Identification and Prediction of Child Behavior Trajectories among Children Who Have Experienced Maltreatment.

Abstract

Background. Child maltreatment affects almost 683,000 children annually. The consequences of child maltreatment range from physical and mental health issues, at the micro-level, to increased child welfare worker caseloads and overcrowded residential facilities at the mezzo-level, to increased costs and policy implications at the macro-level. Children who have been maltreated are at-risk for behavioral problems, yet little is known about the diverse problematic behaviors of these children or main factors causing behaviors. This study aims to identify internalizing and externalizing behavior pathways that follow over a 6-year period, and the predictors of membership in problematic pathways. Methods. Growth Mixture Modeling (GMM) was used to estimate the number of subgroups of children following distinct behavioral pathways. Standard T-scores from the CBCL subscales were entered into a series of unconditional GMM models. BIC, BLRT, and entropy were examined when considering model fit. Multinomial logistic regression was conducted to identify predictors of problematic behaviors over time. Results. There were no unconditional models that fit the data best. Several statistically significant (p < 0.05) factors at the level of the child, caregiver/parent, and environmental influence children’s problematic behaviors. Controlling for all other model variables constant, male children are more likely to exhibit behavioral problems than female children. Children with low social skills are more likely to engage in problematic behaviors. Caregivers with little or no support are more likely to report having children engaged in delinquent behavior. Finally, access to social services significantly lowers the children’s problematic behavior over time. Conclusions. Children differ regarding how they respond to maltreatment and other life events or situations depending upon child, caregiver, and environmental factors. Study results indicated that these factors influence the problematic behaviors of maltreated children. Study results also indicated that improving maltreated children’s social skills and increasing caregiver social support may be key in reducing child behavior problems. Furthermore, identifying early indicators of internalizing and externalizing behavior problems and addressing them with evidence-based interventions to reduce negative behaviors may avert long-term negative outcomes. Limitations of this current study are reviewed; practice and policy implications are discussed as are recommendations for future research.