Date of Award

Spring 5-15-2019

Author's School

Graduate School of Arts and Sciences

Author's Department

Social Work

Degree Name

Doctor of Philosophy (PhD)

Degree Type



While children in the United States experience a number of adverse conditions that may impact behavioral health and child abuse and neglect (or child maltreatment) is one of the most prevalent. About one third of all children who receive a child welfare investigation or assessment following a report of maltreatment are under age five, making this a potential gateway to services for many vulnerable children. Researchers and advocates have pointed out that while early childhood is a time of great vulnerability, greater neuroplasticity makes this an ideal period for intervention to offset later risk of poor outcomes. Yet little is known about young children trajectories once engaged in treatment. There are unique developmental challenges to working with young children that require tailored strategies, such as a greater reliance on participation by a caregiver. Caregiver involvement may be a challenge for child welfare involved families due to the multiple challenges and system intervention. Yet, little is known about behavioral health engagement for this younger child population.

This dissertation used electronic case record data from a large, statewide behavioral health organization that serves children with behavioral health needs, including a large population of young and/or child welfare involved children. Analyses explored whether or not participation and termination reasons differed for younger (ages 2-4) compared to older children (age 5-7) by child welfare involvement and the presence of other childhood adverse experiences. Results indicated that among all children receiving behavioral health services both younger children and those children who were child welfare involved had better clinician reported closure reason. This persisted when analyses were limited to children with adverse childhood contextual indicators. Within the more limited sample, children diagnosed with Adjustment Disorder at baseline were more likely to have a negative case termination. Implications and recommendations for future research and program planning are discussed.


English (en)

Chair and Committee

Melissa Jonson-Reid

Committee Members

F. Brett Drake, Tonya Edmond, Vanessa Fabbre, Joan Luby,


Permanent URL: https://doi.org/10.7936/ah86-rz19

Available for download on Monday, May 15, 2119

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Social Work Commons