title: Health, emergency department use, and early identification of young children exposed to trauma.
abstract: BACKGROUND
  Childhood trauma is an important public health problem with financial, physical health, and mental health repercussions. Emergency departments (EDs) are often the first point of contact for many young children affected by emotionally or psychologically traumatic events (e.g., neglect, separation from primary caregiver, maltreatment, witness to domestic violence within the family, natural disasters).
  
  
  OBJECTIVE
  Describe the prevalence of physical health symptoms, ED use, and health-related problems in young children (birth through 5 years) affected by trauma, and to predict whether or not children experiencing trauma are more likely to be affected by health-related problems.
  
  
  METHODS
  Community-based, cross-sectional survey of 208 young children. Traumatic events were assessed by the Traumatic Events Screening Inventory - Parent Report Revised. Child health symptoms and health-related problems were measured using the Caregiver Information Questionnaire, developed by ORC Macro (Atlanta, GA).
  
  
  RESULTS
  Seventy-two percent of children had experienced at least one type of traumatic event. Children exposed to trauma were also experiencing recent health-related events, including visits to the ED (32.2%) and the doctor (76.9%) for physical health symptoms, and recurring physical health problems (40.4%). Children previously exposed to high levels of trauma (four or more types of events) were 2.9 times more likely to report having had recently visited the ED for health purposes.
  
  
  CONCLUSIONS
  Preventing recurrent trauma or recognizing early trauma exposure is difficult, but essential if long-term negative consequences are to be mitigated or prevented. Within EDs, there are missed opportunities for identification and intervention for trauma-exposed children, as well as great potential for expanding primary and secondary prevention of maltreatment-associated illness, injury, and mortality.
authors.affiliation: Division of Prevention and Community Research, Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut.
authors.forename: Yvonne Humenay
authors.initials: YH
authors.lastname: Roberts
authors.affiliation: Division of Prevention and Community Research, Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut.
authors.forename: Cindy Y
authors.initials: CY
authors.lastname: Huang
authors.affiliation: Division of Prevention and Community Research, Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut.
authors.forename: Cindy A
authors.initials: CA
authors.lastname: Crusto
authors.affiliation: Division of Prevention and Community Research, Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut.
authors.forename: Joy S
authors.initials: JS
authors.lastname: Kaufman
mesh_terms: D002649:Child Abuse / Q000523:psychology; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D007223:Infant; D008016:Life Change Events; D016015:Logistic Models; D008297:Male; D013315:Stress, Psychological / Q000209:etiology; D014481:United States / Q000453:epidemiology
keywords: pediatric; physical health; prevention; trauma exposure