part of 497 ISSN 1758-2008 10.2217/NPY.13.61 © 2013 Future Medicine Ltd Neuropsychiatry (2013) 3(5), 497–511 1 University of Stellenbosch, Faculty of Health Sciences, Department of Psychiatry, PO Box 19063, Tygerberg 7505, South Africa 2 South African Research Chairs Program & MRC Stress & Anxiety Disorders Unit, University of Stellenbosch, Faculty of Health Sciences, Department of Psychiatry, PO Box 19063, Tygerberg 7505, South Africa *Author for correspondence: Tel.: +27 21 9389227; Fax: +27 21 9389738; luellaz@gmail.com REVIEW Leigh Luella van den Heuvel* 1 & Soraya Seedat 1,2 Screening and diagnostic considerations in childhood post-traumatic stress disorder Practice points  Post-traumatic stress disorder (PTSD) is common in children and adolescents, and owing to the high comorbidity with other mental disorders and developmental diferences in symptom expression, diagnosis is difcult.  In children dependent on caregivers, an increased likelihood of chronic trauma exposure, decreased ability to verbalize complex symptoms, as well as expression of a variety of behavioral symptoms, can complicate diagnosis.  Increased risk-taking behaviors in adolescents and developmental changes increase the risk of trauma exposure and, consequently, PTSD; adolescents may also be less likely to report trauma exposure and recognize emotional and behavioral changes as symptoms of PTSD.  Current clinical practice is guided by the American Academy of Child and Adolescent Psychiatry (AACAP) Practice Parameters, which emphasize that developmentally appropriate screening and diagnostic approaches should be used to assist in early and correct identifcation of PTSD, information should be gathered from multiple sources and comorbid disorders should be identifed and treated alongside PTSD.  A variety of screening and diagnostic instruments are available, including self- or parent report, or reports of behavior observed. These can be administered on paper/other media or via interview, require various amounts of training to administer and score, and vary in cost, time to administer and how well their psychometric properties have been elucidated.  Some instruments may be more suited to assessing specifc types of trauma or to specifc trauma populations, such as assessment of domestic violence, sexual abuse and PTSD in delinquent youth.  Instruments are also available for other related aspects, such as the nature of trauma exposure, other symptoms and coping behaviors following a trauma, resilience-related factors and post-traumatic growth.  As research regarding child and adolescent PTSD continues to expand, new tools or changes to existing tools are required to ensure that assessment remains scientifcally and clinically relevant.