A profile of children with disabilities receiving SSI: highlights from the National Survey of SSI Children and Families

This article provides a nationally representative profile of noninstitutionalized children 0 to 17 years of age who were receiving support from the Supplemental Security Income (SSI) program because of a disability. To assess the role of the SSI program in providing assistance to low-income children with disabilities and their families, it is important to obtain detailed information on demographic characteristics, income and assets, health and disabilities, and health care utilization. Yet administrative records of the Social Security Administration do not contain many of the relevant data items, and the records provide only an incomplete picture of the family relationships affecting the lives of children with disabilities. The National Survey of SSI Children and Families fills this gap. This summary article is based on survey interviews conducted between July 2001 and June 2002 and provides some highlights characterizing children with disabilities who were receiving SSI and their families. Most children receiving SSI (hereafter referred to as "SSI children") lived in a family headed by a single mother, and less than one in three lived with both parents. A very high proportion, about half, were living in a household with at least one other individual reported to have had a disability. About 70 percent of children received some kind of special education. SSI support was the most important source of family income, with earnings a close second. On average, SSI payments accounted for nearly half of the income for the children's families, and earnings accounted for almost 40 percent. When all sources of family income were considered, slightly more than half (54 percent) of SSI children lived in families above the poverty threshold, a notable fact given that the federal SSI program guarantees only a subpoverty level of income. However, beyond these averages there was substantial variation, with some children living in families with income well below the poverty threshold and others having income well over 200 percent of the poverty threshold. About one-third of SSI children lived in families owning a home, two-thirds lived with parents or guardians with at least one car, and about 40 percent lived with parents or guardians with zero liquid assets. Less than 4 percent lived with adults who owned stocks, mutual funds, notes, certificates of deposit, or savings bonds. The Social Security Administration's administrative records contain only a limited amount of information about disability diagnoses. The National Survey of SSI Children and Families supplements those records with data from an array of questions on functional limitations, self-reported health, and the perceived severity of disabilities. The data suggest that a great degree of variation in severity exists within the childhood caseload, as reflected in reports of the presence or absence of six functional limitations, perceived overall health status, and perceived impact of disability on the child's ability to do things. Overall, 36 percent of the children were reported to have had disabilities that affected their abilities to do things "a great deal," and for 21 percent their difficulties had very little or no impact. Physical disabilities were most common among children aged 0 to 5, and mental disabilities dominated the picture for the other two age groups: 6 to 12 and 13 to 17. Virtually all SSI children are covered by some form of health insurance, with Medicaid being by far the most common source of health insurance coverage. Just as in the case of the severity of disabilities, substantial variation was reported in health care utilization among SSI children. Almost 30 percent of children had two or fewer doctor visits during the 12 months preceding the interview, and close to 50 percent had five or more doctor visits. About four-fifths of the children had no reported hospitalizations or surgeries during the previous year. More than 40 percent of the children visited an emergency room during the previous year, most of them more than once. Importantly, no out-of-pocket costs associated with medical care were reported for more than two-thirds of the children, and only about 3 percent had annual expenses exceeding $1,000 for physical and mental health care. This finding suggests that SSI payments are not used to cover medical expenses for the overwhelming majority of children. The use of supportive therapies varied widely among SSI children: more than half reported having used physical, occupational, or speech therapy; only 8 percent used respite care for the parents or other family members. An analysis of the perception of the survey respondents shows that more than one-third of children had unmet needs for mental health counseling services, and about three-quarters of families had unmet needs for respite care. In several service categories, the proportion perceived to have had unmet service needs was around 10 percent or less. In the dominant service category of physical, occupational, and speech therapy, only 11 percent perceived to have had unmet service needs.     

Sudden asphyxial death due to an esophageal leiomyoma

An exceedingly rare case of an esophageal leiomyoma causing sudden death by asphyxiation due to tracheal compression is presented. A brief discussion of esophageal leiomyomata is included.     

Otfried Höffe: „Königliche Völker“. Zu Kants kosmopolitischer Rechts- und Friedenstheorie

Ohne Zusammenfassung     

Racial Inequality,Ethnic Inequality,and the System Involvement of At-Risk Youth: Implications for the Racial Invariance and Latino Paradox Theses

Drawing from the inequality and crime, racial invariance, and Latino paradox literatures, the effects of inequality on youth reoffending are examined. Specifically, hierarchical logistic regression models are estimated to determine: (1) whether racial and ethnic inequality have similar contextual effects on the continued delinquent behavior of at-risk youth and (2) whether these effects are specific to black or Latino/a youth residing in Maricopa County, Arizona (N = 13,138). Findings suggest that racial inequality increases reoffending while ethnic inequality decreases reoffending. Additionally, Latino/a youth are less likely to reoffend in areas characterized by high income and racial inequality. Structural theories of crime should continue to account for the importance of culture and the resilient responses employed by Latinos/as living in criminogenic environments.     

Neither Fair nor Unchangeable But Part of the Natural Order: Orientations Towards Inequality in the Face of Criticism of the Economic System

The magnitude of climate change threats to life on the planet is not matched by the level of current mitigation strategies. To contribute to our understanding of inaction in the face of climate change, the reported study draws upon the pro status quo motivations encapsulated within System Justification Theory. In an online questionnaire study, participants (N = 136) initially completed a measure of General System Justification. Participants in a “System-critical” condition were then exposed to information linking environmental problems to the current economic system; participants in a Control condition were exposed to information unrelated to either environmental problems or the economic system. A measure of Economic System Justification was subsequently administered. Regressions of Economic System Justification revealed interactions between General System Justification and Information Type: higher general system justifiers in the System-critical condition rated the economic system as less fair than did their counterparts in the Control condition. However, they also indicated inequality as more natural than did their counterparts in the Control condition. The groups did not differ in terms of beliefs about the economic system being open to change. The results are discussed in terms of how reassurance about the maintenance of the status quo may be bolstered by recourse to beliefs in a natural order.     

Posttraumatic Stress Disorder Symptoms,Traumatic Reminders,and Partner Aggressive Tendencies Among Veterans

This study examined whether laboratory exposure to traumatic reminders potentiated the relationship between veterans’ posttraumatic stress disorder (PTSD) symptoms and intimate partner aggression (IPA) articulations elicited during an anger-induction task. The sample included 82 male Operation Iraqi Freedom/Operation Enduring Freedom veterans. The Articulated Thoughts in Simulated Situations (ATSS) procedure was used to assess physical IPA articulations (i.e., expressions of physically aggressive intentions toward the partner) and verbal IPA articulations (i.e., statements intended to insult or demean the partner) made during “relationship anger” provoking scenarios. Participants were administered versions of the ATSS both with and without trauma cue presentation. Results indicated that trauma cue exposure potentiated the relationship between veterans’ PTSD symptoms and physical IPA articulations, but did not strengthen the significant relationship between PTSD symptoms and verbal IPA articulations. Findings contribute to the literature on veterans’ PTSD symptoms and IPA perpetration by highlighting the influence of traumatic reminders.     

Attentional and intellectual deficits in unmedicated behavior-disordered adolescent inpatients

The authors examined the hypothesis that impairments in attention and verbal intelligence are associated with seriously maladaptive social behavior in behavior-disordered, hospitalized adolescents. Twenty-five unmedicated inpatients with disruptive behavior disorder diagnoses were rated during a one-month period for frequency of severe disruptive episodes, or critical incidents (CI); these included assaults, behavior resulting in the use of restraints, etc. All subjects independently received intelligence testing and continuous performance testing (CPT). Based on CI scores, subjects were divided into a high-CI group (CI>5; N=9) and a low-CI group (CI<4; N=16). On the CPT, the high-CI group showed more impairment in perceptual sensitivity (d; this group also had lower verbal IQ scores. (Both findings were significant at the p<.05 level.) The latter result was largely due to differences in Comprehension subtest scores. These results support the hypothesis, and may have implications for the treatment of behavior-disordered adolescents.Received M.D. from the University of Wisconsin, Major research interests are adolescent psychopathology, disruptive behavior disorders, and information processing.Received Ph.D. from the University of Wisconsin. Major research interests are outcomes measurement, psychosis proneness, and psychodiagnostic assessment.Received Ph.D. from the University of Wisconsin. Major research interests is adolescent psychopathology.Received M.A. from the State University of New York at Buffalo. Major research interests are adult attachment and mental representation.Received M.D. from the University of Pennsylvania. Major research interests are schizophrenia, personality disorders, and trauma.