Conducting a Quick Screen for Trauma - Child Interview

asking children and teens about potential traumas they may have experienced can be challenging particularly for clinicians who and mental health but we know that these adverse childhood experiences are prevalent and significantly impact lifelong health so it's essential that all pediatric health care providers feel comfortable and confident to do a routine screen for these adverse childhood experiences in the previous video we saw demonstrated how a clinician can use the a screening questionnaire to interview a parent and determine a child's ace score dr. Lawson met with ten-year-old Sam and his mom Dana and did a routine physical check-up on Sam and had no concerns for him she was about to finish the interview when Sam's mother raised that he was having difficulties at school and she also noted that there were some stresses at home dr. Lawson interviewed Dana first on her own and gave Sam an ace score of three based on what his mother was reporting she now meets with Sam on his own to ask him the same screening questions and confirm his score I Sam thanks for waiting I've talked to your mom a little bit about some of the things that we're going on at home in school and now I'm gonna spend a few minutes with you asking you some questions questions I asked all the kids some of them are gonna kind of fit for you and some of them might not fit so well but if there's things that you're curious about I'm asking or if you have questions as we're talking then feel free to ask me about why I'm asking something or ask any questions okay the first thing I wanted to check in about was how have things been going at home oh okay I guess okay you guys yeah and it sounds like there's a lot of things that have happened lots of stressors and lots of things that have happened how's your mom doing with all of that stuff okay she's fine have there ever been a time where you feel like your mom isn't able to get out of bed or do the things that she needs to do no no so she's getting out of bed and she's looking after you what's there that time you most of the time watch it's most of the time mean well she's mostly doing a lot of well she's doing a lot of stuff so she's being things pretty good I guess what are some of the things that you might think she might do a bit better oh maybe doing or getting some dinner maybe just taking sometimes I just have to get cool with Cheerios yeah so sometimes you're not having dinner you're having Cheerios for dinner how many times a week would you say that that's happening that you're having Cheerios for dinner pretty much every day pretty much every day and is your mom having Cheerios with you or you on your own having Cheerios what your mom doing Millie them ourselves you're by yourself having Cheerios and when you go to your fridge and you're open it up or is there food in your fridge if you ever had a time where there hasn't been enough food in your fridge really so there's food in your fridge unless a like unless you ate so much okay and if you've been worried about having food instead ever been a concern of yours mm-hmm it's getting pretty cold outside do you have a coat and would your boots and things to make sure you're all set for the winter no my mom keeps saying that we'll make on Marco shopping for one but we never end up doing it because she's too busy with other things so how's your mama doing okay good pretty good are there ever any times that she seems down or upset for days at a time that she hasn't been getting out of bed or that she seems to be having a really tough time she made me a little bit stressed because of Grandma can you tell me more about what you mean by a little bit stressed well they've been arguing and yelling all so who has grandma and mom yeah we've been arguing and yelling mm-hmm can you tell me a little bit more about that well they're just arguing about things aren't very nice I haven't listened to it very much I just go to my room so it's not very nice and when they are you and yell have there ever been times that you've been afraid that someone might get hurt once maybe once can you tell me a bit about that time well they were just getting really mean like more than they usually would this it's happening quite a bit now what it wasn't wasn't too bad I guess so the fighting between your grandma and your mom how intense does it get is it arguing or is it yelling screaming when they argue and yell have there been times when anybody's been physical use their fists or hands know any other way that they may have physically been fighting no no what about throwing objects or no no and what happens to you when they're fighting where are you I just go to my room nor it just so you're going to hear what we had no I'm kind of what happens afterwards well they kind of just stay away from each other for a while okay so when they're fighting it's what what I'm hearing is it's words that they're not physically hurting each other and it gets pretty scary in when people talk to has have has anyone said mean things or hurtful things to you well sometimes my grandma's criticized me a little bit like she'll tell me I'm not doing something right but then will help me with it like or explain it so you're feeling criticized by grandma what about mom she ever said mean or hurtful things to you Sam has anybody touched your body in an inappropriate way or a way that you didn't like what do you mean has anyone touched your private parts to touched you in a sexual way no Sam does anybody in your house ever hit or spank you what about hurting your bodies and they won't hurt your body no and so when I say hurt I mean things like hitting kicking punching scratching so no one's hurt you sexually or physically with anyone in your house has anyone been drinking or never been worried about people drinking too much or getting drunk or no what about other drugs No so you don't have any worries about your parents using drugs or alcohol yeah what about grandma anybody else in your family that you're worried about in that way so Sam how do you feel in your close relationships do you feel loved and cared about and shrugging what's what's that means well my mom pays more attention to my little father and then when I try to talk to my mom I want something I just really like don't really listen that well she just kind of keep doing what she's doing and then my waiter asked me again what do you want not a lot really it and don't you do this so you're not feeling loved is there any place in your life with any adults or with anyone that you're feeling loved liked it made my room but I don't really have any announcements so if you had a problem or you were hurt in some way or something was happening who would you go to for help or what would you do wouldn't have anybody I should go to my room sink like I just like being in my room sometimes and as anybody in your family ever been in jail or in prison yeah so the stressors in your house and what's going on making your mom not be there for you as much what is what do you think are some of those stressful things well probably because my grandma's fighting with your a lot and also my dad moving away because they were divorced that's right you marybelle your mom told me that your dad and your mom are together anymore and that he's moved out to BC to see your dad no when was the last time you saw him a year ago and is there a plan for you to see him no what I've heard is that you know there's some stressors and some things that are hard for you in your life and you talked to me about the arguing that's happening between your mom and your grandma that it that your dad has moved away that you're not always in the right clothes and you have to fix some of your meals and that you're not always feeling left and special but you've also told me that nobody's hurting you in a physical or verbal or a sexual way no nobody's saying mean things to you that you're not worried about your mom emotionally and that she's not worried about her all the time struggling more emotionally and that nobody you know is in prison I've been in prison though and you don't have any concerns about drugs or drinking or in your home Sam do you think some of those stressors are what's making it hard for you at school I think so probably yeah why do you think that might be a because I'm thinking about that and then I'm not I like thinking about what I'm doing at them and then I don't get very much I know that a lot dawn yeah that makes a lot of sense Sam that when things are stressful at home that kids have trouble concentrating and it affects them at school so I'm gonna talk to your mom more and we're gonna try and figure out a way that I can help you and your mom with some of that stuff okay so thanks for coming in dr. Lawson's interview with Sam confirms that as a score is three as he endorses loss of a parent due to divorce physical neglect and also a sense of emotional deprivation so we know that Sam is at elevated risk for a host of physical and mental illnesses beginning and adolescence that could persist throughout his life but dr. Lawson's now in a position to meet again with Sam and his mother and collaboratively develop a focused and evidence-based intervention plan that should help change Sam's lifetime health trajectory clinicians can visit the online trauma toolkit website for a list of resources on these evidence-based interventions which have been shown to be helpful for children like Sam and their families

Channel: Portico Network

Views: 2,160,169

Rating: 4.7575626 out of 5

Keywords: trauma, screening, trauma and children, ACE, childhood trauma

Id: rKTYOAI65zE

Length: 11min 42sec (702 seconds)

Published: Wed Mar 15 2017