3.2.3. Child Maltreatment and Children in Care

Developmental information on children in out-of-home care or those who experience maltreatment has been hard to come by without the opportunities to link administrative data with the EDI. Studies in Australia found that more children who have been maltreated tended to be vulnerable in all domains of their development than those who were not [64,65]. Green and colleagues [64] found that children exposed to two or more types of maltreatment and those with reported maltreatment before the age of 3 years had greater odds of being vulnerable on the EDI compared to their non-maltreated peers. Similarly, for children who were reported to child services by 5 years of age, those with the highest number of reports of maltreatment had the highest odds of being vulnerable on three or more developmental domains [65]. Maltreated children placed in the care of child protection services had slightly better developmental health in three domains (physical health and well-being, language and cognitive development, and communication skills and general knowledge) compared to maltreated children not placed in care. The authors also found that children with reports of maltreatment before the age of 18 months had the highest odds of being vulnerable in at least three domains compared to those with no maltreatment. A Canadian study reported somewhat different results. In a population-based cohort of 53,477 children living in the province of Manitoba, Wall-Weiler and colleagues [66] found that children placed in out-of-home care by child protection services were more likely to be vulnerable than children not placed in care. They also examined vulnerability levels in a subcohort of children for whom one sibling was taken into care while another one was not, as well as for discordant cousins, and did not find any differences in vulnerability between the discordant siblings or cousins. The discrepancy between the findings in the Australian and Canadian studies indicates that while children who experienced maltreatment are at risk for poor developmental outcomes, it is the larger, systemic, environmental, and social factors intersecting with microsystem characteristics (e.g., family environment) that contribute to shaping children's developmental trajectories and that require action at policy levels.
