Frequently Asked Questions

Why is the term “Lucky” used in the Scales

As with all of the language used in the scales, the wording was drafted by experts and then piloted. Reasonable Potential (where, “lucky” is found), underwent some of the most revision, due to the challenging nature of rating something that did not, but could have, happened. “Lucky,” along with the other wording used in this item, was found to be, by far, the best way to express the concept of “reasonable potential” within the severity ratings.

What should I look for/what are some signs to look for to measure the impact on psychological development vs. cognitive development?

Remember that psychological development focuses on emotional/mental ability, and cognitive development is intellect and achievement. These ratings are more challenging, because it is a potential question – What could happen? For these, you’ll want to think about the child’s current level of functioning, and their environment. So, for psychological development, if the child is already exhibiting psychological symptoms, that could put them at a higher risk for future difficulties. This is magnified if they are in a challenging environment (e.g., the mother struggles with depression). For cognitive development, think about how they are functioning in terms of potential achievement. How are they currently performing, and what could that mean for future achievement? Are they in an environment to nurture achievement?

What is the difference between somewhat, highly, and extremely impacted? What can I look for to see the differences between these in regards to {somatic symptoms, child functioning, etc.}?

The differences vary based on the type of maltreatment and the incident being rated.

How do I rate Partner Neglect?

Due to the low base rate of Partner Neglect, there is not a severity scale for Partner Neglect. Instead, it is part of Partner Emotional.

How do I define Tardy?

Assuming this question comes from the descriptions in, “functioning in major roles.” Think of tardy as late to the point where it is noticed. So, a student gets marked into attendance past the first school day bell. An employee’s time card is marked past the start time and it is noted on their record.

How can they be extremely impacted if the victim isn’t suicidal or homicidal?

Extremely impacted means exceptional difficulties in life roles, and can be observed in many ways. One also needs to consider where the person was at baseline, prior to the maltreatment. How did the maltreatment cause or exacerbate the extreme impact? For example: Consider an child who was a scholar athlete prior to maltreatment. Following the maltreatment, the student is failing, suspended from all sports teams, and is at risk for repeating a grade. That is an extreme impact.

How long after the incident can we rate impact like pain or fear/anxiety?

As soon as, and as long as, it is relevant, while remembering the fear/anxiety must be related (caused or exacerbated by) to the maltreatment.

When assessing the impact of a choking incident, what are some of the signs/symptoms I should ask about?

Ask about signs and symptoms like, “What happened during the incident?” Listen for phrases like, “saw stars,” “starting losing vision,” “it was hard to breathe.”

What are some considerations for the reasonable potential of a choking incident (for example, if there reasonable potential for damage to internal organs)?

While injuries like damage to internal organs are possible, seems like the loss of consciousness would be the most immediate/likely if someone were squeezing hard. Loss of consciousness is more likely than damage to the trachea or larynx, and damage seems unlikely without dizziness. So, focus on the reasonable potential for loss of consciousness.

What should I look for/what are some signs to look for somatic symptoms?

Somatic symptoms, bodily/physical complaints and concerns that are directly related to stress, are often challenging to identify. Some factors to look for in children are trips to the school nurse, complaints of stomachaches, and visits to the pediatrician. Some factors to look for in adults are headaches, stomachaches, chest pain, general soreness, and fatigue. Consider frequency, duration, and intensity of somatic symptoms, and answer questions on the ISS about somatic symptoms by looking at how they impact a person’s major roles.

Where does the ISS tool fit into the maltreatment report process?

While the maltreatment report process may vary by location, our general recommendation is that the clinician conducts the incident assessment, analyzes the information, and presents the incident case to the incident determination committee (IDC). If the incident case meets criteria, the clinician should then determine the severity rating using the web-based tool.