Wellbeing of children and adolescents with special health care needs in the child welfare system

Children and adolescents in child welfare have the highest rates of chronic conditions and disabilities of any studied child population. The purpose of this study is to determine the wellbeing of children and adolescents with special health care needs (SHCN) in child welfare compared to their peers without SHCN. Wellbeing was measured using the Child and Adolescent Needs and Strengths (CANS) assessment; children and adolescents were assessed on the domains of Life Domain Functioning, Traumatic Stress Symptoms, Behavioral/Emotional Needs, Risk Behaviors, and Child Strengths. Scores on the CANS were compared between initial entry into the child welfare system and 18 months later. This is the first study to assess wellbeing over time of children and adolescents with SHCN in the child welfare system. This study found that children and adolescents with SHCN had increased wellbeing over an 18-month period. By the 18-month assessment, children and adolescents with SHCN presented similarly to their healthy peers, indicating that wellbeing improved more for children and adolescents with SHCN than those without SHCN across several domains of wellbeing. Children and adolescents with SHCN still had significant needs compared to children and adolescents without SHCN in the area of Life Domain Functioning. Adolescents (ages 12–18), with and without SHCN, had greater needs and fewer strengths compared to children (ages 6–11) both initially and 18 months later. Children and adolescents without SHCN also improved over the 18-month period. While this study specifically measured needs and strengths, the findings show that the wellbeing of children and adolescents, as measured across a variety of domains, improved while in child welfare.