The document summarizes the Maltreatment and Adolescent Pathways (MAP) Research Study, which is a longitudinal multi-method study of youth receiving services from child welfare agencies in Canada. It is funded by the Canadian Institutes of Health Research and other partners and examines the impact of trauma on adolescent outcomes through self-reports from a large sample of over 500 youth. The study finds that traumatic stress symptoms mediate the effects of maltreatment and predict issues like sleep problems, substance use, dating violence, and behavioral issues. It emphasizes the importance of trauma-informed care and building youth resilience through improving social connections, self-compassion, and stress reduction.

1. The Maltreatment and Adolescent
Pathways (MAP) Research Study
• Canadian Institutes of Health Research
• Institute of Human Development and Child
and Youth Health
• “Video Talks” competition (Research-2-
Action)
• 2015 Awardee
https://www.youtube.com/watch?v=3Zes-
PJi2OY

2. The Maltreatment and
Adolescent Pathways (MAP)
Research Study
Christine Wekerle, Ph.D. Pediatrics, McMaster University
Email: wekerc@mcmaster.ca
Twitter: @DrWekerle
ResilienceInYouth Initiative
Website: www.in-car.ca
International Journal of Child
and
Adolescent Resilience
YouTube: ResilienceInYouth
Twitter: ResilienceInYouth
@ResilienceInYou
Instagram: ResilienceInYouth

3. MAP Study Research Team & Funders
Multi-disciplinary Co-Investigator Team (alphabetical order):
Dr. Michael Boyle, McMaster University
Dr. Deborah Goodman, University of Toronto; Child Welfare Institute, Children’s Aid Society of
Toronto
Mr. Bruce Leslie, Catholic Children’s Aid Society of Toronto (retired)
Dr. Eman Leung, City University of Hong Kong
Dr. Harriet MacMillan, McMaster University
Dr. Nico Trocmé, McGill University
Dr. Randall Waechter, St. George’s University
MAP Advisory Board – child welfare agency representatives and researchers
Partner Supporters: Child Welfare Research Portal (cwrp.ca), Child Welfare League of Canada,
First Nations Child and Family Caring Society of Canada, Ontario Association of Children’s Aid
Societies
Collaborating MAP Scientists
CIHR Team grant – male CSA – secondary analyses

4. What’s interesting about the MAP Research Study
• First longitudinal multi-method assessment study of
youth receiving services from child welfare – every 6
months over a 2 to 3 year period
• Random sampling of child welfare caseloads
• Inclusion: all youth excepting adoption caseloads
(youth served in- and out- of home)
• Exclusion: youth in detention, in hospital, suicidality,
crisis at time of study entry
• The value of youth perspective – use of self-report on
maltreatment history and other trauma events
• Large sample for child welfare (N=561 @ initial)

5. Why is understanding trauma important
for the healthcare workforce?
• Trauma Events – Trauma Responses (“kids are do-ers” – often
evidenced as behavioural issues)
• Adolescent trauma responses as “avoidance” “resistance”
“protest” “testing” behaviours
• Behaviours: Conflict w/ authority; sexual acting-out (CSA);
eating problems
• Practically for services? Trauma-informed approach:
Physical, emotional, behavioural safety – health advocate
Create opportunities for resilience
Experience of choice and control – youth preferences and
engagement…

6. Trauma Experiences are high-impact events that are
emotionally difficult to deal with and cause stress
TRAUMATIC
EXPERIENCES
TRAUMATIC
REACTIONS RESILIENCE

7. Crafting A Daily Resilience Practice
Goals:
(1) Reducing everyday experience/perception of
overwhelming stress;
(2) Increasing/solidifying everyday resilience
•Sleep Quality
•Social Connectedness
•Self-compassion
•Exercise/Fitness

8. From the MAP: Role of traumatic stress symptoms
As measured by self-report, trauma symptoms (distress/depression/anxiety/dissociation/anger/hyper-
arousal) mediates in the prediction of:
• Adolescent sleep quality (McPhie et al., 2014)
• Alcohol use and problems (Goldstein et al., 2011)
• Alcohol problems in Indigenous youth (Zahradnik et al., 2011)
• Adolescent dating violence (Wekerle et al., 2009)
• Males report symptoms of preoccupation with sexual thoughts more so than females: females are
otherwise higher than males on all other types of trauma-related symptoms
• Child welfare youth report higher distress, see doctors more often and more often on medication for
anxiety and depression than non-child welfare youth (Hamilton et al., 2011)
• When parental maltreatment considered, parenting stress is the mediator of parental sensitivity to
infant (Periera et al., 2012)
• Core issues: High reactivity to stressors destabilize behaviours; need to target stressors, end on-going
violence/traumatic events; support emotion regulation; work up replacement for behaviourally-acting
out to behaviourally acting resilience (cultural engagement; connectedness; competence;
communication)
• Resilience protective against trauma re-experiencing in Indigenous youth (Zahradnik et al., 2010)

9. Some simple actions
Do We Know What Youth are Coping With?
5As: ask, advise, assess, assist, and arrange
• What is going on for you?
(rather than thinking what is wrong with you?)
• Give specific behaviourally-based positives
(cannot have enough +ves in the day! ;)

10. Thank you for your
attention!
Questions or Comments?