Over-representation Of Indigenous Children Research Articles

An Intersectionality-Based Policy Analysis of Canadian Child Advocate Reviews of Infants, Children and Youth with Prenatal Substance Exposure and Fetal Alcohol Spectrum Disorder in Child Welfare Care

Background and Objective Care providers in the child welfare system often support children with Fetal Alcohol Spectrum Disorder (FASD). Women who give birth to children with FASD face many multi-dimensional socio-structural challenges, including prenatal substance use, that lead to their children being placed in care. Alcohol use disorders have strong associations to trauma histories, psychiatric problems, adverse experiences in life, and other substance use. Children with FASD experience abuse and neglect along with other forms of adversities in childhood and adolescence at higher rates than other children, and are often kept in the care of the child welfare system. Risks of harm for children and youth with FASD exist due to distinct vulnerabilities associated with the disability. Even with child welfare intervention, adverse outcomes remain for children and youth with FASD. Our objective was to examine reports generated from Child Advocate offices in Canada on deaths and serious injuries where FASD was identified to gain a deeper understanding of the experiences of this population in the child welfare system. Material and methods We employed an intersectionality-based policy analysis (IBPA) framework to analyze child welfare reports from 1989 to 2019 available online publicly from Child Advocate (or equivalent jurisdiction) Offices across Canada. An underpinning theoretical framework in this research was life course theory, as it is critical to recognize the connection that exists between early decisions made for infants and children with FASD and later outcomes in life. Reports were included when there was evidence of FASD or prenatal substance exposure in the report. Sequential Excel spreadsheets were employed for data extraction, and individual word documents were generated for each report specific to the IBPA framework. Thematic analysis was employed to identify themes related to serious injuries or deaths in child and youth, report summaries, and recommendations. Results A total of 61 reports were reviewed, and deaths of 17 children or adolescents with FASD were reported. Four categories of reports existed, including investigative death reports, investigative serious injury reports, special reports, and annual reports. Key themes from these reports for this population included: (1) challenges to stability and permanency, (2) challenges to FASD-informed service provision, (3) over-representation of Indigenous children and youth, and (4) presence of concurrent mental health challenges. Recommendations within reports addressed needs of individuals, families, care providers, systems, and policies. There were many consistencies across time and jurisdictions. One notable concern was that FASD, while possible, was often not diagnosed, and therefore supports and services specific to this disability were not provided. It is critical to note that these reports served to document both a child's history and make key policy and practice recommendations to inform a differential response in the child welfare system in the case of FASD. Conclusion This analysis illuminated the risks and vulnerabilities for this population in the child welfare system and has implications for assessment, diagnosis, and practice interventions in responding to the needs of this population. This analysis also identified that many opportunities exist to improve practice and service delivery for individuals with FASD and their families. It is critical to recognize that a connection exists between early decisions made for infants and children with FASD and later outcomes in life.

From unlikely to likely partnerships for change - child welfare and Indigenous tourism in Canada

The Indigenous tourism sector in Canada is rapidly developing. However, Indigenous communities are challenged by the overrepresentation of Indigenous children in the child welfare system. This multidisciplinary paper explores the intersection of child welfare and Indigenous tourism in Canada, specifically, by examining the role of Indigenous tourism in contributing to the welfare of Indigenous children in their communities. This paper reviewed grey Canadian tourism literature and analysed whether the industry is publicly acknowledging child welfare in their public discourse. Results indicate that Canadian tourism associations are not addressing child welfare in their public facing documents. Applying complexity theory as a lens, this paper discusses how this unlikely partnership between the child welfare and Indigenous tourism industry is critical in increasing the benefits of tourism, while intentionally finding ways to reduce the risks, particularly to children. This article concludes with recommendations on how this unlikely partnership can be fostered to become a likely partnership.

(Re) Conceptualizing Neglect: Considering the Overrepresentation of Indigenous Children in Child Welfare Systems in Canada

The current overrepresentation of Indigenous children in Canadian child welfare systems continues a history of government policies that have separated Indigenous families over the course of many generations. Political and legal developments in recent years are creating the possibility to both disrupt Indigenous children’s overrepresentation in child welfare proceedings and support Indigenous self-determination in decision-making related to child welfare. However, the potential to reduce the overrepresentation of Indigenous children in Canadian child welfare systems is still limited, in part, by the absence of a comprehensive framework for transforming existing child welfare legislation. Because the disproportionate representation of Indigenous children is driven largely by investigations of child neglect, there is particular need for a framework for understanding and shifting away from the current approach to assessing neglect cases. In this article, we examine theoretical and legislative conceptualizations of child neglect in terms of their relationship to the disproportionate involvement of Indigenous children in child welfare across Canada and, more specifically, in Quebec. We also briefly examine the concepts of child well-being and cultural safety which we see as useful complements to the current conceptualization of neglect. Our goal is to support ongoing critical dialogue related to the overrepresentation of Indigenous children in Canada’s child welfare systems, and in so doing contribute to the development of a new framework for understanding and operationalizing “neglect” in Indigenous contexts which at its core could bolster Indigenous self-determination.

“Reframing” relation-based practice in the child protection sector in remote Aboriginal communities of Australia

Australia, like other post-colonial countries, witnesses an over-representation of Indigenous children in the child protection sector and the trend continues to rise. International indigenous scholarship in child protection seeks to problematise relation-based practice to instantiate decolonising standards. However, much of this transformative agenda is situated in psychosocial approaches that focus on inherent power relations and thereby jettison strategies enabling social workers to engage in emotional learning to contain their defences against anxieties. An autoethnography of practice stressors in remote Aboriginal Australian communities is provided and a call for the restoration of relational psychodynamics as the most responsive form to decolonising practice standards.

Paediatric tuberculosis in Queensland, Australia: overrepresentation of cross-border and Indigenous children.

Queensland, Australia. Understanding paediatric tuberculosis (TB) is important, as children with TB typically reflect recent community transmission. Children pose unique diagnostic challenges and are at risk of developing severe disseminated infection. To describe the epidemiology, presentation and outcomes of children with TB disease in Queensland. This is a retrospective case series of children diagnosed with TB aged 0-16 years notified in 2005-2014. Data collected in the Queensland Notifiable Conditions System were extracted and analysed. Of 127 children diagnosed with TB, 16 were Australian-born (including 12 Indigenous Queenslanders), 41 were overseas-born permanent and temporary residents and 70 were cross-border Papua New Guinea (PNG) children; 88 children had pulmonary disease (with/without other sites) and 39 had extra-pulmonary disease only, with lymph node TB the predominant extra-pulmonary site; 70.1% of children had laboratory confirmation; and 14 cross-border children had multidrug-resistant TB. Treatment outcomes among children residing in Australia were good (100% among Australian-born and 97.2% among permanent and temporary residents), but they were less favourable among PNG children diagnosed in the Torres Strait Protected Zone (76.6%). Queensland has unique challenges in TB control, with a high proportion of cross-border diagnoses and over-representation of Indigenous children. Vigilance is needed given the wide spectrum of clinical presentation, particularly in high-risk communities.

Child protection and out of home care: Policy, practice, and research connections Australia and New Zealand

This article provides an outline of the early development of care and protection in Australia and New Zealand as a backdrop to an overview of child protection systems and policies and the current child protection profile in both countries. Key issues that have become the focus of policy reform are canvassed and legislative and policy initiatives to promote child safety as well as strengthen families are elaborated. An overview of trends in relation to out of home care, including routes into care, care arrangements and permanency policies is provided. The article profiles selected research studies from Australia focusing on outcomes of care: stability of care, mental health and educational outcomes of looked after children, abuse in care, and routes out of care through reunification and aging out. Other issues treated are the overrepresentation of indigenous children in care systems in both countries and the challenges of maintaining cultural connections. The article concludes with a brief comparative analysis identifying similarities and differences in child welfare systems in both countries.

Is aspiration during swallowing more common in Canadian children with indigenous heritage?

While many factors that contribute to the occurrence of lower respiratory tract infections (LRTI) in Canadian indigenous children have been described, the role of aspiration during swallowing has not been explored in these children. Because of an increase in referrals of indigenous children from our catchment area (Manitoba, North Western Ontario, and Nunavut) for assessment of aspiration during swallowing, we retrospectively reviewed the clinical records of 325 consecutive children undergoing videofluoroscopic swallowing studies (VFSS) to evaluate which factors, including indigenous heritage and LRTI, were associated with aspiration during swallowing. Our sample had an overrepresentation of indigenous children (35% compared to 23% in the catchment area). These children were more likely to aspirate during swallowing (P = 0.001) and to have experienced an LRTI prior to the VFSS (P = 0.000). When separating the children who aspirated into two groups based on indigenous heritage, the indigenous children were more likely to have had an LRTI (P = 0.028) than the other children in the sample. With logistic regression analysis, significant correlations between indigenous heritage, LRTI (P = 0.000), and aspiration (P = 0.009) were found. When aspiration during swallowing was the factor of interest, it correlated with both LRTI (P = 0.001) and the presence of congested upper airway noises after eating (P = 0.000). These upper airway noises were strongly associated with aspiration in indigenous children (P = 0.004). While prospective data are required to determine if the correlations seen in this retrospective review will remain robust, indigenous children were more likely to aspirate during swallowing and have LRTI in this sample. Whether aspiration during swallowing is related to environmental, ethnic, or biological factors in indigenous children remains to be determined, but the association between aspiration and congested upper airway noises after eating may assist in the early diagnosis of aspiration during swallowing, and thereby enable timely intervention to decrease aspiration risk in children already at risk of repeated LRTI due to a number of other confounding factors.