Assessing Trauma

TOP Trauma Screen

The TOP Trauma Screen (TTS) identifies the symptoms of trauma and alerts the child welfare staff when a child shows sign of trauma and may need services. The TTS focuses on behaviors that result from trauma, rather than relying solely on the identification of past traumatic events.  Children can experience the same event differently.  By identifying the behaviors, rather than just the cause(s), that indicate trauma, TTS stands apart from typical child welfare trauma screens.

The TTS also relies on input from multiple raters, including the caseworker, the foster parent, the bio-parent and the child.  Using the perspectives of many people in the child’s life means that TTS is more likely to capture multiple symptoms of trauma rather than simply relying on a caseworker’s sometimes incomplete awareness of traumatic events that may have occurred. 

How TOP Trauma Screen works:

The TTS assesses behaviors that reflect symptoms captured by the diagnosis of PTSD as well as complex trauma symptoms that are frequently experienced by children, including:

  • Hyperarousal symptoms (such as the TOP separation anxiety items and some of the ADHD items)
  • Re-experiencing symptoms (such as the TOP sleep scale items)
  • Avoidance symptoms (such as the TOP  Violence, ADHD, Conduct and Depression).  

Finally, the TOP Trauma Screen uses a stress scale to determine the occurrences and severity of major stressful and traumatic events experienced by a child. With benchmarks to the general population, it allows workers to understand just how overwhelming stressful life events and trauma exposure has been.