Child Well-Being Among Child Welfare Involved Children: Predictors of Deficits Across Multiple Domains

Purpose: Child welfare-involved children (CWIC) have high rates of deficits across multiple developmental domains including physical health, cognitive development, social skills and emotional/mental health.  However, because deficits are usually studied for a specific age group using a narrow definition of a single aspect of the domain, the proportion of CWIC experiencing deficits in each of these domains is unknown.  Improved understanding of the scope of the problem would allow child welfare systems to develop and implement appropriate screening tools to identify service needs at the point of system contact.  If strong predictors of the type of deficit can be identified then those predictors could guide the screening process.  This study aims to identify the number of child welfare-involved children with a deficit in each domain (physical health, cognitive development, social skills, and emotional/mental health) and to explore predictors of the type of deficits that children present with.

Methods: This analysis used the full baseline sample of the second cohort of the National Survey of Child and Adolescent Well-Being (children 0-17 years old, n=5,872).  This weighted sample is nationally representative of children investigated for maltreatment in the 42 participating states.  The four dependent variables were created using eighteen measures in the NSCAW II along with caretaker reports of specific problems.  Measures were grouped by domain and using standard thresholds scores on each measure were dichotomized into above or below the threshold.  A score below the clinical threshold on any measure in the domain classified the child as having a deficit in that domain.  Predictor variables included in all models were child’s gender, age, race/ethnicity, placement in foster care, previous reports of maltreatment and primary type of maltreatment.  For children who remained in their home-of-origin measures of family poverty, parental education and employment were included.  Logistic regression was used to identify the characteristics associated with having a deficit in each domain.

Results: Forty-four percent (44%) of children had an emotional/behavioral deficit; 42.7% had a health deficit; 33.2% had a cognitive deficit and 23.4% had a social deficit.  In the full-sample, males had higher odds of a cognitive, emotional and health deficit.  African Americans had the lowest odds of an emotional/behavioral problem.  Older children had lower odds of a cognitive problem and higher odds of all other deficits.  Sexual or physical abuse as the primary type of maltreatment was associated with higher odds of a social deficit.  Prior report of maltreatment was associated with higher odds of a health deficit.  Foster care placement was not significantly related to having any type of deficit.

Implications:  CWIC are at high risk of a deficit in at least one domain.  Results suggest that all CWIC should receive a thorough assessment of all four domains because none of the characteristics considered here were strongly predictive of having a deficit in a specific domain.  This recommendation includes older children because of their higher needs and children who remain in their home-of-origin who, despite similar levels of need, are less likely to receive services than children in foster care.