An examination of the social emotional development of young children in care: The Ages and Stages QuestionnaireL Minorities and the ASQ:SE

Greenberg, Barbara; Miller, Meagan; Michael, Erik; Flynn, Robert J. - University of Ottawa

Background: The social-emotional development of young children is foundational to well-being and has long term effects including greater mental health, lessened likelihood of drug or alcohol abuse, and fewer relationship problems (Jones et al., 2017). Children in out-of-home care are at risk for social and emotional difficulties due to prior trauma, discontinuity of care, and the accumulation of health and emotional problems (Jee et al., 2010). As a result, monitoring their development in the child welfare system is crucial to ensuring they receive services to address developmental difficulties. Objective: This exploratory paper’s purpose is to determine the effect of demographic, risk, and protective factors on social-emotional development, as measured by the Ages and Stages Questionnaire Social Emotional (ASQ:SE), in children age 8 months to 5 years in out-of-home care in Ontario, Canada. The ASQ:SE is a developmental screening tool used to determine if a child is either “typical” or “identified.” Children who are “identified” are recommended for further evaluation to determine if services are needed (Squires et al., 2002). Method: The cross-sectional sample consisted of 1022 young children aged 8 months to 5 years, living in out-of-home care in Ontario, Canada who participated in the completion of the ASQ:SE as a part of an Assessment and Action Record (AAR-C2-2010; Flynn, et al., 2010) between January 1, 2016 and December 31st 2017. The AAR-C2-2010 is the core instrument used in the Ontario Looking After Children needs assessment and outcome monitoring project. The AAR-C2-2010 is completed annually in a conversational interview designed to facilitate dialogue among the child welfare worker, child, and caregiver(s) in order to guide and monitor developmental outcomes and well-being. Results: A logistic regression was completed to examine the effect of demographic, risk, and protective factors in the identification of social-emotional difficulties using the ASQ:SE. The results of this model found that Black (African or Caribbean ethnicity) children were 96% more likely than non-Black children to be identified for further screening. Additionally, children with a developmental delay were 126% more likely to be identified than their peers. Older age and a higher number of changes in caregiver since birth were statistically significant risk factors, whereas the positive parenting scale, developmentally appropriate communication, problem solving, and personal social skills were significant protective factors. Implications and Conclusions: While it was not unexpected that children with developmental delay would likely be identified by the ASQ:SE more often than their peers, it is surprising that children who were Black (African or Caribbean ethnicity) showed such a higher likelihood than their non-Black peers to be identified by their ASQ:SE scores. In the Ontario Child Welfare system minority children (Indigenous and Black -African or Caribbean ethnicity) are disproportionately represented and face higher levels of disparity. Our results reveal several questions for further research, including why are Black children almost twice as likely to be identified for further developmental screening than non-Black children? How do systemic factors such as poverty, community boundaries, and possible decision making inconsistencies or bias affect their ASQ:SE scores? The findings of this model have practical implications for practitioners and caregivers. Once a child is identified, caregivers should work to help the child build skills at home, and workers should ensure the child receives any necessary interventions, as well as be aware of the risk and protective factors to help mitigate difficulties in a child’s social-emotional development.