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The Georgia Cold Case Project

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children in our study had documented involvement with the juvenile justice system; one in five has been labeled a runaway. Four girls in the sample got pregnant while in DFCS care; two children were babies born to teen moms in DFCS custody.

Case reviews revealed that 85% of the children had some type of disability or special need. The most common was a mental health problem (56%), followed by behavioral issues (47%), medical/physical problems (34%), a history of sexual assault (34%), learning disabilities (22%), emotional problems (20%) and developmental delays (8%). Mental health problems are discussed in detail below (see Child Psychological Assessments). Behavioral issues very often centered around attachment-related issues and defiance. Nearly one half (47%) of the children with medical issues suffered from asthma. The most common learning issues involved ADHD and borderline intellectual functioning. Depression and anxiety were the most common emotional issues.

While assessing sexual activity was not an original project priority, the prevalence of activity discovered early in the study led the research team to add supplemental questions about sexual activity and sexual health to the file review form. Ten percent of the cold case children were consensually sexually active, according to file reviews. Of those, only one in five were known to use some form of birth control. Four of the females in our study were either currently pregnant or had given birth; one was pregnant for the second time. The files did not contain notations about children fathered by the males in the study. Of course, the true level of engagement in sexual activity and level of sexual health knowledge among cold cases is difficult to glean.

Child Psychological Assessments

One out of three children (38%) in our study resided in an institution or residential therapeutic treatment setting for the treatment of mental health problems. Given the critical importance of understanding the connection between mental health and difficulties with permanency placement, file reviews included specific data collection from child psychological assessments completed by mental health professionals. Almost all children (93%) had at least one psychological assessment in their DFCS file, with an average of three assessments per child. Some children (18%) had assessments done prior to the current removal, often during a previous removal. If not completed prior to the current removal, the first assessment was typically conducted within 48 days from home removal. Fully 20% of the children did not have an assessment conducted until 18 months after removal from the home.

The assessments themselves varied in many ways, including by the type and number of psychological assessments administered and the level of detail of written recommendations provided by the clinician. It was clear from the assessments that some clinicians had been provided with background information and prior assessment results, while others were seeing a child for the first time and had little to no background information on the child or their history. In addition, some files contained evidence that assessments were conducted regularly, while others indicated that assessments were

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