Heterogeneous Treatment Needs of Court-Involved Youth Based on Adverse Childhood Experience Exposures

Background/purpose : Court-involved youth report substantial burdens of trauma and adverse childhood experiences (ACEs; Baglivio et al., 2014). These experiences figure significantly in psychosocial functioning and recidivism, both in youth and adulthood, underscoring the importance of interventions that respond to corrosive childhood backgrounds. Best practice strategies suggest treatment offerings matched to diverse clinical needs, although specific practice guidelines lag. The present study provides an innovative, detailed assessment of the distinctive treatment needs of heterogeneous groups of court-involved youth, based on profiles of ACEs.

Methods: Data derive from a court-based assessment of moderate- and high-risk youth on probation in a large, diverse Northwestern jurisdiction (n=5,378). Study sample included 24% female, 56% White, 24% African American, 3% American Indian/Alaskan Native, 3% Asian American, 1.5% Native Hawaiian or Pacific Islanders, and 5.7% Latino. Six classes were identified using Latent Class Analysis (LCA) based on their experiences of childhood victimization, family dysfunction, and social disadvantage reported at baseline (Logan-Greene, Kim, & Nurius, in press). Groups were then assessed for differences across an extensive array of psychosocial factors important for interventions, including mental health, substance use, protective skills, school functioning, aggression, and impulsivity.

Results: The six classes varied significantly across all psychosocial functioning indicators. In summary, youth in: 1) Parental substance use and incarceration group demonstrated greater needs for protective skills, family functioning and school improvements, and substance abuse treatment. 2) Family health problems and poverty group had high levels of aggression and poor protective resources but relatively little problems from drugs and alcohol. 3) High family conflict group had the most mental health problems and high aggression, despite relatively advantageous personal resources. 4) High abuse histories group was frequently in foster care with favorable family support, otherwise socially isolated with generally poor protective skills. 5) Across-the-board adversity group demonstrated needs in all domains with high re-offense. 6) Low risk group had relatively low ACEs and low needs.

Conclusions/Implications: These analyses provide valuable insight into structure within the heterogeneity of court-involved youth and how practitioners across service system may best respond to their diverse needs. It is especially important for those undertaking trauma-informed care in juvenile justice setting to acknowledge the distinct experiences these youth bring. Importantly, this study makes draws from a commonly used state assessment, rendering directly  applicable results to service planning regarding tailored interventions within the juvenile justice system. Furthermore, these findings have particular resonance for youth with disproportionate justice system contact, such as minority and impoverished youth, a valuable response to the Grand Challenge for Ensuring Healthy Development for all youth.