The Professional Counselor | Volume 11, Issue 3 287 the brain. Some researchers speculate that elevated levels of certain hormones and hyperactive regions within the brain signal the body’s biological attempt to reduce the negative impact of PM through the fight-flight-freeze response (Porges, 2011; van der Kolk, 2014). Purpose of Present Study At the time of this research, there were few formal measures using child self-report to assess how children experience PM. We developed the PMI as an initial quantifiable measure of child PM for children and adolescents between the ages of 8 and 17, as modeled by Tonmyr and colleagues (2011). The PMI was developed in multiple stages, including 1) a review of the literature, 2) a content validity survey with subject matter experts (SMEs), 3) a pilot study (N = 21), and 4) a large sample study (N = 166). An additional instrument, the Trauma Symptom Checklist for Children Screening Form (TSCC-SF; Briere &Wherry, 2016), was utilized in conjunction with the PMI to explore occurrences of general trauma symptoms among respondents. The following four research questions were investigated: 1. How do respondent demographics relate to PM? 2. What is the rate of PM experience with respondents who are presently involved in an open CM case? 3. What is the co-occurrence of PM among various forms of CM allegations? 4. What is the relationship between the frequency of reported PM experiences and the frequency of general trauma symptoms? Method Study 1: PMI Item Development and Pilot Following the steps of scale construction (Heppner et al., 2016), the initial version of the PMI used current literature and definitions from facilities nationwide that provide care for children who have experienced maltreatment and who are engaged with court systems, mental health agencies, or social services. Our lead researcher, Alison M. Boughn, developed a list of 20 items using category identifications from Glaser (2002) and APSAC (2019). Items were also created using Slep et al.’s (2015) proposed inclusion language for the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) diagnostic codes and codes from the International Classification of Diseases, 11th edition (ICD-11) definition criteria (APA, 2013). Both Boughn and Daniel A. DeCino, our other researcher, reviewed items for consistency with the research literature and removed four redundant items. The final 16 items were reevaluated for readability for future child respondents using a web-based, age range–appropriate readability checker (Readable, n.d.) and were then presented to local SMEs in a content validity survey to determine which would be considered essential for children to report as part of a child PM assessment. Expert Validation A multidisciplinary team (MDT) serving as SMEs completed an online content validity survey created by Boughn. The survey was distributed by a Child Advocacy Center (CAC) manager to the MDT. Boughn used the survey results to validate the PMI’s item content relevance. Twenty respondents from the following professions completed the survey: mental health (n = 6), social services (n = 6), law enforcement (n = 3), and legal services (n = 5). The content validity ratio (CVR) was then calculated for the 16 proposed items. Results. The content validity survey scale used a 3-point Likert-type scale: 0 = not necessary; 1 = useful, but not essential; and 2 = essential. A minimum of 15 of the 20 SMEs (75% of the sample), or a CVR ≥ .5, was required to deem an item essential (Lawshe, 1975). The significance level for each item’s
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