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Child healthcare sits between two worlds: in the past, with a focus on the prevention and treatment of infectious and chronic disease and the current more expansive view of child health and our role in child health promotion. As a result, disagreements concerning the evidence basis for our work have also arisen. Clinicians may stay on track by considering multiple sources of evidence in making clinical decisions. In doing so, it helps to consider each activity from the perspective of the child, family, and community. Screening and intervention may look for existing problems, for risk and resilience factors, and for opportunities to optimize each child's developmental potential. Integration of these various concerns underlies the art of modern practice, provides the assistance that families want, and leads to continued professional satisfaction.

This paper describes the development and initial validation of the Intervention Stressors Inventory (ISI), a new scale designed to measure the level of stress sexually abused children experience as a result of societal intervention. Estimates of the relative stress level of various interventions were obtained from 98 professionals; a police interview was the designated anchor with a score of 50 points. Resulting scores from the survey included 35 points for social worker interview, 100 points for placement in foster care, and 111 points for testimony in criminal court. Factors that could potentially modify the stress of any given event were also considered. Interviews with 254 sexually abused children and their parents, 9 months after their cases were reported, provided an opportunity to examine the validity of the instrument. Weighted scores for each child were generated based on their experiences. Validity was supported by higher scores for older children, varying patterns of scores in different jurisdictions and a decline in scores over the one-year period in which jurisdictions were actively seeking to reduce the intrusiveness of intervention. Early results suggest that the ISI is useful as a research tool and as a guide in our efforts to reduce the trauma of intervention.