In psychological treatment facility for children, which are established to support children with emotional problems that interfere with their daily lives, most of the children have a history of adverse childhood experiences (ACE). The impact of ACE ranges widely from psychological to behavioral aspects, and lasts into adulthood. The behavior of children with a history of ACE is diverse, and the staff at such facilities pay attention to different aspects of those. Consequently, there is inadequacy in consensus over the therapeutic goals for the sheltered children and over the criteria for the therapeutic efficacy at psychological treatment facility for children. van der Kolk made a critique that the current diagnostic system fails to conceptualize their difficulties properly, and proposed a new diagnostic concept of developmental trauma disorder (DTD). Although this was not adapted in the DSM-5, it has enabled us to conceptualize symptoms that had been captured separately in the conventional diagnostic system as a single entity rather than as multiple comorbid diagnoses, and to further evaluate symptoms that had been previously overlooked under the current diagnostic system. After evaluating children at the facility from the perspective of DTD, we found that, with exceptions of a few items, over 60% of the children demonstrated behavior characteristic of DTD. DTD can provide clinically useful assessment criteria as we discuss treatment goals and evaluate treatment efficacy. Henceforth, we aim to accumulate data and examine the efficacy of DTD while exploring optimal treatment options for children with a history of ACE.
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