# Evidence-based assessment/Instruments/Child PTSD symptom scale

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The Child PTSD Symptom Scale (CPSS) is a free checklist designed for children and adolescents to report traumatic events and symptoms that they might feel afterward. The items cover the symptoms of posttraumatic stress disorder (PTSD), specifically, the symptoms and clusters used in the DSM-IV. Although relatively new, there has been a fair amount of research on the CPSS due to the frequency of traumatic events involving children. The CPSS is usually administered to school children within school boundaries, or in an off-site location to assess symptoms of trauma. Some, but not all, people experience symptoms after a traumatic event, and in serious cases, these people may not get better on their own. Early and accurate identification, especially in children, of experiencing distress following a trauma could help with early interventions. The CPSS is one of a handful of promising measures that has accrued good evidence for reliability and validity, along with low cost, giving it good clinical utility as it addresses a public health need for better and larger scale assessment.

## Development and history

The instrument was developed in order to address the issues that the previous child PTSD assessment, namely the CPST-RI, failed to consider. Specifically, the CPSS was created to ensure that the symptoms of flashbacks, feelings of a shortened future, memory gaps of the trauma, irritability or anger, and hyper-vigilance are assessed for children at risk of having PTSD. The CPSS was developed using the PTDS (Posttraumatic Diagnostic Scale) scale as a model of a well-validated assessment for adults; researchers modified it to make it more comprehensible for children. It has one question for every of the 17 symptoms mentioned in DSM IV and includes a section assessing relationships and school-work. The seven items added to assess daily functioning were made child-relevant. The changes were made in order to create a practical scale that could better assess each symptom cluster in PTSD, and could be used efficiently with groups of children in setting such as schools, while requiring less administration time.

## Use in other populations

The CPSS has been translated into multiple languages including Armenian, Chinese, German, Hebrew, Korean, Norwegian, Polish, Russian, Spanish, and Swedish.

## Scoring and Interpretation

The CPSS contains a total of 26 questions, the first two of which are free-response items about the patient's most recent distressing event. The next 17 items have the patient report the frequency of a symptom over a two-week period on a 0 (not at all) to 3 (almost always) Likert scale. The last 7 items inquire if the patient has had functional impairment in certain areas the last two weeks, and these items are scored Yes or No.
The ratings of the first 17 items on the CPSS are summed and have a range of 0-51. The CPSS scoring sheet generally divides this range into PTSD severity, increasing from below threshold (0-10) to moderate (21-25) to extremely severe (41-51).
The last portion of the CPSS has a separate impairment severity score with a range of 0-7. A "No" on an item is graded a 0, and a "Yes" on an item is graded a 1.