Abstract
The WHO defines child maltreatment as any form of neglect, exploitation, and physical, emotional, or sexual abuse, committed against children under the age of 18. Youth involved in the child welfare system report more maltreatment experiences and environmental turbulence (e.g., number of moves, caseworkers), placing them at greater risk for poorer physical and mental health. The International Classification of Functioning, Disability, and Health (ICF) provides a framework to describe health conditions and severity of disabilities for an individual and/or group in the context of environmental factors. The Maltreatment and Adolescent Pathways (MAP) study is a longitudinal study, assessing self-reports on variables (e.g., child maltreatment history, trauma symptoms, dating violence, and substance use) of youth in an urban child protection service system. This study focuses on 11 of the 24 MAP publications that pertain to health and functioning, which can be considered applicable to the ICF framework, following established linking rules. The purpose of this study is to analyze these MAP sub-studies, with maltreatment and involvement in the child welfare system as environmental factors that impact the functioning of child welfare-involved youth. Findings indicate significant relationships across environmental factors (i.e., child maltreatment histories, child welfare system involvement), health conditions (i.e., trauma symptomatology, psychological distress, intellectual disabilities), and functioning problems (i.e., substance use, adolescent dating violence, sexual risk-taking, coping motives, sleep problems). The interrelated nature of these factors in the MAP sub-studies suggests the value of the ICF model to a holistic health view of use to practitioners supporting system-involved youth, clarifying unattended environmental factors in guiding service provision for foster care and/or maltreated youth.
Highlights
Child maltreatment is a significant public health issue
We review a selection of studies that use data from the first comprehensive research study on child welfare system-involved youth in Canada, known as the Maltreatment and Adolescent Pathways (MAP) study
Most youth will exit the child welfare system in the age ranges of 16–18 years, with some extending support to age 21. By investigating these MAP substudies in the context of the ICF framework, we aim to explore the complex interactions of factors that affect the functioning and health of maltreated, system-detected youth and propose a model of distal and proximal considerations
Summary
Child maltreatment is a significant public health issue. While most countries have child welfare systems, many maltreated youths are undetected by practitioners, and practitioners experience hesitation in fulfilling mandatory reporting duties [e.g., [1]]. In North America, the median prevalence of physical abuse was 24.3% for boys and 21.7% for girls. Median rates of neglect differed substantially between girls (40.5%) and boys (16.6%) [4]. It is well-recognised that polyvictimisation describes many youths in the child welfare system and is related to poorer outcomes [5]. Based on official reporting data, the cost of non-fatal child maltreatment in 2015 was estimated to be $830,928 per case, and fatal outcomes cost $16.6 million in the United States [8]. It is clearly established that maltreatment yields lifespan impact to physical, mental, and financial health
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