CTC Childhood Trauma Assessment Techniques 3 — Questions and Answers
Question 1: Which measure specifically assesses adverse childhood experiences (ACEs) across 10 categories of household dysfunction and abuse?
- ACE Questionnaire (Correct answer)
- Childhood Trauma Questionnaire (CTQ)
- Pediatric Symptom Checklist
- Trauma Assessment Pathway (TAP)
Correct answer: ACE Questionnaire
The ACE Questionnaire, originating from the Felitti et al. (1998) study, scores 10 categories of adverse childhood experiences including abuse, neglect, and household dysfunction.
Question 2: A trauma consultant observes that a 6-year-old exhibits repetitive play involving themes of a car accident the child witnessed. This behavior is BEST understood as:
- Normal imaginative play with no clinical significance
- Post-traumatic play, a potential indicator of trauma processing (Correct answer)
- Evidence of conduct disorder
- A sign of intellectual disability
Correct answer: Post-traumatic play, a potential indicator of trauma processing
Post-traumatic play, in which children repetitively reenact trauma themes, is a recognized indicator of unresolved trauma in young children.
Question 3: The Clinician-Administered PTSD Scale for Children and Adolescents (CAPS-CA) is considered a gold standard because it:
- Can be self-administered by children as young as 5
- Provides both frequency and intensity ratings for each PTSD symptom (Correct answer)
- Relies entirely on behavioral observation without interviewing
- Is the only free, publicly available PTSD measure
Correct answer: Provides both frequency and intensity ratings for each PTSD symptom
The CAPS-CA captures both the frequency and intensity of each PTSD symptom, yielding dimensional severity scores aligned with DSM criteria.
Question 4: When using the Child Behavior Checklist (CBCL) in a trauma assessment, the consultant should be aware that:
- It directly diagnoses PTSD
- Elevated scores must always indicate trauma-specific pathology
- Elevated internalizing and externalizing scores may reflect trauma but require integration with history and clinical interview (Correct answer)
- It is only valid for children over 12
Correct answer: Elevated internalizing and externalizing scores may reflect trauma but require integration with history and clinical interview
The CBCL measures broad behavioral and emotional problems; elevated scores are nonspecific and must be interpreted within the full clinical context.
Question 5: A 10-year-old denies any distress about a confirmed trauma event. The MOST clinically sound response is to:
- Accept the denial at face value and close the case
- Diagnose the child with avoidant attachment disorder
- Recognize that minimization and avoidance are common trauma responses and gather collateral information (Correct answer)
- Conclude that no trauma impact occurred
Correct answer: Recognize that minimization and avoidance are common trauma responses and gather collateral information
Avoidance and minimization are core features of post-traumatic stress; obtaining collateral data from caregivers and teachers provides a fuller picture.
Question 6: Which developmental consideration is MOST important when assessing trauma in a toddler (ages 1–3)?
- Toddlers can reliably complete structured self-report inventories
- Behavioral observation and caregiver report are the primary assessment methods (Correct answer)
- Toddlers do not experience PTSD and assessment is unnecessary
- Projective sentence-completion tasks are the preferred method
Correct answer: Behavioral observation and caregiver report are the primary assessment methods
Toddlers lack the verbal and cognitive capacity for self-report, making caregiver-report instruments and direct behavioral observation essential.
Question 7: Functional impairment is assessed in trauma evaluations primarily to:
- Determine whether the child is eligible for criminal prosecution
- Establish symptom severity, guide treatment planning, and meet DSM diagnostic thresholds (Correct answer)
- Replace the need for a trauma exposure history
- Calculate the child's IQ score
Correct answer: Establish symptom severity, guide treatment planning, and meet DSM diagnostic thresholds
DSM-5 requires clinically significant impairment in social, academic, or other functioning for a PTSD diagnosis, and severity informs treatment intensity.
CTC Childhood Trauma Assessment Techniques 3
Which measure specifically assesses adverse childhood experiences (ACEs) across 10 categories of household dysfunction and abuse?