La santé mentale des enfants placés. Une revue de la littérature

Prevalence of depression and protective factors in a population of children aged 8 to 10 years, suffering from specific learning disorders, in a special education and home care service (SESSAD)

OBJECTIVES

Evaluate the prevalence of depression in a population of children aged 8 to 10 years with learning disabilities treated in a Special Education and Home Care Service (SESSAD) and identify the protective factors that might preserve these children from depressive and affective problems.

METHODS

Twenty children, aged 8 to 10, with learning disabilities were evaluated prior to their admission in SESSAD. Depression had been assessed through the Multiscore Depression Inventory for Children (MDIC), adapted to the French population as well as their developmental position in relation with their perceptual maturity of their body schema, through the Draw your family drawing. The protective factors were assessed through the qualitative analysis of the stories told on the Draw your family projective drawing and card 4, 9, 20 of The Socialization Test for Children (TSEA). Quantitative data were computed through descriptive statistics and non-parametric tests (Spearman's correlation test) by the jamovi© statistic software (V.2.3.24), and the qualitative data were analyzed through thematic content analysis and lexical text analysis through the TROPES software (V.8.3).

RESULTS

Quantitative data showed for the entire group: (1) a perceptual maturity delay of the body schema in 75% of the sample; (2) a low incidence of depression in this population with, however, 40% of the sample, (aged 8 and 9) displaying a critical threshold for feelings of helplessness. The qualitative analysis of the Draw your family and TSEA stories allowed to underline some of the protective factors against depression and those which refer, in decreasing order, to the social support given by family members, peers, and the emotional substitutes (animals).

CONCLUSIONS

This research highlighted the precocity of the feelings of helplessness in this population and the importance given by these children to the social support. These findings and future research on the topic might be used to guide the design and implementation of adjusted interventions addressing both the development of their learning capability and psychological empowerment.

The physical and psychological health of children entrusted to the care of the child protection and welfare service in Vendée

BACKGROUND

The international literature has long established the importance of health issues presented by children entrusted to Child Protection and Welfare Service (Aide Sociale à l'Enfance -ASE, in France). This study examined the health of children entrusted to the ASE in Vendée (a French administrative region) in order to better understand and address their health needs.

METHODS

A retrospective study of all children (623 out of 920) aged 0-18 years placed in foster care or an institution during 2019 was carried out. The data collection was based on the information in the medical form completed by the doctor during the annual health check.

RESULTS

More than one quarter of the children had a written or spoken language disorder, 32% of children did not have a normal body mass index for their age, 10% of children suffered from enuresis, 4% from encopresis, and sleep disorders were observed in 29% of the study population. Furthermore, 51% of the children expressed psychological distress by internalizing or externalizing it, and 6% of children over 6 years of age had already run away or put themselves in danger.

CONCLUSION

The results of our study are congruent with the international literature and confirm that children and adolescents in out-of-home care (foster care, residential care) have significantly higher healthcare needs than their peers. The findings also suggest several areas for improving the healthcare of children and adolescents entrusted to the care of the child protection and welfare services.