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不良童年经历与寄养安置稳定性。

Adverse Childhood Experiences and Foster Care Placement Stability.

机构信息

School of Social Welfare, University of Kansas, Lawrence, Kansas.

出版信息

Pediatrics. 2021 Dec 1;148(6). doi: 10.1542/peds.2021-052700.

Abstract

OBJECTIVES

To examine the impact of cumulative adverse childhood experiences (ACEs) on a child's foster care placement stability in Kansas.

METHODS

Secondary data analysis was conducted by using a purposive cohort sample of 2998 children, from 6 to 18 years old, in Kansas's foster care system between October 2015 and July 2019. Multivariate hierarchical logistic regression models were used to examine the influence of cumulative ACEs on a child's placement stability. ACEs were measured at foster care intake and self-reported by the child. Placement stability variables were obtained through the state administrative database.

RESULTS

Children in foster care with greater cumulative ACE exposure were significantly more likely to experience placement instability. Compared to children with 1 to 5 ACEs, when controlling for all other variables, children with ≥10 ACEs had an increased odds of experiencing placement instability by 31% (odds ratio: 1.31; P < .05); and children with 6 to 9 ACEs had a 52% (odds ratio: 1.52, P < .001) increased odds of experiencing placement instability. A child's race, biological sex, age at episode start, and whether they had siblings in foster care all significantly influenced placement instability.

CONCLUSIONS

Findings from this study, in conjunction with previous research on ACEs and foster care, highlight the need to proactively address ACEs and trauma exposure at foster care entry.

摘要

目的

研究累积性不良儿童经历 (ACEs) 对堪萨斯州儿童寄养安置稳定性的影响。

方法

通过使用 2015 年 10 月至 2019 年 7 月堪萨斯州寄养系统中 6 至 18 岁的 2998 名儿童的目的队列样本进行二次数据分析。采用多变量分层逻辑回归模型,考察累积 ACEs 对儿童安置稳定性的影响。ACEs 在寄养入院时由儿童自我报告测量。安置稳定性变量通过州行政数据库获得。

结果

累积 ACE 暴露程度较高的寄养儿童更有可能经历安置不稳定。与 1 至 5 项 ACEs 的儿童相比,在控制所有其他变量的情况下,具有≥10 项 ACEs 的儿童经历安置不稳定的可能性增加了 31%(优势比:1.31;P<.05);具有 6 至 9 项 ACEs 的儿童经历安置不稳定的可能性增加了 52%(优势比:1.52,P<.001)。儿童的种族、生物性别、发病年龄以及是否有兄弟姐妹在寄养中,都显著影响安置不稳定。

结论

本研究结果与 ACEs 和寄养方面的先前研究相结合,突出表明需要在进入寄养时主动解决 ACEs 和创伤暴露问题。

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