Feasibility and reliability of a trauma-informed measure of child well-being

As interest in trauma-informed assessment grows, client-level screening and diagnostic tools, as well as organizational- and systems-level evaluation tools, are emerging. However, measures conceptually grounded in a developmental trauma framework are still lacking. The purpose of the present study is to describe the development and initial testing of the Trauma-Informed Child Well-Being Scale (T-CWS), a developmentally informed, relationship-based, and trauma-sensitive measure of child social-emotional well-being.

The T-CWS is a 25-item observational tool based on child-caregiver dyadic interactions. Consistent with the principles of trauma-informed care, the T-CWS has three subscales: Connection, Felt-Safety, and Regulation. Participants comprised 20 clinicians who were trained to use the T-CWS and then independently scored 15 prerecorded videos, for a total of 300 observations. Participants also rated the T-CWS for feasibility, appropriateness, and acceptability.

Using generalizability theory to account for the variance attributable to participants, repeated scale items, and repeated videos viewed, analyses indicated moderate to substantial internal consistency. The T-CWS reliably differentiated stable individual differences between cases and was able to detect systemic variation in videos. Further, participants rated the T-CWS as a feasible, appropriate, and acceptable instrument for use in clinical practice.

The T-CWS shows promise as a new measure for assessing child well-being through the lens of developmental trauma. While further testing is needed, the T-CWS could help providers better evaluate the needs and treatment goals of trauma survivors. Further, the T-CWS could prove useful for assessing individual outcomes associated with trauma-informed care. (PsycInfo Database Record (c) 2025 APA, all rights reserved).