Abstract
Objective
To document the persistence and predictors of mental health problems in children aged
12 to 18 months investigated for alleged maltreatment.
Methods
Data came from the second National Survey of Child and Adolescent Well-being (NSCAW
II), a longitudinal study of youth 0 to 17.5 years referred to US child welfare agencies.
These analyses involved children 12 to 18 months. Baseline sociodemographic, social
services, developmental data, and health data were collected on children and caregivers.
Potential social-emotional problems at baseline were assessed with the Brief Infant–Toddler
Social and Emotional (BITSEA) scales. Outcomes were scores over the clinical cutoff
on the Child Behavior Checklist (CBCL) 1.5–5 assessed at 18 months after study entry.
Results
The multivariable analyses showed that an elevated BITSEA score at baseline (odds
ratio 9.18, 95% confidence interval 1.49, 56.64; P = .018) and living with a depressed caregiver (odds ratio 13.54, 95% confidence interval
2.50, 73.46; P = .003) were associated with CBCL scores in the clinical range at the 18-month follow-up.
For children who scored both positive on the BITSEA and lived with a depressed caregiver,
62.5% scored positive on the CBCL compared to 10.7% of the children with one risk
factor and 3.8% of the children with neither risk factor. Only 23.9% of children and/or
their caregivers received any service.
Conclusions
Data show considerable persistence of mental health problems in very young children
that 2 factors could identify. Lack of services to these children is a tremendous
missed opportunity for identification and treatment that could potentially prevent
more serious mental health problems.
Keywords
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Article Info
Publication History
Accepted:
June 1,
2013
Received:
November 16,
2012
Footnotes
The authors declare that they have no conflict of interest.
Identification
Copyright
© 2013 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.