Needs and outcomes for low income youth in special education: Variations by emotional disturbance diagnosis and child welfare contact

Exposure to IPV among Children in the Child Welfare System and an Emotional-Behavioral Disability: the Role of Maternal Depression and Social Support

This study examines the relationship between children's exposure to IPV and EBD among children involved in the child welfare system for suspected maltreatment (both substantiated and unsubstantiated). It specifically examines how children's trauma symptoms, maternal depression, and maternal social support may impact the relationship between exposure to IPV and EBD. This study uses structural equation modeling with data from the second National Survey of Child and Adolescent Wellbeing to examine the relationship between exposure to IPV and EBD among 989 children (ages 8-17) involved in the child welfare system. Moderated mediation was employed to examine whether children's trauma symptoms mediate the relationship between IPV exposure and EBD and whether differences in maternal depression and social support impact such mediation effect. Child trauma symptoms and maternal social support were significantly related to EBD. The current study highlights the relationship between children's trauma symptoms and EBD among children in the child welfare system. The study also provides preliminary evidence for maternal social support as a protective factor for children developing EBD. Implications of this research include providing interventions as well as increasing maternal social support to potentially reduce the likelihood of children developing EBD.

Examining the association between suicidal behaviors and referral for mental health services among children involved in the child welfare system in Ontario, Canada

Although various studies have investigated factors associated with mental health service utilization, few studies have examined factors associated with referral for mental health services among maltreated children. The objective of this study was to examine the association between suicidal thoughts and self-harming behavior and referral for mental health services among children involved in the Child Welfare System in Ontario, Canada. Data for this study were obtained from the Ontario Incidence Study of Reported Child Abuse and Neglect 2013. An estimate 57,798 child maltreatment investigations was analyzed using binary logistic regression with referral for mental health service as the outcome variable. Of the 57,798 cases, 4709 (8.1%), were referred for mental health services. More than seven out of ten maltreated children who engaged in self-harming behavior and two out of three maltreated children who expressed suicidal thoughts were not referred for mental health services. In the multivariate logistic regression model, children who expressed suicidal thoughts had 2.39 times higher odds of being referred for mental health services compared to children with no suicidal thoughts (AOR = 2.39, 99% C.I. 2.05-2.77) and children who engaged in self-harming behavior had 1.44 times higher odds of being referred for mental health services compared to children who did not engage in self-harming behavior (AOR = 1.44, 99% C.I. 1.24-1.67), both after controlling for child demographic characteristics, maltreatment characteristics, and child functioning concerns. Given that referral is the initial step towards mental health service utilization, it is important that child welfare workers receive the necessary training so as to carefully assess and refer children in care who expressed suicidal thoughts or engaged in self-harming behavior for appropriate mental health services. The paper discusses the results and their implications for child welfare policy and practice.

Childhood Maltreatment, Public Service System Contact, and Preventable Death in Young Adulthood

Data from a longitudinal cohort study of low-income children reported for maltreatment matched to similarly poor nonreported children were used to examine intentional and unintentional injury deaths in young adulthood. The goal was to examine the unique contribution of maltreatment history and identify other potential systems for preventive efforts. Maltreatment reports were associated with increased risk of injury-related death per 6-month intervals (hazard ratio [HR] = 1.09, p < .05). Young adults with histories of both status offenses and delinquent offenses were at greater risk for later death (HR = 2.24, p < .05) as were those with histories of emergency room (ER) treatment for intentional injury prior to age 18 years (HR =3.95, p < .05). More than 50% of the deaths were firearm-related; nearly all firearm deaths occurred among Black youth. Implications for prevention within at-risk populations are discussed.

The association between childhood maltreatment experiences and the onset of maltreatment perpetration in young adulthood controlling for proximal and distal risk factors

The evidence for association between child maltreatment victimization and later maltreatment perpetration is both scant and mixed. The objective of the present study was to assess the association between childhood maltreatment experiences and later perpetration of maltreatment in young adulthood controlling for proximal young adult functioning, prior youth risk behaviors, and childhood poverty. The study included 6,935 low-income children with (n=4,470) or without (n=2,465) maltreatment reports prior to age 18 followed from ages 1.5 through 11 years through early adulthood (ages 18-26). Administrative data from multiple regional and statewide agencies captured reports of maltreatment, family poverty and characteristics, system contact for health, behavioral risks and mental health in adolescence, and concurrent adult functioning (crime, mental health and poverty). After controlling for proximal adult functioning, repeated instances of neglect or mixed type maltreatment remained associated with young adult perpetration. Females and subjects with adolescent history of runaway, violent behaviors or non-violent delinquency also had higher risk. Greater caregiver education remained associated with reduced risk. The study concludes that prevention of recurrent neglect and mixed forms of maltreatment may reduce risk of maltreatment for future generations. Intervening to increase parental education and decrease adolescent risk behaviors may offer additional benefit.

Prevalence of maltreatment among youths in public sectors of care

Few studies have investigated the prevalence of maltreatment among youths in public sectors of care despite the critical public health concern and the burden of suffering on such youths. The current study examined the prevalence of multiple types of maltreatment across five public sectors of care. Youths aged 11-18 (n = 1,135) enrolled in one of five public sectors of care reported on their maltreatment history using the Childhood Trauma Questionnaire. Across all sectors, 78% of youth reported experiencing at least moderate levels of maltreatment with the majority (58%) reporting multiple types of maltreatment. The prevalence of maltreatment was highest for youths involved in the alcohol/drug (86%) and child welfare (85%) sectors, and lowest in the serious emotional disturbance sector (72%). Logistic regressions were conducted to examine differences in the likelihood of multiple types of maltreatment by sector affiliation, controlling for the effects of gender, race/ethnicity, and age. The results indicate that rates of maltreatment across sectors do not differ greatly from those in child welfare. The high incidence of maltreatment across all sectors, not solely child welfare, indicates that all youth in public sectors of care should be screened for a history of maltreatment when they enter into care.