Division of Developmental Pediatrics, Dayton Children's Hospital, Dayton, OH.
Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH.
J Dev Behav Pediatr. 2022 Sep 1;43(7):418-426. doi: 10.1097/DBP.0000000000001083. Epub 2022 Apr 22.
The purpose of this study was to determine whether children with developmental disorders (DDs) in protective custody are more likely to experience specific placement types and stay in care longer than their typically developing peers. Furthermore, in the DD-only group, we examined whether the likelihood of each placement type differed by specific DD diagnosis.
This observational retrospective study used child welfare administrative data linked to electronic health records in a large Ohio county. Participants were aged 5 to 20 years (N = 2787). DD diagnoses were determined using problem list and encounter diagnosis codes.
Children with versus without DD were less likely to be in kinship placement (adjusted odds ratio [aOR], 0.79; 95% confidence interval [CI]: 0.66-0.94) and more likely to be in congregate care (aOR, 1.26; 95% CI: 1.04-1.53) and nonrelative foster care (aOR, 1.20; 95% CI: 1.00-1.45). A likelihood of independent living placement did not differ for those with and without DD. Those with versus without DD had longer lengths of stay in protective custody ( p ≤ 0.001), but the number of placement changes did not differ after accounting for length of stay. The pattern of results differed somewhat by individual DD diagnosis.
Compared with their typically developing peers, children with DD are less likely to be in kinship care and tend to have longer lengths of stay in protective custody. If replicated, these findings suggest the need to identify and address mechanisms to support children with DD across placement settings and to better understand factors prolonging their protective custody stay.
本研究旨在确定受监护的发育障碍（DD）儿童是否比其正常发育的同龄人更有可能经历特定的安置类型并在护理中停留更长时间。此外，在仅 DD 组中，我们检查了每种安置类型的可能性是否因特定的 DD 诊断而有所不同。
这项观察性回顾性研究使用了儿童福利行政数据，并与俄亥俄州一个大县的电子健康记录相关联。参与者年龄在 5 至 20 岁之间（N=2787）。DD 诊断是通过问题清单和就诊诊断代码确定的。
与没有 DD 的儿童相比，有 DD 的儿童不太可能被安置在亲属家中（调整后的优势比 [aOR]，0.79；95%置信区间 [CI]：0.66-0.94），而更有可能被安置在集体护理中（aOR，1.26；95% CI：1.04-1.53）和非亲属寄养中（aOR，1.20；95% CI：1.00-1.45）。有 DD 和没有 DD 的儿童获得独立生活安置的可能性没有差异。与没有 DD 的儿童相比，有 DD 的儿童在保护性监护中的停留时间更长（p≤0.001），但在考虑停留时间后，安置变化的数量没有差异。个别 DD 诊断的结果模式略有不同。
与他们正常发育的同龄人相比，患有 DD 的儿童不太可能被安置在亲属照顾中，并且在保护性监护中的停留时间往往更长。如果这些发现得到复制，这表明需要确定和解决在各种安置环境中支持 DD 儿童的机制，并更好地理解延长他们保护性监护停留时间的因素。
