title: [Study of reports to the departmental home of disabled children placed in social assistance to children in the Bouches-du-Rhône].
abstract: BACKGROUND
  By the end of 2011, 275,000 children in France were included in the Aide sociale à l'enfance (ASE, Child Welfare System). Half of these children were entrusted to public care. There is limited data on these children. The MDPH (Maison départementale des personnes handicapées) is an administrative body assisting in the care of disabled children, through material, financial, and human means. Analyzing MDPH medical records can provide medical information about these children. The aim of this study was to describe the characteristics of children left to the ASE with a record at MDPH in Bouches-du-Rhône.
  
  
  METHODS
  We extracted administrative data from two registers, the ASE register and the MDPH register. The MDPH medical files of each patient were analyzed and their medical information was coded: gestational age, deficiencies, and pathologies.
  
  
  RESULTS
  In Bouches-du-Rhône, 2965 children were entrusted, 506 (17%) of whom were known by the MDPH: 30.6% of the entrusted children known by MDPH were taken into foster care and 48% were in residential group homes. Half of the MDPH notifications concerned a referral to a school or medico-social institution. By analyzing the medical data, we observed an average of 2.1 deficiencies per child. The types of deficiencies were distributed as follows: 35.9% were psychological deficiencies, 26.4% were speech deficiencies, and 21.6% were intellectual cognitive deficiencies. The most common pathology was mental and behavioral disorder (71% of diagnoses).
  
  
  CONCLUSIONS
  The MDPH notification rate in children entrusted to public care was seven times higher than in the general population. Overall, explaining the relation between child abuse and neglect and disability is difficult. The psychopathology of these children is complex. These results show the importance of specific medical monitoring for these children.
authors.affiliation: Service de pédiatrie, centre hospitalier du Pays d'Aix, avenue des Tamaris, 13616 Aix-en-Provence, France.
authors.forename: L
authors.initials: L
authors.lastname: de Montaigne
authors.affiliation: Protection maternelle et infantile, conseil général des Bouches-du-Rhône, 4, quai d'Arenc, 13304 Marseille, France.
authors.forename: O
authors.initials: O
authors.lastname: Bernard
authors.affiliation: Unité de pédopsychiatrie, hôpital Salvator, 249, boulevard Sainte-Marguerite, 13009 Marseille, France.
authors.forename: D
authors.initials: D
authors.lastname: Da Fonseca
authors.affiliation: Aix-Marseille université, UMR912 SESSTIM (Inserm-IRD-AMU), 13005 Marseille, France.
authors.forename: J
authors.initials: J
authors.lastname: Gaudart
authors.affiliation: Maison départementale des personnes handicapées, conseil général des Bouches-du-Rhône, 4, quai d'Arenc, 13304 Marseille, France.
authors.forename: A
authors.initials: A
authors.lastname: Richardson
authors.affiliation: Maison départementale des personnes handicapées, conseil général des Bouches-du-Rhône, 4, quai d'Arenc, 13304 Marseille, France.
authors.forename: M
authors.initials: M
authors.lastname: Soffer
authors.affiliation: Unité de neuropédiatrie, CHU Timone Enfant, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France.
authors.forename: B
authors.initials: B
authors.lastname: Chabrol
authors.affiliation: Unité de médecine infantile, CHU Timone Enfant, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France.
authors.forename: J-C
authors.initials: JC
authors.lastname: Dubus
authors.affiliation: Unité de médecine infantile, CHU Timone Enfant, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France. Electronic address: emmanuelle.bosdure@ap-hm.fr.
authors.forename: E
authors.initials: E
authors.lastname: Bosdure
mesh_terms: D000293:Adolescent; D002648:Child; D002653:Child Behavior Disorders / Q000453:epidemiology; D002662:Child Health Services / Q000706:statistics & numerical data; D002669:Child Welfare; D002675:Child, Preschool; D003072:Cognition Disorders / Q000453:epidemiology; D003430:Cross-Sectional Studies; D019988:Children with Disabilities / Q000706:statistics & numerical data*; D005260:Female; D005581:Foster Home Care / Q000706:statistics & numerical data; D005602:France / Q000453:epidemiology; D006301:Health Services Needs and Demand; D006699:Home Care Services / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007805:Language Development Disorders / Q000453:epidemiology*; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012189:Retrospective Studies