College of Public Health and Social Justice, St. Louis University, St. Louis, MO.
School of Social Work, University of Minnesota, St. Paul, MN.
J Dev Behav Pediatr. 2019 May;40(4):285-292. doi: 10.1097/DBP.0000000000000655.
Although there is agreement that childhood disability is both a risk and result of maltreatment, the extent of disability in the child welfare system remains unclear. Our objective is to determine the prevalence and severity of child impairment in a national sample of child abuse and neglect investigations in the United States.
We used data from the National Survey of Child and Adolescent Well-Being II, a study of 2644 children older than 3 years who were subjects of child abuse and neglect investigations. Groups of children were identified by latent profile analysis using continuous standardized measures of intelligence, emotional or behavioral impairments, adaptive behaviors, and social skills.
Whether the child remained in home or was removed to foster care after an investigation, 3 classes of children were identified: (1) slightly over one-tenth were in an intellectual disability subgroup characterized by marked intellectual impairments alongside delays in daily living functioning, (2) over one-third were in an emotional or behavioral impairment subgroup characterized by both frequent and severe internalizing and externalizing behaviors, and (3) slightly over half were in a typically developing subgroup.
When using standardized measures of disability, nearly half of the children investigated by child protection in the United States are not typically developing. These findings suggest that those working for the child welfare system need to be attentive to the complex needs of children with intellectual disabilities and emotional or behavioral impairments and their families, many of whom are under significant stress.
尽管人们普遍认为儿童残疾既是虐待的风险因素,也是其结果,但儿童在福利系统中的残疾程度仍不清楚。我们的目的是确定美国全国范围内虐待和忽视调查中儿童残疾的患病率和严重程度。
我们使用了来自国家儿童和青少年福利调查 II 的数据,该研究调查了 2644 名年龄在 3 岁以上的儿童虐待和忽视调查对象。使用连续标准化智力、情绪或行为障碍、适应行为和社会技能测量来进行潜在剖面分析,以确定儿童组。
无论儿童在调查后是否留在家庭中或被安置在寄养中,都确定了 3 类儿童:(1)十分之一以上的儿童属于智力残疾亚组,其特点是存在明显的智力障碍以及日常生活功能障碍;(2)三分之一以上的儿童属于情绪或行为障碍亚组,其特点是频繁出现严重的内化和外化行为;(3)略多于一半的儿童属于正常发育亚组。
当使用残疾的标准化测量方法时,美国受儿童保护调查的近一半儿童发育不正常。这些发现表明,为儿童福利系统工作的人员需要关注那些有智力残疾和情绪或行为障碍的儿童及其家庭的复杂需求,他们中的许多人都承受着巨大的压力。