Stahmer Aubyn C, Leslie Laurel K, Hurlburt Michael, Barth Richard P, Webb Mary Bruce, Landsverk John, Zhang Jinjin
Child and Adolescent Services Research Center, San Diego, CA 92123, USA.
Pediatrics. 2005 Oct;116(4):891-900. doi: 10.1542/peds.2004-2135.
To determine the level of developmental and behavioral need in young children entering child welfare (CW), estimate early intervention services use, and examine variation in need and service use based on age and level of involvement with CW by using a national probability sample in the United States.
As part of the National Survey of Child and Adolescent Well-Being, data were collected on 2813 children <6 years old for whom possible abuse or neglect was investigated by CW agencies. Analyses used descriptive statistics to determine developmental and behavioral needs across 5 domains (cognition, behavior, communication, social, and adaptive functioning) and service use. Logistic regression was used to examine the relationship between independent variables (age, gender, race-ethnicity, maltreatment history, level of CW involvement, and developmental or behavior problems) and service use.
Results indicate that age and level of CW involvement predict service use when controlling for need. Both toddlers (41.8%) and preschoolers (68.1%) in CW have high developmental and behavioral needs; however, few children are receiving services for these issues (22.7% overall). Children that remain with their biological parents have similar needs to those in out-of-home care but are less likely to use services. Children <3 years of age are least likely to use services.
Children referred to CW have high developmental and behavioral need regardless of the level of CW involvement. Both age and level of involvement influence service use when controlling for need. Mechanisms need to be developed to address disparities in access to intervention.
利用美国的全国概率样本，确定进入儿童福利系统（CW）的幼儿的发育和行为需求水平，估计早期干预服务的使用情况，并研究基于年龄和与儿童福利系统的参与程度的需求及服务使用差异。
作为全国儿童和青少年福利调查的一部分，收集了2813名6岁以下儿童的数据，儿童福利机构对这些儿童进行了可能遭受虐待或忽视的调查。分析采用描述性统计来确定5个领域（认知、行为、沟通、社交和适应功能）的发育和行为需求以及服务使用情况。使用逻辑回归来检验自变量（年龄、性别、种族-族裔、虐待史、儿童福利系统参与程度以及发育或行为问题）与服务使用之间的关系。
结果表明，在控制需求的情况下，年龄和儿童福利系统参与程度可预测服务使用情况。儿童福利系统中的幼儿（41.8%）和学龄前儿童（68.1%）都有较高的发育和行为需求；然而，很少有儿童因这些问题接受服务（总体为22.7%）。与亲生父母生活在一起的儿童与家庭外照料儿童有相似的需求，但使用服务的可能性较小。3岁以下儿童使用服务的可能性最小。
无论儿童福利系统的参与程度如何，被转介到该系统的儿童都有较高的发育和行为需求。在控制需求的情况下，年龄和参与程度都会影响服务使用情况。需要建立机制来解决干预机会方面的差异。
