1. Alaska Child Trauma Intervention Outcomes Study Alaska Child Trauma Center at Anchorage Community Mental Health Services Done in collaboration with Duke Clinical Research Institute and the University of Alaska Anchorage Center for Human Development Institutional Review Boards: University of Alaska Anchorage Duke University Principal Investigator: Joshua Arvidson, MSS., LCSW

2. Outcomes Data 17.2 point drop in CBCL T-Scores from Baseline to Discharge = At baseline 85 th percentile At discharge 49 th percentile Statistically Significant with a 0.01 Confidence Interval

3. Number of Traumas X Total Co-morbid Conditions NCTSN Core Data Set (N=8,120)

5. Child Trauma History: Most Frequent Exposure Types

6. Complex Posttraumatic Sequelae: Most Frequent Difficulties

7. Complex Traumatic Exposures Aggregate data on 1,699 children served across 25 sites within the National Child Traumatic Stress Network reveals that 78% of these children have been exposed to multiple and/or prolonged trauma. Aggregate data on 1,699 children served across 25 sites within the National Child Traumatic Stress Network reveals that 78% of these children have been exposed to multiple and/or prolonged trauma. Spinazzola, Ford, van der Kolk, et al. (2003) Spinazzola, Ford, van der Kolk, et al. (2003)

8. What is “Complex Trauma”? Dual Definition: Dual Definition: Exposure to multiple traumatic events, frequently within a caregiving system that is supposed to be the source of safety and stability Exposure to multiple traumatic events, frequently within a caregiving system that is supposed to be the source of safety and stability Impact of those events, across domains of development, on both immediate and long-term outcomes Impact of those events, across domains of development, on both immediate and long-term outcomes

9. Mean Age of Onset: 5.0 (SD = 2.8) Mean Age of Onset: 5.0 (SD = 2.8) Median: 5.0 Median: 5.0 Min, Max: 0, 13.0 Min, Max: 0, 13.0 Child Trauma Exposure: Age of Onset in NCTSN Child Trauma Exposure: Age of Onset in NCTSN Early Exposure : Early Exposure : Over 1/3 of the sample is adolescent and yet 98% of clinicians surveyed report average age of onset under 11

10. Trauma Exposure, Adverse Experiences, and Diverse Symptom Profiles in a National Sample of Traumatized Children Robert S. Pynoos, MD, John A. Fairbank, PhD, Ernestine C. Briggs-King, PhD, Alan Steinberg, PhD, Christopher Layne, PhD, Bradley Stolbach, PhD and Sarah Ostrowski Sarah Ostrowski National Center for Child Traumatic Stress

11. Prevalence of Multiple Traumas

12. Met Full Criteria for PTSD Percent