가정배치의 영향요인에 관한 연구 : 미국의 정서장애 아동을 중심으로 = Indicators of Out-of-Home Placements in Children with Serious Emotional Disturbance

다국어 초록 (Multilingual Abstract)

The purpose of the study was to examine indicators of out-of-home placements in children with serious emotional disturbances(SED). Using samples from Children's Partnership, a systems of care program funded by the Center for Mental Health Services (CMHS) that serves children with SED, the study predicted future out-of-home placements in children with SED. A series of hierarchical logistic regression analyses were conducted to evaluate conceptual models and impacts of each indicators. Results suggested descriptive indicators (diagnostic information and risk factors) and protective indicators (the BERS and the FAD) were not statistically significant predictors of future out-of-home placements. Only two pathological indicators, as a set, showed a significant contribution to predicting future out-of-home placements. The CAFAS, which is measuring functional impairment of children with SED, demonstrated a strong individual relationship with out-of-home placements even after controlling for all the other indicators in the model. Findings of the study help clinicians identify children with high risk of out-of-home placement from the beginning, and assist them utilize profile information for their service planning and the early intervention.

국문 초록 (Abstract)

본 연구의 목적은 정서장애(Serious Emotional Disturbance, SED)를 가진 아동들이 가정으로부터 벗어나 거주가 제한된 생활중심의 시설에서 서비스를 제공받는 가정외배치(Out-of-Home Placement)의 영향요인들이 무엇인지를 알아보는데 있다. 연구의 대상들은 미국의 정신보건 프로그램(Childrens Partnership)에 참여한 정서장애 아동과 그 가족들이다. 초기면접과 사정단계에서 파악된 아동과 가족의 특성을 이용해, 초기 면접 후 일년 간 이들이 경험하게 될 가정외배치의 유무를 예측하였는데, 연구의 이론적 모형과 각 변수들의 관계를 평가하기 위해 두 변수씩 세 개의 블록(Block)으로 구성된 일련의 위계적 이항회귀분석(Hierarchical Logistic Regression Analysis)이 실시되었다. 분석모형에 투입된 세 가지의 요인 군 중, 아동의 심리 및 기능장해를 측정하는 병리적 변인들이 미래의 가정외배치를 통계적으로 유의미하게 예측하였으며, 기술적 변인(DSM 진단내용과 위험요인)과 예방적 변인(강점척도와 가족기능)들은 병리적 변인들의 영향력이 고려된 후에는 종속변수에 대한 독자적인 설명력이 없는 것으로 관찰되었다. 특히, 기능장해를 평가하는 CAFAS라는 척도가 정서장애 아동들의 가정외배치를 잘 예측해주는 것으로 조사되었다. 본 연구의 결과는 실천현장의 특수교사나 상담가, 사회복지사들이 가정외배치의 위험이 높은 정서장애 아동들을 면접 초기에 파악할 수 있도록 도와 줄 뿐 아니라, 그 정보를 바탕으로 개별화된 초기 개입과 장기적인 교육 및 서비스를 수립하는데도 기여 할 것으로 보인다.

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