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Resiliency among ChildResiliency among Child
Welfare Youth: Findings fromWelfare Youth: Findings from
The Maltreatment andThe Maltreatment and
Adolescent Pathways (MAP)Adolescent Pathways (MAP)
ProjectProject
Christine Wekerle, Ph.D.
Associate Professor, Education, Psychology & Psychiatry
The University of Western Ontario
Presented at the September 25th, 2008
Meeting of the Child Welfare Outcomes Expert Reference Group
Ontario Ministry of Child and Youth Services
Toronto, Canada
MAP InvestigatorsMAP Investigators
Christine Wekerle, Ph.D.Christine Wekerle, Ph.D. (PI; UWO; cwekerle@uwo.ca)(PI; UWO; cwekerle@uwo.ca)
Co-investigators in alphabetical order:
Michael Boyle, Ph.D.Michael Boyle, Ph.D. (McMaster)(McMaster)
Deborah Goodman, Ph.D.Deborah Goodman, Ph.D. (Toronto CAS)(Toronto CAS)
Bruce Leslie, M.S.W.Bruce Leslie, M.S.W. (Catholic CAS)(Catholic CAS)
Eman Leung, Ph.D.Eman Leung, Ph.D. (UWO)(UWO)
Harriet MacMillan, M.D.Harriet MacMillan, M.D. (McMaster)(McMaster)
Brenda Moody, M.B.A.Brenda Moody, M.B.A. (Peel Region CAS)(Peel Region CAS)
Nico Trocmé, Ph.D.Nico Trocmé, Ph.D. (McGill)(McGill)
Randall Waechter, Ph.D.Randall Waechter, Ph.D. (UWO)(UWO)
MAP Advisory Board:MAP Advisory Board: Kong Chung, Lori Bell, NatashaKong Chung, Lori Bell, Natasha
Budzarov, Darlaine Mathews, David Firang, Dan Cadman, Susan GainesBudzarov, Darlaine Mathews, David Firang, Dan Cadman, Susan Gaines
Cherry Chan, Mario Giancola, Judith Wharton, Bervin Garraway, CarlaCherry Chan, Mario Giancola, Judith Wharton, Bervin Garraway, Carla
Da Fonte, Jacqueline BittencourtDa Fonte, Jacqueline Bittencourt
MAP Project Funding AgenciesMAP Project Funding Agencies
The MAP Project consists of 3 studies: MAP Feasibility Study;The MAP Project consists of 3 studies: MAP Feasibility Study;
MAP Longitudinal Study (Males & Females); MAP KnowledgeMAP Longitudinal Study (Males & Females); MAP Knowledge
Translation Study. The MAP thanks the following agencies:Translation Study. The MAP thanks the following agencies:
• The Canadian Institutes of Health Research (CIHR),The Canadian Institutes of Health Research (CIHR),
Community Action HealthCommunity Action Health Research and theResearch and the Institute ofInstitute of
Gender and HealthGender and Health
• The Ontario Ministry of Children & Youth ServicesThe Ontario Ministry of Children & Youth Services
• The Ontario Mental Health FoundationThe Ontario Mental Health Foundation
• The Provincial Centre of Excellence in ChildThe Provincial Centre of Excellence in Child && YouthYouth MentalMental
Health at the Children’s Hospital of Eastern OntarioHealth at the Children’s Hospital of Eastern Ontario
• Canadian Institutes of Health Research/Ontario Women’sCanadian Institutes of Health Research/Ontario Women’s
Health Council Mid-Career Award (to CHealth Council Mid-Career Award (to Christinehristine Wekerle)Wekerle)
• The Public Health Agency of CanadaThe Public Health Agency of Canada
• The Centre for Excellence in Research in Child WelfareThe Centre for Excellence in Research in Child Welfare
MAP- General MethodsMAP- General Methods
 Adolescents on active child welfare caseload in a large urbanAdolescents on active child welfare caseload in a large urban
centre, from mid-adolescence to young adulthoodcentre, from mid-adolescence to young adulthood
 Youth are randomly selected for participation from all activeYouth are randomly selected for participation from all active
participating Children’s Aid Society cases in 14.0 to 17.0 yearparticipating Children’s Aid Society cases in 14.0 to 17.0 year
age range (open for >6 months)age range (open for >6 months)
 Recruitment rate of eligible participants at the initial testingRecruitment rate of eligible participants at the initial testing
point is approximately 70% (retention rate is 84%)point is approximately 70% (retention rate is 84%)
 Testing points across 3 yrs, mostly self-report measuresTesting points across 3 yrs, mostly self-report measures
 Also includes brief intelligence testing, computerized diagnosticAlso includes brief intelligence testing, computerized diagnostic
interview, neuropsychological tests, and the Ontario Studentinterview, neuropsychological tests, and the Ontario Student
Drug Use & Health Survey (OSDUHS; given at Years 1,2,3Drug Use & Health Survey (OSDUHS; given at Years 1,2,3
testings) to compare child welfare youth to the Ontariotestings) to compare child welfare youth to the Ontario
population of youthpopulation of youth
Initial TestingInitial Testing –– DemographicsDemographics
 N=453 child welfare-involved youth (52% female) participants atN=453 child welfare-involved youth (52% female) participants at
the initial time point (data collected Oct. 2002 – July 2008)the initial time point (data collected Oct. 2002 – July 2008)
 Mean age: M=16.4 years (SD=0.99)Mean age: M=16.4 years (SD=0.99)
 CAS status: 63% crown ward, 16% society ward, 16%CAS status: 63% crown ward, 16% society ward, 16%
community family, 5% temporary carecommunity family, 5% temporary care
 Self-endorsed ethnicity: 30% two or more; 30% White, 25%Self-endorsed ethnicity: 30% two or more; 30% White, 25%
Black, 3% Latin American, 1% Chinese, 1% Filipino, 1% SouthBlack, 3% Latin American, 1% Chinese, 1% Filipino, 1% South
Asian, 1% Arab/West Asian, 1% South East Asian, 1% Native,Asian, 1% Arab/West Asian, 1% South East Asian, 1% Native,
6% Other6% Other
 Living arrangements: 44% with foster parents, 24% in a groupLiving arrangements: 44% with foster parents, 24% in a group
home, 8% with a single parent, 5% with one biological parenthome, 8% with a single parent, 5% with one biological parent
and one other parent, 5% living on own or with a friend, 4% withand one other parent, 5% living on own or with a friend, 4% with
two biological married or common-law parents, 4% with othertwo biological married or common-law parents, 4% with other
relatives, 6% otherrelatives, 6% other
1-Year Testing1-Year Testing –– DemographicsDemographics
 N=241 child welfare youth (53% female) at the 1-year timeN=241 child welfare youth (53% female) at the 1-year time
point (data collected Aug. 2003 – July 2008)point (data collected Aug. 2003 – July 2008)
 Mean age: M=17.35 years (SD=0.96)Mean age: M=17.35 years (SD=0.96)
 CAS: 66% crown ward, 14% society ward, 16% communityCAS: 66% crown ward, 14% society ward, 16% community
family, 4% temporary carefamily, 4% temporary care
 Self-endorsed ethnicity: 33% two or more, 27% White, 25%Self-endorsed ethnicity: 33% two or more, 27% White, 25%
Black, 7% Other, 3% Latin American, 1% Chinese, 1%Black, 7% Other, 3% Latin American, 1% Chinese, 1%
Filipino, 1% Arab/West Asian, 1% South East Asian, 1%Filipino, 1% Arab/West Asian, 1% South East Asian, 1%
NativeNative
 Living arrangements: 38% with foster parents, 14% in a groupLiving arrangements: 38% with foster parents, 14% in a group
home, 14% living on own or with a friend, 11% with a singlehome, 14% living on own or with a friend, 11% with a single
parent, 10% other, 4.5% with other relatives, 4% with oneparent, 10% other, 4.5% with other relatives, 4% with one
biological parent and one other parent, 2.5% with twobiological parent and one other parent, 2.5% with two
biological married/common-law parents, 2% adoptive parentsbiological married/common-law parents, 2% adoptive parents
Ways to Think about ResiliencyWays to Think about Resiliency
Defined globally as “dynamic process” of “positive adaptation” in
context of “significant adversity” (Luthar et al., 2000)
-Agent – community; family; individual
- Timepoint - situational; developmental period; longitudinal
- Process – self-righting; “spontaneous remission”; positive intervention
effects; social influences (peers, family)
- Dimension – self-concept (confidence, persistence, optomism);
Achievement (education, sports, art); Interpersonal/Relationships
- Normative Context – delayed entry or abstinence from health risk
behaviours; average range or better on functioning (intellectual,
achievement, mental health; adaptive/age-appropriate independence and
self-sufficiency); recovery ability (clinically significant reduction; return to
normal range)
- Perceptual – Attributions (Hostile; Global; Stable etc.), Beliefs about
Resiliency;
MAP findings – Age of Entry
Average Age % under 13 years
Sexual Intercourse (60%; 4% under 13)= 14. 47 years (SD=1.8)
Alcohol (71%; 8% under 13) = 13.18 years (SD=2.23)
Cannabis (52%; 10% under 13) = 13.57 years (SD=1.76)
Dating (59%; 7% under 13) = 13.67 years (SD=1.97)
Pregnant/Father (19%)
Dating:
MAP Females = 13.03 years (SD=2.33)
MAP Males = 12.35 years (SD=2.37)
When MAP Avg Age= 15-16 years;
MAP Females’ Partners=18 years (SD=3.0);
MAP Males’ Partners = 15 years (SD=5.0)
Any dating violence item endorsed, 40-60% endorsement
MAP findings (referenced to SES, gender and
age-matched Ontario youth; OSDUHS)
 MAP youth are 3-4 less likely to be over 16 years old and have a driver’s
license, as compared to ON youth (OSDUHS); non-Crown Wards (18+
times more likely to not have a driver’s licence)
 MAP youth are about on par w/ ON youth in terms of jobs outside the
home, self-ratings of physical health, amount of exercise, drug-selling
(marijuana, hashish), ever seriously considered suicide,
depression(GHQ)
 MAP youth are over 4 times more likely to have changed schools 4 or
more times in the past 5 years, as compared to ON youth (OSDUHS)
 MAP youth are about 1.5 times more likely to bully others at school at a
daily or near daily level, to carry a weapon, to have a physical fight on
school property, to be part of gangs, to have tried marijuana (OSDUHS);
non-Crown Wards show higher likelihoods, up to 5x more likely
 Some MAP youth are more likely to report depression (CESD), especially
Non-Crown Wards
 Crown Wards have lower than normative alcohol use, except on category
of frequent alcohol use (almost every day); Non-Crown Wards have
MAP findings (referenced to test norms)
 About 6-7% of MAP Males exceed the clinical cut-off on
Trauma Symptom Checklist for Children subscales:
Anxiety, Anger, Post-traumatic stress response, Dissociation
(11%), Depression (12%), Sexual Concerns (11%)
 About 10-12% of MAP Females exceed the clinical cut-off on
Trauma Symptom Checklist for Children subscales:
Anxiety, Depression, Anger, Post-traumatic stress response,
Dissociation, Sexual Concerns (19%)
Selected MAP Outcome Measures:Selected MAP Outcome Measures:
Suicidality over time (Brief SymptomSuicidality over time (Brief Symptom
Inventory)Inventory)
Thoughts on MAP FindingsThoughts on MAP Findings
 Child welfare youth have unique challenges to resiliency: 8%Child welfare youth have unique challenges to resiliency: 8%
of MAP youth self-identify as LGB, 92% as heterosexual;of MAP youth self-identify as LGB, 92% as heterosexual;
LGB youth have greater likelihoods of alcohol, drug,LGB youth have greater likelihoods of alcohol, drug,
emotional health problemsemotional health problems
 Most child welfare youth are doing on par with ON teens onMost child welfare youth are doing on par with ON teens on
most health dimensions, as they have been measured so far,most health dimensions, as they have been measured so far,
some indications of issues in drug use and PTSD/mood areassome indications of issues in drug use and PTSD/mood areas
 Between 5-20% of youth are having serious/chronic troubles:Between 5-20% of youth are having serious/chronic troubles:
Child welfare youth are more likely to have serious troublesChild welfare youth are more likely to have serious troubles
when having troubleswhen having troubles (daily bullying, daily drinking)(daily bullying, daily drinking)
 Seems important to minimize transition stressSeems important to minimize transition stress

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Resiliency among Child Welfare Youth: Findings from The Maltreatment and Adolescent Pathways (MAP) Project

  • 1. Resiliency among ChildResiliency among Child Welfare Youth: Findings fromWelfare Youth: Findings from The Maltreatment andThe Maltreatment and Adolescent Pathways (MAP)Adolescent Pathways (MAP) ProjectProject Christine Wekerle, Ph.D. Associate Professor, Education, Psychology & Psychiatry The University of Western Ontario Presented at the September 25th, 2008 Meeting of the Child Welfare Outcomes Expert Reference Group Ontario Ministry of Child and Youth Services Toronto, Canada
  • 2. MAP InvestigatorsMAP Investigators Christine Wekerle, Ph.D.Christine Wekerle, Ph.D. (PI; UWO; cwekerle@uwo.ca)(PI; UWO; cwekerle@uwo.ca) Co-investigators in alphabetical order: Michael Boyle, Ph.D.Michael Boyle, Ph.D. (McMaster)(McMaster) Deborah Goodman, Ph.D.Deborah Goodman, Ph.D. (Toronto CAS)(Toronto CAS) Bruce Leslie, M.S.W.Bruce Leslie, M.S.W. (Catholic CAS)(Catholic CAS) Eman Leung, Ph.D.Eman Leung, Ph.D. (UWO)(UWO) Harriet MacMillan, M.D.Harriet MacMillan, M.D. (McMaster)(McMaster) Brenda Moody, M.B.A.Brenda Moody, M.B.A. (Peel Region CAS)(Peel Region CAS) Nico Trocmé, Ph.D.Nico Trocmé, Ph.D. (McGill)(McGill) Randall Waechter, Ph.D.Randall Waechter, Ph.D. (UWO)(UWO) MAP Advisory Board:MAP Advisory Board: Kong Chung, Lori Bell, NatashaKong Chung, Lori Bell, Natasha Budzarov, Darlaine Mathews, David Firang, Dan Cadman, Susan GainesBudzarov, Darlaine Mathews, David Firang, Dan Cadman, Susan Gaines Cherry Chan, Mario Giancola, Judith Wharton, Bervin Garraway, CarlaCherry Chan, Mario Giancola, Judith Wharton, Bervin Garraway, Carla Da Fonte, Jacqueline BittencourtDa Fonte, Jacqueline Bittencourt
  • 3. MAP Project Funding AgenciesMAP Project Funding Agencies The MAP Project consists of 3 studies: MAP Feasibility Study;The MAP Project consists of 3 studies: MAP Feasibility Study; MAP Longitudinal Study (Males & Females); MAP KnowledgeMAP Longitudinal Study (Males & Females); MAP Knowledge Translation Study. The MAP thanks the following agencies:Translation Study. The MAP thanks the following agencies: • The Canadian Institutes of Health Research (CIHR),The Canadian Institutes of Health Research (CIHR), Community Action HealthCommunity Action Health Research and theResearch and the Institute ofInstitute of Gender and HealthGender and Health • The Ontario Ministry of Children & Youth ServicesThe Ontario Ministry of Children & Youth Services • The Ontario Mental Health FoundationThe Ontario Mental Health Foundation • The Provincial Centre of Excellence in ChildThe Provincial Centre of Excellence in Child && YouthYouth MentalMental Health at the Children’s Hospital of Eastern OntarioHealth at the Children’s Hospital of Eastern Ontario • Canadian Institutes of Health Research/Ontario Women’sCanadian Institutes of Health Research/Ontario Women’s Health Council Mid-Career Award (to CHealth Council Mid-Career Award (to Christinehristine Wekerle)Wekerle) • The Public Health Agency of CanadaThe Public Health Agency of Canada • The Centre for Excellence in Research in Child WelfareThe Centre for Excellence in Research in Child Welfare
  • 4. MAP- General MethodsMAP- General Methods  Adolescents on active child welfare caseload in a large urbanAdolescents on active child welfare caseload in a large urban centre, from mid-adolescence to young adulthoodcentre, from mid-adolescence to young adulthood  Youth are randomly selected for participation from all activeYouth are randomly selected for participation from all active participating Children’s Aid Society cases in 14.0 to 17.0 yearparticipating Children’s Aid Society cases in 14.0 to 17.0 year age range (open for >6 months)age range (open for >6 months)  Recruitment rate of eligible participants at the initial testingRecruitment rate of eligible participants at the initial testing point is approximately 70% (retention rate is 84%)point is approximately 70% (retention rate is 84%)  Testing points across 3 yrs, mostly self-report measuresTesting points across 3 yrs, mostly self-report measures  Also includes brief intelligence testing, computerized diagnosticAlso includes brief intelligence testing, computerized diagnostic interview, neuropsychological tests, and the Ontario Studentinterview, neuropsychological tests, and the Ontario Student Drug Use & Health Survey (OSDUHS; given at Years 1,2,3Drug Use & Health Survey (OSDUHS; given at Years 1,2,3 testings) to compare child welfare youth to the Ontariotestings) to compare child welfare youth to the Ontario population of youthpopulation of youth
  • 5. Initial TestingInitial Testing –– DemographicsDemographics  N=453 child welfare-involved youth (52% female) participants atN=453 child welfare-involved youth (52% female) participants at the initial time point (data collected Oct. 2002 – July 2008)the initial time point (data collected Oct. 2002 – July 2008)  Mean age: M=16.4 years (SD=0.99)Mean age: M=16.4 years (SD=0.99)  CAS status: 63% crown ward, 16% society ward, 16%CAS status: 63% crown ward, 16% society ward, 16% community family, 5% temporary carecommunity family, 5% temporary care  Self-endorsed ethnicity: 30% two or more; 30% White, 25%Self-endorsed ethnicity: 30% two or more; 30% White, 25% Black, 3% Latin American, 1% Chinese, 1% Filipino, 1% SouthBlack, 3% Latin American, 1% Chinese, 1% Filipino, 1% South Asian, 1% Arab/West Asian, 1% South East Asian, 1% Native,Asian, 1% Arab/West Asian, 1% South East Asian, 1% Native, 6% Other6% Other  Living arrangements: 44% with foster parents, 24% in a groupLiving arrangements: 44% with foster parents, 24% in a group home, 8% with a single parent, 5% with one biological parenthome, 8% with a single parent, 5% with one biological parent and one other parent, 5% living on own or with a friend, 4% withand one other parent, 5% living on own or with a friend, 4% with two biological married or common-law parents, 4% with othertwo biological married or common-law parents, 4% with other relatives, 6% otherrelatives, 6% other
  • 6. 1-Year Testing1-Year Testing –– DemographicsDemographics  N=241 child welfare youth (53% female) at the 1-year timeN=241 child welfare youth (53% female) at the 1-year time point (data collected Aug. 2003 – July 2008)point (data collected Aug. 2003 – July 2008)  Mean age: M=17.35 years (SD=0.96)Mean age: M=17.35 years (SD=0.96)  CAS: 66% crown ward, 14% society ward, 16% communityCAS: 66% crown ward, 14% society ward, 16% community family, 4% temporary carefamily, 4% temporary care  Self-endorsed ethnicity: 33% two or more, 27% White, 25%Self-endorsed ethnicity: 33% two or more, 27% White, 25% Black, 7% Other, 3% Latin American, 1% Chinese, 1%Black, 7% Other, 3% Latin American, 1% Chinese, 1% Filipino, 1% Arab/West Asian, 1% South East Asian, 1%Filipino, 1% Arab/West Asian, 1% South East Asian, 1% NativeNative  Living arrangements: 38% with foster parents, 14% in a groupLiving arrangements: 38% with foster parents, 14% in a group home, 14% living on own or with a friend, 11% with a singlehome, 14% living on own or with a friend, 11% with a single parent, 10% other, 4.5% with other relatives, 4% with oneparent, 10% other, 4.5% with other relatives, 4% with one biological parent and one other parent, 2.5% with twobiological parent and one other parent, 2.5% with two biological married/common-law parents, 2% adoptive parentsbiological married/common-law parents, 2% adoptive parents
  • 7. Ways to Think about ResiliencyWays to Think about Resiliency Defined globally as “dynamic process” of “positive adaptation” in context of “significant adversity” (Luthar et al., 2000) -Agent – community; family; individual - Timepoint - situational; developmental period; longitudinal - Process – self-righting; “spontaneous remission”; positive intervention effects; social influences (peers, family) - Dimension – self-concept (confidence, persistence, optomism); Achievement (education, sports, art); Interpersonal/Relationships - Normative Context – delayed entry or abstinence from health risk behaviours; average range or better on functioning (intellectual, achievement, mental health; adaptive/age-appropriate independence and self-sufficiency); recovery ability (clinically significant reduction; return to normal range) - Perceptual – Attributions (Hostile; Global; Stable etc.), Beliefs about Resiliency;
  • 8. MAP findings – Age of Entry Average Age % under 13 years Sexual Intercourse (60%; 4% under 13)= 14. 47 years (SD=1.8) Alcohol (71%; 8% under 13) = 13.18 years (SD=2.23) Cannabis (52%; 10% under 13) = 13.57 years (SD=1.76) Dating (59%; 7% under 13) = 13.67 years (SD=1.97) Pregnant/Father (19%) Dating: MAP Females = 13.03 years (SD=2.33) MAP Males = 12.35 years (SD=2.37) When MAP Avg Age= 15-16 years; MAP Females’ Partners=18 years (SD=3.0); MAP Males’ Partners = 15 years (SD=5.0) Any dating violence item endorsed, 40-60% endorsement
  • 9. MAP findings (referenced to SES, gender and age-matched Ontario youth; OSDUHS)  MAP youth are 3-4 less likely to be over 16 years old and have a driver’s license, as compared to ON youth (OSDUHS); non-Crown Wards (18+ times more likely to not have a driver’s licence)  MAP youth are about on par w/ ON youth in terms of jobs outside the home, self-ratings of physical health, amount of exercise, drug-selling (marijuana, hashish), ever seriously considered suicide, depression(GHQ)  MAP youth are over 4 times more likely to have changed schools 4 or more times in the past 5 years, as compared to ON youth (OSDUHS)  MAP youth are about 1.5 times more likely to bully others at school at a daily or near daily level, to carry a weapon, to have a physical fight on school property, to be part of gangs, to have tried marijuana (OSDUHS); non-Crown Wards show higher likelihoods, up to 5x more likely  Some MAP youth are more likely to report depression (CESD), especially Non-Crown Wards  Crown Wards have lower than normative alcohol use, except on category of frequent alcohol use (almost every day); Non-Crown Wards have
  • 10. MAP findings (referenced to test norms)  About 6-7% of MAP Males exceed the clinical cut-off on Trauma Symptom Checklist for Children subscales: Anxiety, Anger, Post-traumatic stress response, Dissociation (11%), Depression (12%), Sexual Concerns (11%)  About 10-12% of MAP Females exceed the clinical cut-off on Trauma Symptom Checklist for Children subscales: Anxiety, Depression, Anger, Post-traumatic stress response, Dissociation, Sexual Concerns (19%)
  • 11. Selected MAP Outcome Measures:Selected MAP Outcome Measures: Suicidality over time (Brief SymptomSuicidality over time (Brief Symptom Inventory)Inventory)
  • 12. Thoughts on MAP FindingsThoughts on MAP Findings  Child welfare youth have unique challenges to resiliency: 8%Child welfare youth have unique challenges to resiliency: 8% of MAP youth self-identify as LGB, 92% as heterosexual;of MAP youth self-identify as LGB, 92% as heterosexual; LGB youth have greater likelihoods of alcohol, drug,LGB youth have greater likelihoods of alcohol, drug, emotional health problemsemotional health problems  Most child welfare youth are doing on par with ON teens onMost child welfare youth are doing on par with ON teens on most health dimensions, as they have been measured so far,most health dimensions, as they have been measured so far, some indications of issues in drug use and PTSD/mood areassome indications of issues in drug use and PTSD/mood areas  Between 5-20% of youth are having serious/chronic troubles:Between 5-20% of youth are having serious/chronic troubles: Child welfare youth are more likely to have serious troublesChild welfare youth are more likely to have serious troubles when having troubleswhen having troubles (daily bullying, daily drinking)(daily bullying, daily drinking)  Seems important to minimize transition stressSeems important to minimize transition stress