Half of Children in Welfare System Have History of Special Health Care Needs

Half of the children in the nation's child welfare system have a history of special health care needs, according to a new study by researchers at RTI International and the University of Illinois.

The study, published in the July 7 online issue of Pediatrics, found that during a three-year period, half of the children involved in the Child Welfare System had special health care needs that included chronic health conditions, such as asthma, as well as behavioral, emotional and developmental problems.

"This study is the first to examine longitudinally the extent of special health care needs among children in the child welfare system," said Heather Ringeisen, Ph.D., director of the Children and Families Research Program at RTI and the study’s lead author. "Our results underscore the need for cross-system service collaboration between health, mental health and social service providers to better meet their needs. Inattention to these special health care needs may not only compound the immediate effects of abuse and neglect, but also may increase the risk of future long-term impairment for these children."

The study used data from the National Survey of Child and Adolescent Well-Being. The survey, conducted by RTI International, followed approximately 5,500 children over the course of five to seven years. The children ranged in age from birth to 15 years old and were reported for child maltreatment in 1999.

The study examined child outcomes for three years beyond the maltreatment investigation. The researchers found that boys, children over the age of two, and children living in poverty were all more likely than their counterparts to have special health care needs. Adopted children and children living in foster care were also more likely to have a history of special health care needs than children without any experience with out-of-home placement.

The results showed that during that three-year period, 21 percent of children in the child welfare system had a history of learning disabilities, 14 percent exhibited emotional disturbances, and 12 percent had speech impairment. Those rates of incidence are all significantly higher than those of children not in the child welfare system.

Nearly half of the children with special health care needs also had behavioral and developmental problems.

"The high rates of special health care needs, the diversity of conditions and the associated functional impairments found among these children require a substantial investment by health, mental and education systems in partnership with the Child Welfare System," said Cecilia Casanueva, Ph.D., a child development researcher at RTI and the paper’s co-author. "Families need help coping with their child’s chronic health, developmental and behavioral needs."

The study was funded by the Administration for Children and Families as part of the National Survey of Child and Adolescent Well-Being.