The "Experiences" section of the Montana EES includes questions about what, if any, potentially traumatic experiences or events (PTEs) the child has encountered. Questions in the "Experiences" section are informed by a review of screening instruments designed to detect trauma in young people and existing by research concerning the most common categories of victimization and trauma types. Montana EES questions were vetted and fine-tuned by the LSOC research team, the Vision 21 Screening Tool Workgroup, and national partners including National Children's Trauma Network, the Child and Family Service Division of the Montana Department of Public Health and Human Services, the Montana Alliance for Youth, and the Montana Institute for Educational Research & Service. Nine primary categories of victimization and trauma are included in the Montana EES (OJJDP; Finkelhor et al., 2015). They include:

1. Maltreatment and neglect, including physical abuse by a caregiver, psychological or emotional neglect, and family abduction.
2. Property victimization, such as theft from family or the young person. Research indicates that children who have been victims of theft are more likely to be poly-victimized (Plass, 2014).
3. Peer and sibling victimization, such as gang or group assault, peer or sibling assault, physical intimidation by peers, and peer relational aggression.
4. Sexual victimization, which constitutes all unwanted sexual touch.
5. Witnessed victimization, is when someone the young person knows is threatened or harmed.
6. Exposure to family violence and abuse, including instances in which a parent verbally threatens the other parent, or physically assaults the other parent.
7. Internet and cell phone victimization, such as when a peer uses the internet or a cell phone to share unflattering pictures or spread rumors.
8. Bereavement, as with the loss of a loved one.
9. Medical trauma, which addresses the stress associated with living in a home with a sibling, or parent/guardian who has experienced a long-term chronic illness.

Maltreatment and Neglect

Child maltreatment and neglect is addressed below. A “Yes” answer to the question may indicate a parent or caregiver’s inability to provide for their family for a variety of reasons. Of particular concern, a “Yes” response could suggest a parent’s inability to look after a child because of drug or alcohol abuse or psychological problems. It may also indicate parental abandonment or that people who are in the home make the child fearful. A “Yes” answer could also indicate that the home is unsafe or unsanitary, suggesting a failure to attend to the child’s welfare.

• Have you frequently been denied meal because your caregiver or parent was angry with you?
• Have you ever not had a home or shelter to stay in?
• Has anyone kept you from seeing the doctor when you were hurt?

Property Victimization

Having something taken unexpectedly can result in a feeling of vulnerability and helplessness and a decreased sense of safety.

• Has anyone ever stolen something form you or your family?
  • Finkelhor: “any property victimization, including robbery, vandalism, or theft by a non-sibling.”

Maltreatment and Neglect

The question below also addresses child maltreatment and neglect. Answering “Yes” to this question could suggest a parent’s inability to look after a child because of drug or alcohol abuse or psychological problems. It could also indicate parental abandonment, that there is a presence in the home of people who make the child fearful, or that the home is unsafe or unsanitary. A “Yes” answer here may also suggest a failure to attend to the child’s welfare.

• Have you ever seen someone who cares for you drink a lot or do drugs in front of you?
• ACEs: “Did you live with anyone who was a problem drinker or alcoholic or who used street drugs?

Peer and Sibling Victimization

Examples include emotional bullying or relational aggression, spreading lies or rumors, or otherwise trying to disparage a young person. Further instances of peer and sibling victimization occur when peers exclude, ostracize or ignore a child

• Have other kids, including your brothers or sisters, ever hurt you or threatened to hurt you (emotionally or physically)?
  • Finkelhor: Types of emotional bullying or relational aggression, including peers, spreading lies or rumors about the child or otherwise trying to make the child be disliked; and peers excluding, ostracizing, or ignoring a child.
  • Finkelhor: Also found under “Assaults and bullying: Any physical assault, assaults with weapon, assaults with injury, assaults without a weapon or injury, attempted assault, attempted or completed kidnapping, assaults by a juvenile sibling, assault by a non-sibling peer, assault by a gang or a group.”
  • CTS Question: “has someone ever really hurt you? Hit, punched, or kicked you really hard with hands, belts, or other objects, or tried to shoot or stab you?
  • CCDCI: How often have you been threatened or beaten up?

Medical Trauma

The following question addresses a different kind of trauma that can have lasting effects. This question specifically addresses medical trauma. Literature surrounding the topic suggests that children who have siblings or parents with long-term medical issues are at an increased risk for developing feelings of “loneliness and isolation, anxiety, depression, vulnerability, anger, worry, school problems, withdrawal or shyness, somatic complaints, low self-esteem, and internalizing or externalizing behavior problems.” (Chen, 2017; Williams et al., 2009; and Sharp and Rossiter, 2002).

• Has anyone in your home had special care because they were sick for a long time *cancer, epilepsy, cystic, fibrosis, etc.)?
  • Discussion in the workgroup based on prior experience led to the inclusion of this question.
  • Loosely associated with ACEs: “was a household member depressed or mentally ill or did a household member attempt suicide.
  • CTS: “Serious accident or illness?”

Internet/Cell Phone Victimization

The following question addresses internet and cell phone victimization, which can trigger significant trauma in young people. Examples of this could include, but are not limited to, sharing of personal information, such as photos or texts, and spreading rumors.

• Has anyone ever used the internet or a cell phone to hurt or embarrass you (starting rumors, sharing pictures)?
  • Finkelhor: “Use of cell phone/texting to harass a child or spread harmful words and pictures about or of the child.”

Witnessed or Indirect Victimization

The following question addresses exposure to family violence and abuse, the sixth category of trauma and victimization identified in OJJDP literature. Children living in homes where domestic violence occurs are exposed to the physical and emotional abuse of the adult victim (a mother, father, grandparent, or caregiver, for example). They may witness an abuser physically or verbally harming their caregiver. The abuser may threaten a household member with guns, knives or other weapons with the child present. Research shows that children and youth who witness a parent being abused may suffer from detrimental effects (Osofsky, Joy D. 1999; Koenen, K.C., et al., 2003). Even if the juvenile doesn't see an actual physical assault, they are often exposed to its aftermath - broken furniture, food strewn about, and smashed pictures. It is not uncommon for young witnesses to observe adult victims who are upset, crying or carry evidence of the family violence, such as bruises and scratches.

• Have you ever seen one of your parents or caregivers threaten to or physically hurt another person in your home?
  • Finkelhor: “Any witnessed violence (if the child saw or heard the assault); witnessed family assault; witnessed partner assault; witnessed physical abuse; witnessed other family assault.”
  • CANS: “Severity of exposure to family violence.”
  • ACES: “Was your mother or stepmother often pushed, grabbed, slapped, or had something thrown at her? Or sometimes or often kicked, bitten hit with a fist, or hit with something hard? Or ever repeatedly it over at least a few minutes or threatened with a gun or knife?
  • CCDCI: How often have you seen someone threatened or beaten up?

Maltreatment and Neglect

The following question focuses on physical maltreatment of a juvenile by a person responsible for the child or youth’s welfare. State law requires all incidents of physical maltreatment be reported to child welfare officials.

• Has a parent or caregiver physically hurt you?
  • Finkelhor: “Any maltreatment, physical abuse, psychological or emotional abuse, neglect, custodial interference, or family abduction.”
  • CANS: Child’s/youth’s experience of physical abuse
  • ACEs: “Did a parent or other adult in the household often: swear at you, insult you, put you down or humiliate you? Or act in a way that made you afraid that you might be physically hurt?”
  • ACEs: “Did a parent or other adult in the household often push, grab, slap, or throw something at you? Or ever hit you so hard that you had marks or were injured?”
  • CCDCI: How often have you been slapped, punched, or hit?

Bereavement

The next question was built to address trauma associated with witnessing a parent or caregiver removed from the home. With this prompt, the LSOC Team seeks to identify feelings of abandonment and of bereavement.

• Have you ever seen a parent or loved one removed from your home (kicked out or arrested)?
  • ACEs: “Did a household member go to prison?”
  • CTS: “separated from loved one?

Bereavement

Research shows that the loss of someone close can have traumatic effects, regardless of whether the loved one was lost suddenly, or over time due to a chronic illness.

• Has a parent or anyone close to you died (illness, injury, suicide)?
  • Workgroup added this based on a group discussion of the need for a bereavement question.
  • CTS: “Loved one died?”

Witnessed or Indirect Victimization

Common types of community violence that affect youth include individual and group conflicts, such as bullying, fights among peers and shootings in public areas. Although there can be advance warnings for some types of traumas, community violence often happens suddenly. Consequently, youth and families suffering the fallout of such violence can experience increased fear and feelings that harm could come to them at any time.

• Have you ever seen or experienced violence in your school or community (physical force meant to harm someone)?
  • Finkelhor: “Any witnessed violence (if the child saw or heard the assault); any witnessed assault in the community; or exposition to shooting, bombs, or riots.”
  • CTS Question: Have you ever seen people pushing, hitting, throwing things at each other, or stabbing, shooting, or trying to hurt each other?
  • CANS: “Severity of exposure to community violence.”
  • CCDCI: How often have you seen someone threatened or beaten up?

Sexual Victimization

The following question seeks to determine if the child has experienced sexual victimization. Sexual victimization includes any unwanted sexual touch, including sexual assault and attempted or completed rape.

• Has anyone ever touched, or tried to touch, private parts of your body in a way that made you uncomfortable?
  • Finkelhor: “Any sexual victimization, sexual assault, completed rape, attempted or completed rape, sexual assault by a known adult, sexual assault by an adult stranger, sexual assault by a peer, flashing or sexual exposure by a peer, flashing or sexual exposure by an adult, sexual harassment, or internet sex talk.”
  • CTS Question: “Has someone ever touched you on the parts of your body that a bathing suit covers, in a way that made you uncomfortable? Or had you touch them in that way?”
  • ACEs: “Did an adult or person at least 5 years older than you ever touch or fondle you or have you touch their body in a sexual way? Or try to or actually have oral, anal, or vaginal sex with you?”
  • CANS: “Child’s or youth’s experience of sexual abuse”
  • CCDCI: How often have you been touched in a private place on your body where you didn’t want to be touched?