Post-Traumatic Stress Disorder (PTSD) and Trauma in Children 0–5 CLINICAL PEARLS • In Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the diagnosis of “Posttraumatic stress disorder for children 6 and younger” was added due to the strength of evidence that PTSD symptoms and treatment look different in children younger than age six. • There is no evidence to support the use of medications for PTSD and trauma in young children, and this practice should be avoided based on the strength of evidence for certain therapies. ￮ Co-morbid conditions should be treated as well, and these conditions may have supporting evidence for psychotropic use. • There is strong evidence that evidence-based therapies are effective for PTSD and trauma in this age group. Effective treatment requires the participation of a primary caregiver. • Trauma should be screened for at well-child checks and any time there is a safety concern for the child. If there is a concern for trauma and/or PTSD in infants and young children, referrals for further evaluation should be made to a trained infant mental health clinician. • In Oklahoma, every adult is a mandated reporter; if you suspect a child is a victim of abuse, neglect or exploitation, call the child abuse reporting hotline at 800-522-3511. • The Oklahoma Warmline (888-574-5437) is available to help find treatment providers for infants and young children. RATING SCALES • Questions regarding trauma and abuse are found in many developmental screeners. It is recommended that the developmental, emotional/behavioral symptoms and family/ environmental context are all screened. If there is concern for trauma symptoms in the child based on observation or initial screening, follow-up screening using the Young Child PTSD Checklist is recommended. In addition, if there is concern, the young child should be referred to an infant mental health provider. ￮ Survey of Well-Being of Young Children Screens three domains—developmental, emotional/behavioral, and family context, including safety questions. https://www.floatinghospital.org/The-Survey-of-Wellbeing-of-Young-Children/Overview ￮ Bright Futures Pediatric Intake Form Screens for environmental and emotional risk factors in the home, which can lead to trauma and PTSD.
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