An Examination of Exposure to Traumatic Events and Symptoms and Strengths for Children Served in a Behavioral Health System of Care.

The present study examined how exposure to traumatic events impacts children with severe emotional disturbance who are being served in a school-based system of care. Multilevel growth curve models were used to examine the relationships between a child's history of traumatic events (physical abuse, sexual abuse, or domestic violence) and behavioral and emotional strengths, internalizing problem behaviors, or externalizing problem behaviors over 18 months. Results indicate that children receiving services (N = 134) exhibited increased emotional and behavioral strengths and decreased internalizing and externalizing problem behaviors from enrollment to 18 months follow-up. Children with a history of traumatic events improved more slowly than children without such a history on both strengths and internalizing problem behaviors, even after controlling for dosage of services received and other characteristics previously found to predict outcomes. Gender was also related to improvement in internalizing symptoms. Results highlight the continued need to assess the impact of exposure to traumatic events for children served in a system of care.