176855 Pretreatment risk factors and social-emotional impairment: Comparing children in treatment and standard foster care

Monday, October 27, 2008

Deborah Braxton, BS , Family Center, Kennedy Krieger Institute, Baltimore, MD
Patricia Martens, PhD , Family Center, Kennedy Krieger Institute, Baltimore, MD
Mariflor Jamora, MD , Family Center, Kennedy Krieger Institute, Baltimore, MD
Harolyn Belcher, MD , Kennedy Krieger Family Center/Johns Hopkins Department of Pediatrics, Kennedy Krieger Insitute, Baltimore, MD
Background

Children whose needs are not adequately addressed in regular foster care (RFC) typically are referred to more intensive treatment foster care (TFC). The purpose of this study is to examine differences in environmental and health risks and social-emotional impairment between RFC and TFC children.

Method

Medical record review was conducted on charts of 174 children, matched for gender, age, and year of entry into mental health treatment; 93 in TFC and 81 in RFC. The clinician-rated Child and Adolescent Functional Assessment Scale (CAFAS) total score (combined Home, School, Community, Behavior Toward Others, Mood, Thinking, Self-Harm subscale scores) was used to measure child impairment. A p-value of <0.05 was considered statistically significant. Results

The majority of subjects were male (66.7%) and African American (85.1%), with a mean age of 8.9 years (SD=3.1). TFC children had significantly greater rates of physical abuse (c2=4.5, p<.05), community violence exposure (c2=4.5, p<.05), asthma (c2=59.6, p=.000), and growth retardation (c2=7.3, p<.01). TFC status predicted higher CAFAS scores (indicating greater impairment) even after controlling for the effects of baseline CAFAS (ΔR2 = .097, b = -22, p < .05.) Conclusions

TFC status is associated with greater exposure to environmental risks compared to children in RFC. Higher rates of asthma and growth retardation noted in children with TFC suggest an increased medical vulnerability in this population. Total CAFAS impairment score is almost twice as high for the TFC group, supporting the need for specialized trauma-informed mental health services.

Learning Objectives:
1. Identify different pre-treatment experiences with interpersonal and health risk factors between standard foster care children and those referred for more intensive foster care treatment. 2. Define intervention purposes of Treatment Foster Care. 3. Identify differences in functional impairment between children requiring more intensive foster care and children who succeeded in standard foster care. 4. Understand the relationship between environmental and health risk factors.

Keywords: Mental Health Services, Risk Factors

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I collected data, entered data, and assisted with analyses and abstract writing.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: Mental Health Section Posters III
See more of: Mental Health