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Objectives Children-in-care are frequently exposed to trauma which disrupts a stable, nurturing upbringing. Consequences may include greater risk of developmental disorders. Regular health assessments are conducted to monitor/initiate prompt intervention to mitigate health risks. However, this could be too little too late. This study explored age and Adverse Childhood Experiences (ACEs) of children-in-care and how their development was impacted. Methods A retrospective cohort study was completed in 32 patients Results 71.8% of children were noted to have child protection concerns before their placement. The most common reasons were neglect (43.7%), physical abuse (25%), and substance misuse (12.5%). The highest proportion of children-in-care were: 0–6 months (40.6%), 2–3 years (12.5%), and 4–5 years (15.6%). 78% of placements were with a single foster carer. At initial assessment: 21.8% of children were identified as having developmental concerns, and to be equally exposed to the commonest ACEs Only 15.6% were assessed against the Schedule of Growing Skills II (SOGS II) and 18.7% against Griffiths III 65.6% were not assessed for developmental needs at all. We reviewed the developmental assessment tools performed during each contact, finding Griffiths III to be the 'gold standard' due to its personal-social-emotional sub- scale. We noted that a large proportion of children had no formal developmental assessment in the first year. At the final review assessment, 21.8% of children were noted to have a speech and language delay and 18.7% had social communication disorder. Conclusion ACEs, genetic predisposition, and intrauterine exposure to drugs/alcohol increase risk of developmental concerns, as shown in our results. The key developmental periods are 15 months (language) and 24 months (attachment). This study demonstrates 68.4% of 32 children were placed in care by 3 years and 43.5% had developmental concerns. Within the looked-after population, attachment/communication disorders may present similarly in both sexes. Therefore, it is vital to conduct formal developmental assessments within the first year of care (or upon entry) to catalyse early support.
Latchman et al. (Tue,) studied this question.