An Intersectionality-Based Policy Analysis of Canadian Child Advocate Reviews of Infants, Children and Youth with Prenatal Substance Exposure and Fetal Alcohol Spectrum Disorder in Child Welfare Care
Notice bibliographique
Résumé
Background and Objective Care providers in the child welfare system often support children with Fetal Alcohol Spectrum Disorder (FASD). Women who give birth to children with FASD face many multi-dimensional socio-structural challenges, including prenatal substance use, that lead to their children being placed in care. Alcohol use disorders have strong associations to trauma histories, psychiatric problems, adverse experiences in life, and other substance use. Children with FASD experience abuse and neglect along with other forms of adversities in childhood and adolescence at higher rates than other children, and are often kept in the care of the child welfare system. Risks of harm for children and youth with FASD exist due to distinct vulnerabilities associated with the disability. Even with child welfare intervention, adverse outcomes remain for children and youth with FASD. Our objective was to examine reports generated from Child Advocate offices in Canada on deaths and serious injuries where FASD was identified to gain a deeper understanding of the experiences of this population in the child welfare system. Material and methods We employed an intersectionality-based policy analysis (IBPA) framework to analyze child welfare reports from 1989 to 2019 available online publicly from Child Advocate (or equivalent jurisdiction) Offices across Canada. An underpinning theoretical framework in this research was life course theory, as it is critical to recognize the connection that exists between early decisions made for infants and children with FASD and later outcomes in life. Reports were included when there was evidence of FASD or prenatal substance exposure in the report. Sequential Excel spreadsheets were employed for data extraction, and individual word documents were generated for each report specific to the IBPA framework. Thematic analysis was employed to identify themes related to serious injuries or deaths in child and youth, report summaries, and recommendations. Results A total of 61 reports were reviewed, and deaths of 17 children or adolescents with FASD were reported. Four categories of reports existed, including investigative death reports, investigative serious injury reports, special reports, and annual reports. Key themes from these reports for this population included: (1) challenges to stability and permanency, (2) challenges to FASD-informed service provision, (3) over-representation of Indigenous children and youth, and (4) presence of concurrent mental health challenges. Recommendations within reports addressed needs of individuals, families, care providers, systems, and policies. There were many consistencies across time and jurisdictions. One notable concern was that FASD, while possible, was often not diagnosed, and therefore supports and services specific to this disability were not provided. It is critical to note that these reports served to document both a child's history and make key policy and practice recommendations to inform a differential response in the child welfare system in the case of FASD. Conclusion This analysis illuminated the risks and vulnerabilities for this population in the child welfare system and has implications for assessment, diagnosis, and practice interventions in responding to the needs of this population. This analysis also identified that many opportunities exist to improve practice and service delivery for individuals with FASD and their families. It is critical to recognize that a connection exists between early decisions made for infants and children with FASD and later outcomes in life.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,015 | 0,063 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,022 | 0,038 |
| Études des sciences et des technologies | 0,007 | 0,002 |
| Communication savante | 0,006 | 0,001 |
| Science ouverte | 0,002 | 0,003 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».