Screening for trauma in pediatric primary care

Purpose of Review
Provided the high prevalence of trauma exposure in childhood as well as the risk for morbidity, this article examines evidence, a recommended approach, and key implementation factors relevant to screening for trauma in pediatric primary care.

Recent Findings
A standardized approach to trauma screening is possible, but previous attempts have relied heavily upon exposure screening and failed to guide an individualized response specific to the impact of trauma on the child and family. Trauma screening tools for pediatric primary care should be brief and inform the care response based on screening for trauma exposure, traumatic stress symptoms, functional impact, and suicidality.

Summary
Clinicians should use trauma screening to (1) identify if the child has any ongoing risk of harm and report where required; (2) determine risk of suicidality and respond appropriately; (3) assess need for evidence-based trauma treatment based on symptoms and functional impact; and (4) provide a skill or guidance targeting the most severe or pressing traumatic stress symptoms.