Children birth to three entering the state's custody

Reams, Redmond

doi:10.1002/(sici)1097-0355(199922)20:2<166::aid-imhj4>3.0.co;2-v

Cited by 51 publications

(40 citation statements)

References 4 publications

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“…Rates of physical and developmental health problems were comparable with those of previous studies with children in foster care 13,22,41-43 ; rates of mental health problems reported were more comparable with reports in community samples than rates in children in foster care. 13,22,42,44,45 When we examined types of problem by initial placement type, no physical health problems were significant when using a Bonferroni adjustment for multiple comparisons. Whereas children entering nonrelative foster care were found to be more likely to have "Suspect" scores on the initial Denver-II screening test, no differences between placement types were observed on full evaluation using either the Bayley Scales of Infant Development II (Bayley-II) or the Stanford-Binet IV (SB-IV).…”

Section: Discussionmentioning

confidence: 99%

The Physical, Developmental, and Mental Health Needs of Young Children in Child Welfare by Initial Placement Type

Leslie¹,

Gordon²,

Meneken³

et al. 2005

Journal of Developmental & Behavioral Pediatrics

171

122

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The American Academy of Pediatrics recommends comprehensive assessments for children entering foster care. These children may be placed with biological parents, kin, or in nonrelative foster care. It is not known whether health-related needs differ by placement. Chart abstractions were conducted of child welfare and medical records of 1542 children, ages 3 months to 5 years 11 months, admitted to San Diego's sole emergency shelter/receiving facility from April 1, 1998, through June 30, 1999, for investigation of alleged maltreatment. Children were discharged to three placement types: biological parents (28.5%), kinship caregivers (28.4%), or nonrelative foster parents (43.1%), Overall, 86.7% of children studied demonstrated physical, developmental, or mental health needs, with more than half displaying two or more problems. More than half of the children had a "Suspect" score on the Denver-II; 70.3% of children with "Suspect" scores were found to have delay on a development evaluation. Almost one tenth of the sample were diagnosed with one or more mental health conditions. Few differences were found for physical, developmental, or mental health concerns by placement. Results suggest that young children placed with biological parents or in kinship care have similar needs to those of children placed with foster parents. This study confirms the importance of comprehensive assessments for young children removed from their homes, regardless of placement. It also illustrates a need for standardized assessment criteria, particularly for developmental and mental health status, and for collaborative care models for all young children entering the child welfare system, regardless of their placement following investigation. Index termsfoster care; child welfare; developmental delay; mental health; physical healthThe estimated 826,000 children currently served by the child welfare/child protective services system 1 (hereafter termed child welfare) are more susceptible to poor health outcomes than any other subpopulation of youth in the United States. These children are removed from their homes when parents are unable to care for them due to prenatal drug/alcohol exposure, abuse, neglect, and/or violence. These background risk factors predispose these children to a myriad of physical, developmental, and mental health problems. Infants and toddlers, who are dependent on the care of others during a critical phase of brain development, 2-5 are especially vulnerable to both the experience and consequences of maltreatment 6-9 and are the most rapidly expanding age group entering child welfare. 3,10 Overall, the largest age group in child welfare (30%) is composed of children younger than 5 years of age. 1 Out-of-home placement can compound these problems if services are not provided effectively. Recent federal amendments to the Child Abuse Prevention and Treatment Act (CAPTA) in 2003 recommend that states enhance collaboration among public health agencies, child welfare, and community programs to address the comprehensive...

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Section: Discussionmentioning

confidence: 99%

The Physical, Developmental, and Mental Health Needs of Young Children in Child Welfare by Initial Placement Type

Leslie¹,

Gordon²,

Meneken³

et al. 2005

Journal of Developmental & Behavioral Pediatrics

171

122

View full text Add to dashboard Cite

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“…7-9 Studies examining behavior problems report that as many as 25% to 40% of children under the age of 6 who enter out-of-home care have significant behavioral issues. 4,5,10 This is much higher than the overall prevalence rate of behavioral issues in the general population of preschoolers, which has been estimated at between 3% and 6%. 11,12 Greater attention has been focused on children in out-of-home care despite the fact that nearly 90% of children whose reports of abuse and neglect are serious enough to trigger an investigation will remain at home after the close of the investigation.…”

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confidence: 96%

“…Research on children placed in out-of-home care suggests that between 23% and 61% of children under the age of 5 are significantly delayed when screened for developmental problems. [3][4][5][6] This elevated rate, compared with a rate of 10% to 12% of those with developmental delays in the general population, may be a result of increased risk of prenatal exposure to maternal alcohol and drug abuse, abuse and neglect in their birth homes, or increased medical conditions such as complications from low birth weight or prematurity. 7-9 Studies examining behavior problems report that as many as 25% to 40% of children under the age of 6 who enter out-of-home care have significant behavioral issues.…”

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confidence: 99%

Developmental and Behavioral Needs and Service Use for Young Children in Child Welfare

et al. 2005

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Objective-To determine the level of developmental and behavioral need in young children entering child welfare (CW), estimate early intervention services use, and examine variation in need and service use based on age and level of involvement with CW by using a national probability sample in the United States.Methods-As part of the National Survey of Child and Adolescent Well-Being, data were collected on 2813 children <6 years old for whom possible abuse or neglect was investigated by CW agencies. Analyses used descriptive statistics to determine developmental and behavioral needs across 5 domains (cognition, behavior, communication, social, and adaptive functioning) and service use. Logistic regression was used to examine the relationship between independent variables (age, gender, race-ethnicity, maltreatment history, level of CW involvement, and developmental or behavior problems) and service use.Results-Results indicate that age and level of CW involvement predict service use when controlling for need. Both toddlers (41.8%) and preschoolers (68.1%) in CW have high developmental and behavioral needs; however, few children are receiving services for these issues (22.7% overall). Children that remain with their biological parents have similar needs to those in outof-home care but are less likely to use services. Children <3 years of age are least likely to use services.Conclusions-Children referred to CW have high developmental and behavioral need regardless of the level of CW involvement. Both age and level of involvement influence service use when controlling for need. Mechanisms need to be developed to address disparities in access to intervention.Address correspondence to Aubyn C. Stahmer, PhD, Child and Adolescent Services Research Center, 3020 Children's Way, MC 5033, San Diego, CA 92123. E-mail: astahmer@casrc.org. No conflict of interest declared.The information and opinions expressed herein reflect solely the position of the authors. Nothing herein should be construed to indicate the support or endorsement of its content by the Administration on Children, Youth and Families/Department of Health and Human Services. Each year ~2.6 million referrals regarding 4.5 million children are made to child welfare (CW) agencies throughout the nation, and 1.8 million of those referrals are accepted for investigation. 1 Overall, at least 12.3 children in every 1000 have been victims of child abuse or neglect. The highest rates of abuse and neglect occur in children under the age of 6. In 2001, >30% of children in CW were between the ages of 0 and 5. 2 Because these same children are frequently seen in medical offices throughout the country, both before and after allegations of abuse are made, the medical, developmental, and behavioral issues that face them are important to pediatricians. NIH Public AccessAlthough limited data exist, local studies suggest that this population of young children is at higher risk for developmental and behavioral problems than children who have not interacted with CW. This is p...

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“…[4][5][6][7][8] Children in OHP settings are also considerably more likely than other children to experience a host of risk factors, including child maltreatment, poverty, parental substance abuse, and mental health problems, which are likely to jeopardize their development independent of OHP. [9][10][11][12] Thus, research has not established whether poor developmental outcomes are the result of OHP or whether the association between OHP and adverse outcomes is spuriously driven by other factors.…”

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confidence: 99%