The Impact of Early Social

Factors on Trajectories of
Internalizing Behavior Problems
Within Maltreated Foster Care Youth

Ethan Paschall, M.S.

Dean Lauterbach, Ph.D.
Eastern Michigan University
ESTSS 2017
Contact: epaschal@emich.edu 1
Goals of the Present Study

1. Estimate the number, size, and shape of

internalizing behavior symptom trajectories
using Latent Class Growth Analysis (LCGA).

2. Identify the relationship between early social

factors and trajectories of behavior problems
later in life.
2
Foster Care Within The United States
N u m b e r o f C h ild r e n

427,910

450,000
414,429
420,000 401,213
397,605 397,301
390,000
360,000
330,000
300,000 269,509
264,555
270,000
251,450 251,354 254,712
240,000
2011 2012 2013 2014 2015

Number in foster care on September 30

Number entered foster care

3
Reasons for Entering Foster Care

Reason for Removal/ Total Percent/

Demographics Mean
Neglect 161,791 61%
Physical Abuse 34,647 13%
Sexual Abuse 10,330 4%
Age NA 8.6 Years
Time in Care NA 1.7 Years
Males 222,849 52%
U.S. Department of Health and Human Services, Administration for Children and
Families, Administration on Children, Youth and Families, Children's Bureau, 2016

4
 What We Know About Trauma Exposure:
Foster Care Vs. Non-Foster Care

• Maltreated children vs. non-maltreated children

• 62% of maltreated children met criteria for at least one clinically
significant behavioral problem (McCrae, 2009).

• Foster care population vs. non-foster care population

• Children in foster care have 2.5 times the rate of behavior problems in
the clinical or borderline ranges of the Child Behavior Checklist (CBCL)
(Achenbach, 1991; Clausen et al., 1998).

• Experiencing abuse at young ages vs. older ages

• Experiencing abuse at a young age will have the strongest impact
on a child’s early years of development (Cicchetti, 1996; Ney et al., 1994). 5
 What We Know About Trauma Exposure:
Internalizing Symptoms
• Maltreatment predicts internalizing/externalizing symptoms
• Child maltreatment at a young age predicts internalizing and externalizing
symptoms in both the general population and foster care (Ackerman et al., 1998;
Higgins & McCabe, 2003; McWey et al., 2010).

• Symptom presentation is influenced by a number of factors

• Age of the child at the time of abuse, maltreatment type, and severity (Manly et
al., 2001).

• Exposure maltreatment has significant negative effects on the

development of young children (Cicchetti, 1996). 6
 What We Know About Trauma Exposure:
Social Risk and Protective Factors
• Low levels of social and emotional competence
• Linked to future behavior problems (Lansford et al., 2006)

• High aggressive behavior at a young age

• Linked to future externalizing behavior problems
(Desbiens & Gagné, 2007; Weeks et al., 2014)

• Low levels of perceived social support

• Linked to future depressive symptoms (Salazar et al., 2011)
7
 What’s Missing in the Literature
• The influence of early social factors on future
internalizing behavior problems in children with
disrupted social environments.

• Are behavior problems consequences of abuse or specific

foster care placement characteristics? (Lawrence et al., 2006)

• Few studies have used longitudinal designs to study the

developmental trajectories present within this high-risk
population.
8
 The Basics of LCGA

• Conventional growth modeling methods assume that all

participants come from a single population with a single
growth trajectory (Jung & Wickrama, 2008).

• LCGA allows for the examination of:

• Subgroups within heterogenous samples
• Trajectories taken by each class over time
• Between-class variability

9
LONGSCAN - N = 1534
 Data is from the Consortium for Longitudinal Studies of Child Abuse and
Neglect (LONGSCAN), a 5-site longitudinal project started in 1990
(Hunter et al., 2003).
 Five independent sites sharing common procedures, protocols, and
instrumentation
Site N Gender Race
East 282 54% Boys African American (93%), White/Hispanic (5%), Multiracial (1%)
Midwest 245 49% Boys African American (49%), White (14%), Hispanic (15%), Multiracial
(20%)
South 243 45% Boys African American (62%), White (37%), Multiracial (1%)
Northwest 254 51% Boys African American (21%), White (52%), Multiracial (21%), Hispanic
(2%)
Southwest 322 47% Boys African American (38%), White (29%), Hispanic (17%), Multiracial
(16%)
(Hunter et al., 2003)
10
Southwest Sample - N = 322

Status at Initial Interview Total Percent

Still in non-kin foster care at age 4 78 24.2%
Still in kin foster care at age 4 58 18.0%
Adopted by non-kin at age 4 51 15.8%
Adopted by kin at age 4 20 6.2%
Reunified with biological parent at age 4 112 34.8%
Unknown 3 0.9%
(Hunter et al., 2003)
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Measures Part 1
Outcome Variable:
• Child Behavior Checklist (CBCL; Achenbach, 1991) – Internalizing Problems
(α = .62-.92 boys; α = .66-.92 girls)
• Empirically based set of measures from the perspective of the child’s primary caregiver
Social Support:
• My Family and Friends (Reid & Landesman, 1986) – Child Social Support
(α = .77 family members; α = .61 non-family members)
• Emotional support perceived by the child from family members and individuals outside of
the family
• The Pictorial Scale of Perceived Competence and Social Acceptance for Young
Children (Harter & Pike, 1984) - α = .69 Maternal Acceptance; α = .72 Peer Acceptance)
• 24-item measure assessing Peer Acceptance and Maternal Acceptance

12
Measures Part 2
(Un)Popularity & Aggression:
• Teacher’s Estimation of Child’s Peer Status (TRPA) (Lemerise & Dodge, 1990) Peer
Relationships (α = .84)
• Two scales: Popularity (3 items) and aggression (2 items)
Cognitive Ability
• Wechsler Preschool and Primary Scale of Intelligence – Revised (WPPSI-R):
Short Form Vocabulary and Block Design (Wechsler, 1989) Early
Cognitive Ability (α = .84 Vocabulary; α = .85 Block Design)
• Two subtests recommended for screening and research purposes to assess general intellectual
functioning and cognitive ability
Trauma Exposure:
• Things I have Seen and Heard (Richters & Martinez, 1990) - Exposure to Violence (α = .77)
• 16 items assessing the number of times a child has been exposed to a traumatic event
• 4 questions about the number of times a child feels safe in different contexts
• Total number of Child Protective Service (CPS) Allegations of Maltreatment
• LONGSCAN review and coding of CPS files regarding maltreatment history 13
 Results – Description Of Sample
Measure M Implications
CBCL: T Scores 51-53 Within normal range
My Friends and Family: Total emotional 39.1 Range 0-50. Fairly high perception of emotional
support support
Perceived Social Acceptance:
Total peer acceptance 3.4 Range 1-4. Perceived as high acceptance
Total maternal acceptance 3.0 Perceived as above average acceptance
WPPSI-R: Total scaled score 15.7 Estimated IQ of ~90
Teacher’s Estimation:
(Un)Popularity 9.5 Range 3-15. Fairly unpopular children
Aggression 4.6 Range 2-10. Slightly below average aggression
Things I Have Seen and Heard:
Total violence exposure 13.3 Range 0-60.
Total sense of safety 12.6 Range 1-16. Fairly high sense of safety
Maltreatment: Number of allegations 6.7 Range 0-43. HIGH 14
C B C L In te rn a liz in g T S c o re
One Class Model

Clinically Significant Cut-Off: 63

70
65
60
55
50
45
40
6 8 10 12 14 16

Age 15
Estimated Means Sample Means
 Latent Class Growth Analysis (LCGA)
Model Fit Indices

          Posterior Smallest
Classes Entropy ABIC LMR BLRT Probabilities Class1
1 – 10909 CFI=.96 – RMSEA=.06 –
2 0.77 11063 p<.0044 p<.00005 .91-.94 28.6%
3 0.69 10975 p<.0165 p<.00005 .84-.84 16.5%
4 0.72 10953 NS (.10) p<.00005 .85-.91 2.2%
5 0.66  10937 NS (.37)  p<.00005 .79-.80 3.1%
Note. 1Value based on most likely latent class membership. *p < .05, **p < .01, ***p < .001; ABIC = Adjusted
Bayesian information criteria; LMR = Lo-Mendell-Rubin likelihood ratio test; BLRT = bootstrap likelihood
ratio test.

16
C B C L In te rn a liz in g T S c o re Missing values in covariates
Three Class Model computed using multiple
imputation

N=53

N=168
70
65
60
55
N=101
50
45
40
6 8 10 12 14 16

Age
High and Consistent Sample Means High and Consistent Estimated Means
Moderate and Increasing Sample Means Moderate and Increasing Estimated Means 17
Low and Consistent Sample Means Low and Consistent Estimated Means
Results
• Surprisingly, none of the covariates were predictive
of group membership.

• Social Support
• NS (p = 0.16 - 0.97)
• (Un)popularity
• NS (p = 0.32 - 0.92)
• Aggression
• NS (p = 0.19 - 0.70)
• Cognitive Ability
• NS (p = 0.25 - 0.82)
• Trauma Exposure
• NS (p = 0.53 - 0.97)
18
 Discussion, Limitations, and Future Directions
• Goal 1: Three sub-groups identified with most children in the moderate and
increasing group that remains within the normal range of symptoms.

• Goal 2: Early social factors were not predictive of class membership.

• Limitations: Changes in primary caregiver not recorded which may have

influenced ability to assess internalizing symptoms.

• Future studies could further explore the stability of behavior problems that
present at a young age as well as persist beyond age 16. 19
 References Contact: epaschal@emich.edu
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