Special health care needs among children in the child welfare system.
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.
Ringeisen
Heather
H
RTI International, 3040 Cornwallis Rd, PO Box 12194, Research Triangle Park, NC 27709-2194, USA. hringeisen@rti.org
Casanueva
Cecilia
C
Urato
Mathew
M
Cross
Theodore
T
D000293:Adolescent; D000300:Adoption; D002648:Child; D002649:Child Abuse / Q000706:statistics & numerical data; D002657:Child Development; D002669:Child Welfare; D002671:Child, Exceptional; D002675:Child, Preschool; D002908:Chronic Disease / Q000453:epidemiology; D005190:Family; D005260:Female; D005581:Foster Home Care / Q000706:statistics & numerical data; D006301:Health Services Needs and Demand; D006801:Humans; D007223:Infant; D007859:Learning Disabilities / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D012944:Social Support; D012946:Social Welfare / Q000706:statistics & numerical data; D014481:United States