Developmental Status and Early Intervention Service Needs of Maltreated Children. Appendix A: Glossary of Terms

Baseline:

 

The baseline NSCAW assessment occurred following the report of a child for child maltreatment and the subsequent investigation by child welfare services (and closing of the investigation).

Biomedical Risk Factors:

States have the option to provide Part C services to children with medical or other biologically-based problems which increase the likelihood of developmental problems. These included arthritis, joint problems or other orthopedic impairment, chronic cardiac problems, dental problems, hernia, hypertension, lead poisoning, obesity, persistent bowel problems, physical deformities, repeated ear infections, severe allergies, respiratory problems, acquired immune deficiency syndrome, low birthweight, anemia, and other similar health problems.

Caregiver:

Caregiver refers to the person who has legal custody of the child or is the foster parent. The caregiver completes the assessment questions about the child as well as the self-report questions about family characteristics. In NSCAW, more than 80% of the caregivers are mothers (biological and foster), but there are some grandmothers, aunts, biological fathers, and unrelated adults who are also caregivers.

Child Welfare Setting:

The place of physical residence of the child combined with the type of service. In NSCAW this may be In Home Without On-Going Services, In Home With On-Going Child Welfare Services, Foster Care, Kinship Care, Group Care, or Other Out-of-Home Care.

Developmental and Risk Indicator Groups (DRIGs):

In order to describe the developmental characteristics of maltreated infants and toddlers, children were classified into one of three mutually exclusive groups called Developmental and Risk Indicator Groups (DRIGs). The Measured Delay group consisted of those who had a measured delay on one or more developmental measure. These children were subject to varying number of risk factors. This category also included a small proportion of children with an established risk condition which made them eligible for Part C services (e.g., cerebral palsy) regardless of measured delay, however almost all of the children with an established risk condition also had a measured delay. A second group, the High Risk group, consisted of children who had at least five risk factors associated with developmental problems (e.g., poverty level, active domestic violence, substance abuse), but no measured delay. All children in NSCAW had at least one risk factor; a maltreatment experience. The final group, the Lower Risk group, had fewer than 5 risk factors and no measured delay. The groups are mutually exclusive so a child with a measured delay was in that group regardless of the number of risk factors they experienced.

Developmental Delay:

Under Part C of IDEA, states must provide services to any child under 3 years of age who needs early intervention services (IDEA 2004, §632(5)(A)) because the child: (i) is experiencing developmental delays, as measured by appropriate diagnostic instruments and procedures in 1 or more of the areas of cognitive development, physical development, communication development, social or emotional development, and adaptive development (Shackelford, 2006). The degree of delay, number of areas and how it is measured is up to the individual states to define.

Environmental Risk Factors:

Children at environmental risk include those whose caregiving circumstances and current family situation place them at greater risk for delay than the general population. As with biological/medical risk, states are not required, but may chose to include children at environmental risk under the optional Part C eligibility category of at risk. Examples of environmental risk factors may include parental substance abuse, family social disorganization, poverty, homelessness, parental developmental disability, parental age, parental educational attainment, and child abuse or neglect.

Established Risk Condition:

A condition of established risk is defined as a diagnosed physical or mental condition which has a high probability of resulting in developmental delay. Children with these conditions are eligible for Part C services without documentation of delay. These conditions include, but are not limited to, chromosomal abnormalities; genetic or congenital disorders; severe sensory impairments, including hearing and vision; inborn errors of metabolism; disorders reflecting disturbance of the development of the nervous system; congenital infections; disorders secondary to exposure to toxic substances, including fetal alcohol syndrome; and severe attachment disorders.

High Risk (in the context of child welfare):

A child welfare case in which there exists strong reason to believe maltreatment will occur in the future, absent intervention, regardless of whether maltreatment has occurred in the past.

Indicated Maltreatment:

A child welfare case in which there is not sufficient evidence to meet the standard of substantiation, but where some evidence of maltreatment does exist. Not used in every state or court.

Logistic Regression:

An adaptation of the linear regression model suitable for use with dichotomous outcomes.

Measured Delay:

An infant or toddler in NSCAW who scored at least one standard deviation below the mean on any two developmental instruments or at least one and one-half standard deviations below the mean on any single developmental instrument. Because screener versions or only portions of instruments were used, the young age of the children at baseline, and because these scores do not constitute a formal evaluation, a measured delay is not a diagnosis of developmental delay.

Risk Factors:

Risk factors such as poverty or maternal mental health have been shown to be associated with poorer outcomes for infants and toddlers. However the most detrimental effects on child development are the cumulative effect of multiple risk factors (such as low caregiver education, teenage caregiver, biomedical risk, minority status, single caregiver, caregiver substance abuse, active domestic violence against the caregiver, caregiver mental health problems, and poverty).

Substantiated Maltreatment:

A child welfare case in which there is sufficient evidence to determine that maltreatment occurred. This standard varies by state and court.

Unsubstantiated maltreatment:

A child welfare case in which there is not sufficient evidence to determine that maltreatment occurred.

 

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