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Specialized assessments for children in foster care
S M Horwitz1, P Owens, M D Simms
1Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, Connecticut 06520-8034, USA. patricia.krieger@yale.edu
Insights
A specialized program identified more developmental and mental health needs in children entering foster care. These children also received more health services, highlighting the need for tailored care for vulnerable youth.
Area of Science:
- Child Health
- Pediatrics
- Psychology
Background:
- Children entering foster care often have complex health and developmental needs.
- Existing community-based services may not adequately identify or address these unique challenges.
- Early identification and intervention are crucial for improving outcomes for children in out-of-home care.
Purpose of the Study:
- To compare health problem identification and service utilization between children in foster care receiving a multidisciplinary intervention versus customary care.
- To evaluate the effectiveness of a comprehensive program in detecting developmental and mental health issues in young children entering foster care.
Main Methods:
- A quasi-experimental design enrolled 120 young children entering foster care into either a multidisciplinary intervention (n=62) or customary care (n=58).
- Assessments included foster parent interviews, medical exams, and developmental, psychological, speech/language, and motor evaluations at baseline, 6, and 12 months.
- Data were collected using standardized assessments and provider identification of problems.
Main Results:
- Foster mothers identified similar medical and educational problems in both groups.
- Providers were significantly more likely to identify developmental (56.5% vs 8.6%) and mental health problems (37.1% vs 13.8%) in the intervention group.
- Children in the intervention group received more referrals (71.0% vs 43.1%) and follow-up care at 6 and 12 months.
Conclusions:
- Community providers effectively identify medical and educational needs but often miss developmental and mental health issues in children entering foster care.
- A specialized multidisciplinary program enhances the identification of critical developmental and mental health needs.
- Findings support the establishment of specialized services to address the comprehensive needs of children entering out-of-home care.
Objective:
To investigate the differences in health problems identified and health services received by children newly entering foster care who participated in a comprehensive multidisciplinary program, compared with children newly entering foster care who received customary community-based services.
Methods:
Using a 2-group quasiexperimental design, 120 young children entering foster care were enrolled in a multidisciplinary intervention program (n = 62) or were followed by customary care providers (n = 58). An interview with the foster parent; a complete medical examination; and a battery of developmental, psychological, speech/language, and motor assessments were completed for each child at baseline. Children in both groups participated in follow-up assessments at 6 and 12 months.
Results:
No significant differences between the 2 groups existed in medical, educational, developmental, or mental health problems identified by foster mothers. However, children in the intervention group were more likely to be identified with developmental (56.5% vs 8.6%) and mental health problems (37.1% vs 13.8%) by providers than children in the comparison group. Children in the intervention group were also more likely to be referred for health services at baseline (71.0% vs 43.1%) and receive follow-up care at 6 and 12 months of age than children in the comparison group.
Conclusions:
Findings indicate that community providers identify medical and educational needs but do not recognize developmental and mental health needs of young children newly entering foster care. The discrepancies in the number of recommended services and follow-up care between the 2 groups make a case for the establishment of specialized services for children entering out-of-home care.