Pennsylvania — Targeted Issue
Screening and Secondary Prevention for Psychological Sequelae of Pediatric Injury
March 1, 2002 - Feb. 29, 2008


University of Pennsylvania School of Medicine
Principal Investigator(s)
Award Amount


HRSA Region


EMSC Region


HPP Region





Name Roles Agency Mailing Address Office Phone Email
Flaura Winston, MD, PhD
  • Principal Investigator
University of Pennsylvania School of Medicine


Title Published Description Format Availability
Helping You Help Your Child 2005 This information and activity book are designed to help parents help their child
after an injury.
Audiocast Not Available 2012 This website was developed by an interdisciplinary team of researchers and practitioners with expertise in pediatric injury, child health care, and traumatic stress. Primary authors of site content are Flaura Winston, MD, PhD, and Nancy Kassam-Adams, PhD. Our team includes pediatricians, psychologists, trauma surgeons, trauma nurses, and others. Since 1996, this team at The Center for Injury Research and Prevention has been at the forefront of research about the effect of injury on children and their parents. Social media site Available Online
Coping With Injury: Skills for Trauma Recovery, Tools for Kids 2005 This activity book was put together to help children figure out ways to take good care of tehmselves and feel better after an injury. The book helps children to think and write about their condition since their injury and ways to facilitate their healing. The book encourages family participation by having the child share the activities with their parents or family. PDF booklet Not Available
After the Injury: Tips for Kids 2005 This activity document helps children understand their feelings following an injury and guides them to express how they are feeling following their own injury. The activity also helps children to recover by giving tips for coping. PDF document Available Online


Title Published Author Abstract Publication PMID
Looking Beyond the Physical Injury: Posttraumatic Stress Disorder in Children and Parents After Pediatric Traffic Injury 1999 Aiko P. J. de Vries, Nancy Kassam-Adams, PhD, Avital Cnaan, PhD, Elisabeth Sherman-Slate, MSW, Paul R. Gallagher, MA, Flaura K. Winston, MD, PhD Background. Traffic crashes are the leading health threat to children in the United States, resulting in nearly 1 million injuries annually. The psychological consequences of these injuries are primarily unknown. The aims of this study were to estimate the prevalence of posttraumatic stress disorder (PTSD) in traffic-injured children and their parents and to identify risk factors for PTSD development.

Methods. A prospective cohort study of traffic-injured children between 3 and 18 years of age was conducted at a level 1 Pediatric Trauma Center. The children were enrolled as part of an ongoing surveillance system of traffic-related injuries. Presence and severity of PTSD were determined in the children and their parents through a validated diagnostic questionnaire 7 to 12 months after child injury.

Results. Twenty-five percent of the children and 15% of the parents suffered diagnostic PTSD, but only 46% of the parents of affected children sought help of any form (including from friends) for their child and only 20% of affected parents sought help for themselves. Child PTSD was associated with older child age and parent PTSD. Parent PTSD was associated with younger child age, child PTSD, and parent witnessing the event. Injury severity was not predictive of PTSD.

Conclusions. PTSD in children and their parents is a common, yet overlooked, consequence of pediatric traffic-related injury with prevalence rates similar to those found in children exposed to violence. Physicians managing the pediatric trauma patient, regardless of injury severity or whether the injury was intentional, should screen for PTSD and refer for treatment where appropriate.
Pediatrics 0