Predicting health service use in antisocial children using the early assessment risk list for boys (EARL20B)

Abstract

Purpose of the Study: To examine the relationship between the Early Assessment Risk List for Boys (EARL20B) total and item scores and the prevalence of health service use, disease and mental health status in a sample of antisocial boys, followed up between the ages of 12 and 21.
Methods: information contained in clinical files of 234 boys seeking treatment for conduct problems was used to rate each of the twenty EARL20B risk factors (012)
to yield total scores ranging between 0 and 40. Provincial health records were used to derive health outcome variables based on outpatient, emergency room and inpatient
encounters, and to facilitate analyses based on ICD9 disease categories and specific mental health diagnostic variables.
Results: significant associations were found between the EARL20B total score and emergency room use, particularly for encounters due to accidents and injuries. Total EARL20B scores also predicted mental and behavioural problems such as mood and anxiety disorders and disorders of childhood and adolescence. Using logistic and linear regression, several individual EARL20B items were identified as significant predictors of these outcomes.
Conclusions: This study showed that the EARL20B, initially designed to assess risk for later criminality in children, also predicted health and mental health outcomes previously shown in the literature to be associated with conduct disorder. Study findings support the addition of accident prevention and health promotion training and education in interventions targeted at antisocial children and their families.