Developmental Status of Young Children in Foster Care.

Abstract

Children in foster care (CFC) may be at higher risk for developmental problems. This study sought to determine (1) the percentage of CFC with developmental problems seen at an integrated primary care clinic and (2) whether the presence of various risk factors was associated with increased odds of developmental problems in general and across developmental domains. This cross-sectional study used the Ages and Stages Questionnaire, Third Edition, demographic, and health-related data retrieved from electronic health records. The study included 796 children aged 1 to 66 months seen at an integrated primary care clinic exclusively serving CFC. Frequencies and percentages of children with developmental problems were calculated, and relationships between developmental status and potential risk factors were accessed using χ2 and bivariate logistic regression analyses. Overall, 68.5% had scores indicative of developmental concern (DC), and 39.8% had scores indicating developmental delay (DD). After adjusting for other risk factors, analysis suggested that being male (odds ratio [OR] 2.169, 95% confidence interval [CI] 1.595-2.950) and exhibiting trauma symptoms (OR 1.51, 95% CI 0.993-2.295) were associated with higher odds of exhibiting DC, whereas being in a kinship placement (OR 0.55, 95% CI 0.359-0.842) was associated with lower odds. Odds were higher for exhibiting DD for children who were male (OR 1.716, 95% CI 1.278-2.303), born prematurely (OR 2.165, 95% CI 1.438-3.259), experienced physical abuse (OR 1.541, 95% CI 1.040-2.283), and presented trauma symptoms (OR 1.441, 95% CI 0.975-2.130). The findings suggest that early screening is vital for CFC to identify developmental impairment so that appropriate education and interventions can be offered.