Mary Bruce Webb

Developmental and behavioral needs and service use for young children in child welfare.

Objective. To determine the level of developmental and behavioral need in young children entering child welfare (CW), estimate early intervention services use, and examine variation in need and service use based on age and level of involvement with CW by using a national probability sample in the United States. Methods. As part of the National Survey of Child and Adolescent Well-Being, data were collected on 2813 children <6 years old for whom possible abuse or neglect was investigated by CW agencies. Analyses used descriptive statistics to determine developmental and behavioral needs across 5 domains (cognition, behavior, communication, social, and adaptive functioning) and service use. Logistic regression was used to examine the relationship between independent variables (age, gender, race-ethnicity, maltreatment history, level of CW involvement, and developmental or behavior problems) and service use. Results. Results indicate that age and level of CW involvement predict service use when controlling for need. Both toddlers (41.8%) and preschoolers (68.1%) in CW have high developmental and behavioral needs; however, few children are receiving services for these issues (22.7% overall). Children that remain with their biological parents have similar needs to those in out-of-home care but are less likely to use services. Children <3 years of age are least likely to use services. Conclusions. Children referred to CW have high developmental and behavioral need regardless of the level of CW involvement. Both age and level of involvement influence service use when controlling for need. Mechanisms need to be developed to address disparities in access to intervention.

Alcohol, Drug, and Mental Health Specialty Treatment Services and Race/ Ethnicity: A National Study of Children and Families Involved With Child Welfare

We used data on a national sample of children involved with child welfare systems to compare American Indian caregivers with White, Black, and Hispanic caregivers in their need for, and receipt of, specialty alcohol, drug, and mental health treatment. American Indian caregivers were significantly less likely to receive services than were Hispanic caregivers (P<.05) but not significantly less likely than were White or Black caregivers. Child placement, child age, and caregiver psychiatric comorbidity were significantly associated with service receipt.

Beyond Child Protection: Promoting Mental Health for Children and Families in the Child Welfare System

The child welfare system is in a period of significant reform that offers both opportunities and challenges regarding more effective collaboration between the mental health and child welfare systems. In this article we examine recent federal, state, and local initiatives that have influenced child welfare policy and practice on a national scale,with particular emphasis on those policies that offer opportunities for better coordination of services between mental health and child welfare agencies.To plan for effective services, mental health policy makers and practitioners must be cognizant of available funding streams for child welfare, trends and innovations within the child welfare system, the contextual factors that shape services to the children and families who are under its supervision, and the special characteristics of the population that it serves.

Caregiver instability and early life changes among infants reported to the child welfare system.

This study describes the extent of caregiver instability (defined as a new placement for 1 week or longer in a different household and/or with a new caregiver) in a nationally representative sample of infants, followed for 5-7 years. Data were drawn from the National Survey of Child and Adolescent Well-Being (NSCAW), a longitudinal study of 5,501 children investigated for child maltreatment. The analysis sample was restricted to 1,196 infants. Overall, 85.6% of children who were infants at the time of the index maltreatment experienced at least one caregiver instability event during their first 2 years of life. Caregiver instability was associated with the child having a chronic health condition and the caregiver being older than 40 years of age at baseline. The levels of instability reported in this study from infancy to school entry are extremely high. Children with more risk factors were significantly more likely to experience caregiver instability than children with fewer risk factors. The repeated loss of a young childs primary caregiver or unavailable, neglectful care can be experienced as traumatic. Some evidence-based programs that are designed to work with young maltreated children can make a substantial positive difference in the lives of vulnerable infants.

Enhancing Capacity for Evidence-Based Policymaking: the Role of Economic Evaluation Standards

This commentary will describe some ongoing activities that are moving the federal government toward stronger use of evidence in decision-making. In particular, the work of the Commission on Evidence-Based Policymaking points to directions that have implications for capacity building and the institutionalization of economic evaluation, as well as mechanisms and resources that could make economic evaluation more feasible. Bipartisan legislation incorporates many of the recommendations of the Commission and reinforces efforts already underway at individual agencies as well as among interagency groups. Understanding the current context of evidence-based policymaking in the federal government can enable economic researchers to better influence the processes of capacity building, shape the designs of evaluations, and inform decision-making. The commentary highlights areas where further elaboration of economic evaluation principles could be useful to support evidence building, implementation, and program improvement.