Screening for child abuse and trauma during the perinatal period

Given established links between child abuse and adverse perinatal effects, many professional organizations recommend screening. Screening provides opportunities to identify survivors who may benefit from interventions and tailor care that minimizes eliciting trauma triggers and prevents re-traumatization. However, there are both client- and provider-level barriers to screening. Conditions that foster disclosures include the application of provider trauma sensitivity and use of culturally congruent screening tools. Screening should be regarded as part of a continuum of trauma responsivity that includes training, preparation, screening, offering referrals and interventions, and evaluating care. Several tools are available to screen for child abuse and other trauma and their sequelae. Basic recommendations across screening contexts include careful preparation and education on the part of the provider, identifying optimal procedures for implementation, establishing good rapport, identifying any provider self-triggers and establishing workplace support including reflective supervision, developing normalizing preamble language prior to screening, connecting past trauma to the present, addressing confidentiality, being an active listener, validating, empathizing, and showing support, "right-sizing" provider response, and making appropriate referrals. Finally, perinatal screening for child abuse must proceed in tandem with the creation, evaluation, and availability of trauma-specific interventions. Why we screen is clear; how to screen bears elucidation.