Abstract
Objective: Children in the Child Welfare System (CWS) are at high risk for multiple adverse outcomes. Since involvement in CWS and having a chronic medical condition are both risk factors for poor academic achievement, a logical view is that the combination is additive, increasing the odds of poor performance. However, several factors may complicate such an association. This study explores negative and positive factors that could affect academic achievement in children in CWS with chronic medical conditions.Method: In a secondary data analysis of a nationally representative, longitudinal sample of children in CWS (N = 5,501), subjects were divided into three groups based on chronic medical condition: High Prevalence, Low Severity (HPLS; asthma, eczema, allergy, diabetes), Other (OTH; all other chronic conditions, including those with primary central nervous system involvement), and NONE (children with no chronic condition). Using weighted analyses, hierarchical logistic regression models addressed factors associated with academic achievement. Predictor variables included chronic condition group, sex, income level, case substantiation, home placement, and school engagement. Intelligence quotient was a covariate. Outcome variables were strong performances for reading and math, defined by standard score ≥85.Results: In TOTAL group, 80% had strong reading; more in HPLS (85%) vs. NONE (79%) and OTH (80%), adjusted F = 433, p < 0.001. In TOTAL group, 67% had strong math; more in NONE (68%) and HPLS (68%) vs. OTH (60%), adjusted F = 1,278, p < 0.001. Models predicting to strong reading and math achievement were significant, R2 = 0.51, p < 0.001 and R2 = 0.43, p < 0.001, respectively. HPLS had increased odds of strong reading achievement (aOR 1.3, 95% CI 1.3–1.4); both HPLS and OTH had lower odds of strong math achievement (aOR 0.87 and 0.76), p < 0.001, respectively. Male sex had lower odds of strong reading (aOR 0.44) and math achievement (aOR 0.62); positive school engagement had higher odds of strong reading (aOR 1.18) and math achievement (aOR 2.04), all p < 0.001.Conclusion: If true, our findings challenge the general belief that chronic illness can only be associated with negative outcomes and that cumulative adversities are simply additive in terms of risk. Increased contact with the medical system may provide an opportunity for improving reading achievement for children in CWS and promoting positive school engagement.
Highlights
Children in the Child Welfare System (CWS) are vulnerable by definition, as they are referred to the system for suspected abuse and/or neglect
The lowest mean scores were the math achievement scores for children in the other chronic conditions (OTH) group, which were significantly lower than both the HPLS and no chronic medical condition (NONE) groups, p < 0.001
The three groups (HPLS, OTH, NONE) had mean reading and math standard scores in the average range (i.e., 88–96), scores were below the population mean of 100
Summary
Children in the Child Welfare System (CWS) are vulnerable by definition, as they are referred to the system for suspected abuse and/or neglect. Whether or not the claim of maltreatment is substantiated, children in CWS are at high risk for multiple adverse outcomes. There are resilience factors that moderate the negative effects of childhood adversity on academic scores, children who are chronically maltreated have lower standardized test scores than children who are not chronically maltreated [2]. A study of 6–10 year old children with maltreatment found lower math and reading achievement scores compared to population norms, with greater effects for math (approximately one-third to almost one SD lower scores) compared to reading (less than one-third SD) [2]. Early abuse and neglect during the first 5 years of life was consistently associated with more interpersonal problems and lower academic achievement from childhood through adulthood at 32–34 years of age [3]
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