Children’s Trauma Assessment Center, Michigan
This is one of 31 program profiles that appears in Support Matters, Lessons from the Field on Services for Adoptive, Foster, and Kinship Care Families (PDF – 2 MB), published March 2015.
The Children’s Trauma Assessment Center at Western Michigan University provides a comprehensive neurodevelopmental assessment of the impact of trauma on children, and informs families and caseworkers about the assessment results.
- Children and youth ages three months to 18 who are in foster care or kinship care or who have been adopted or who otherwise need a trauma assessment.
- Each year, the center serves about 250 children and youth from across Michigan. 75 percent of children served are in foster care or kinship care, 15 percent have been adopted, and 10 percent are with their birth parents.
Theory of change
If caregivers understand the effect of trauma over a child’s lifespan, they are better able to meet the needs of children who have experienced complex trauma and violence. Children have the best chance to succeed in a family and in the community if those caring for and interacting with them understand their behaviors and relationships from a trauma-informed perspective. A trauma-informed perspective also includes a focus on resiliency to create the optimum opportunities for child well-being.
The Children’s Trauma Assessment Center is a transdisciplinary (medicine, social work, occupational therapy, speech and language) clinic at Western Michigan University, which is a public university.
Role of public child welfare agency
Public child welfare agencies across the state make referrals to the program.
Key service components
The neurodevelopmental trauma-informed assessment includes:
- Brief medical exam
- Screening for fetal alcohol spectrum disorder
- Assessment of children’s language, attention, visual processing, motor processing, executive function, and memory
- History from parents and caregivers about children’s social and emotional functioning using the Child Behavior Checklist, Child Sexual Behavior Inventory, and Sensory Profile
- Psychosocial interviews with children to understand each child’s perspective and worldview, including perception of self
- Use of trauma-specific tools to determine symptoms of post-traumatic stress disorder, depression, anxiety, and other conditions that may result from trauma
- Assessment of caregiver and child attachment using
- Theraplay tools
- Immediately after the assessment, staff conduct an interdisciplinary team meeting to discuss assessment results and begin to formulate findings and recommendations. Next, they develop a written report for caregivers presenting and explaining the results and explaining the child’s behavior from a trauma perspective.
- Staff then meet in person or by phone with caregivers to discuss the assessment and explore in-home and out-of-home services and interventions that may help, as well as those that are not likely to benefit the child. Staff educate parents or caregivers about the impact of trauma on the brain and how trauma affects a child’s behavior. If applicable, a physician will discuss options for medications with caregivers and will write a report to the child’s physician about any pharmacological needs.
- In some cases, staff will also:
- Attend school meetings or discuss the assessment findings with treatment providers
- Make recommendations for placement options
- Work with case managers to ensure serves are provided
Some center staff provide children with evidence-informed therapies, such as Trauma-Focused Cognitive Behavioral Therapy, Parent-Child Interaction Therapy, and Theraplay. (See pages 222, 232, and 236 of Support Matters (PDF – 2 MB) for more information on these therapies.) The center typically serves just one or two children at a time, and therapy is provided away from the assessment center.
The center is well known to the child welfare community and most referrals come from caseworkers. For those outside the system, referrals come primarily from doctors or schools.
- 8 staff involved in assessments, including 4 clinicians, 1 clinical director, and 4 university faculty (in speech and language, occupational therapy, medicine, and social work)
- Up to 12 interns per semester, including 4 in the master’s degree of social work program, 3 in speech, 2 in nursing, and 3 or 4 in occupational therapy
- 2 support staff
- 2 staff who work on specific grants
- 1 evaluator who supervises 2 research coordinators working on specific grants
All staff have an educational background or experience in trauma-informed care.
- Interns receive 12 hours of training on the assessment process and the tools used to conduct it, as well as eight to 10 hours of training in issues such as fetal alcohol spectrum disorder and trauma, sensory processing issues, attachment, complex trauma, and trauma-informed assessments.
- Interns also receive one hour of ongoing training each week.
- Supervisors use one-way mirrors to observe assessments and provide feedback to interns during and after assessments.
Evaluation and outcomes
The Center collects data on the children who have been through an assessment and has published several articles from the data, but has not done any research or follow-up with those served. Both caseworkers and parents provide positive reviews of the Center’s services.
Research in the field generally has shown that children who have a thorough assessment fare better than those who do not.
Approximate annual budget for services described
$800,000 (The organization receives an additional $1.3 million dollars a year from federal and state grant work focused on developing trauma-informed systems in Michigan.)
- Child welfare departments pay a fee for the assessment of foster children.
- For adoptive parents, adoption subsidy benefits may pay a portion of the costs; parents may pay the remainder.
- Multiple contracts, including a contract with the Michigan Department of Community Health to provide trauma-informed mental health care to local mental health systems, and two family drug court grants to build trauma-informed drug courts.
- Donations and grants.
- Training fees.
The center also has a number of grants for special research or training projects in certain counties or areas of the state.
Partnerships required or recommended
Center staff work closely with child welfare caseworkers, who make referrals for assessments.
Demand for assessments is very high, and the center has a waiting list of 10 months. A delayed assessment can affect the child’s permanency plan and limit the services or support provided to the child.
The University’s current leadership is very supportive of the program, but there is no formal, ongoing commitment to maintain the Child Trauma Assessment Center. As a result, center staff are committed to identifying other sources of funding and support.
Background and future directions
In 2000, five professionals (three professors, a physician, and a community therapist) with extensive experience working in child welfare began to discuss how the system could better serve children who had experienced trauma. Western Michigan University’s dean of the College of Health and Human Services provided seed money to conduct a needs assessment. Subsequently, a local foundation made a $20,000 start-up grant, which provided the initial funds to open the Children’s Trauma Assessment Center.
Center staff have conducted training around the state to create similar assessment centers. They also have a contract with the State of Michigan to expand trauma-informed practice around the state. As part of this effort, they have conducted training on the assessment and in providing Trauma-Focused Cognitive Behavioral Therapy.
- Dr. James Henry, project director, Children’s Trauma Assessment Center: 269-387-7073
- Margaret Richardson, research evaluator and clinical interventionist: 269-387-7073
- Children’s Trauma Assessment Center website
Betsy Bennett, Connie Black-Pond, James Henry, Frank Vidimos, and Cara Weiler, interview, July 8, 2013.
Children’s Trauma Assessment Center website, accessed July 1, 2013.