Terri Combs-Orme

Using the CBCL to determine the clinical status of children in state custody

Abstract This manuscript reviews information on past use of the CBCL to describe the clinical status of children in state custody and the results of a recent study of a representative statewide sample. The sample included a random sample of children in state custody, including those in foster care, kinship care, group residential facilities, and state institutions. One third (34%) of the children in state custody were reported as having significant behavior problems. The narrow band scales reflecting greatest difficulties included Aggressive, Delinquent, and Withdrawn behavior. The youngest teenage group was significantly more likely to have Internalizing problems in the clinical level, and those living in family homes were more likely to have scores in the non-clinical range than those in foster homes or group placements. There were no effects of gender, race, adjudication status, or length of time in custody. Implications for policy makers, caseworkers, and researchers are discussed.

The Extent of Long-Term Moderate Drinking among Alcoholics Discharged from Medical and Psychiatric Treatment Facilities

To assess the frequency of an evolution to stable moderate drinking among alcoholics coming to medical or psychiatric treatment facilities, we examined the five- to seven-year outcome for 1289 diagnosed alcoholics treated in our facilities during a two-year period (between 1973 and 1975). We obtained data from personal interviews, records, or both for 83 per cent of the sample. Only 1.6 per cent of the subjects met our definition of stable moderate drinking at follow-up, 15 per cent had become totally abstinent, and 4.6 per cent were mostly abstinent with occasional drinking. The only predictors of moderate drinking that we found were female sex and less severe alcoholism. The evolution to stable moderate drinking appears to be a rare outcome among alcoholics treated at medical or psychiatric facilities.

Detecting and Statistically Correcting Sample Selection Bias

ABSTRACT Researchers seldom realize 100% participation for any research study. If participants and non-participants are systematically different, substantive results may be biased in unknown ways, and external or internal validity may be compromised. Typically social work researchers use bivariate tests to detect selection bias (e.g., χ2 to compare the race of participants and non-participants). Occasionally multiple regression methods are used (e.g., logistic regression with participation/non-participation as the dependent variable). Neither of these methods can be used to correct substantive results for selection bias. Sample selection models are a well-developed class of econometric models that can be used to detect and correct for selection bias, but these are rarely used in social work research. Sample selection models can help further social work research by providing researchers with methods of detecting and correcting sample selection bias.

Comorbidity of Mental Health Problems and Chronic Health Conditions in Children

Both mental and physical health problems have significant, costly effects on children and on society, particularly through the health-care delivery system. Many years of research show more mental health problems among children with chronic health conditions, but the research is contradictory and inconclusive. This study is the first to examine the physical health status and problems of children with known mental health problems.The study compares Medicaid children with and without serious mental health problems (n = 965) using parent reports of global health status, physical functioning, and general health perceptions. Children with more serious mental health problems were significantly more likely to have chronic health conditions.The number of chronic health conditions was the most powerful variable in predicting childrens global health status, physical functioning, and general health perceptions. Childrens mental health status, however, was a significant predictor as well, and the inclusion of this variable in the analyses significantly improved the fit of the regression model. Implications for the health-care delivery system are discussed.

Utilization of health care by foster children: Application of a theoretical model

Foster children are among the unhealthiest in this nation, and their health care is grossly inadequate for their needs. This paper uses a model developed by Aday and Anderson (1975) to explore the reasons for the discrepancy between need and services in this population. The health care utilization model conceptualizes utilization to be a product of three factors: relevant health care policy; the structure of the health care system; and certain characteristics of the population, including need, enabling factors, and predisposing factors. It is demonstrated that foster children suffer disadvantages in each area that discourage their appropriate use of the health care system. Given projections for a substantial growth in the foster care population in the future, and the likelihood that this growth will occur disproportionately among children with significant health problems, the paper suggests a framework for improving the use of health care for foster children by using each level of the model, and provides suggestions for evaluation and research.

Anticipatory Guidance and Early Child Development: Pediatrician Advice, Parent Behaviors, and Unmet Needs as Reported by Parents From Different Backgrounds

Anticipatory guidance is acknowledged as an important aspect of pediatric practice, and research shows that parents expect and value the information and advice they receive from their pediatric health care providers. This study surveyed 373 parents (88% mothers) of infants in waiting rooms of diverse pediatric practices in Memphis,Tennessee, about their recall of anticipatory guidance received, unmet needs for anticipatory guidance, preferences for sources of information, and activities to promote healthy development. Most parents recalled specific guidance received (diet, communication, and discipline being the most common), and unmet needs (discipline and development being among the most common). Disadvantaged parents reported the fewest unmet needs. Most parents readily named specific activities they engage in to promote development, including reading, educational toys, and nurturing.

Health effects of adolescent pregnancy: implications for social workers.

Adolescent pregnancy carries significant risks to the health of the pregnant adolescent and her child. These risks, which include pregnancy complications, low birth weight, and infant mortality, are due in large part to the behavior of the adolescent and her socioeconomic circumstances. Early and consistent use of health care can minimize risks by permitting the detection and management of serious problems. Human service professionals should use every opportunity to encourage good prenatal care, while keeping in mind the developmental and personal needs of the pregnant adolescent.

Poverty and the Daily Lives of Infants

It has been amply demonstrated that poor children suffer disadvantages as compared to their more advantaged peers. This paper examines important aspects of infants’ daily experiences in a southeastern city in the United States in order to illustrate differences between poor and non-poor infants. “Poor” infants were compared to their “non-poor” counterparts on the quality of parenting they received; quality of their home environments; relative health and safety; stability, structure, and predictability of their daily lives; and exposure to diverse experiences in the community. Findings reveal that poor infants are at a consistent disadvantage across all domains when compared to their more affluent counterparts. These daily deficiencies might be conceptualized as the mechanisms through which poverty exerts its negative effects. This paper shifts the focus from macro-level variables such as larger economic and social factors to the cumulative effect of deficiencies at the micro-level. Intervening to ameliorate the micro-level deficits that are most modifiable may lessen the cumulative risk and provide some small avenues toward resilience for the most disadvantaged and at-risk infants.

Infant Mortality and Social Work: Legacy of Success

Although it is not widely known, social workers have had a substantial part in the impressive reduction in infant mortality achieved in the United States during this century. This article reviews that contribution, noting a decline in interest in infant mortality in the profession beginning in the 1950s. Recent trends are noted that seem to suggest a renewal in the professions interest in this important subject.

Early Brain Development for Social Work Practice: Integrating Neuroscience with Piaget's Theory of Cognitive Development

Despite social works claim of a bio-psychosocial approach to human behavior and development, the profession fails to incorporate important physiological knowledge into practice, research, and education. This article provides an example of the usefulness of understanding the ontology of early brain development by demonstrating how such knowledge can be integrated into Piagets theory of cognitive development. We suggest that social works focus on evidence-based practice demands the incorporation of neuroscience into the professions body of knowledge.