Child welfare investigation predicts mental health problems in young children

A study published in the June 2012 issue of the Journal of the American Academy of Child and Adolescent Psychiatry found that young children who have been investigated for maltreatment by child welfare agencies have a higher prevalence of mental health problems and that very few receive treatment for those problems.

Using data from the National Survey of Child and Adolescent Well-Being II (NSCAW II), a group of researchers led by Dr. Sarah McCue Horwitz, of Stanford University, examined 1117 children ages 12-36 months to document the frequency and possible predictors of mental health problems and also the likelihood that the children or their families received services for the problems. The children were divided into two groups, ages 12-18 months and ages 19-36 months, and evaluated using the Brief Infant-Toddler Social Emotional Assessment (BITSEA) and the Child Behavior Checklist (CBCL), respectively.

The study found that approximately 35% of 12 to 18 month olds scored high on the BITSEA Problem Scale and 21% had low social competence whereas 10% of the 19-36-month-olds scored in the clinical range on the CBCL. The children overall showed high rates of chronic health problems and many had prior child welfare history, which was shown to be related to low social competence.

Although early intervention has been shown in other studies to help children with mental health issues, only 19.2% of children with mental health problems were shown to have received services directly or via parenting skills training for their caregiver.

The NSCAW II is a longitudinal nationally-representative sample of children ages 0 to 17.5 years whose child welfare investigations closed between February 2008 and April 2009.

Horwitz said of the study, "The fact that so many very young children in contact with child welfare are showing signs of social and emotional problems is somewhat surprising, but that so few children and caregivers receive any services is disturbing given that effective interventions are available and could produce positive changes in the lives of these children."

In a related editorial, Dr. Gail Edelsohn addresses ethical challenges related to research and data acquisition that are highlighted by this study and the NSCAW II, such as informed consent, confidentiality, and beneficence and justice.