Abstract
Early exposure to chronic maltreatment and other biopsychosocial adversities accounts for high prevalence of developmental impairments among children residing in foster care and other types of statutory out-of-home care (OOHC), including: complex, trait-like mental health difficulties; intellectual disability (ID); and speech and language difficulties (SLD). However, little is known about the characteristics and prevalence of co-occurring mental health difficulties and developmental disabilities among this population - which we refer to as inter-developmental impairment. The present article reports findings from epidemiological surveys of pre-adolescent school-aged children (N = 347) and adolescents (N = 230) residing in foster and kinship care in New South Wales, Australia. Mental health was measured from caregiver-reported Child Behavior Checklist and Assessment Checklist for Children / Assessment Checklist for Adolescents scores; and ID and SLD were reported in a caregiver questionnaire. The proportions of children and adolescents with caregiver-reported ID were 22.5% (78/347) and 30.0% (69/230) respectively, while the proportions with SLD were 21.6% (75/347) and 15.7% (36/230) respectively. While mental health case rates were high among the aggregate child (67%) and adolescent (60%) samples, those with ID and/or SLD were considerably more likely to have clinical-level mental health difficulties compared to those without ID or SLD, with odds ratios ranging from 1.9 to 6.5. The prevalence of inter-developmental impairment (defined as having ID and/or SLD, as well as mental health caseness) among the child and adolescent samples was 23.9% and 28.7% respectively. Children and adolescents with inter-developmental impairment on average had with more complex symptomatology than did mental health cases without reported developmental difficulties. The article discusses mechanisms accounting for inter-developmental impairment among formerly maltreated children residing in foster care, and implications for clinical services.