The health needs of Aboriginal and Torres Strait Islander children in out‐of‐home care

Abstract

Aim Children in statutory out‐of‐home care (OOHC) are known to have poorer physical, developmental and mental health outcomes compared with their peers. The number of children in OOHC is increasing in Australia, with Aboriginal and Torres Strait Islander children disproportionately represented. To document the health needs of Aboriginal and Torres Strait Islander children and adolescents in OOHC attending the paediatric service at the Victorian Aboriginal Health Service (VAHS) between February 2014 and February 2016. Methods The electronic medical records of all patients in OOHC seen by a paediatrician at VAHS between February 2014 and February 2016 were audited. Demographic data, including age and type of OOHC placement, were recorded, as were their health needs. Results Of the 200 children seen by a paediatrician over this 2‐year period, 103 were identified as being in OOHC for all or some of this same period: 43 in foster care, 8 in residential care and 52 in kinship care. Of the 103 children, 35 were <6 years of age, 51 between 6 and 13 years and 17 between 13 and 18 years; 66% were identified as having mental health problems, 37% hearing problems, 34% vision problems, 40% dental caries and 46% developmental delay including 36% with speech delay. Conclusions Aboriginal and Torres Strait Islander children in OOHC seen by the paediatric service at VAHS have high rates of physical, developmental and psychological health needs. These data have significant potential to inform government policy and investment in effective models of care to better meet the needs of Aboriginal and Torres Strait Islander children in OOHC.

The engagement of children in out‐of‐home care with nursing and allied health professionals: A scoping review

“…Many of the articles ( n = 17) reported on samples of children across the 0‐ to 18‐year age range (Arora et al, 2014; Byrne & Lyddiard, 2013; Dubowitz, 1990; Emery, 2006; Flaherty & Weiss, 1990; Hill & Watkins, 2003; Hodges et al, 2018; Horwitz et al, 2000; Hunter et al, 2008; Jaudes et al, 2004; Kaltner & Rissel, 2011; Kling et al, 2015; McCool & Stevens, 2011; Nathanson et al, 2009; Raman et al, 2017; Shmerling et al, 2020; Williams et al, 2001). Eight articles ( n = 8) examined specific age groups, these being infants aged 0 to 12 months (Gennaro et al, 1998), children aged 0 to 12 years (Blatt et al, 1997; Halfon et al, 1995; Hatten & Hatten, 1971; Takayama et al, 1994), primary (junior) school children aged 6 to 12 years (Festinger & Duckman, 2004) or young people aged 12 years and over (Ensign, 2001; Graham‐Ray, 2017).…”

“…Many of the included articles ( n = 22) examined health outcomes based on the results of screening or assessment procedures conducted within multidisciplinary medical clinics, which would typically be within the scope of practice for nursing or allied health professions. These results were collected prospectively and/or obtained retrospectively (Arora et al, 2014; Blatt et al, 1997; Dubowitz, 1990; Emery, 2006; Ensign, 2001; Festinger & Duckman, 2004; Flaherty & Weiss, 1990; Gennaro et al, 1998; Halfon et al, 1995; Hill & Watkins, 2003; Hodges et al, 2018; Horwitz et al, 2000; Jaudes et al, 2004; Jones et al, 2012; Kaltner & Rissel, 2011; Kling et al, 2016; Köhler et al, 2015; Nathanson et al, 2009; Raman et al, 2017; Shmerling et al, 2020; Takayama et al, 1994; Williams et al, 2001). Ten articles focused solely on nursing practices and research aimed at improving health and wellbeing outcomes for children in OOHC (Carabez & Kim, 2019; Foster et al, 1982; Gennaro et al, 1998; Graham‐Ray, 2017; Hapak, 2015; Hunter et al, 2008; Schneiderman, 2003, 2004, 2006, 2008).…”

“…The samples in the retrieved articles involved children and young people in different OOHC settings, including kinship care (Dubowitz et al, 1992; Gennaro et al, 1998), foster care (Festinger & Duckman, 2004; Foster et al, 1982; Graham‐Ray, 2017; Halfon et al, 1995; Hatten & Hatten, 1971; Hill & Watkins, 2003; Hodges et al, 2018; Horwitz et al, 2000; Jaudes et al, 2004; Kaltner & Rissel, 2011; Kling et al, 2016; Köhler et al, 2015; Takayama et al, 1994), residential care (Hunter et al, 2008; Kling et al, 2016; McCool & Stevens, 2011), emergency shelter‐based foster care (Ensign, 2001), medical foster care (Foster et al, 1982) or local authority care (where a child is made the subject of a care order and the local authority has the legal responsibility for the child) (Williams et al, 2001). Eight articles did not specify the OOHC setting (Arora et al, 2014; Blatt et al, 1997; Byrne & Lyddiard, 2013; Emery, 2006; Flaherty & Weiss, 1990; Nathanson et al, 2009; Raman et al, 2017; Shmerling et al, 2020).…”

“…The majority of the 37 articles originated from the United States ( n = 22) (Blatt et al, 1997; Carabez & Kim, 2019; Dubowitz, 1990; Dubowitz et al, 1992; Ensign, 2001; Festinger & Duckman, 2004; Flaherty & Weiss, 1990; Foster et al, 1982; Gennaro et al, 1998; Greiner & Beal, 2018; Halfon & Klee, 1987; Halfon et al, 1995; Hapak, 2015; Hatten & Hatten, 1971; Hodges et al, 2018; Horwitz et al, 2000; Schneiderman, 2003, 2004, 2006, 2008; Takayama et al, 1994), with the other articles originating from the United Kingdom ( n = 7) (Emery, 2006; Graham‐Ray, 2017; Hill & Watkins, 2003; Hunter et al, 2008; Jones et al, 2012; McCool & Stevens, 2011; Williams et al, 2001), Australia ( n = 6) (Arora et al, 2014; Byrne & Lyddiard, 2013; Kaltner & Rissel, 2011; Nathanson et al, 2009; Raman et al, 2017; Shmerling et al, 2020) or Sweden ( n = 2) (Kling et al, 2016; Köhler et al, 2015).…”

“…Findings from articles included in the scoping review can be summarized under five broad themes: (1) nursing and allied health professionals engaging with children in OOHC to support their health and development ( n = 9) (Foster et al, 1982; Graham‐Ray, 2017; Hapak, 2015; Hunter et al, 2008), (2) opportunities and challenges for nursing and allied health professionals to engage children in OOHC in their own healthcare ( n = 11) (Byrne & Lyddiard, 2013; Graham‐Ray, 2017; Hatten & Hatten, 1971; Horwitz et al, 2000; Kaltner & Rissel, 2011; McCool & Stevens, 2011; Nathanson et al, 2009; Raman et al, 2017; Schneiderman, 2003, 2004, 2006), (3) identification and complexity of healthcare needs ( n = 10) (Dubowitz et al, 1992; Ensign, 2001; Festinger & Duckman, 2004; Flaherty & Weiss, 1990; Gennaro et al, 1998; Halfon et al, 1995; Hodges et al, 2018; McCool & Stevens, 2011; Nathanson et al, 2009; Shmerling et al, 2020), (4) access to healthcare services ( n = 10) (Arora et al, 2014; Dubowitz, 1990; Ensign, 2001; Greiner & Beal, 2018; Jaudes et al, 2004; Jones et al, 2012; Kling et al, 2016; Köhler et al, 2015; Takayama et al, 1994; Williams et al, 2001) and (5) coordination of healthcare ( n = 4) (Blatt et al, 1997; Halfon & Klee, 1987; Hunter et al, 2008; Schneiderman, 2008). All articles are summarized in Table A2.…”