Interactional models of learning disabilities: Evidence from students entering foster care

Cognitive Functioning of Children in Out-of-Home Care

PURPOSE

Most children who enter out-of-home care (OHC) have been subjected to prolonged maltreatment. Maltreatment potentially contributes to a cumulative deficit in neurocognitive maturation and development that is likely to proceed with the child's placement into OHC and persist throughout adulthood. From the theoretical perspective of how maltreatment may affect the developing brain, this study examines the IQ and executive function of children placed in OHC on standardized, norm-referenced measures. Furthermore, the study investigates the prevalence of serious cognitive delays, defined by scores in the clinical range on the administered instruments.

METHODS

The study included 153 children in foster care (66% female), aged 6-15 (M = 10.5, SD = 2.1). Independent two-sample t-tests were run to test for significant differences between the sample and the norm population on the applied neuropsychological measures.

RESULTS

The results showed that discrepancies in cognitive development were global in scope, with the children lagging significantly behind the norm population on all applied measures with discrepancies ranging from 0.61 to 2.10 SD (p < .001). Also, serious developmental delays in all cognitive domains were vastly overrepresented in the sample ranging from 11.3% (IQ) to 66.0% (executive function).

CONCLUSIONS

The results document a very high prevalence of cognitive deficits and delays among the children in the sample. The implications of identifying the neurocognitive effects of maltreatment in the practices of the child welfare system are discussed in terms of developing suitable assessment and intervention strategies.

Cumulative adverse childhood experiences among children in foster care and the association with reunification: A survival analysis

BACKGROUND

Research shows children in foster care are at amplified risk of experiencing cumulative adverse childhood experiences (ACEs). Though separate bodies of literature exist for ACEs and foster care, ample research demonstrates overlap in negative outcomes between ACEs and foster care involvement, such as substance use, early pregnancy, and poorer educational outcomes, among others. Rare are studies that have explored ACEs influence on targeted foster care outcomes.

OBJECTIVE

To address this gap in the literature, this study's objective was to investigate the association between cumulative ACEs and reunification.

PARTICIPANTS AND SETTING

2,998 American children between 6-18 years old in foster care between October 2015 and July 2019 in a Midwestern state.

METHODS

Cox proportional hazard regression was utilized to examine likelihood of and time to reunification, comparing children with 1-5 ACEs, 6-9 ACEs, and 10+ ACEs.

RESULTS

Increased cumulative ACE exposure among children in foster care significantly impeded likelihood of reunification, and slowed time to reunification. Children with 6-9 ACEs and 10+ ACEs were 28 % (HR = .72, p = .024) and 42 % (HR = .58, p = .000) less likely to reunify, respectively, when compared to their counterparts with 1-5 ACEs. Other significant predictors of reunification included: race, age at foster care entry, siblings in foster care, and placement setting type.

CONCLUSION

Results support the notion that among an already vulnerable population, subgroups of children may disproportionally experience negative foster care outcomes. Continued research is necessary to further examine intersections and implications of cumulative ACEs among children in foster care.

Attachment Representations in a Sample of Neglected Preschool-Age Children

A number of studies (see Éthier, 1999) have shown that neglect has a deleterious impact on children's development. However, the effect of neglect on a child's internal representations of their family still needs to be investigated. The aim of this study was to examine the attachment patterns observed in a subsample of neglected children as compared with a control group, using a representational assessment method. The overall sample consisted of 74 preschool-age children, with a clinical group comprised of 39 children referred to social services because of neglect and a control group including 35 children recruited in ordinary kindergartens. Children's attachment representations were assessed with the Doll Play Narrative Classification System (George and Solomon, 1990, 1996, 2000) as well as the complementary Disorganization Scales (George and Solomon, 1998). Mothers' reports consisted of: (1) an in-house socio-demographical questionnaire and (2) the shorter French version of the Parental Stress Index (Bigras et al., 1996). Results showed: (1) a significant difference in attachment representation classifications between the neglected group and the control group even when socio-economic status and maternal stress were controlled for and (2) a significantly higher proportion of avoidant attachment classification in the neglected group. Moreover, neglected avoidant children displayed more overall disorganized markers, and specifically more frightening markers, than normative avoidant children; they also depicted their mother as being less available than normative children. These results are discussed in the light of other findings as well as on theoretical grounds.

Do youth in out-of-home care receive recommended mental health and educational services following screening evaluations?

For children in out-of-home care, a significant gap exists between those who need services and those who receive them. Screening all children in out-of-home care is recommended to reduce this gap. This study was designed to determine if recommendations from mental health and educational screening evaluations were related to service implementation for youth in out-of-home care. Screening evaluations were completed with 171 maltreated youth (ages 9 to 11) in out-of-home care within the prior year. Written reports summarizing the findings were provided to children's caseworkers. Service utilization was assessed at baseline (T1; before screening reports were completed) and follow-up (T2; 9-12 months later) interviews. For children not already receiving services at T1, logistic regression analyses tested the association between T1 recommendations for services and new service implementation by T2. Mental health (youth-report) and educational (teacher-report) outcomes were analyzed separately. Screening evaluations identified 22% of children with unmet mental health needs and 36% with unmet educational needs at T1. Children who received a recommendation for new services (i.e., all of those with unmet needs) were more likely to receive mental health (OR=2.50, p=.06) and/or educational (OR=3.54, p=.04) services by T2 than children who did not receive recommendations for services. While recommendations increased the odds of receiving services, almost half of the children with unmet mental health needs did not receive services, and 84% of children with unmet educational needs did not receive services by T2. Much work remains to ensure youth receive needed services.

Medical status of school-age children reentering foster care

Medical status changes between foster care placements were investigated to determine whether medical status improves and whether medical status changes predict reentry into care. Three hundred and ninety-two school-age children reentering foster care received comprehensive medical evaluation on each foster care entry. Results indicated that students reentering care had worsened medical status. Comparison with matched students having a single foster care placement did not show medical status predictive of foster care reentry but suggested that some medical status declines were age related.