Data from the Adverse Childhood Exp

Data from the Adverse Childhood Experiences (ACE) Study
demonstrate that family experiences have lifelong consequences
[5,29e34] and a recently released report from the American
Academy of Pediatrics found that toxic stress experienced from
exposure to adverse childhood events can disrupt the development
of healthy coping skills and create “maladaptive coping
patterns and fragmented social networks” [35]. Teens who have
been reported to child welfare for alleged maltreatment can
often lack stable and nurturing relationships. Placement in foster
care has been shown to increase access to needed services;
therefore, those children who remain at home may not only
continue to be exposed to considerable stress, but also are less
likely to receive services to assist them in developing the
capacity to handle negative environments.
Although these data provide a unique opportunity to examine
MH problems in teens in the child welfare system, they are not
without limitations. Most of the variables examined, including
the outcome variables, are self-reported by the teen and the
teen’s caregiver with no independent corroboration. For children
in out-of-home placements, caregivers may have more limited
knowledge of the teen and could only report on the past 4
months in most cases. Also, the measures used are largely
symptom measures and, although they correlate well with
psychiatric diagnoses, they are not diagnostic. Thus, our findings
should be thought of as identifying potential MH problems.
Finally, these data must be interpreted in the context of the
method of ascertainment and the time frame considered for
each of the MH problems examined.
This study highlights the high rates of MH problems present
across the entire range of teenage years, and suggests that teens
involved with child welfare systems should be screened for MH
problems regardless of their post-investigation placement.
Services such as The National Youth Advocate Program’s
Constant and Never-ending Improvement (CANEI) program [36],
and other strength-based programs [37] that focus on increasing
resilience and enhancing relationships for teens, would benefit
teens at risk, especially those who remain in their homes without
ongoing child protection services.