Evaluating Treatment Outcomes for Maltreated Preschoolers: The Role of Trauma-Informed Assessment

• In Event: Poster Session 04
  In Poster Session: PS 04 Topic - Prevention and Interventions

Abstract

Growing evidence suggests that severe maltreatment threatens to disrupt the development of preschool-aged children. Indeed, early and sustained maltreatment increases the risk for significant impairment across a variety of domains (Cicchetti et al., 2016; Cowell et al., 2015). Effects of such developmental impairment can be long-lasting; developmental cascades propel untreated impairment into adulthood (Masten & Cicchetti, 2010). As such, effective interventions can support a critical shift for children with impairment from trauma exposure – yet outcomes for children who evidence dysfunction in multiple domains can be challenging to assess. The present study will address the recovery process of treatment-seeking preschoolers with severe maltreatment histories, with the goal of understanding developmentally sensitive and trauma-informed measurement practices that may lead to more accurate outcomes assessment, including delayed baseline assessment.

Children in this study received trauma-informed services aiming to build developmental capacity, for example by improving dysregulation in self-regulatory and relational domains. Children’s recovery process was assessed across three domains: child behavior problems (teacher report, CTR-F; Achenbach & Rescorla, 2001), child protective factors (therapist report, DECA-C; LeBuffe & Naglieri, 2003), and adaptive functioning (therapist report, Vineland-3; Sparrow et al., 2016).

Participants were 25 preschoolers ages 3- to 6-years old (M = 4.16, SD = .59), who received services at a therapeutic preschool in a Midwestern city from 2017-2020. The majority of children (64%) were male. Sixty-four percent of the children were African American or Black, 28% were White, and 8% were biracial (African American/Black and White). All children received an initial assessment after 30 days of treatment; this delay occurred as a trauma-informed approach to allow time for raters to better understand children’s complex symptoms and to build comfort in reporting on sensitive issues. Given the severity of dysregulation seen in the population, however, it is not clear whether 30 days is sufficient or if more time is necessary to receive accurate reporting of children’s baseline functioning. Children were also assessed after 3 and 6 months of treatment.

The aim of this project is to describe developmentally informed measurement practices for treatment-seeking maltreated children. We will examine whether a 30 day or a 3 month assessment is most appropriate for a baseline assessment. We expect that the severity of children’s symptoms will be substantial at both 30 day and 3 month time points, which perhaps indicates that either time point might provide an appropriate baseline assessment. We will evaluate children’s progress from both the 30 days and 3 month baselines over time to the 6 month time point as a way to examine utility of a delayed baseline assessment.

Preliminary descriptive analyses (see attached table) suggest that children entering treatment presented with severe symptomology. These symptoms remained elevated at 3 months of treatment, but began to improve in some domains after 6 months. Given continued elevation at 3 months, considerations for delayed baseline assessment will be discussed. Despite some relief, significant difficulty persists for these children at 6 months, indicating that additional time to heal is needed for children with such substantial initial severity.

Authors

• Luisa Lopez Mader, University of Missouri - Kansas City
  Presenting Author

• Kaia Schott, University of Missouri-Kansas City
  Non-Presenting Author

• Jennifer O. Collins, University of Missouri-Kansas City
  Non-Presenting Author

• Sharon Skidmore Stern, FamilyForward
  Non-Presenting Author

• Erin Porter Hambrick, University of Missouri - Kansas City
  Non-Presenting Author