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By Sandra J. Altshuler, Ph.D., L.I.C.S.W. Amber Cleverly-Thomas, M.S.W.

Presentation for: 1 st International Society for Child Indicators Conference June 28 th , 2007 - Session 23. How Are Drug-Endangered Children Faring? Mining Agency Records for Measuring Well-Being. By Sandra J. Altshuler, Ph.D., L.I.C.S.W. Amber Cleverly-Thomas, M.S.W.

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By Sandra J. Altshuler, Ph.D., L.I.C.S.W. Amber Cleverly-Thomas, M.S.W.

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  1. Presentation for:1st International Society for Child Indicators ConferenceJune 28th, 2007 - Session 23 How Are Drug-Endangered Children Faring? Mining Agency Records for Measuring Well-Being By Sandra J. Altshuler, Ph.D., L.I.C.S.W. Amber Cleverly-Thomas, M.S.W.

  2. A Collaborative Response for Drug-endangered Children: Empowering A Community to Protect Children from Methamphetamine* This project was supported by Cooperative Agreement Numbers 2003-JS-FX-K083 and 2005-JL-FX-K122 awarded by the Office of Juvenile Justice and Delinquency Prevention, Office of Justice Programs, U.S. Department of Justice. The Spokane County DEC Team stewards are: Spokane County Sheriff’s Office, Spokane Police Department, Spokane County Prosecuting Attorney’s Office, Child Protective Services (Washington Department of Social and Health Services, Division of Children and Family Services), Partners with Families and Children—Spokane (formerly Casey Family Partners—Spokane), Lutheran Community Services Northwest, Spokane School District 81, Educational Service District 101, Washington Department of Corrections, and Counseling Resources for Youth and Families. Special thanks are extended to Esther Larsen, J.D., Karen Winston, M.S.W., and Kyle Bunge, M.S.W.

  3. Spokane County DEC Partners(see logic model also) Spokane County Sheriff’s Office Spokane Police Department Spokane County Prosecutor Child Protective Services Partners with Families and Children Lutheran Community Services Spokane School District 81 ESD 101 Department of Corrections

  4. What is the Drug Endangered Children (DEC) Program? • A collaborative effort to address the needs of children identified as drug endangered. • A partnership among law enforcement, Child Protective Services, prosecutors, and agencies providing services to children. • Guidelines for the delivery of services to drug endangered children. • A system for identifying and monitoring the well-being of children identified as drug endangered.

  5. Who is a Drug Endangered Child? Any child living in an environment where adults are manufacturing, selling, and/or using drugs.

  6. What Does a Drug Environment Look Like?

  7. Evaluation Methodology Research questions: • What is the level of interdisciplinary collaboration achieved by the Spokane County DEC Team in its first year of functioning? (see article included in packet) • To what extent are the needs of drug endangered children being addressed?

  8. Evaluation Methodology Sources of data(includes administrators, line staff, and case records): • Spokane County Sheriff’s Office • Spokane Police Department • Spokane County Prosecutor • Child Protective Services • Partners with Families and Children • Lutheran Community Services • Spokane School District 81

  9. Evaluation Methodology The Perry et al (2003) schema for assessing neglected children includes 6 life domains, plus we added last 2: • Physical/medical • Trauma history • Developmental • Social/family • Mental health/emotional/behavioral • Cognitive/ academic: “school functioning” • Child welfare history • Demographics

  10. Evaluation Methodology Instrumentation—Measure of Physical/Medical Health • Was a “Kids Screen” completed by DCFS? • Pediatric Exam • Height • Weight • Head Circumference • Does child have a “medical home” or identified pediatrician?

  11. Evaluation Methodology Instrumentation—Measure of Trauma • Trauma Symptom Checklist for Children (ages 8-16) or Trauma Symptom Checklist for Young Children (ages 3-12) (Briere, 1996) • parent or caretaker report, standardized, strong validity • Assesses levels of: • Anxiety • Depression • Anger • Posttraumatic stress • Dissociation • Sexual concerns • Aggression

  12. Evaluation Methodology Instrumentation—Measures of Development I • Battelle Developmental Inventory (ages 1-8) (Newborg et al., 1984) • Parent/caregiver report, plus observation, time tests • standardized, strong validity • Assesses levels of: • Personal-social • Adaptive functioning • Total motor (gross and fine) skills • Total communication (expressive and receptive) skills • Cognition

  13. Evaluation Methodology Instrumentation—Measures of Development II • Ages and Stages Questionnaire (Squires, Potter, & Bricker, 1999) (ages 4-60 months) • Parent/caregiver report • standardized, strong validity • Assesses levels of: • Communication • Gross motor • Fine motor • Problem solving • Personal/Social

  14. Evaluation Methodology Instrumentation—Measure of Family History • Adverse Childhood Experiences (Felitti, et al., 1998) • Parent report of growing up with: • Recurrent physical abuse • Contact sexual abuse • Domestic violence • Recurrent severe emotional abuse • Parental substance abuse • Imprisoned parent • Parental chronic mental illness • Loss of at least one parent during childhood • DCFS report of female caregiver history of childhood abuse or neglect

  15. Child Behavior Checklist (ages 4-18) (Achenbach, 2003) Parent/caregiver report standardized, strong validity Assesses levels of: Emotional: “Internalizing Behavior” Behavior: “Externalizing Behavior” Assess domains of: Anxious/depressed Somatic complaints Withdrawn Attention problems Aggressive behaviors Sleep problems (1 ½ - 5 yrs) Social problems (6 – 18 yrs) Thought problems(6 – 18 yrs) Rule Breaking behaviors(6 – 18 yrs) Telesage (all ages) Mental Health Management Outcomes System Parent/caregiver report; client self-report Selected parts of variety of standardized measures Assesses domains of: Hopefulness Problem severity Internalizing Externalizing Delinquency Evaluation MethodologyInstrumentation—Measure of Mental Health: Emotional/Behavioral

  16. Evaluation Methodology Instrumentation—Measure of Mental Health: Social Functioning • Ages and Stages Questionnaire: Social-Emotional (Squires, Bricker, & Twombly, 2003) (ages 0-6) • Parent/caregiver report • standardized, strong validity • The child’s total score is compared with an empirically derived cutoff point. If the child’s score is higher than the cutoff, it suggests the child should be referred for further mental health evaluation.

  17. Evaluation Methodology Instrumentation—Measurement of School Functioning • Mining of school data (ages 5-18) • Grades • # of schools attended • Attendance/Truancy history • Discipline history • Special Education Status and disability • Retention history

  18. Evaluation Methodology Instrumentation—Measures of Child Welfare History • # of CPS referrals for each child, # accepted for investigation • Assigned risk tag (0=no risk, 5=highest risk) • Reason for referral • Relationship of each referral reason to drugs • Parent’s drug of choice, including poly-drug use • #, length of previous out-of-home placements • Type of current placement (non-related, kinship, etc.) • Permanency plan and current legal status

  19. Evaluation Methodology Instrumentation--Demographics • Age (at time of referral to DEC program) • Gender • SES • Ethnicity • Was child placed with sibling? • Family Structure at time of placement

  20. Evaluation Methodology Data Analysis Plan • Univariate analyses • Assess for normalcy • Simple descriptive summaries • Exploratory analyses • Isolate any demographic variables that correlate with either enhanced or degraded outcomes (appropriate to the measurement level of each variable) • To understand the natural history of the study participants, baseline values for DEC participants will be examined from date of admission to the DEC program to determine if characteristics of the population sample changed during the time frame of the study (thereby hoping to reduce the need for a separate comparison group and maximize the internal validity of the data collected). • Future analyses (dependent upon above results) to determine predictors of outcomes (e.g, impact of ACEs, child welfare history, etc.)

  21. *Domains excluding PTS: t-score less ≤ 64 is considered normal, 65-69 are potentially problematic, and ≥ 70 are clinically significant. For PTS: t-score ≤ 64 is considered normal, 65-69 are “often associated with at least one elevated PTSD symptom cluster,” and ≥ 70 suggest relatively severe posttraumatic disturbance (Briere, 1996)

  22. **p = .01

  23. *Z-score of 1.5 or below indicates a performance deficit (Newborg, Stock, Wnek, Guidubaldi, Svinicki., 1984)

  24. *p = .05 **p = .01

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