Young Child PTSD Screen

Abstract

The Young Child Post-Traumatic Stress Disorder Screen (YCPS) is a specialized, six-item, caregiver-report checklist designed for the rapid screening of PTSD symptoms in very young children (ages 3–6 years) following a traumatic event. Developed by Michael Scheeringa, the YCPS is intended for use in the acute aftermath of trauma (2–4 weeks post-event) or in settings where extensive mental health assessment is impractical. It is engineered to identify children who require immediate referral for clinical intervention, specifically targeting the identification of youth exhibiting at least five diagnostically relevant PTSD symptoms based on developmentally sensitive diagnostic criteria.

Keywords

Young Child PTSD Screen, YCPS, Post-Traumatic Stress Disorder, Child Trauma, Caregiver Report, Early Childhood Screening, Acute Stress, Developmental Psychopathology

Authors

Michael Scheeringa, MD, MPH

Purpose

The primary purpose of the Young Child PTSD Screen (YCPS) is to serve as a quick, developmentally sensitive checklist for caregivers to complete, enabling rapid identification of young children who require referral for clinical treatment following a traumatic event. The tool is highly specialized, consisting of only six items aimed at maximizing efficiency.

The YCPS is specifically intended for use in the acute phase following trauma, typically within two to four weeks of the event, and in clinical or community settings where time constraints prevent longer, more comprehensive assessments. It is crucial to note that the YCPS is explicitly designed as a screening instrument and is not validated or intended for making a formal clinical diagnosis of PTSD.

Construct

The YCPS measures the presence and severity of core symptoms associated with Post-Traumatic Stress Disorder (PTSD) in young children, utilizing a developmentally sensitive approach aligned with diagnostic algorithms proposed by Scheeringa and colleagues. The scale focuses on symptoms that are most commonly observed and reliably reported by caregivers in this age group, specifically targeting items from the re-experiencing cluster (Criterion B) and the increased arousal cluster (Criterion D) of PTSD criteria.

The six chosen items were empirically derived to maximize the probability of identifying children who meet the threshold of at least five PTSD symptoms, which is a common inclusion requirement for clinical intervention trials. Symptoms related to foreshortened future and lack of memory were deliberately excluded, as they are rarely endorsed in this population, ensuring the scale maintains developmental appropriateness and utility.

Validity

The validity of the YCPS was established through an empirical selection process using data from 284 trauma-exposed children aged 3–6 years participating in a National Institute of Mental Health-funded study (R01 MH65884-01A1). The gold standard used to evaluate the screen’s performance was the presence of at least five diagnostically relevant PTSD symptoms.

The six final items (b4b1b2d1d2d5) were selected because this combination demonstrated the highest sensitivity (100%) and a perfect Negative Predictive Value (NPV=100%) when requiring two endorsed symptoms for a positive screen. This combination also provided the best balance, including three items from the re-experiencing cluster and three items from the increased arousal cluster, while utilizing items considered easiest for caregivers to understand and rate accurately. The performance measures of the selected six-item set were: Sensitivity (100%), Specificity (42.9%), Positive Predictive Value (PPV) (70.8%), and NPV (100%).

Reliability

While the source content does not explicitly provide traditional internal consistency or test-retest reliability statistics (such as Cronbach’s alpha), the scale’s development process relied on rigorous empirical data selection to ensure symptom items were highly relevant and frequently endorsed (occurring in at least 20% of the subjects in the validation sample). The selection criteria prioritized combinations exhibiting high sensitivity and NPV, suggesting the tool is highly reliable in identifying true positive and true negative cases relative to the established clinical criterion.

Factor Analysis

Formal factor analysis results are not provided; however, the scale structure is based on the conceptual grouping of PTSD symptom clusters. The final six-item set was explicitly chosen to maintain a balance between two major symptom clusters: three items from Criterion B (Re-experiencing) and three items from Criterion D (Increased Arousal). This structural choice reflects an attempt to cover the primary symptomatic domains relevant to PTSD diagnosis in young children, avoiding redundancy (like the exclusion of avoidance due to its high correlation with distress at reminders).

Instrument

Test Type: Screening Checklist / Caregiver Report

Format: 6 symptom items, preceded by a 12-item traumatic event checklist. Symptom items are scored using a 3-point Likert scale, but scored dichotomously (0 vs. 1/2).

Language Available: English (Original)

Population Group: Clinical and community youth exposed to trauma.

Age Group: Young children (typically 3 to 6 years old).

Population Details: The scale was developed using empirical data from 284 trauma-exposed children aged 3–6 years.

Test Methodology: The caregiver rates the frequency/severity of six specific symptoms over the last two weeks using a 3-point Likert scale (0=No, 1=A little, 2=A lot). Scoring is dichotomous: any endorsement (1 or 2) counts as a “yes.” A total of two or more “yes” answers constitutes a positive screen, recommending referral for treatment. A single endorsed symptom is considered marginally positive and warrants further testing.

Keywords

YCPS, Child Mental Health, Trauma Screening, Clinical Referral, Sensitivity, Specificity, Caregiver Checklist

Authors

Author ORCID Identifier: Not provided in source content.

Affiliation Email addresses: [email protected]

Correspondence Address: Michael Scheeringa, MD, MPH, Tulane University, New Orleans, LA.

Permissions & Fee and Test Year

The Young Child PTSD Screen (YCPS) was developed in 2010. The author, Michael Scheeringa, MD, MPH, grants permission for this form to be reproduced and used for free, provided it is not sold. Permissions should be directed to the author via email.

Reference’s

• Scheeringa MS (2009). Posttraumatic stress disorder. In CH Zeanah (Ed.), Handbook of Infant Mental Health, third edition (pp. 345-361). New York, NY: Guilford Press.

• Cohen JA, Deblinger E, Mannarino AP, Steer RA (2004). Journal of the American Academy of Child and Adolescent Psychiatry 43(4), 393-402.

• Cohen JA, Scheeringa MS (2009). Post-traumatic stress disorder diagnosis in children: Challenges and promises. Dialogues in Clinical Neuroscience 11(1), 91-99.

• Scheeringa MS (in press). PTSD in Children Younger Than Age of 13: Towards a Developmentally Sensitive Diagnosis. Journal of Child & Adolescent Trauma.

• Scheeringa MS, Weems CF, Cohen JA, Amaya-Jackson L, Guthrie D (2010). Trauma-focused cognitive-behavioral therapy for posttraumatic stress disorder in three through six year-old children: A randomized clinical trial. Journal of Child Psychology and Psychiatry. Article first published online 14 Dec. 2010. doi: 10.1111/j.1469- 7610.2010.02354.x

Items of the Young Child PTSD Screen

YOUNG CHILD PTSD SCREEN (YCPS)

• Name
• ID
• Date

TRAUMATIC EVENTS

An event must have led to serious injury or be perceived as if it could have led to serious injury to the child, or to another person (usually a loved one) and the child witnessed it and is usually sudden and/or unexpected.

0 = Absent 1 = Present

Circle 0 if the event has not happened and 1 if the event has happened to your child.

Frequency is the number of events the child can remember. Generally, children start remembering events around 3 years of age.

Frequency

Below is a list of symptoms that children can have after life-threatening events. Circle the number (0, 1, or 2) that best describes how often the symptom has bothered your child in the LAST 2 WEEKS. Circle a 1 or 2 only if the symptom began or worsened after one of the traumatic events on the first page.

SCORING

Two symptoms endorsed (either 1 or 2) is considered a positive screen and should be referred for treatment. A child with one only symptom endorsed is marginally positive and should be referred for further testing at a minimum.