Occupational Medicine & Health Affairs
Open Access

Abstract

Introduction: The purpose of this study was to determine the institutional trajectory and future of young children in child welfare. Materials & Methods: A catamnetic study – based on data from child welfare office in Maine-et-Loire, France, from 1994 to 2001 – was conducted by a child psychiatrist and a psychologist. Medical, judiciary and educational data (development, health, pathways in child protection) were collected and analyzed regarding the status of these children fifteen years later, adding information gathered by interviewing child welfare and foster family consultant. Results: We included 128 children admitted in the child welfare office before 4 years old. Admission in the child welfare suffers from care delays (13.1 months average between the first child protection referral and placement) with an average entry age of 17 months, frequent cases of child abuse e.g. 7 Silverman syndrome cases). The physical and mental health status of children was bad (poorly monitored pregnancies, prematurity, low birth weight). More than a third of children had growth failure at admission, with catch-up in half of the cases. The average length of stay in the child welfare was 13.2±4.6 years. At the end of the follow-up, there were specific measures to safeguard vulnerable adults: “young adult” (24 cases), “major protection” (8 cases) and “disabled living allowance” (9 cases). One hundred and sixteen children suffer from psychiatric disorders at the entrance and ninety eight at the end. The general functioning of children – assessed by the Children’s Global Assessment Scale (CGAS) – showed a statistically significant improvement. One in two young adults showed difficulties in social integration with chaotic pathways: many foster placement, unsuccessful child return in his family, academic failures. Conclusion: Clinical situations of children in the child welfare office and their long-term evolution confirm the importance of this public health problem. If the measures can largely improve their physical and psychic recovery with evidence to thrive, these elements remains limited: only few of them are well integrated socially with school effectiveness.

Biography

Email: SeFanello@chu-angers.fr