Developmental delay in young children in child welfare by initial placement type

Abstract

Estimates of developmental delay in children in out-of-home foster care range from 13-62%. Overlooked in these studies are comparisons of developmental delay differentiated by a child's initial placement type (i.e., biological parent, kinship care, or nonrelative foster care) following evaluation for possible abuse and/or neglect. The developmental status of children residing in these different placement types warrants further scrutiny by clinicians and policy makers, especially due to the recent trend towards family preservation efforts and the growing use of kinship care. Data were collected on 798 children, ages 3-36 months, who were admitted to San Diego's sole emergency shelter/receiving facility from April 1, 1998 through June 30, 1999 for investigation of alleged maltreatment. Children admitted received a physical exam and developmental screening using the Denver Developmental Screening Test (Denver-II). Sixty two percent of children (491) scored "suspect" on the Denver Developmental Screening Test II (Denver-II). Of these children, 73% received a developmental evaluation using the Bayley Scales of Infant Development II (Bayley-II). Over 34% of these children evaluated scored more than 2 standard This project was approved by the Institutional Review Board Children's Hospital, San Diego, and the San Diego County Health and Human Services Agency. Funding for the Developmental Screening and Evaluation Project's (DSEP) clinical component was provided by Children's Hospital San Diego, the Child Abuse and Prevention Foundation (CAPF), the San Diego County Health and Human Services Agency (HHSA), and the San Diego County Office of Education. The evaluation component of the project was funded by the Center for Healthier Communities for Children, Children's Hospital, San Diego. The project is indebted to the staff at Polinsky Children's Center (Polinsky) for their dedication to improving service delivery for children in child welfare, particularly those people who worked on the DSEP Project: Nancy Graff, M.D., James Wilkes, Ph.D., John Peoples, and Julie Webster, P.H.N. In addition, Patti Rahiser (HHSA) and Regina Meyer (CAPF) have worked tirelessly to build a multiagency collaborative effort to support this project. We also thank the children at Polinsky for helping us learn more about the needs of children in child welfare. We also want to especially thank Lynn Martin for her commitment to every aspect of this project. We are grateful for the research mentorship provided by John Landsverk, Ph.D., Director of CASRC, and the administrative and statistical support provided by Jennifer Green, James Gearity, M.S.W., and Jennifer A. 497deviations below the mean on at least one component of the Bayley-II regardless of placement type. Although children with "suspect" scores on the Denver-II were more likely to be placed in nonrelative foster care (p Ͻ .013), there was no difference between placement types for children with delay on the Bayley-II. Results for children released to their biological parent(s) shou...

Infants placed in foster care prior to their first birthday: Differences in kin and nonkin placements

“…These findings are similar to those of studies that used cognitive screening tools, but different from those that used developmental assessments. For example, Leslie, Gordon, Ganger, and Gist (2002) and Leslie et al (2005) found that rates of cognitive and motor delay and mental health concerns were not different among placement type We also found that children in foster care exhibited poorer inhibitory control than did those in kinship placements, consistent with other research that has demonstrated that children with greater socioemotional, cognitive, or health risk factors are placed in foster care at a higher rate than they are placed into kinship care (Rubin et al, 2008).…”

“…Infants in this study did not receive a developmental assessment, and developmental screening tools are designed to have a high rate of false positives. The current analyses also are limited to infants under 12 months of age whereas the studies conducted by Leslie et al 2002Leslie et al , 2005 included children between birth and 3 or 5 years. Furthermore, it is possible that the biological parents of infants who experienced more serious abuse were estranged from their own family for various reasons or that their family members were not deemed appropriate to care for infants; that is, these infants may be from higher risk families and may be more difficult to care for.…”

Addressing the Developmental and Mental Health Needs of Young Children in Foster Care

“…60 Data from San Diego County suggests that only the most severely developmentally delayed or mentally ill young children are referred for assessment, whereas children with less conspicuous delays or behavioral problems are frequently missed. 38 Other studies indicate that even when recommendations for specialty medical evaluations are deemed "urgent," many children do not receive them early enough to prevent detrimental outcomes. 28…”

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

“…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.…”