To determine whether the psychiatric profile of children in foster care is more similar to clinical or community profiles.
Method:
Caregiver and teacher ratings of DSM-III-R externalizing and internalizing symptoms were collected for 3 groups of children: children in foster care, children assessed at a children's mental health centre, and a community sample.
Results:
Children in foster care approximated the numbers and types of symptoms of the clinical sample. Coming from a family on social assistance, having a parent with a criminal history, and being of the male gender were correlated with higher externalizing and internalizing symptom scores independent of group membership. Group membership accounted for less than 5% of the variance in psychiatric symptom scores.
Conclusions:
The high symptom burden of children in care is substantially attributable to their high-risk histories, and treatment should be designed with this in mind.
WolkindSRutterM.Children who have been “in care”: An epidemiological study. J Child Psychol Psychiatry1977;14:97–105.
2.
ShahCP. The value of admission medical in child welfare. The Ontario Association of Children's Aid Societies Journal1972;15:8–12.
3.
SchorE.The foster care system and health status of foster children. Pediatrics1982;69:521–8.
4.
MoffattMPeddieMStulginskasJPlessIBSteinmetzN.Health care delivery to foster children: A study. Health Soc Work1985;10:129–37.
5.
McIntyreAKeeslerTY. Psychological disorders among foster children. Journal of Clinical Child Psychology and Psychiatry1986;15:297–303.
6.
HochstadtNJJaudesPKZimoDASchachterJ.The medical and psychosocial needs of children entering foster care. Child Abuse Negl1987;11:53–62.
7.
ThompsonAHFuhrD.Emotional disturbance in fifty children in the care of a child welfare system. Journal of Social Service Research1992;15:95–112.
8.
SteinEGrantNI RaeAcklandSAvisonW.Psychiatric disorders of children “in care”: Methodology and demographic correlates. Can J Psychiatry1994;39:341–7.
9.
CostelloEJ. Developments in child psychiatric epidemiology. J Am Acad Child Adolesc Psychiatry1987;28:836–41.
10.
LambertLEssenJHeadJ.Variations in behaviour ratings of children who have been in care. J Child Psychol Psychiatry1977;18:335–46.
11.
HulseyTCWhiteR.Family characteristics and measures of behavior in foster and non-foster children. Am J Orthopsychiatry1989;59:502–8.
12.
SteinE.Emotional and behavioral disorders of children in care. Bulletin of the Department of Psychiatry, University of Western Ontario1994;9403:1–58.
13.
UrquizeAJ. Treatment models for the provision of mental health services for children in child welfare systems. California: Child Protection Center, University of California Davis Medical Center; 1992.
14.
GrizenkoNFisherC.Review of studies of risk and protective factors for psychopathology in children. Can J Psychiatry1992;37:711–21.
15.
PalmerS.Children in long-term care: Their experiences and progress [dissertation]. MSW; 1979.
16.
PardeckJT. Multiple placement of children in foster family care: An empirical analysis. Soc Work1984;29:506–9.
17.
EricksonMFEgelandB.A developmental view of the psychological consequences of maltreatment. School Psychology Review1987;16:156–68.
18.
FanshelDFinchSJGrundyJF. Foster children in a life course perspective. New York: Columbia University Press; 1990.
19.
McCordJ.A forty year perspective on effects of child abuse and neglect. Child Abuse Negl1983;7:265–70.
20.
RogenessGASuchakornAAMacedoCA. Psychopathology in abused or neglected children. J Am Acad Child Adolesc Psychiatry1986;25:659–65.
21.
BoyleMHOffordDRRacineYFlemingJSzatmariPSanfordM.Evaluation of the revised Ontario child health study scales. J Child Psychol Psychiatry1993;34:189–213.
22.
AchenbachTMEdelbrockCS. Behavioral problems and competencies reported by parents of normal and disturbed children aged 4 through 16. Monogr Soc Res Child Dev1981;46:1–88.
23.
BoyleMHOffordDRHoffmannHG, and others. Ontario child health study, 1: Methodology. Arch Gen Psychiatry1987;44:826–31.
24.
Financial Post Datagroup. Canadian markets. 68th ed.Toronto: The Financial Post Company; 1994.
25.
CohenJ.Statistical power analyses for the behavioral sciences. Orlando: Academic Press; 1977.
26.
ClarkeM.Wasting our future: The effects of poverty on child development: Position paper of the Canadian Council on Children and Youth. Ottawa: 1987.
27.
GotlibIHAvisonWR. Children at risk for psychopathology. In: CostelloCG, editor. Basic issues in psychopathology. New York: Guilford Press; 1993. p 271–319.
28.
SteinhauerPD. Four innovative models of foster care. In: The least detrimental alternative: A systematic guide to case planning and decision making for children in care. Toronto: University of Toronto Press; 1991. p 283–99.
29.
Ontario Ministry of Community and Social Services. Income maintenance handbook. Toronto: Queen's Printer for Ontario; 1992.
30.
EwingJA. Detecting alcoholism: The CAGE questionnaire. JAMA1984;252:1905–7.
