Understanding the ecological context of mental, emotional, and behavioral health problems: A person-centered approach.

AIMS: The social/environmental context of youth is important for mental, emotional, and behavioral (MEB) health. This study used person-oriented methods to examine the influences of family, neighborhood, and poverty on late adolescent MEB outcomes. METHODS: Latent class analysis was used to discern significant clusters of at-risk, diverse young men (N = 625) based on contextual factors; differences in MEB outcomes were examined. RESULTS: Four classes emerged. Resourced and Protected youth had low risk across all indicators. Non-resourced and Protected youth lived in poverty, poor neighborhoods, but had good parenting; despite low delinquency, substance use was elevated. Resourced but High Risk youth had negative parenting but good neighborhoods. Outcomes included elevated delinquency and mental health problems. Non-resourced and High Risk youth were poor, lived in bad neighborhoods, and experienced abusive parenting; MEB outcomes were poor. CONCLUSION: Findings confirm the unique effects that negative parenting, neighborhoods, and poverty have on adolescent development. Implications are discussed.

Improving Access to Trauma-Informed Adoption Services: Applying a Developmental Trauma Framework.

Foster and adopted children often experience multiple traumatic and adverse experiences. A growing body of literature indicates the negative impact of trauma on developmental milestones and brain development, which supports the need to address complex trauma among this vulnerable population of foster and adopted youth. This paper presents an overview of the unique needs of children adopted from the foster care system from the perspective of adverse childhood experiences (ACEs), complex trauma, and developmental trauma disorder (DTD). There is an increasing number of evidence-based trauma-focused services and interventions for children and youth. However, many adoptive parents have limited trauma-informed training and limited access to trauma-informed and adoption-competent professionals, particularly long-term supports across developmental stages, making them ill-prepared to meet the needs of children in their care. This paper contributes to the understanding of how access to these trauma-focused services can be increased through new technologies, to better prepare and empower adoptive parents to deal effectively with difficult adoption issues when they arise and to improve outcomes for children and youth adopted from the public child welfare system. Several innovative approaches toward this end include harnessing technology to: (1) improve access to suitable adoption resources, (2) improve mechanisms to track critical events, behaviors, emotions, functional abilities, strengths, etc., in order to determine timely, on-demand contextual services, and (3) extend professional, supportive environments beyond the adoptive family context by proposing the use of technology to build interdisciplinary, virtual community partners.

Impact of individualized education plans on academic success of youth with early onset schizophrenia.

PURPOSE: Youth with early onset schizophrenia (EOS) are eligible for an individualized education plan (IEP) in school settings, yet often have declining academic performance over time. This study examines the impact of IEP and comorbid conditions on educational outcomes for youth with EOS. METHOD: We used mixed models and logistic regression to answer the research questions using data from 129 youth with EOS who participated in a longitudinal study from 1998 to 2006. RESULTS: Not all children had an IEP in all waves. Of those that did, findings demonstrated that having an IEP did not improve absenteeism or academic performance. In addition, regardless of whether they had an IEP, rates of dropping out were equal. CONCLUSIONS: Social workers should consider more individualized approaches to IEPs for youth with EOS to target the specific complexities of the disorder as well as its implications for school success.

Demographic and Environmental Factors Associated With Successful Day School Treatment Program Outcomes.

In this study the authors examine the impact of admission characteristics of 105 students admitted to a day school treatment program on outcomes. Those who graduated, earned a general education diploma (GED), or were returned to a regular classroom setting were categorized as successful and those placed in a more restrictive settings (including detention), dropped out, or left the program with no known outcome were unsuccessful. The sample was largely male (n = 78, 74.3%), Caucasian (64%, n = 67), poor (53.4%), and entered in middle school or high school (73%). The majority (53.3%) had 4 or more prior educational placements before entering. They stayed in the program on average 2.5 years (SD = 2.17) with a range from 6 days through 10 years. Forty-three (41%) students were successfully discharged. Unsuccessfully discharged students dropped out (31.4%), placed in residential programs (19%), or were psychiatrically hospitalized (5.7%). At intake, 56 (53.3%) had a history of truancy, 38 (37.1%) had a PINS and 28 (26.7%) had been on probation. African Americans were approximately 73% less likely to succeed and were more likely to be from families meeting federal poverty guidelines and to live in single family households. Those who entered the program in grades K-6 or 10-12 were over 3 times more likely to succeed than students admitted in grades 7-9. Using logistic regression to assess the bivariate relationships of the demographic characteristics with successful discharge, race, admission while in grades 7-9, having both parents at home, and number of days in the program were significantly associated with success. Having externalizing behaviors, 5 or more prior placements, history of truancy, and contact with the juvenile justice system were associated with unsuccessful outcomes. Students with a history of being in the juvenile justice system were 87% less likely to succeed in the program. Implications for school social workers are discussed.

Factors associated with admission to a day school treatment program.

In this study the authors examine the individual and family characteristics of youth (N = 105) admitted over a five year period to a day school treatment program in a western New York community. All had exhausted alternative school placements within their home school districts and had a history of severe emotional or behavioral problems. Consistent with national patterns, more males (78%) than females were admitted, but in contrast to national trends, more Caucasians (63.8%) than students of color (36.2%) were admitted. Most lived in female headed single-parent households (51.4%). A few were foster children living with relatives or in non-relative foster homes (14.3%). Poverty was common with 45.7% of these youth eligible for free lunches. Most were on psychotropic medications (57.1%) and had histories of outpatient (62.9%) and inpatient hospitalizations (23.6%) at admission. Involvement in the juvenile justice system was common with nearly a quarter involved in the juvenile justice system (n = 25; 23.8%).