Confirmatory factor analysis of the PedsQL among youth in a residential treatment setting.

PURPOSE: The Pediatric Quality of Life assessment (PedsQL™) is the most widely used measure for assessing adolescent health-related quality of life (HRQoL). While youth in residential treatment facilities face many physical and mental health, behavioral, education, and familial challenges that could impact their HRQoL, no research has sought to assess the factor structure of the PedsQL™ among youth receiving residential care. METHODS: High school-aged youth (N = 229) attending a large residential treatment center in Omaha, NE were recruited to complete a data collection packet comprised of various health assessments including the PedsQL. Four competing confirmatory factor analysis models were used to test the hypothesized internal structure of the PedsQL™ 4.0 Teen Report. RESULTS: Models A, B, and C had acceptable CFI (≥.90), TLI (≥.90), and RMSEA (≤.08) fit indicators. However, factor loadings for items 5 and 6 were problematic. After removing the two problematic items, Model D was fit to the data and proved to be the superior of the four models. This model included two first-order factors (physical health problems; school attendance problems) and one second-order factor (psychological health problems). CONCLUSIONS: The findings suggest that researchers and practitioners studying youth in residential settings can reliably use the PedsQL™ to assess their HRQoL.

Comparison of On the Way Home aftercare supports to traditional care following discharge from a residential setting: a pilot randomized controlled trial.

This study compares the On the Way Home (OTWH) aftercare program to traditional aftercare supports on placement and school stability for 82 youth (43 treatment, 39 control) with disabilities discharging from residential care. One-year-post-discharge results revealed that negative event occurrence (i.e., returning to care or discontinuing enrollment in the community school) was three to over five times less likely for OTWH youth compared to youth in the control condition.

Overlooked: children with disabilities in residential care.

While estimates suggest that 10% to 31% of children in residential care are identified as with a disability, little is known about their characteristics or functioning as compared to nondisabled peers. This study evaluated data of 123 children with (n=34) and without (n=89) disabilities in residential care to determine demographic, behavioral, mental health, and educational characteristics. Data included demographic, behavior checklist, and standardized mental health and academic measures. Results indicated that both groups presented elevated risks; however, scores for children with disabilities revealed even greater levels of need. Primary risks were found on indicators of behaviors (e.g., social functioning), mental illness (e.g., anxiety), and academic performance (e.g., general knowledge and reading). Implications, limitations, and recommendations for future research are discussed.

Prevalence of physical health issues of youth with school identified disabilities in residential settings: a brief report.

BACKGROUND: Each year a number of youth with a school identified disability are placed in residential care. It has been well documented that these youth enter with elevated rates of behavioral, emotional, educational, mental health, and familial challenges. However, the physical and medical condition of these youth remains unstudied. OBJECTIVE: The purpose of the present study was to determine the prevalence of health and medical problems among a group of youth with school identified disabilities at entrance to a residential care center. METHODS: Archival medical, demographic, and disability status data were obtained for 346 youth served in a large residential care center in the Midwest. Chi-square and correlation tests, and relative risk ratio estimates, were used to evaluate the relationship between medical condition and hypothesized correlates. RESULTS: Findings revealed that over one-third of the sample had at least one medical condition, with asthma being the most prevalent (15.6%). Rates of medical condition differed by disability type and prevalence of asthma differed by race/ethnicity. CONCLUSIONS: Youth with a school identified disability in care demonstrate health care needs that need to be addressed while in care and following community reintegration. Intervention programs and targeted curriculum are needed to teach youth how to manage their health specific needs and how to independently navigate the health care system.

Health-related quality of life among adolescents in residential care: description and correlates.

The purpose of this article is to describe the health-related quality of life (HRQoL) of adolescents in residential care and to examine selected correlates. A sample of 229 adolescents (mean age=17 years) living in a residential care setting completed a validated measure of HRQoL (PedsQL 4.0 Generic Scales). Mean-level scores for Total HRQoL, Physical HRQoL, and Psychosocial HRQoL were examined, and the percentage of youth scoring below a clinical cutoff value was reported. Demographic and psychotropic medication data for each youth were accessed from an electronic database maintained by the residential care program and used to examine correlates of HRQoL. Approximately 25% of youth had at least 1 HRQoL score in the "at risk" range, indicating a significant proportion of youth in residential care have significant impairments in HRQoL. Younger age and female gender were associated with poorer HRQoL. Psychotropic medication prescriptions were associated with poorer HRQoL. A significant percentage of adolescents in residential care may experience suboptimal HRQoL, and certain demographic and clinical factors appear to be associated with greater risk. Systematic assessment of HRQoL is recommended for youth in residential care, and interventions to promote better HRQoL among youth at particularly high risk may be beneficial.

The academic and functional academic skills of youth who are at risk for language impairment in residential care.

PURPOSE: Undiagnosed language impairment (LI) for youth in residential care is a concern as similar populations have shown elevated levels of language delays. Therefore, the purposes of this study were to identify the percentage of youth in residential care who are at risk for LI and to compare the demographic, academic achievement, and functional academic skills of youth with or without possible LI. METHOD: Participants were 80 youth in residential care. Risk for LI was determined using the Clinical Evaluation of Language Fundamentals-4 Screening Test (E. Semel, E. H. Wiig, & W. A. Secord, 2004). Independent-samples t tests and chi-square analyses were conducted to assess the differences between groups. Measures used included the Woodcock-Johnson Test of Achievement (R. W. Woodcock, K. S. McGrew, & N. Mather, 2001) and the Kaufman Functional Academic Skills Test (A. S. Kaufman & N. L. Kaufman, 1994). RESULTS: More than half of the sample (54%) were identified as being at risk for LI. Statistically significant differences between youth with and without LI were found on academic variables. Specifically, youth who were at risk for LI presented academic achievement and functional academic scores in the low to low-average ranges. CONCLUSION: Findings suggest that there is a need to screen youth entering residential programs for possible LI. Implications for treatment and program planning are discussed.