen and Learn, Episode 54: Supporting Parenting and Expectant Teens in Foster Care, Episode 53: Creating a Family First Prevention Plan - Utah. NC CHILD WELFARE MANUAL FOR CPS INTAKE, CPS ASSESSMENTS, IN-HOME, & PERMANENCY PLANNING. Methods: The initial draft of the instrument was developed after input from scientists and practitioners representing 40 countries. There was no significant difference in sensitivity and specificity of HITSS and CTSPC in correctly identifying victims of child abuse. Fam Med. Methods: Participants included 422 pediatric patients (n=242 nonabused; n=180 abused subsample) recruited from an ambulatory care setting, a medical center at-risk referral clinic, or homeless shelter clinic. Dubowitz H, Prescott L, Feigelman S, Lane W, Kim J. Child and adolescent trauma and PTSD measures are listed here. Higginbotham et al 2 implemented an algorithm for child abuse screening in children <1 year of age presenting with fractures. Welcome to Health Care Toolbox, brought to you by the Center for Pediatric Traumatic Stress (CPTS), a multidisciplinary center co-located at the Children’s Hospital of Philadelphia and Nemours A.I. Straightforward statistics for the behavioral sciences. Mass screening. Previous article in issue; Next article in issue; Keywords. This toolkit, supported by Public Health England is a brief for how companies can quickly and efficiently address domestic abuse. Diagnosis and Management of Physical Abuse in Children Maguire-Jack K, Lanier P, Johnson-Motoyama M, Welch H, Dineen M. Geographic variation in racial disparities in child maltreatment: the influence of county poverty and population density. A greater understanding of the risk factors and strategies for screening can help professionals working with children and families identify different types of maltreatment and high-risk situations. The Cronbach α (ie, internal reliability) of the PedHITSS and CTSPC scales were calculated for the present sample; both Cronbach α and specific interitem correlations were reported. However, the model was nonsignificant. Webster, NC: Psytec; 1980. Fam J (Alex Va). 2004;2(2):161-169. McKelvey LM, Conners Edge NA, Fitzgerald S, Kraleti S, Whiteside-Mansell L. Adverse childhood experiences: screening and health in children from birth to age 5. Most mandated reporters, regardless of where they work, perform some kind of routine intake assessment—for example, as a child enters a new school, as part of a medical examination, or as part of case management services. LARA-VP. California Evidence-Based Clearinghouse for Child Welfare, Risk Factors That Contribute to Child Abuse and Neglect, Child Welfare Information Gateway is a service of the, What Is Child Abuse and Neglect? Epub 2009 Oct 25. This page provides a selection of useful links to assessment tools and guidance. Lastly, construct validity of the PedHITSS is examined using factor analysis. Children’s ages ranged from 0-12 years (Mean=5.8, SD = 3.8). North Carolina Child Welfare Manual (July 2019) Page i . Model fit for the EFA and CFA is reported using χ2. Shakil A, Day PG, Chu J, Woods SB, Bridges K. PedHITSS: A Screening Tool to Detect Childhood Abuse in Clinical Settings. Los Angeles, CA: Western Psychological Services; 2003. Includes expert talks, real-life videos on patient stories, fact sheets, news and a reference database. Further, we prioritized sensitivity in our analyses in order to maximize the likelihood of capturing a serious and potentially health-altering adverse childhood experience for pediatric patients. We expect that abuse status misclassification rates were low given the extensive inclusion criteria for our abused subsample. The results of the CFA (χ2=1.76, P=.185) demonstrated two clusters of items: (1) insult, threaten, and scream, and (2) hurt and, to a much lesser extent, sexual abuse. Acts of omission: an overview of child neglect. … We explored the reliability, validity, sensitivity, and specificity of the PedHITSS, including its ability to detect child abuse among a sample of parents/guardians whose children have confirmed abuse experiences, in comparison to a community pediatric nonabused sample. 2018;86:49-55. Christian CW; Committee on Child Abuse and Neglect, American Academy of Pediatrics. The ability of the PedHITSS to detect whether a participant’s child was in the nonabused (specificity) or abused subsample (sensitivity), was estimated using a receiver operating characteristic (ROC) curve. Centers for Disease Control and Prevention (2016) Child Welfare Information Gateway. Author information. S. ERVICES. Journal of Child Sexual Abuse: Vol. Convergent and discriminant validity was assessed using Pearson correlation to calculate within-participant concordance between PedHITSS responses and responses on corresponding CTSPC subscales. R.A.D.A.R. The Screening Tool Finder is not exhaustive, and other screening tools may be available. Further, it does not provide established clinical cutoffs that would indicate abuse to health care providers,15 rendering the measure impractical for use in clinical settings. Further, the PedHITSS was at least as effective at discriminating between abused and nonabused child subsamples as the CTSPC, indicated by a greater AUC. The PedHITSS screening tool performed as well as the CTSPC in correctly classifying abused and nonabused children, and offers greater utility to providers by supplying an actionable cut score. Distinguishing domestic abuse and harmful conflict screening tool: Private law: This tool is designed to be used early in the life of a case to assist the FCA in deciding which will be of most assistance in their assessment: the blue domestic abuse tools and guidance or the orange harmful conflict tools and guidance. The page also includes questions to ask parents when practitioners suspect maltreatment. The Child Abuse Potential Inventory: Manual. ISPCAN Child Abuse Screening Tool Children’s Version (ICAST-C): instrument development and multi-national pilot testing. We used the Conflict Tactics Scale: Parent-Child Version (CTSPC) to evaluate concurrent and discriminant validity.15,21 CTSPC was designed to measure childhood maltreatment using parent/guardian self-report.15 CTSPC contains 22 items and has been validated to measure child maltreatment in children from infancy to 17 years of age using the following subscales: nonviolent discipline (four items), psychological aggression (five items), and physical assault (13 items).15 We included two additional sexual abuse items that are adjunctive to the CTSPC.15 Items are prompted with, “During the last year, how often would you estimate that an immediate family member has done each of the following?” Parents/guardians then indicate how often nonviolent and violent specific scenarios (eg, “You threw or knocked down your child”) occurred. Following referral a CSE assessment, using the Surrey Children’s Services tool, may then be undertaken by a Social Worker. Specific to the abused subsample, abused status was confirmed and verified by: (1) reviewing parental admission of abuse, participant medical history, and CPS reports for victims recruited at shelter sites and the referral clinic, and (2) confirming abuse using the shelter intake procedures for children residing at a shelter who did not have a CPS report on file. Participation was voluntary; no incentive was provided. US Department of Health and Human Services Administration for Children and Families, Administration on Children Youth and Families, Children’s Bureau. Tools to help Children and Young People be safe and to recover . Finklehor D, Turner H, Shattuck A, Hamby S, Kracke K. Children’s exposure to violence, crime, and abuse: an update. Therefore, a one-factor solution is preferable. Post-hoc Analysis. Child Abuse Negl. Current child abuse screening tools lack brevity and usefulness in clinical settings. The findings of this study suggest that PedHITSS is a valid and reliable tool to screen for physical and sexual abuse in children ages 12 years and under in clinical settings and can help health care providers detect child abuse and initiate appropriate intervention. Affiliations. Interitem correlations are presented in Table 2. Serious health problems, risky behavior, and poor health habits persist among adolescents despite access to medical care. Convergent validity (ie, similarity between PedHITSS and CTSPC responses in corresponding content areas) is determined by strong, positive, significant correlations (r>.60, P<.05).22 Discriminant validity (ie, dissimilarity between PedHITSS and CTSPC responses in corresponding content areas) is determined by nonsignificant, weak correlations (r<.40, P>.05). However, further study is necessary to investigate the accuracy of this screening tool using a national child abuse registry. Child Abuse Directory Washington, DC: US Government Printing Office; 2018. The University of Texas Southwestern Medical Center Institutional Review Board mandated that only verbal consent could be collected from participants; written consent was not documented due to the possibility that an abusive family member with access to the patient’s medical record could discover that abuse was disclosed. The results of this study should be considered in light of its limitations. - University of Texas Southwestern Medical Center, Department of Family and Community Medicine, Jessica Chu, MPH Domestic Abuse Risk Assessment for Children (DARAC) This Domestic Abuse Risk Assessment for Children (DARAC) tool can be used by professionals who are undertaking an assessment of risk to children who are living in a home where domestic abuse or violence has already been identified. Child and Adolescent Screening and Assessment Tools Randall Stiles, PhD. We have developed field guides and data entry templates for the ICAST C and its modules, also available from … Provides guidance to practitioners on indicators and evaluation methods of suspected maltreatment of children. Ann Emerg Med. Validation studies as topic. For best results, it is recommended that users review available instruction manuals before administering, scoring, and analyzing results of the scoring tools. 2014;168(8):706-713. Screening at a teen’s first visit, at every well-child visit, and when there are concerns about risky behaviors or comorbidities (e.g., depression) can help remove bias and avoid missing patients engaged in risky substance use. Stanford Medicine US Department of Health and Human Services AfCaF; Administration on Children, Youth and Families; Children's Bureau. Fam Med. Kodner & Wetherton (2013) Child Abuse and Neglect: Risk and Protective Factors 2015;23(2):109-119. Further, the two measures were significantly correlated within expected coordinated PedHITSS item-CTSPC subscales (Table 2), indicating convergent validity. PedHITSS is completed by parents or guardians of pediatric patients (≤12 years), and includes five Likert-scaled items measuring acts of commission. Well-Being Outcome Measures and Instruments U.S. Department of Health & Human Services, Administration for Children & Families, Children's Bureau (2017) Offers a list of screening and assessment instruments compiled by the … The lack of screening and detection of child abuse or maltreatment in health care may be attributable to the unavailability of brief screening tools developed and validated for use in clinical settings.12 Standardized screening instruments such as the 160-item Child Abuse Potential Inventory,13 the 82-item International Society for the Prevention of Child Abuse and Neglect Child ICAST questionnaire,14 and the 22-item Conflict Tactics Scale: Parent-Child Version (CTSPC)15 have been used for research purposes, but these lengthy assessments are burdensome and are neither intended nor appropriate for screening in outpatient settings.16 It is critical to address the dearth of brief screens for child abuse, and the limitations of extant tools in order to improve health care provider assessment, recognition, and intervention for pediatric patients experiencing child abuse. U.S. Department of Health and Human Services. This table is not exhaustive, and other screening tools may be available. American Academy of Pediatrics Apply for and manage the VA benefits and services you’ve earned as a Veteran, Servicemember, or family member—like health care, disability, education, and more. adolescents, while the SWYC is a series of screening tools for parents of young children. These differ from those identified for child abuse (maltreatment) more generally: Finally, we compared the PedHITSS to the gold standard CTSPC. abuse screening,”“child maltreatment screening, ”“child abusescreeninginstruments,”and “childabusedetection.” Articles included in this review focused on a specific child abuse screening instrument for the identification of child abuse in individual children, were limited to those in the 2015;47:1-13. CONCLUSIONS: Applied accurately and consistently, … Children’s ages ranged from 0-12 years (Mean=5.8, SD = 3.8). Most adolescents do not seek advice about preventing leading causes of morbidity and mortality in their age group, and physicians often do not find ways to provide it. Participants’ ages ranged from 18-71 years (Mean=33.52, SD=8.5); the majority of parents/guardians were female and English-speaking (Table 1). Future research should investigate the clinical utility of this measure, including physician follow-up directed at the parent/guardian versus follow-up questions directed at the child patient. Further, 100% of the sample is correctly classified (ie, false positives are eliminated) at a PedHITSS score of 8.5 out of 20. The Ask Suicide-Screening Questions (ASQ) toolkit is designed to screen medical patients ages 8 years and above for risk of suicide As there are no tools validated for use in kids under the age of 8 years, if suicide risk is suspected in younger children a full mental … Fam Med. Participants were told participation was confidential and would not affect patient care. The page also provides information on protective factors and includes a resource section for more information on child maltreatment. Shakil A, Donald S, Sinacore JM, Krepcho M. Validation of the HITS domestic violence screening tool with males. Describes an assessment tool, the Treatment Outcome Package (TOP), designed to help child welfare systems measure a child's social and emotional well-being. 2017;67(1):54-63. Measures physical, mental, & social health … Milner JS. Specifically, the PedHITSS AUC was .85 (SE=.02, P<.01, 95% CI, 0.81-0.89), while the AUC for both the 22-item and 24-item CTSPC was .74 (SE=.03, 95% CI, 0.69-0.80; Figure 1). H. UMAN . The CTSPC (24-item) and PedHITSS scale totals were strongly correlated (r=.70, P<.01). Emergency service . NIDA Launches Two Brief Online Validated Adolescent Substance Use Screening Tools. SBIRT for Adole… In other words, clinicians using the PedHITSS should follow up any positive response, and ask the parent/guardian completing the assessment to describe their answer. The one-factor model accounted for 63% of the variance of the five items, with an eigenvalue of 3.15 (model fit: χ2(5)=25.78, P<.01). The Escape instrument is a useful tool for ED staff to support the identification of those at high risk for child abuse. 2015;24(1):41-64. Episode 52: Creating a Family First Prevention Plan - Washington, D.C. Intervening on behalf of battered women is an active form of preventing child abuse. 2010;17(2):109-117. Although the use of assessment tools (both consensus-based and actuarial) has become widespread in the child protection practices of a number of countries, the use of these instruments - and indeed the very notion of structuring child protection systems around the prediction of future risk - has been criticised by a number of authors. Evans JD. Child Sexual Exploitation (CSE) – Screening Tool SSCB has developed a screening tool which all professional groups will use when they have concerns. An ED based screening tool for child abuse consisting of 8 questions for injured children younger than 14 years old was developed. MENTAL HEALTH TOOLS FOR PEDIATRICS . Conversely, given the age range of 0-12 years, it would be impossible for the majority of children this age to complete the measure themselves. The following table is a snapshot of a work in progress of the American Academy of Pediatrics (AAP) Mental ... guidance in interpreting results of commonly used screening tools, including a number of those ... Substance Abuse Research The first two tests should be closer to 1, and significant, respectively, to indicate a factor analysis of the individual PedHITSS items is possible. The two factors appear to index items reflective of verbal abuse and physical/sexual abuse. Conflict Tactics Scale: Parent-Child Version. Child Abuse Negl. 2014;46(3):180-185. The most frequently used substance abuse screening tool in Massachusetts is the CRAFFT. The screening, brief intervention, and referral to treatment (SBIRT) model is widely recommended as part of routine visits in pediatric primary care. NIDA Launches Two Brief Online Validated Adolescent Substance Use Screening Tools. The Evaluation of Suspected Child Physical Abuse (PDF - 849 KB) Tell me where it hurts: assessing mental and relational health in primary care using a biopsychosocial assessment intervention. PedHITSS is an adaptation of the family violence HITS tool, used in adult primary care populations; this measure has been repeatedly demonstrated as valid, reliable, and feasible for use in clinical care.17-20 PedHITSS uses the four valid HITS items and was adapted by adding a question about sexual abuse. It is available in six languages for international research to estimate child victimization. Objective: To develop a child victimization survey among a diverse group of child protection experts and examine the performance of the instrument through a set of international pilot studies. The guide also provides information on prevention and treatment options. encourages primary care clinicians to follow the SBIRT model and recommends universal screening for substance use with adolescents. Instead, our present preliminary analyses indicate that scores greater than eight may indicate that engaging protective services is beneficial, as this score correctly identified participants in the abused child subsample 100% accurately (ie, a specificity score of 1.00). Therefore, the optimal PedHITSS cutpoint is one, indicating that in either scoring method, a positive answer on any item requires physician follow-up. CPTS was created to address medical trauma in the lives of children and families. Unless specified these tools are applicable across the UK. R.A.D.A.R. 2005;37(3):193-198. An abused subsample included 180 parents/guardians of confirmed victims of child abuse either receiving treatment at a medical center’s at-risk referral clinic or residing in four area shelters. S. OCIAL . The American Academy of PediatricsExternal link, please review our disclaimer. Affiliations: University of Texas Southwestern Medical Center, Department of Family and Community Medicine, Philip G. Day, PhD Taken together, these findings suggest that the PedHITSS may be an effective clinical screening tool for child abuse in pediatric populations. However, further study is necessary to investigate the accuracy of this screening tool using a national child abuse registry. The authors acknowledge the University of Texas Southwestern Medical Center Department of Family and Community Medicine for continued support. Straus MA, Hamby SL, Warren WL. To validate the Pediatric Hurt-Insult-Threaten-Scream-Sex (PedHITSS) screening tool, a 5-item questionnaire designed to detect and prompt provider investigation into child abuse in clinical settings, the PedHITSS was compared to the Conflict Tactics Scale: Parent-Child Version (CTSPC) screening measure. Pediatricians can increase their confidence in recognizing and reporting cases of physical child abuse with a new interactive teaching tool developed by experts in child abuse and neglect. Reliability. Commitment, confidence, and concerns: assessing health care professionals’ child maltreatment reporting attitudes. 1. Sensitivity and specificity analyses for the PedHITSS indicate that one positive answer on any of the measure’s five items requires clinician follow-up to promote the greatest likelihood of capturing potential ongoing child abuse.