The Full Picture: Incorporating Ecological Factors When Conducting Developmental Screening with Young Children Experiencing Homelessness.

Conducting a neurodevelopmental screening without considering ecological factors is insufficient and may underestimate the actual risk to development for children living in poverty. This article describes ecological risk factors among a nationwide sample (n = 231) of young children experiencing homelessness. Researchers examined rates of health care access and continuity, food insecurity, lead exposure, ACEs, and access to safe places to play using a new ecological screening tool developed for the population. Children in the sample experienced high rates of food insecurity, faced significant challenges to health care access, and significant exposure to adverse childhood events. Children experiencing homelessness and poverty experience more barriers to health care access and significantly more food insecurity and hunger. A third of caregivers reported that their child had some exposure to lead, primary due to substandard housing. And the majority were enduring long periods of homelessness with over half (56%) being between 1-6 months. Findings are discussed within a social determinants of health perspective.