Child and caregiver concordance of potentially traumatic events experienced by orphaned and abandoned children

Exposure to trauma is associated with significant emotional and behavioral difficulties among children. Overall, reports of trauma and violence experienced by children are discrepant from those of their caregivers. Even less is known about the extent of concordance between orphans and their caregivers. This study examines the correlates of concordance in reported traumatic experiences between 1269 orphaned and abandoned children (OAC) and their caregivers. The OAC lived in family-settings in five low-and middle-income countries (LMICs) and were part of a longitudinal study, Positive Outcomes for Orphans (POFO) that enrolled children aged 6 to 12 at baseline. By examining concordance with respect to specific types of trauma reported, this study expands the understanding of who reports which types of traumas experienced by OAC, thereby improving the potential to provide targeted interventions for children who have experienced such events. In this study, children and caregivers were asked separately if the child had experienced different types of potentially traumatic events (PTEs). Children were significantly more likely to report physical abuse, sexual abuse, and family violence than were caregivers. Caregivers were significantly more likely than children to report natural disasters and accidents. High levels of concordance were found in the reporting of wars, riots, killings, and deaths in the family. The impacts of trauma on behavior and mental health are profound, and highly effective interventions targeting sequelae of childhood trauma are currently being developed for use in low-resource areas. Findings from this study demonstrate that it is feasible to conduct screening for PTEs utilizing child self-report in resource limited settings and that child self-report is crucial in evaluating trauma, particularly family violence and physical or sexual assault.