Abstract
Children (0–18 years) with maltreatment histories are vulnerable to experiencing difficulties across multiple domains of functioning, including educational outcomes that encompass not only academic achievement but also mental well-being. The current literature review adopted Slade and Wissow’s model to examine (1) the link between childhood maltreatment and academic achievement, (2) the link between childhood maltreatment and mental health outcomes (i.e., emotional and behavioral difficulties), and (3) the bidirectional relationship between childhood academic achievement and mental health. In addition, we reviewed variables that might influence or help explain the link between childhood maltreatment and educational outcomes, drawing on developmental perspectives and Bronfenbrenner’s ecological model. Finally, whenever possible, we presented findings specific to maltreated children in out-of-home care to highlight the unique challenges experienced by this population. Results indicated that children with maltreatment histories often experience impairments in both their academic performance (e.g., special education, grade retention, lower grades) and mental well-being (e.g., anxiety, low mood, aggression, social skills deficits, poor interpersonal relationships). These impairments appeared to be particularly pronounced among maltreated children in out-of-home care. Findings, albeit sparse, also indicated that mental health difficulties are negatively associated with children’s academic achievement and, similarly, that academic achievement deficits are linked with mental health problems. The link between childhood maltreatment and educational outcomes may be partly explained through the disruption of key developmental processes in children, such as attachment, emotion regulation, and sense of agency. As well, maltreatment characteristics and the functioning of various systems in which children are embedded (e.g., family, school, child welfare) can serve to positively or negatively influence the educational outcomes of maltreated children. The theoretical, research, and applied implications stemming from the findings are considered.
In this literature review of the relationship between childhood maltreatment and educational outcomes, we focused on children (defined as individuals younger than 18 years of age) who experienced childhood maltreatment in the form of abuse and neglect. These experiences occur primarily within the family context and typically include sexual abuse, physical abuse, emotional abuse, exposure to intimate partner violence, and neglect. Maltreatment experiences are relatively common among children. The 2008 Canadian Incidence Study of Reported Child Abuse and Neglect (Trocmé, Fallon, MacLaurin, Hélie, & Turcotte, 2010) tracked child maltreatment investigations in a representative sample of 112 Canadian child welfare agencies during the fall of 2008. Estimates indicated that 235,842 investigations were conducted in Canada (39.16 per thousand 0- to 16-year-olds). Of those investigations that were substantiated (an estimated 85,440 investigations or 14.19 per 1,000 children), the incidence rates were the following: exposure to intimate partner violence (34%), neglect (34%), physical abuse (20%), emotional maltreatment (9%), and sexual abuse (3%). In the United States, data on children referred to Child Protective Services (9.2 per 1,000 children) in 2010 indicated the following incidence rates: neglect (78.3%), physical abuse (17.6%), sexual abuse (9.2%), and emotional maltreatment (8.1%; U.S. Department of Health and Human Services, 2011).
Children with maltreatment experiences are sometimes placed in out-of-home care, such as with foster or kinship caregivers. Recent Canadian data indicate that 47,885 children were living in out-of-home care (Statistics Canada, 2011). Not including children in group homes (which represent about 1% of all substantiated cases of maltreatment in Canada; Trocmé et al., 2010), the breakdown across Canada was as follows: 8,590 (17.9% of the total) 0- to 4-year-olds; 8,855 (18.5% of the total) 5- to 9-year-olds; 12,150 (25.4% of the total) 10- to 14-year-olds; and 11,455 (23.9% of the total) of the 15- to 19-year-olds. Children in out-of-home care are an especially vulnerable group of maltreated children because of their removal from biological caregivers, which is often due to multiple adversities that have compromised their well-being and which often results in a number of transitions to various out-of-home placements (McDonald, Allen, Westerfelt, & Piliavin, 1996).
Childhood maltreatment can have a devastating developmental impact both on a short- and long-term basis. Research has found that children with maltreatment histories are at greater risk for difficulties across a range of domains, including mental health (emotional and behavioral) functioning as well as cognitive and language development (Hoch, 2009; Kaplan, Pelcovitz, & Labruna, 1999; Manly, Cicchetti, & Barnett, 1994; Pantin & Flynn, 2006; Pears & Fisher, 2005; Petrenko, Friend, Garridoa, Taussiga, & Culhanea, 2012; Snow, 2009). Maltreatment tends to exert such a far-reaching impact because these domains of functioning are all interrelated and mutually influential (English et al., 2005). As such, it is not surprising that the educational outcomes of maltreated children are often compromised, even though childhood maltreatment occurs primarily within the family home (Leiter & Johnsen, 1994; Slade & Wissow, 2007; Trout, Hagaman, Casey, Reid, & Epstein, 2008). These findings are important because early school experiences help shape expectations for future success, not only on the part of children themselves (Veltman & Browne, 2001) but also on the part of significant others, such as caregivers and teachers (Tideman, Vinnerljung, Hintze, & Isaksson, 2011). Moreover, without mastery of basic academic skills, maltreated children may be at increased risk for short- and long-term academic failure, school dropout, involvement in criminal activity, incarceration, dependency on welfare programs, and homelessness (Snow, 2009; Trout et al., 2008). In fact, a growing body of literature has underscored the importance of improving academic achievement for children who have experienced maltreatment as it represents one of the greatest needs for this population, especially among maltreated children in out-of-home care (Snow, 2009; Trout et al., 2008).
Research on the educational outcomes of children with maltreatment histories has tended to focus on academic achievement, but a child’s school success is dependent on various interrelated and mutually influential factors. As such, we adopted a holistic approach that defined educational outcomes in terms of both children’s academic achievement and mental well-being (i.e., emotional and behavioral functioning). This approach is consistent with Slade and Wissow’s (2007) three-factor heuristic model that (1) links childhood maltreatment to the development of difficulties in both children’s mental health and academic achievement, (2) posits a bidirectional relationship between mental health and academic achievement (both of which play a role in educational outcomes and success), and (3) acknowledges that mental health may mediate the link between childhood maltreatment and academic achievement and, likewise, that academic achievement may mediate the link between childhood maltreatment and mental health (see Figure 1).
Simplified heuristic model linking childhood maltreatment with later academic performance and mental health outcomes (Slade & Wissow, 2007).
Within this context, our objective was to review the empirical literature on childhood maltreatment and educational outcomes as a way of better understanding this complex and dynamic relationship. As part of this review, we also examined variables that might help explain the relationship between maltreatment and educational outcomes, using Bronfenbrenner’s (1979) ecological model as our theoretical framework. Finally, whenever possible, we presented findings specific to maltreated children in out-of-home care to highlight the unique challenges experienced by this population. However, it should be noted that we were not able to systematically make comparisons on the educational outcomes of maltreated children living with their biological families versus those in out-of-home care because of the relatively underdeveloped state of current research on this topic.
Method
For the current literature review, we considered articles that examined the association between childhood maltreatment and educational outcomes. The included studies were identified through (a) electronically searching databases (i.e., PsychINFO, PsycARTICLES, ERIC, International Bibliography of the Social Sciences, MEDLINE, PubMed), (b) hand searching relevant journals (e.g., Child Abuse & Neglect, Children and Youth Services Review), and (c) reviewing articles identified in the reference lists of relevant articles. Key words used for the electronic searches included maltreatment, victimization, child abuse, neglect, physical abuse, sexual abuse, emotional abuse, out-of-home care, foster care, education, educational outcomes/difficulties, academic achievement, school performance, emotional, and behavioral outcomes/difficulties. The inclusion criteria were empirical articles and research syntheses (e.g., literature reviews, systematic reviews, meta-analyses) published between 1990 and 2013 on the subject of educational and mental health outcomes in children (age 0–18) with maltreatment histories. We focused on articles and syntheses in which children’s maltreatment was determined in a relatively objective manner, such as through their contact with child welfare services or their removal from the care of biological parents. As such, articles that examined the educational outcomes of children in out-of-home care were considered. Articles not in the English language or contained in the gray literature (e.g., conference papers) were not considered.
Theoretical Framework
In order to better understand the relationship between childhood maltreatment and educational outcomes, we considered a number of variables that have been organized using Bronfenbrenner’s (1979) ecological framework. This framework describes five systems that influence children’s development and functioning, albeit in a more proximal (direct) or distal (indirect) manner. The two more distal systems include the macrosystem, which refers to the cultural beliefs and values influencing general lifestyles as well as services offered in any given society, and the exosystem, defined as different structures or settings in the community that do not directly involve the developing individual (e.g., neighborhoods, availability of services, support groups, socioeconomic climate; Bronfenbrenner, 1979; Cicchetti & Toth, 1997; Cicchetti & Valentino, 2006). The two more proximal systems include the microsystem, which represents all immediate settings in which the developing individual directly evolves (e.g., family, school) as well as any activities, roles, and interpersonal relationships experienced by this individual, and ontogenic development, which refers to characteristics within the individual that influence his or her development and adaptation (e.g., resolution of developmental tasks; Cicchetti & Toth, 1997; Cicchetti & Valentino, 2006). Finally, the mesosystem represents the interactions among the different systems in which the developing individual is nested, such as the relationship between the child’s parents and his or her school setting (Bronfenbrenner, 1979).
Results
Childhood Maltreatment and Academic Achievement
Using our search criteria, we located 16 empirical articles (Table 1) and four research syntheses (Table 2) which included information on academic achievement for maltreated children. For the empirical articles, Table 1 indicates that most studies (70.6%) were conducted in the United States, followed by Canada (23.5%) and Israel (5.9%). There was variability in sample characteristics (e.g., sample size, age range, placement in out-of-home care, convenience vs. more representative sample), study methodology (e.g., primary vs. secondary data, cross-sectional vs. longitudinal design, inclusion of a comparison group), and data collection measures (e.g., multiple informant reports, standardized testing, administrative databases, school records). This variability undoubtedly resulted in a range of outcomes related to the academic achievement of maltreated children. We have attempted to distill main findings as follows: Children and adolescents with maltreatment histories often exhibit impairments in their academic performance, as evidenced through markers such as involvement in special education interventions, poor performance across a range of school subjects and on standardized achievement measures, lower grade point averages, higher grade retention, and frequent school absences and/or changes. In terms of child characteristics, risk of academic achievement deficits appears to be greater for boys (than girls) and for adolescents (than younger children). In terms of maltreatment characteristics, there appear to be several differential effects. Children who have experienced primarily neglect seem to have greater impairments in academic achievement than children with primarily other types of maltreatment, in particular physical abuse. In addition, multiple maltreatment experiences and earlier age of maltreatment onset appear associated with greater academic difficulties. In terms of placement characteristics, there were few studies that compared the academic achievement of maltreated children as a function of their living arrangement. However, Attar-Schwartz (2009) found that children and adolescents in family-based out-of-home settings performed better academically than those in group-based care.
Summary of Empirical Studies on the Relationship Between Childhood Maltreatment and Academic Achievement.
Summary of Research Syntheses on the Relationship Between Childhood Maltreatment and Academic Achievement.
Turning to the research syntheses in Table 2, findings mirrored and extended those in Table 1. Specifically, there was an association between childhood maltreatment and a number of academic-related outcomes, including lower grades, higher grade repetition, achievement below expectations, given one’s intellectual capacities, greater cognitive and language delays, and greater involvement in special education interventions. Most research has not investigated the association between childhood maltreatment and academic achievement in a comprehensive and consistent manner that takes into account variables that might potentially modify this association. However, preliminary findings indicate that difficulties in academic achievement may be particularly pronounced among children with the following characteristics: multiple maltreatment experiences, certain types of maltreatment (e.g., neglect), early onset maltreatment, unsubstantiated maltreatment allegations, residential mobility, and out-of-home care.
What might account for the relationship between childhood maltreatment and difficulties in academic achievement? As a prelude, we wish to mention that we relied on Bronfenbrenner’s ecological framework to organize this section and that we drew on any findings from Tables 1 and 2 that speak to the issue. However, it should again be noted that few studies have empirically tested mediating and/or moderating models to understand the link between maltreatment and achievement among children. Beginning with Bronfenbrenner’s ontogenic level, childhood maltreatment often interrupts normal brain development and, in this way, can disrupt such basic cognitive processes as concentration, memory, and language as well as the organizational abilities needed by children to function well in school (Cole et al., 2005; Eisen, Goodman, Qin, Davis, & Crayton, 2007; Toth & Cicchetti, 2006). Each of these difficulties, alone or in combination, can increase the risk of academic difficulties because they have been found to interfere with children’s ability to learn. Lowenthal (2000) identified the two following ways in which neurodevelopment can be influenced or even interrupted by maltreatment and can therefore lead to impairments in brain regions responsible for physical, social, and cognitive functioning: (a) insufficient sensory experiences during sensitive periods of brain development (e.g., neglect) and (b) atypical activation of neurons caused by early life stress (e.g., physical abuse, sexual abuse).
Maltreatment characteristics, such as onset, type, and duration, may also influence the extent to which children experience academic difficulties (English et al., 2005; Layne, Bernat, Victor, & Bernstein, 2009; Manly et al., 1994; Veltman & Browne, 2001). With regard to onset, it has been suggested that children who experience maltreatment early in life may exhibit the most pervasive deficits because the brain is developing very rapidly and in a diversity of ways during the first few years of life (Keiley, Howe, Dodge, Bates, & Pettit, 2001). As shown in Table 1, Leiter and Jonsen (1997) found that earlier maltreatment onset was, in fact, associated with an increased likelihood of receiving a special education placement and a greater probability of grade retention. These researchers also found that early maltreatment onset, coupled with a recent maltreatment incident (an indicator of chronicity), was related to the greatest problems in academic achievement, as measured by grade point average, involvement in special education programs, and school dropout. It may be that there is a cumulative effect for individuals who experience early and chronic maltreatment such that the accumulation of their experiences “reaches a threshold and spills out of the confines of family life to affect the child’s school life adversely” (Leiter & Johnsen, 1997, p. 581). Finally, the predominant type of maltreatment experienced by children might also influence the extent to which academic difficulties are observed. Several studies on younger (3- to 6-year-olds; Pears, Kim, & Fisher, 2008) and older (9- to 11-year-olds; Petrenko et al., 2012) maltreated children in out-of-home care found that those who experienced neglect (with or without physical abuse) were at greatest risk for cognitive delays, which are undoubtedly linked with academic achievement. These findings are consistent with a number of reviewed studies (Table 1) and research syntheses (Table 2). Neglect appears to be a particularly severe form of maltreatment as it typically begins and spans a child’s early years, thereby impacting various critical periods of brain development linked with such foundational processes as attachment, cognitive functioning, and emotion regulation (Culp et al., 1991; Hildyard & Wolfe, 2002; Kurtz, Gaudin, Howing, & Wodarski, 1993).
Within Bronfenbrenner’s microsystem and, more specifically, the family setting, research has underscored the importance of the caregiver–child relationship in influencing the association between childhood maltreatment and academic achievement. Negative caregiver–child interactions characterized by authoritarian or inconsistent/unpredictable parenting are frequently found in homes where maltreatment has occurred. This type of caregiving environment can interfere with children’s healthy development in a number of ways, including attachment, emotion regulation, and sense of agency. With regard to the latter, an impaired sense of agency is critical for children’s developing view of themselves as competent and successful in school-related (and more general) tasks (Lowenthal, 2000). This occurs because a sense of agency fosters exploration of the environment, autonomous functioning, and a feeling of self-efficacy (Cicchetti & Toth, 1995; Cicchetti & Valentino, 2006). When children grow up in an inconsistent and unpredictable caregiving environment, they have difficulty developing a sense that they can influence what happens to them and in the world around them, which may contribute to passivity as well as a sense of helplessness and hopelessness (Cole et al., 2005).
Within the family setting, a caregiver’s involvement and expectations may also influence the association between childhood maltreatment and academic achievement. As shown in Table 1, Cheung, Lewin, and Jenkins (2012) found that caregiver education-related variables, including involvement in school-related activities, home literacy environment, and expectations around the value and use of education, were significantly associated with their children’s academic success. The researchers posit that caregiver involvement may promote a stronger caregiver–child relationship, indicate greater sensitivity to the child’s individual needs, and/or help children internalize the value of education. The findings from Cheung et al. are consistent with others which have found maltreating caregivers to be often unresponsive to their children’s academic abilities, interests, and needs, so that appropriate academic support and encouragement are frequently lacking (Berridge, 2012; Hattie, 2009; Veltman & Browne, 2001). Maltreating caregivers may also struggle to provide children with the cognitive and emotional resources to engage and perform well in school (Cicchetti & Toth, 1995, 1997). Indeed, this lack of stimulation has often been proposed to account for the poor school performance that is frequently experienced among children with maltreatment histories (Lowenthal, 2001).
The school setting, which also falls within Bronfenbrenner’s microsystem, may also play an instrumental role in influencing the association between childhood maltreatment and academic achievement. The school setting represents one of the most consistent institutions in children’s lives (Cicchetti & Toth, 1997), and it can offer an important form of stability and continuity for children who have experienced maltreatment and family disruption (Berridge, 2012). In addition, by offering a structured environment with adults and peers who can serve as role models and supportive figures, the school setting can help buffer some of the detrimental impact of childhood maltreatment. It should also be noted that variables outside of the actual classroom setting may help promote academic success. For example, research has found that children’s participation in organized extracurricular activities is linked with the development of personal, social, and cognitive skills, all of which undoubtedly impact academic achievement (Durlak & Weissberg, 2007; Durlak, Weissberg, & Pachan, 2010; Zielinski & Bradshaw, 2006). Finally, a teacher’s involvement and expectations can impact children’s academic achievement (Hattie, 2009). In sum, it would appear that positive school experiences can help reduce the effects of a stressful home environment, increase children’s sense of agency, and promote resilience among children with maltreatment histories (Zielinski & Bradshaw, 2006).
Most of the research on variables that might influence maltreatment effects has focused on ontogenic- and microsystem-level factors, which is understandable, given that these two systems have the most direct impact on children’s development and functioning. Nevertheless, for maltreated children and especially for those living in out-of-home care, exosystem variables related to child welfare policies and decisions would also appear to be quite important. However, little is known about the manner in which child welfare variables might influence children’s outcomes, especially those related to academic success (Conger, Rebeck, & Vera Institute of Justice, 2001). Emerging evidence suggests that placement type may be related to the academic achievement of maltreated children in out of care (Attar-Schwartz, 2009; Cheung, Lewin, & Jenkins, 2012). Cheung et al. (2012) reported that placement type accounted for 12–15% of the variance in academic success among 10- to 15-year-olds. However, the researchers noted that certain types of placements may be more likely associated with the care of children with particular characteristics (e.g., age, sex, externalizing behaviors), thus suggesting that the influence of placement type on academic success may be explained by these child characteristics. In fact, findings supported this suggestion because the inclusion of child-level variables into the statistical model predicting academic outcomes resulted in the amount of variance explained by placement type becoming statistically insignificant (Cheung et al., 2012).
The limited research on placement type tends to support the beneficial impact of home-based care (i.e., kinship care, nonrelative foster home placement) on academic success, compared to group-based care because the former may provide children with a greater sense of stability and safety (Conger et al., 2001; Stone, 2007). It may also be that the more restrictive nature of group-based care plays a role, as children in such settings have been found to complete fewer years of school and to present with lower educational aspirations in young adulthood (Conger et al., 2001; Mech & Che-Man Fung, 1999). Conger, Rebeck, and Vera Institute of Justice (2001) examined New York City’s child welfare database and found no difference between kinship and foster care on children’s school attendance, even though kinship caregivers appeared to be less educated and to live in more disadvantaged neighborhoods than foster caregivers. Foster placement, however, was associated with an increased risk of school transfer within the same year of placement, suggesting that placement stability also plays an important role in influencing the academic success of maltreated children in substitute care. In fact, Conger et al. found that children who remained in foster care for a full semester after placement showed improved attendance rates, whereas those with shorter placements (<90 days) were more likely to reenter care, thereby contributing to even more instability. Additional research (Pecora et al., 2003) has also emphasized the importance of placement stability in predicting school success and high school completion.
Childhood Maltreatment and Mental Health
As previously mentioned, we defined educational outcomes as including both academic achievement and mental well-being (i.e., emotional and behavioral functioning). As noted in Slade and Wissow’s (2007) model, childhood maltreatment can impair children’s mental well-being, which can then influence (and be influenced by) academic achievement. Regarding the relationship between childhood maltreatment and mental health, there is overwhelming research evidence attesting to the deleterious short- and long-term impact of maltreatment on children’s mental well-being across a range of emotional (e.g., anxiety, mood) and behavioral (e.g., aggression, social skills deficits, peer relations, substance use) domains (Attar-Schwartz, 2009; Cicchetti & Toth, 1994; Cicchetti & Valentino, 2006; English et al., 2005; Flynn, Ghazal, Legault, Vandermeulen, & Petrick, 2004; Haskett, Nears, Ward, & McPherson, 2006; Kaplan et al., 1999; Kurtz et al., 1993; Shonk & Cicchetti, 2001; Staudt, 2001; Stone, 2007; Veltman & Browne, 2001; Wodarski, Kurtz, Gaudin, & Howing, 1990). Findings indicate that the prevalence of clinically significant mental health difficulties among maltreated children ranges from 40% to 80% (Burge, 2007; Czincz & Romano, 2009), which is in stark contrast to rates of 14–18% reported for nonmaltreated children (Stein, Rae-Grant, Ackland, & Avison, 1994; Waddell, Offord, Shepherd, Hua, & McEwan, 2002).
What explains the relationship between childhood maltreatment and mental health? Several of the same variables previously considered within the context of academic success would also appear to be at play. For example, maltreatment characteristics (Bronfenbrenner’s ontogenic level), such as onset, type, and duration, have been found to impact children’s mental well-being in differential ways and with varying degrees of severity (English et al., 2005; Manly et al., 1994; Newton & Vandeven, 2008; Staudt, 2001). To illustrate, Newton and Vandeven (2008) found that children who experienced maltreatment prior to 6 years of age reported greater depression and anxiety through childhood and into adulthood. In contrast, maltreatment during middle childhood had a greater association with antisocial and externalizing behaviors over time. Information processing biases in children with maltreatment histories are also linked with mental well-being. Maltreated children (especially those who have experienced physical and emotional abuse) have a tendency to perceive greater hostility, threat, danger, and/or aggression in their interactions with others (Cicchetti & Valentino, 2006; Hamby & Grych, 2013). While such perceptions may have served them well within the context of their maltreating caregiving environment, they can seriously interfere with their emotional and behavioral functioning. Relatedly, maltreated children have learned that others cannot be trusted because they can be sources of danger and harm. These perceptions are often carried forth into peer interactions so that maltreated children often exhibit certain interpersonal behaviors (e.g., approach avoidance, hostility/aggression, less prosocial behavior) that make it difficult to develop and/or maintain satisfying relationships (Blaustein & Kinniburgh, 2010; Cicchetti & Valentino, 2006; Shonk & Cicchetti, 2001).
At the level of the microsystem, maltreatment almost always implies a level of family dysfunction, which can seriously compromise children’s attainment of important developmental tasks. Maltreated children often have an insecure attachment to their primary caregiver, which has implications for their sense of self, of others, and of themselves in relation to others. These representations undoubtedly impact children’s expectations with regard to future interactions and relationships with other individuals, which is inextricably linked with mental well-being (Bowlby, 1982; Cicchetti & Valentino, 2006; Stroufe, 1989). Another developmental process that is related to attachment and that is often problematic among maltreated children is that of emotion regulation (Cicchetti & Toth, 1995; Cicchetti & Valentino, 2006; Hamby & Grych, 2013; Haskett et al., 2006). This is not altogether surprising, given that the safe context and effective parenting required to foster adaptive emotion regulation strategies are often inadequate in homes where maltreatment has occurred (Blaustein & Kinniburgh, 2010). Moreover, children who experience maltreatment live under conditions of continual stress and/or fear so more extreme emotional states (e.g., shutting down, constantly looking for signs of danger) may have become an adaptive and conditioned way of interacting in their environment (Cole et al., 2005). Finally, children learn emotion regulation strategies by observing the various ways in which their caregivers cope with their own feelings. In homes where maltreatment has occurred, caregivers often have their own difficulties with emotion regulation and, as such, their ability to serve as effective role models of how to recognize, identify, regulate, and express emotions can be seriously compromised (Cicchetti & Valentino, 2006; Haskett et al., 2006).
As another example of the link between maltreatment and children’s mental health, socioeconomic disadvantage (an exosystem variable) is important because such stressful conditions as poverty often compromise effective parenting practices (Cicchetti & Valentino, 2006; Zielinski & Bradshaw, 2006). Moreover, social support, which can help buffer the negative effects of stress, is often limited in families struggling with poverty. Zielinski and Bradshaw’s (2006) literature review noted that families in which maltreatment has occurred typically have fewer friends, less contact with other family members, and more short-lasting and nonreciprocal relationships with others. This situation often serves to further exacerbate the detrimental impact of socioeconomic adversity on parenting practices and, subsequently, on children’s mental well-being (Cicchetti & Valentino, 2006; Zielinski & Bradshaw, 2006).
The Link Between Children’s Academic Achievement and Mental Health
Now that we have considered the association between childhood maltreatment and academic achievement/mental health as well as several variables that might influence these associations, we turn to the final link in Slade and Wissow’s (2007) model, namely that of the bidirectional association between children’s academic achievement and their mental well-being. We must preface this section by noting that few studies have directly examined this association. Among those studies that have investigated the link between academic achievement and mental health, they have not focused on samples of maltreated children, and they have focused primarily on the impact of mental health difficulties on academic achievement (and not vice versa). To illustrate, Halonen, Aunola, Ahonen, and Nurmi (2006) studied the impact of internalizing difficulties (i.e., anxiety/depression) on academic achievement in a community-based sample of 196 children. Internalizing problems and reading performance were assessed when the children were aged 5–6 (in preschool) and in first grade. Results indicated that internalizing problems predicted subsequent problems in reading performance, both during the transition from preschool to primary school and while in primary school.
Hinshaw (1992) conducted a review of the literature examining the association between externalizing difficulties (i.e., aggression, oppositional behavior, inattention/hyperactivity) and academic achievement in general population samples of children. Overall findings indicated that externalizing problems were associated with academic underachievement and that the link between childhood inattention/hyperactivity and academic delays was strongly related with later adolescent delinquency and school failure. The author noted that the overlap between externalizing problems and academic underachievement appears to occur early in life (often during the preschool years), suggesting that there may be similar etiological factors, such as language deficits, neurodevelopmental delays, and/or poor verbal skills. Other empirical studies and research syntheses have also lent support to the impact of emotional and behavioral impairments on a variety of academic-related outcomes, including learning delays, lower standardized achievement scores, lower school grades, and school dropout (Crozier & Barth, 2005; Kauffman, 2001; Roeser, Eccles, & Strobel, 1998; Trout, Nordness, Pierce, & Epstein, 2003). In their review of 65 articles published between 1961 and 2000 on the association between children’s academic status and emotional/behavioral difficulties, Trout, Nordness, Pierce, and Epstein (2003) found that students with emotional or behavioral difficulties performed below their peers on tasks of reading, math, and writing. These authors concluded that, without targeted interventions, children’s emotional and behavioral difficulties are likely to persist over time. Moreover, these children are likely to continue experiencing lower academic scores, lower graduation rates, and lower pursuit of postsecondary education.
Discussion
Children with maltreatment histories often experience difficulties in their educational settings, and these difficulties can span academic achievement as well as mental well-being. The extent to which educational outcomes are impacted by childhood maltreatment is the result of complex and dynamic processes that include the disruption of key developmental processes (e.g., attachment, emotion regulation, sense of agency), the interplay among ecological systems (e.g., families, schools) in which children are embedded, and the bidirectional link between children’s academic success and mental health. These various forces that serve to shape educational outcomes become even more complicated among children who not only have experienced maltreatment but who have also been removed from the care of their biological parents, because of serious attachment disruptions and often frequent out-of-home care placements.
What are the implications stemming from this literature review? From a theoretical perspective, it would seem important to conceptualize educational success among maltreated children in terms of both academic achievement and mental well-being, as these domains of functioning are often both impacted by maltreatment and they mutually influence one another. With such a perspective, related research efforts would benefit from a more comprehensive definition of educational success that also incorporates children’s mental health functioning as well as a more concerted focus on the ways in which academic achievement and mental health among maltreated children might work together to promote educational success. This latter point suggests (1) understanding educational success among children with maltreatment histories as the product of a number of emotional and behavioral skills that complement and interact with academic achievement (and associated cognitive abilities) and (2) examining these skills within a broader framework that considers the moderating and mediating roles of developmental and ecological influences.
From an applied perspective, our findings suggest that a number of individuals play important and complementary roles in advancing the educational success of children who have experienced maltreatment, including caregivers (biological and substitute), school personnel, and child welfare professionals (in cases of reported or substantiated maltreatment cases). As such, they must work together in a coordinated manner to ensure that the most appropriate plan is developed (and regularly monitored) to address the multiple academic and mental health needs that are so often found among maltreated children. To this end, these individuals need to create a positive culture of expectations with regard to educational success because this will influence the attitudes and motivation of maltreated children with whom they interact either as caregivers or professionals. Part of this culture would seem to imply engagement and continued involvement in children’s educational outcomes (Berridge, 2012).
Another important consideration is that the organizations in which professionals work, such as schools and child welfare agencies, must be committed to efforts aimed at creating trauma-sensitive school environments and promoting educational success among maltreated children. One such example can be found in the report Helping Traumatized Children Learn (Cole et al., 2005), which developed a framework with multilevel recommendations (i.e., school-wide infrastructure, culture, and policies; staff training; cross-sectoral links; academic and nonacademic strategies) to assist schools in helping promote the educational success of children with trauma histories. These include recommendations such as the following: (1) identifying/correcting barriers among school personnel (e.g., believing that trauma is a home and not a school problem, providing personnel with resources for handling trauma and also for dealing with its impact on their own well-being) in order to develop a school environment that is sensitive to the needs of children with trauma histories and (2) training school personnel (especially teachers) to recognize/address trauma-related manifestations by helping children with emotion regulation, creating a safe environment through the establishment of routines and rules that are fair and consistently enforced, appropriately managing disruptive behavior and reinforcing acceptable behavior, helping build children’s sense of agency (e.g., by building on strengths) and avoiding biases related to the experience of trauma. It would seem critical to invest in such efforts as a way to underscore the important goal of educational success for maltreated children and to develop procedures to ensure that all relevant stakeholders can contribute to this goal.
Footnotes
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This article is based on a report provided to the Crown Ward Championship Team of Ottawa as part of a contract to the first author.