Objective: 

The purpose of this study was to determine whether children with developmental disorders (DDs) in protective custody are more likely to experience specific placement types and stay in care longer than their typically developing peers. Furthermore, in the DD-only group, we examined whether the likelihood of each placement type differed by specific DD diagnosis.

Methods: 

This observational retrospective study used child welfare administrative data linked to electronic health records in a large Ohio county. Participants were aged 5 to 20 years (N = 2787). DD diagnoses were determined using problem list and encounter diagnosis codes.

Results: 

Children with versus without DD were less likely to be in kinship placement (adjusted odds ratio [aOR], 0.79; 95% confidence interval [CI]: 0.66–0.94) and more likely to be in congregate care (aOR, 1.26; 95% CI: 1.04–1.53) and nonrelative foster care (aOR, 1.20; 95% CI: 1.00–1.45). A likelihood of independent living placement did not differ for those with and without DD. Those with versus without DD had longer lengths of stay in protective custody (p ≤ 0.001), but the number of placement changes did not differ after accounting for length of stay. The pattern of results differed somewhat by individual DD diagnosis.

Conclusion: 

Compared with their typically developing peers, children with DD are less likely to be in kinship care and tend to have longer lengths of stay in protective custody. If replicated, these findings suggest the need to identify and address mechanisms to support children with DD across placement settings and to better understand factors prolonging their protective custody stay.

中文翻译：

---

发育障碍儿童的儿童保护性监护安置

 客观的：

本研究的目的是确定处于保护性监护中的患有发育障碍 (DD) 的儿童是否比正常发育的同龄人更有可能经历特定的安置类型并在照顾中停留更长时间。此外，在仅 DD 组中，我们检查了每种放置类型的可能性是否因特定 DD 诊断而异。

 方法：

这项观察性回顾性研究使用了与俄亥俄州一个大县的电子健康记录相关的儿童福利管理数据。参与者年龄在 5 至 20 岁之间（N = 2787）。 DD 诊断是使用问题列表和遇到的诊断代码来确定的。

 结果：

与无 DD 的儿童相比，患有 DD 的儿童不太可能处于亲属安置中（调整后优势比 [aOR]，0.79；95% 置信区间 [CI]：0.66–0.94），更有可能处于集体护理中（aOR，1.26；95%） CI：1.04–1.53）和非亲属寄养（aOR，1.20；95% CI：1.00–1.45）。对于患有和不患有 DD 的人来说，独立生活安置的可能性没有差异。与没有 DD 的人相比，他们在保护性拘留中的停留时间更长 ( p ≤ 0.001)，但在考虑了停留时间后，安置变更的数量没有差异。结果模式因个体 DD 诊断而有所不同。

 结论：

与正常发育的同龄人相比，患有 DD 的儿童接受亲属照顾的可能性较小，并且往往在保护性监护下停留的时间较长。如果重复的话，这些发现表明需要确定和解决在不同安置环境中支持 DD 儿童的机制，并更好地了解延长其保护性监护时间的因素。