Identification and Prediction of Child Behavior Trajectories among Children Who Have Experienced Maltreatment.
Date
2017-08
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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.
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Keywords
internalizing behavior, externalizing behavior, child behavior, NSCAW, behavioral trajectories
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