Risk Assessments at Birth Predict Kindergarten Achievement and Involvement with Child Protective Services.

Abstract

Screening for family risk factors at birth is one way that early childhood programs and practitioners can identify families who might benefit from prevention efforts. Some prevention programs currently use cumulative risk (i.e., total number of risk factors present) to determine eligibility for services. More recently, however, person-centered approaches that take into account combinations of risk (versus cumulative risk) have emerged as an approach that could complement current risk assessment methods and illuminate the extent to which classes of family risk are associated with different outcomes in early childhood. Grounded in ecological theory, we tested cumulative family risk and latent classes of family risk at birth as predictors of kindergarten outcomes and mother-reported involvement with Child Protective Services (CPS). Families in the Fragile Families and Child Well-being Study were included in this study if they had medical records data available at the child's birth as well as children's age 5 kindergarten outcomes (N = 757). Cumulative risk was positively associated with children's attention problems, letter-word recognition skills, CPS involvement, and both covariates (i.e., child's diagnosed disability status and mother's ethnicity/race), but not aggression or social skill problems. In terms of latent classes, children from higher risk classes tended to fare significantly worse on kindergarten outcomes and were more likely to have reported involvement with CPS when compared to the lower risk classes. Implications are discussed related to primary prevention, the merits of screening for risk, and comparisons between cumulative risk and classes of risk approaches.