By Lisa Conradi
According to the National Survey on Children’s Exposure to Violence, most of our society’s children are exposed to violence and trauma in their daily lives. Each year, millions of children and adolescents in the United States are exposed to violence in their homes, schools, and communities. Researchers have labeled children who have experienced seven or more types of victimization as “polyvictims.” For many of these children, this exposure can have both short- and long-term effects. Short-term effects include difficulty regulating emotions, challenges in cognitive development, behavior problems and attachment difficulties. Long-term effects include a higher likelihood of adverse health outcomes, such as obesity, heart disease, and cancer (Felitti et al., 1998).
In order to address this critical need, multiple efforts are underway to increase awareness, early identification, and intervention efforts related to children’s exposure to violence and trauma. One of the critical areas in need of training on the impact of violence on children is the legal system. Recently, the Safe Start Center, the American Bar Association (ABA) Center on Children and the Law, and Child & Family Policy Associates developed the “Polyvictimization and Trauma Identification Checklist and Resource Guide” (Checklist). This Checklist was designed to help lawyers and other legal advocates for children recognize the prevalence and impact of polyvictimization and perform more trauma-informed legal and judicial system advocacy. The Checklist, along with the Flowchart on Trauma-Informed Actions (Flowchart), can be used by children’s attorneys, juvenile defenders, court-appointed special advocates, and other advocates in both the dependency (child welfare) and delinquency (juvenile justice) systems.
This Checklist is not designed for attorneys or other legal professionals to administer directly to clients. Rather, it is a provider completed Checklist that provides a structure to assist the legal professional in making sense of the information they already have about the child and use that information to direct referral for treatment and other services. The Checklist is designed for legal professionals to review existing case files and information and do the following:
- Identify the types of violence exposure that the child has experienced both in his or her lifetime and more specifically within the past year. These include physical abuse, witnessing domestic violence and violence in the community.
- Identify past and current symptoms that the child is exhibiting related to the victimization. These include sleep disturbances, attachment problems, avoidance and emotional/behavioral problems.
This Checklist is designed to help the legal professional make sense of the information they have about the child’s history of exposure to violence and symptoms and use a flowchart to determine the types of services that the child needs at this time. For example, if a child is actively suicidal or homicidal, referral for immediate stabilization is warranted. If the child has a history of multiple types of victimization, is exhibiting pronounced reactions to reminders of traumatic experiences, or the caregiver identifies significant changes in the child’s emotional state, interests, or abilities during or soon after the trauma, then a referral for a trauma-informed mental health assessment and services by a trained provider is warranted. If the child is exhibiting behavior problems and no signs of trauma are evident, then referral to a general mental health provider may be indicated. Finally, if past victimization occurred without any current behavior or functioning problems then no referral may be needed at this time. The Checklist can be completed for clients of any age and can be completed at regular intervals during a case or after particular milestones or case events.
While this checklist is not designed to be diagnostic in nature, it is a valuable tool for legal professionals and advocates because it provides basic education on polyvictimization and its effects, and assists the legal professional in determining how to best meet the mental health needs of children in the justice system.
Lisa Conradi, Psy.D., is a Clinical Psychologist and Co-Director of the SAMHSA-funded CTISP-DI and ACYF-funded CASAT at the Chadwick Center for Children and Families, Rady Children’s Hospital, San Diego. Conradi was part of the team who developed the Checklist and Resource Guide on Identifying Polyvictimization and Trauma among Court-Involved Children and Youth (for Attorneys and Other Legal Advocates) with Safe Start Center, Child and Family Policy Associates, and the American Bar Association Center on Children and the Law.