Sex differences in psychological distress,behavioural and emotional problems,and substance use in young people in out‐of‐home care

The aim of the study was to examine sex differences in self‐reported psychological distress, behavioural and emotional problems, and substance use in young people living in out‐of‐home care (OoHC). One hundred seventy‐six young people aged 12–17 years (females 53.4%) in OoHC in metropolitan Melbourne, Australia, were interviewed. Participants completed self‐report measures: Kessler Psychological Distress Scale, Strengths and Difficulties Questionnaire, and the World Health Organization Alcohol, Smoking, and Substance Involvement Screening Test—Youth Version. Girls had more OoHC placement instability over the past year compared with boys (p = .019). Compared with boys, the girls had significantly higher levels of distress (p < .001) (p = .007), were more likely to have self‐reported emotional symptoms (p < .001) and peer relationship problems (p = .043) and were more likely to use sedatives (p = .004). Girls had more psychological distress, behavioural disturbance, and sedative abuse; placement instability might contribute to these problems. Greater integration across OoHC, mental health, and substance use sectors is required. Girls in OoHC may benefit from interventions targeting problems with peer relationship and substance use and supporting prosocial behaviour; such targets may reduce distress and emotional symptoms and possibly prevent longer term problems.     

Emotional kinship care and neutral non‐kinship care — the struggle between discourses

In this paper, social workers' ideas of kinship care and non‐kinship care as foster placement alternatives for vulnerable children are analysed and discussed. The study is based on group interviews with Swedish social workers, using a discourse analytic approach. The interviews took two vignettes of children who needed an immediate and long‐term placement because one of the parents had killed the other parent, as their point of departure. Domestic violence is a common social problem across countries, and controversies about placement alternatives become even more apparent when discussing lethal violence. The analysis revealed three main discourses: ‘emotional kinship care’, ‘neutral non‐kinship care’ and ‘a real family’. The emotional kinship care discourse also revealed two competing sub‐discourses: ‘emotions as glue that binds’ and ‘emotions as obscuring a child perspective’, displaying a struggle concerning the advantages and risks that social workers connected to kinship care. In this paper, the results and their implications for vulnerable children are discussed.     

Stability and change – a 7‐ to 8‐year follow‐up study of mental health problems in Norwegian children in long‐term out‐of‐home care

The aim of the study was to explore stability and change in mental health problems in Norwegian children aged 6–12 years old (n = 70) in long‐term out‐of‐home care. The children's mental health problems were assessed shortly after the placement and 7–8 years later by the caregivers and the teachers on the Revised Rutter Scales. Information on pre‐placement and placement factors were collected from the child welfare workers. At a group level the children's mental health problems had improved significantly over time according to the teachers' reports. According to the caregivers' reports, however, the children's problems were high and stable across time. Analyses aimed at detecting individual changes revealed a great variability in development according to both informants, indicating that treating the placed children as a homogenous group could be misleading. Several pre‐placement and placement variables were associated with the change in the children's mental health problems from the time of placement to the follow‐up time according to both informants' reports. However, all the predictors were accounted for by the strong effect of the children's problem scores when entering care.     

Well‐being among employed and non‐employed caregiving women in Taiwan

Chou Y‐C, Kröger T, Chiao C, Pu C‐Y. Well‐being among employed and non‐employed caregiving women in Taiwan This study addressed various groups of non‐employed/employed and non‐caring/caring women in Taiwan. Data from the 2006 National Taiwanese Women Survey (at age 16–64, n= 6,017) were analysed to determine whether there are differences in terms of well‐being, as measured by self‐rated health and family life satisfaction, between women who work and/or care and between different carer groups. Other factors associated with well‐being of carers of young children (n= 1,697) were also analysed. The results showed that non‐employed carers of disabled adults stood out as the most disadvantaged group. However, the importance of work has been replaced by support among carers of young children. This study suggests that unpaid carers, particularly carers of disabled adults who are non‐employed, ought to be supported by policies. To improve carers' well‐being, care–work reconciliation among working‐age women needs to be included in the future care scheme in Taiwan.     

Predictors of outcome for unrelated adoptive placements made during middle childhood

This paper reports on a follow‐up to adolescence of two longitudinal prospective studies of children placed from public care with non‐related adoptive families in the UK. Factors associated with outcome are presented for 99 children (one index child per adoptive family) who were between 5 and 11 years of age at placement. Information concerning the children's backgrounds and care histories was obtained shortly after placement (T1), from social workers. Adopters were interviewed at T1 and again at the end of the first year (T2). A further follow‐up was conducted an average of six years after placement (T3). Outcomes at T3 were classified as either disrupted, which was true for 23%, continuing and ‘positive’ (49%) or continuing but ‘difficult’ (28%). Bivariate analyses revealed a number of attributes, related to both the child and the adoptive parents, which were associated with differential outcomes. Logistic regression produced five predictors of placement disruption: age at placement, behavioural problems, preferential rejection, time in care and the child's degree of attachment to the new mother. Differences were found between ‘positive’ and ‘difficult’ outcomes in continuing placements as well as between continuing and disrupted placements. The analysis suggests that adoption should certainly be considered as an option for children over 5 years of age while recognizing the need for both preparation and post‐placement support. Evidence of differential outcome in continuing placements provides support for efforts to reduce the number of placements and returns home that a child at risk experiences.     

Who Takes Care of Education 18 months on? A follow‐up study of looked after children's perceptions of support for educational progress

This paper represents a follow‐up publication to the findings of a previous paper by documenting the views of a follow‐up sample of 56 young people, aged 12–19 years, looked after in three English local authorities. Young people were interviewed on two separate occasions, 18 months apart, to assess their perceptions of educational progress and identify factors that might support or hinder their education. The interviews took place as part of an ongoing evaluation of the Taking Care of Education project, a development programme designed to facilitate improvements in the education of looked after children. Most young people were aware of individual project‐related activities and a number of these were seen to contribute towards educational progress. Perceptions of educational progress were significantly higher at follow‐up interview and an increased proportion of young people reported that being looked after had had a positive impact upon their education. Carers and teachers continued to be the most frequently mentioned providers of educational support, but the proportion of comments relating to educational support from social workers increased at follow‐up. The most consistent explanation given for improved educational progress was the availability of support and encouragement for educational progress and acknowledgement of young people's achievements.     

Effects of individualised follow‐up on activation programme participants' self‐sufficiency: A cluster‐randomised study

Recent developments within activation policies emphasise tailor‐made and individualised services; however, little is known of what the effects of these initiatives are. The aim of this study was, therefore, to analyse, in a cluster‐randomised design, the long‐term effects of an individualised follow‐up model on welfare recipients' self‐sufficiency. The follow‐up model systematises the work done by social workers within the Qualification Programme, which is a welfare‐to‐work programme in Norway. In the study, 18 labour and welfare offices were randomised to experimental and control groups. The data consist of baseline questionnaires for Qualification Programme participants (n = 617) and follow‐ups based on administrative data at 12, 24 and 30 months after baseline. The results show significant effects of individualised follow‐up on self‐sufficiency at the 30‐month follow‐up and strong positive trends at the 18‐ and 24‐month follow‐ups. Thus, comprehensive and individualised follow‐up of participants within activation programmes seems to generate positive long‐term effects on self‐sufficiency.     

Predictors of behavioural and emotional problems of children placed in children's homes in Croatia

Since children's homes in Croatia and elsewhere nowadays deal with children who have more problems than in the past, there is a need to identify predictors of the children's behavioural and emotional problems in order to provide adequate interventions and an appropriate developmental environment. This research was carried out in all children's homes in Croatia. The sample consisted of 263 children aged 10–14. Standardized instruments (Youth Self‐Report and Child Behaviour Check‐List) were used as outcome measures of children's psychosocial functioning. The results showed significantly more behavioural and emotional problems in children in children's homes than in the comparison group of children living with their families. Child care‐workers assessed fewer behavioural and emotional problems than did the children themselves. Multiple regression analyses were used to determine predictors for well‐being scores. The level of everyday stress in children's homes, coping strategies, perception of social support and school achievements proved to be the most significant predictors. Since those variables belong to mediating variables within the suggested model of research, it is argued that positive changes in these areas can facilitate a better psychosocial functioning of the children in children's homes.     

Young carers in Sweden—A pilot study of care activities,view of caring,and psychological well‐being

Children who have parents with any kind of illness may become young carers who take a responsibility not expected of children for household tasks, or personal or emotional care for parents and siblings. So far, little is known about children in Sweden who are at risk of becoming young carers. The aim of this article is therefore to explore the extent and impact of children's caring activities as reported in a pilot study by a sample of children in Sweden. A number of international questionnaires measuring the amount of caring activities, impact of caring, quality of life, and psychological well‐being were translated and combined into a survey. The pilot survey was completed by 30 children 10–18 years of age. Also, when completing the survey, the children were interviewed concerning their experiences of caregiving. The participants report on a group level emotional symptoms such as fear and nervousness above the clinical cut‐off value. They also rate a lower level of caring compared with findings from the United Kingdom, but they report a higher degree of negative impact of caring than young carers in the United Kingdom.     

The key role of positive parenting and children’s temperament in post‐institutionalized children’s socio‐emotional adjustment after adoption placement. A RCT study

Parenting interventions represent a means for experimentally inquiring socio‐emotional change of post‐institutionalized children after adoption. We used this approach in a three time point RCT study involving 83 post‐institutionalized children (M_age = 33.5 months, SD = 17.1) and their adoptive mothers (M_age = 42.6, SD = 3.9), attending either the Video‐Feedback Intervention to promote Positive Parenting in adoption and foster care or a dummy intervention. Controlling for gender and age at adoption, children showed a significant change in their socio‐emotional adjustment in the specific variables inquired—that is, emotional availability‐EA, and behavioral problems—after intervention attendance. Mediation and moderated mediation models showed that maternal EA was a main factor affecting children’s EA and externalizing behavioral problems, with a key moderating role played by children’s temperament; children with high scores on temperamental negative affect benefitted most from their mothers’ increase in EA.     

Supporting foster and kinship carers to promote the mental health of children

The majority of children and young people removed from the care of their parents by the state of Victoria, Australia, reside in foster or kinship care. These children have experienced a broad range of adverse conditions and are up to 4 times more likely to experience problems with mental health than their mainstream peers. This paper draws on the perspectives of foster and kinship carers, describing the disconnection between their role as mental health advocates and their interest in early intervention in a field which is dominated by crisis and the historic marginalisation of foster and kinship carers. Thirty‐one foster and kinship carers across greater metropolitan Melbourne, Australia, contributed to this study through interviews and focus groups. Participants demonstrated a practical understanding of mental health and an ability to identify a range of conditions that have an adverse impact on the mental health of children and young people in their care. The paper concludes that there is a lack of systemic support and even a range of barriers that affect the capacity of foster and kinship carers to promote the mental health and well‐being of the children and young people in their care.     

Child and Youth Coaching in families experiencing complex and multiple problems: A longitudinal evaluation study

Studies investigating services for families experiencing complex and multiple problems have emphasized the need for more child-centred support. The aim of this longitudinal study was to investigate whether providing child-centred services (Child and Youth Coaching) combined with family-focused services (Ten for the Future) is effective for children growing up in families experiencing complex and multiple problems. Children's psychosocial skills, emotional and behavioural problems, and the quality of their pedagogical environment were measured at baseline, 6 months and 12 months. Parent and coach reports of children indicated for Child and Youth Coaching (n = 57) and nonindicated children (n = 18) were analysed using repeated measures multilevel models. Both parents and coaches reported improved psychosocial skills of children, but changes were only significant for coach reports. In both reports, no significant decrease in emotional and behavioural problems was observed for both indicated and nonindicated children. Many children still experienced considerable problems at case closure. Furthermore, no significant improvement in quality of the pedagogical environment was observed in both groups. Given the limitations in this study, more research is needed to identify whether these findings can be replicated and attributed to the Child and Youth Coaching and Ten for the Future programmes.     

Predicting the recipients of social work support,and its impact on emotional and behavioural problems in early childhood

This paper examines the recipients of social work support in the Millennium Cohort Study. Using panel analysis and fixed effects models, it investigates the factors that lead to the receipt of any type of social work support for individuals with young children and the effects of this support on changes in the prevalence of emotional and behavioural problems in these children. We find that divorce or separation, and episodes of homelessness are two important factors that lead to the receipt of social work support. Mothers with male children are also more likely to receive social work support. However, we find no clear evidence that social work support has any effect on changes in children's emotional and behavioural problems over time. The implications of these findings for social work research and for practice and policy are discussed.     

Behavioural and emotional problems of children by type of out-of-home care in Croatia

The aim of this article is to compare the kinds of behavioural and emotional problems of youth in relation to type of out-of-home placement in Croatia. Children living in children's homes manifest significantly more behavioural and emotional problems than other groups of children in out-of-home care or children living in their primary families. Children living in foster families or in family-type homes integrated in the community do not differ from a comparative group of children living in primary families. Regardless of differences among sub-samples regarding behavioural and emotional problems, the current problems of individual children in all groups of children in out-of-home placement were connected more to currently experienced stressors than to unfavourable circumstances before their removal. This indicates that there are benefits to be gained by improving services in the children's present care environment.     

Children in Residential and Foster Care – a Swedish Example

The article reports on a longitudinal study of children placed in a children's home in Malmö, Sweden, at the beginning of the 1980s. The 26 children, placed when younger than four years of age and staying more than four weeks in the children's home, were followed up three and nine months after leaving the children's home as well as five, ten and fifteen years later. Interviewing the parties concerned was the predominant research method. Twenty of the 26 children in the research group also had later experiences of out-of-home care, including foster care, in addition to the stay at the children's home. This article is about them, 15–20 years old when interviewed in the latest follow-up study. Three aspects of "outcome" are focused on: the degree of stability in the children's living conditions; relationships to parents and foster parents; well-being and emotional and behavior problems. Bearing in mind that the concept of well-being is relative, a cautious conclusion is that a third of the children in the study experienced well-being, a third felt "o.k.," and a third had serious problems, including criminal activities and drugs. The somewhat unclear connection between well-being, stability in living conditions, and sense of family belonging is discussed.     

Use of population measures and norms to identify resilient outcomes in young people in care: an exploratory study

The purposes of this study were to derive a new method for identifying resilience (i.e. positive adaptation in spite of serious adversity) among young people in care and to determine the percentage of the latter who experienced resilience on selected outcomes, as conceptualized from within the developmental approach of Looking After Children. The participants comprised two samples of young people who were living in out‐of‐home care (mainly foster care) in the province of Ontario, Canada, 340 aged 10–15 years and 132 aged 5–9 years. Virtually all had experienced severe adversity in their families of origin, such that in most cases the legal custody, care, and control of the young people had been permanently transferred from their parents to a local Children's Aid Society. Corresponding to each in‐care sample was a general‐population sample of the same age range that served as a normative comparison group and was drawn from the National Longitudinal Survey of Children and Youth (NLSCY). The NLSCY is an ongoing, long‐term social‐policy study of the development of a nationally representative sample of Canadian children into adolescence and early adulthood. The general‐population samples were composed, respectively, of 5539 young people aged 10–15 years and 11 858 children aged 5–9 years. Resilience among the young people in care was operationally defined, on each outcome variable, as average or above‐average functioning relative to that of the general‐population sample of the same age range. The percentage experiencing resilience was relatively high on the outcomes of health, self‐esteem, and pro‐social behaviour, moderate on the outcomes of relationship with friends and anxiety and emotional distress, and low on the outcome of academic performance. The implications of the findings are discussed.     

The proof of the pudding: What difference does multi‐agency working make to families with disabled children with complex health care needs?

More than 20 years of research with disabled children, young people and their families has highlighted the need for the different professionals and services that support them to work more closely together. The British policy and legal framework for ‘joined up working’ has never been stronger. However, there has been an assumption that multi‐ or inter‐agency working will inevitably be a ‘good thing’ for families. This paper discusses findings from a 3‐year research project which looked at both the process and impact of multi‐agency working on families with a disabled child with complex health care needs. Interviews with 25 parents and 18 children and young people who used six developed, multi‐agency services were carried out. Findings suggested that the services had made a big difference to the health care needs of disabled children but were less able to meet the wider needs of the child and the family – particularly in relation to social and emotional needs. Multi‐agency working appeared to make some positive, but not significant, differences to the lives of families.     

Physical and mental health changes in aging foster parents: Do child behavioural problems hasten declines?

This study examined foster parent physical and mental health over time. It was hypothesized that increased severity and frequency of child behavioural problems, whether externalizing or internalizing, would be associated with poorer health over time, especially for foster parents ≥60 years of age. Data from the baseline and Wave 2 interview of the 2010 National Survey of Child and Adolescent Well‐Being were used. The final analytic sample included kin and nonkin foster parents who had custody of a foster child for both waves of data collection (n = 962). Ordinary Least Squares regression models with lagged dependent variables showed that foster parents ≥60 had deteriorating physical health over time, but caregiver age alone had no association with worsening mental health. However, parents ≥60 caring for children with externalizing behavioural problems had significantly improved physical health. Mental health of parents ≥60 significantly diminished if child externalizing or internalizing problems worsened. Findings indicate that for aging foster parents, externalizing child behaviours may stimulate physical activity and improved physical health, yet any type of child behavioural problem can deteriorate mental health functioning.     

Reactive and proactive aggression in children with and without ADHD and negative emotional lability

Children with attention‐deficit/hyperactivity disorder (ADHD) exhibit marked difficulty with frequent and intense shifts in negative or positive emotions, referred to as emotional lability. This study examines the relationships between negative emotional lability (NEL), ADHD, and reactive and proactive aggression. A community sample of 96 children (53 with ADHD, 43 control) ages 8–12 and their parents completed a baseline session include a diagnostic structured interview and the Reactive–Proactive Aggression Questionnaire (RPAQ). Parents then rated their child's NEL using the Positive and Negative Affect Scale as part of an Ecological Momentary Assessment protocol 3 times a day for 28 days. Seventy‐three participants (37 with ADHD, 36 control) completed the RPAQ at follow‐up. Hierarchical regression analyses indicated that NEL significantly and independently estimates reactive aggression at baseline and follow‐up, regardless of ADHD status. NEL and ADHD status significantly estimates concurrent proactive aggression, but not at follow‐up. Results of this study suggest that NEL accounts for a significant amount of the variability in reactive aggression, a common difficulty in children with ADHD. Further, individuals that are reportedly emotionally labile become more reactively aggressive over time. Both ADHD diagnostic and NEL are predictors of proactive aggression at baseline, although no interaction occurred.