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.     

Finding common ground in the study of child maltreatment, youth violence, and adult domestic violence

For several decades, we have witnessed a surge in public policies aimed at ending child maltreatment, youth violence, and adult domestic violence. Commensurate with this increased interest has been a growing body of research on each issue's etiology, affected population, and the public policy and prevention impacts. Even a cursory review of the literature suggests a number of commonalities across these forms of violence. As such, it seems timely and prudent to craft a research framework that facilitates the identification and dissemination of practice and policy innovations that can address all three concerns. This article articulates an overarching framework to guide researchers in better identifying common avenues of study. After summarizing the commonalities found across the three areas, the authors identify cross-cutting issues that have particular relevance for advancing our understanding of violence and its effects on personal and social interactions.     

Family Functioning and School Success in At-Risk, Inner-City Adolescents

The relation between family functioning and school success was examined in 211 at risk, African American, inner city adolescents attending middle school (grades 6–8). Interviews with adolescents and caregivers yielded data on family cohesion, parental monitoring, and school engagement; school records provided data on grade point average. Results showed that both family cohesion and parental monitoring predicted school engagement, but neither family characteristic predicted GPA. Important gender differences also emerged. For boys only, the relation between family cohesion and school engagement was stronger when parental monitoring was high. For girls only, the effects of cohesion and monitoring on school engagement were additive: girls with both high family cohesion and high parental monitoring were most likely to be engaged in school. These findings extend the research base on family protective factors for antisocial behavior in young adolescents. Implications for future examination of family process characteristics in high-risk adolescents are discussed. This work is based on the dissertation research of the first author submitted to the Department of Psychology at Fordham University. Research Associate, Hudson Valley Cerebral Palsy, Patterson, NY. Professional Training: PhD, Developmental Psychology, Fordham University. Major interests include etiology and treatment research on developmental disabilities and psychological health problems in children and adolescents. Senior Research Associate, The National Center on Addiction and Substance Abuse (CASA) at Columbia University, New York, NY. Professional Training: PhD, Clinical Psychology, Temple University. Major interests include development of family-based interventions for adolescent drug use and delinquency, adherence and process research on family intervention models. Research Associate, National Clinical Assessment Authority, London, England. Professional Training: PhD, Developmental Psychology, Fordham University. Major interests include mental health services research and program evaluation. Professor and Director, Center for Treatment Research on Adolescent Drug Abuse, University of Miami School of Medicine, Miami, FL. Professional Training: EdD, Counseling Psychology and Family Therapy, Northern Illinois University. Major interests include developing, testing, and disseminating family-based treatment for adolescent substance abuse and related behvioral problems.     

Canadian Abortion Policy: National Policy and the Impact of Federalism and Political Implementation on Access to Services

The Canada Health Act requires provinces and territories toprovide medically necessary services and to provide equal accessto such services. Since 1995, the governing Liberal Party hasissued statements indicating that it views abortion servicesas medically necessary services. Yet the operation of healthdelivery systems in Canada is primarily reserved for the provincesand territories. Provincial and territorial access to abortionservices is significantly affected by bottom-up political implementation,where national policy is often undermined and "trumped" by thepolitics and pressures operative within provincial and territorialpolitical systems and by other intense interest group pressures.     

Using hydrophilic adhesive tape for collection of evidence for forensic DNA analysis

Known exemplar samples of human DNA have traditionally been body fluids, such as blood, saliva, and semen. In each case, the presence of water is a risk for the bacterial growth, which may degrade the DNA evidence. In this study, the authors have developed a method that employed a hydrophilic adhesive tape (HAT) for collecting DNA evidence. The HAT method was used to remove surface cells from relatively hairless areas on the body. The area examined were ankle, arm, behind the ear, between fingers and back of the neck. The HAT was then dissolved in the extraction buffer. DNA typing was performed at vWA, THo1, F13A1, and FES loci using the short tandem repeat (STR) analysis. Our results show that the samples collected from ear give the best results with a success rate of 100%. All subjects tested by this method had known STR genotypes established from buccal swabs. The authors' results suggest that the HAT method can be used as a less invasive method for collecting biological evidence for forensic DNA analysis. In addition, this collection method should reduce the risk of DNA degradation due to the moisture, which is encountered using conventional collecting methods.     

Analysis of potassium permanganate as addictive drug "precursor"

Potassium permanganate is used for the production of cocaine and methylcathinone. The third convention of the UN against narcotic drugs (1988) contains a list of so-called precursors, substances commonly used for the production of narcotic drugs. The control of the precursors can be a very important step to prevent the illicit production of narcotic substances. A chemical characterization of a seized product may contribute to determine the origin of the producing company and the trade channels and to prevent further illicit deliveries. 31 samples of permanganate (19 authentic and 12 seized samples) have been analyzed for 9 metallic elements. Detailed procedures for the emission spectrography and ICP-analysis are given and the range of concentrations is tabulated. It was surprising that no significant concentrations of metals like chromium, nickel or cobalt were present. Nor was the difference between the technical and analytically pure products sufficient to make a differentiation according to origin. This is probably attributable to the technical manufacture of permanganate by electrolysis. All the statistical analyses of the results performed on the available data do not allow conclusions as to the country of origin or manufacturer, as production batches of one and the same manufacturer may also show differences. Only the morphology of the product (crystals, powder or "free flowing") allows a certain characterization. Nevertheless it seems necessary to analyze all seized samples for impurities and to establish a table of "impurity profiling" in the future in order to receive more information and to find correlations in selected cases.