P-Kic — Pediatrics For Kids in Care

Abstract

Background: Children coming into care have a high incidence of unmet physical, developmental & mental health problems. The Canadian Paediatric Society has recently underlined the unique position of Pediatricians as advocates for these very vulnerable children & has provided specific recommendations in this regard. Objectives: P-KIC (Pediatrics for Kids in Care) is an innovative partnership between Calgary Child & Family Services, Calgary Health Region, Southern Alberta Child & Youth Health Network, & the Division of Community Pediatrics (Calgary) to meet the needs of, & improve outcomes for, children in care. Design: The P-KIC process has been designed to ensure close communication & collaboration between Child & Family Services personnel, Pediatricians, foster parents &, where appropriate, biologic parents, to facilitate timely (ideally 8 weeks from apprehension) & comprehensive Pediatric evaluations of children recently placed in care. This collaborative approach ensures the best interests of the child with respect to issues such as placement, permanency planning, medical, developmental & mental health treatment plans. Cases are actively managed by a coordinator who ensures that available data (birth details, health information, etc.) are collated & provided to the Pediatrician in advance of an assessment & that all relevant parties are either able to be present at the assessment or are in receipt of conclusions & recommendations. In addition, efforts have been taken to standardize the reporting process. Result: A total of 327 children (0-18 years, 153 female, 174 male, mean age 6.3 years) have been seen through the P-KIC program since September 2008. Pediatric services have been provided by 12 community Pediatricians. The majority of children (85%) are less than 10 yrs old. Of the children assessed, 50% have required follow-up pediatric visits & most required referral to other services, which is consistent with the CPS prediction. The mean time to assessment was 14 weeks (range 8-16). The hope is that, with increased capacity, this time to assessment will consistently be at 8 weeks. Common diagnoses include speech & language delays, gross & fine motor delays, cognitive impairment, ADHD, Attachment Disorder, Anxiety Disorder & Depression. Conclusion: Providing early comprehensive assessments for children in care helps caseworkers, foster parents, biological families & the justice system understand the child's needs & provide optimal support. By assuming both advocacy & service provision roles within a coordinated & collaborative program, Pediatricians can provide a pivotal role in the lives of our most vulnerable children. It is hoped that ongoing program evaluation will confirm that this unique P-KIC program & process translates into better care & long-term outcomes for foster children.