Published online July 1, 2008
PEDIATRICS Vol. 122 No. 1 July 2008, pp. e232-e241 (doi:10.1542/peds.2007-3778)
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ARTICLE

Special Health Care Needs Among Children in the Child Welfare System

Heather Ringeisen, PhDa, Cecilia Casanueva, PhDa, Mathew Urato, PhDa and Theodore Cross, PhDb

a RTI International, Research Triangle Park, North Carolina
b Child and Family Research Center, School of Social Work, University of Illinois, Urbana-Champaign, Illinois

OBJECTIVE. The aim of this study was to determine levels of special health care need among children in the child welfare system and how these needs may affect children's functioning.

METHODS. Data were from the National Survey of Child and Adolescent Well-being, a national probability study of children investigated for child maltreatment. The sample consisted of 5496 children aged 0 to 15 years at baseline. For analysis, we used descriptive statistics to determine special health care needs and children's functioning from baseline to 3-year follow-up. Logistic regression was used to examine correlates of special health care needs.

RESULTS. At any point in the study period, approximately one third of the children were identified as having special health care needs. Overall, across 3 years of follow-up data, 50.3% of the children were identified as having special health care needs. Boys were significantly more likely than girls to have had special health care needs, and children aged 0 to 2 years at baseline were significantly less likely to have had special health care needs than older children. Adopted and foster children were significantly more likely to have had special health care needs than children never placed out of the home. The most commonly reported type of chronic health condition was asthma. The most commonly reported type of special need was a learning disability.

CONCLUSIONS. Special health care needs are prevalent among children in the child welfare system. Many children with special health care needs have cognitive, language, adaptive, social, or behavioral functional impairments. Mechanisms are needed to ensure that this vulnerable population has access to and receives coordinated health and related social services.

Key Words: child development • chronic conditions • maltreatment • special needs • survey

Abbreviations: SHCN—special health care need • CWS—child welfare system • NSCAW—National Survey of Child and Adolescent Well-being • MCHB—Maternal and Child Health Bureau • SSRS—Social Skills Rating System

Accepted Feb 8, 2008.


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