Broadening Our View

Summary

The growth in child welfare caseloads and the increasing use of kinship foster care has raised new questions about effective permanency planning. The majority of children in kinship foster care are children of color and have been less likely to exit the custody of the child welfare system than children placed in traditional foster care. Permanency planning which ensures the long-term protection and well-being of children from diverse cultural backgrounds requires a broad view of family, ongoing striving for cultural competence, collaboration between the formal child welfare system and the kinship systems of children in state custody, and a long-term view of permanency planning and child-rearing that builds on the case-management capacities of kinship networks to support permanent plans, looks beyond the child's exit from state custody, and helps families and larger kinship systems make long-term plans for the protection, permanence, and well-being of children.     

Achieving Permanence in Foster Care for Young Children: A Comparison of Kinship and Non-Kinship Placements

ABSTRACT

A number of child welfare policies have reinforced the use of kinship care as the most preferred placement for foster children, reflecting the philosophy that maintaining children within their own extended family system contributes to their stability and well-being. Given the growing utilization and legislative emphasis on kinship care along with the push for an immediate implementation of permanency plans for children in foster care, this study examines how the permanency goal under the 1997 Adoption and Safe Families Act (ASFA) is being implemented and achieved. The reunification and permanency placement (adoption or legal guardianship) outcomes of children in relative and non-relative care are analyzed, focusing on the experiences of young children. Based on public child welfare agency data from 2000 to 2003, child, case, and placement variables are explored to identify which set of factors best explains case outcomes. The present study identifies the total length of foster placement (kinship and non-kinship), the length of family maintenance services, and the number of placement changes as the most important variables in determining family reunification and permanent placement (legal guardianship and adoption) outcomes for young children.     

Kinship Care and Public Child Welfare: Challenges and Opportunities for Social Work Education

Abstract

The growing practice of arranging and financing “foster placement” of abused and neglected children with relatives provides an opportunity to redefine relationships between extended families and the child welfare system. The dilemmas and possibilities presented by kinship care as a child welfare service challenge schools of social work to provide intellectual leadership and to prepare social workers for changing child welfare practice. The author's ideas concerning responses to this challenge focus on key mandates of the Council on Social Work Education's Curriculum Policy Statement and on five principal curriculum areas in social work education.     

Kinship Care: Analysis of the Health and Well-Being of Grandfathers Raising Grandchildren Using the Grandparent Assessment Tool and the Medical Outcomes Trust SF-36 TM Health Survey

ABSTRACT

As more and more children are being separated from their biological parents because of AIDS, substance abuse, mental and physical illness, incarceration, and child abuse and neglect, child welfare agencies are relying more often on kinship care as a viable option for out-of-home placements. In many cases, kinship care falls on the grandparents. While keeping children within their families is generally viewed as preferable by child welfare agencies, it can be a burden on grandparent caregivers, who often exist on severely limited incomes and without much assistance or support from social service agencies. A research project was conducted which used both quantitative and qualitative data from research conducted by Jones and Gibbons (2000) on grandparent care, but this study focuses on the experiences of grandfathers who participated in the project and examines their outcomes in several different areas.     

Motivations for Providing and Utilizing Child Care by Grandmothers in South Korea

The purpose of this study was to construct a conceptual understanding of the motivations of grandmothers and mothers to provide and utilize child care by grandmothers in Korea. Grounded theory methods were used to collect and analyze interview data with 21 matched pairs of caregiving grandmothers and employed mothers. The grandmothers' motivations were concern for their adult children's well‐being and a feeling of responsibility to fulfill their parental responsibility for support. The mothers' motivations were the benefits they received as employed mothers and their trust of family care with prior expectations of the grandmothers' support. The core category integrating the findings was bilateral familism supporting traditional gender role ideology. The results suggest that changes from patrilineal to bilateral kinship interactions have been largely based on the influence of familism, which has created a cultural setting of expectations for downstream intergenerational support to maintain traditional gender roles despite increased maternal employment.     

Connective complexity: African American adolescents and the relational context of kinship foster care

Attempts to address racial disproportionality in child welfare must include a focus on the benefits and challenges facing children in kinship care. African American children not only are overrepresented in the child welfare system, but also are placed disproportionately in kinship foster care. Using a sample of 18 African American adolescents ages 11 to 14, this article explores how the relational context of care experienced by adolescents in kinship foster care differs from that of adolescents in nonkinship foster family placements. Findings are presented regarding the stability of relationships as well as complex role dilemmas experienced by kinship youth as they relate to caregivers and birthparents in the child welfare context. Implications are given for practice with kinship families.     

Identified Problems and Service Utilization Patterns Among Kinship Families Accessing Mental Health Services

Abstract

This study examined the mental health problems and service utilization patterns of kinship families who accessed services in an urban outpatient child psychiatry clinic. A random sample of children who completed the intake process during a calendar year yielded 47 children, or 19% of the sample, whose primary caregiver was a relative, other than a biological parent; approximately half of those families were involved with the child welfare system. Data from an administrative database and from medical records describe the diagnoses, identified problems, and services used by the kinship families. Academic or school-related problems emerged as an identified problem in approximately half of the kinship cases, but school intervention was not a primary target for clinicians. The kinship sample was also compared with a random stratified sample of children who were living with primary caregivers other than kin. Kinship families were more likely to be African-American, but few differences were found between kin and non-kin cases on diagnoses and frequency, duration, or type of services received. The findings suggest that collaboration with schools might increase the engagement and retention of kinship families in mental health services.     

Challenging implicit bias: preparing students to practice with African American families

ABSTRACT

The disparity of African American families in the foster care system is a concern in the field of child welfare services and the social work profession. African American families experience unique challenges related to discriminatory practices and implicit biases in the child welfare system and by mandated reporters. To address these inequalities, state and local agencies have implemented prevention and intervention services to support minority families. Additionally, child welfare agencies have invested in professional development training for their workers to alleviate possible intolerant practices. This article describes implicit biases and considers how they could contribute to the disparity of African American families involved in the child welfare system. Furthermore, the article presents approaches to help social work students to identify and challenge their implicit biases to support culturally sensitive practices while working with African American families. It concludes with implications for social work education.     

The Perceptions of Welfare Reform by Michigan Families Whose Children Have Disabilities and Welfare Caseworkers

Abstract

This article examines family and caseworker perceptions of welfare reform and services as they relate to families who have a child with a disability. Interviews were conducted with 39 families and 77 caseworkers. Family questions addressed their perceptions of the welfare system, factors impacting their self-sufficiency, and their perceptions of needed program changes. Caseworker questions addressed their perceptions of welfare practices and policies and their education needs related to serving families who have children with disabilities. Familial perceptions of the welfare system were validated by caseworker reports. Implications for service improvement are discussed.     

Factors Associated with the Decision-Making Process in Kinship Diversion

During the past two decades, child welfare professionals have given kinship care priority as the preferred least restrictive, most family-like placement option when a child has to be removed from his or her family. However, the available literature lacks investigation into what factors drive the decision to use kinship care, specifically an understanding of why some children are diverted from child welfare system (CWS) into unpaid kinship arrangements while other children enter the traditional foster care system. This study uses baseline (Wave 1) data from the National Survey of Child and Adolescent Well-being II (NSCAW II), which provides information about children and caregivers in different types of kinship care. The data were analyzed using multinomial logistic regression based on the multiple imputed data files using NSCAW II weights. Results show important predictors of a child being diverted into private kinship care included the child’s age, caseworker’s educational background, and caseworker’s assessment of harm level. Important predictors of a child being diverted into voluntary kinship care included the maltreatment type, family structure, caseworker’s educational background, and caseworker’s assessment of risk level. Differentiating between the types of kinship diversion has important implications for practice and policy. Examining a variety of factors can help child welfare scholars develop a comprehensive understanding of the decision-making processes used in selecting kinship diversion for out-of-home placements.     

Socioemotional Problems Among Young Children in Out-of-Home Care: A Comparison of Kinship and Foster Care Placement

This study examined socioemotional problems among children age 0 to 5 years in formal kinship and foster care across a northeastern state. Findings revealed that more than one third of children in both types of care showed socioemotional problems. More children were placed in kinship care when they lived in rural settings, were biracial, or spent time in the neonatal intensive care (NICU) after birth. Unique child and maltreatment characteristics predicted socioemotional problems scores for each placement type. Among children in kinship care, being biracial, spending time in the NICU, and being referred to child welfare for either caregiver substance abuse or neglect were related to socioemotional problems. When children were in foster care, spending time in the NICU, being referred to child welfare for child neglect, or being referred for intimate partner violence were all related to socioemotional problems. The results have implications for child welfare policy and practice, especially in light of increased efforts to place children with kin.     

Delineating disproportionality and disparity of Asian-Canadian versus White-Canadian families in the child welfare system

ObjectiveThis paper builds upon the analyses presented in three companion papers using data from the 2003 and 2008 cycles of the Canadian Incidence Study of Reported Child Abuse and Neglect (CIS-2003 and CIS-2008) and the Ontario Child Abuse and Neglect Data System (OCANDS) to examine disproportionality and disparity of child welfare involvement for Asian-Canadian children involved in the child welfare system.MethodsThis study used CIS-2008 data adjusted by Census child population data to examine rates per 1000 and three disparity indexes (population-based disparity index [PDI], decision-based disparity index [DDI], and maltreatment-based disparity index [MDI]) to determine the representation of child maltreatment investigations for Asian-Canadian versus White-Canadian children involved in the child welfare system. Logistic regression analyses were conducted to determine the odds of case closure for substantiated child maltreatment investigations, and whether Asian ethnicity remained significant while controlling for child demographics and household composition, case characteristics, and clinical concerns.ResultsThis study found that Asian-Canadian children were underrepresented in the child welfare system compared to White-Canadian children (13.9 per 1000 Asian children in the Canadian population vs. 36.1 per 1000 White children in the Canadian population). Child welfare involvement for Asian-Canadian children are almost 2 times more likely to close after an investigation than White-Canadian children. The three disparity indexes (PDI, DDI, MDI) showed substantially different results with respect to the representation of child maltreatment investigations involving Asian-Canadian versus White-Canadian children for physical abuse, sexual abuse, neglect, emotional maltreatment, and exposure to domestic violence.ConclusionsDisproportionality and disparity are complex phenomena. The variation in results derived from different methods of calculating representation suggests the need for greater clarity and consistency in the definitions and methodology in examining racial disparity in child welfare research. Some methodological considerations for future child welfare research with Asian-Canadian populations were discussed.     

Kinship care for children in the UK: messages from research,lessons for policy and practice1

This article presents a comprehensive overview of kinship care, or as it is also known, family and friends care, paying particular attention to the UK child welfare, legal, policy/practice contexts. The aim of the article is to raise awareness, and provide information, about a hitherto largely invisible, yet expanding placement option being widely used in child welfare systems in the UK, in Europe and elsewhere. The article places kinship care within a UK and European child welfare legal context, including the European Convention on Human Rights 1998 [Articles 8 and 14] and European kinship care developments are also highlighted. It contains the main findings of a kinship care research study conducted by the author, based on interviews with children and young people living with kinship carers, as well as with the kinship carers. Following an examination of theoretical and policy issues, the article examines ways forward for developing and supporting kinship care. In the final section, and based on the research findings and literature review, a new paradigm for child welfare is introduced. It is argued that this new paradigm is necessary in order for kinship care practice and policy to develop within a supported and sustainable family support framework.     

Replication of the KEEP foster and kinship parent training program for youth with externalizing behaviors

This article presents findings from Maryland KEEP, a replication of KEEP (Keeping Foster and Kinship Parents Trained and Supported), a foster and kinship parent training intervention. We examined child behavior change, changes in caregiver parenting style, and permanency and placement stability at baseline and then after the KEEP intervention. The KEEP intervention was provided to 65 foster and kinship parents providing care for children ages 4–12. Children who participated in the study were referred due to behavior problems, as reported by foster parents: they all scored in the clinical range for externalizing behavior on the Child Behavior Checklist (CBCL). Baseline and posttest analyses assessed for child behavior and parenting style changes. Permanency data, including placement moves and exits from child welfare were examined. Overall, foster and kinship parents reported significantly fewer child behavior problems at posttest; severity levels on the CBCL and scores on the Parent Daily Report decreased. However, there were not any changes in parenting styles from baseline to posttest. Placement stability significantly increased between baseline and post-KEEP intervention. The results provide support for the effectiveness of KEEP for a child welfare population with a high level of behavior problems and for the effectiveness of KEEP as a training program for foster and kinship parents.     

Kin and non-kin foster care—findings from a National Survey

This article uses national data to look at the differences between children in kinship and non-kinship care arrangements. Three groups are compared: children in non-kin foster care, children in kinship foster care, and children in “voluntary” kinship care. Children in voluntary kinship care have come to the attention of child welfare services, are placed with kin, but unlike those in kinship foster care, these children are not in state custody. Findings suggest that children in the kin arrangements faced greater hardships than those in non-kin care. They more often lived in poor families and experienced food insecurity. They were more likely to live with a non-married caregiver who was not working and did not have a high school degree. And fewer kin than expected received services to overcome these hardships. In addition, nearly 300,000 children lived in voluntary kinship care arrangements; these children are of particular concern because they are not in state custody and therefore may or may not be monitored by a child welfare agency.     

Effects of kinship care on behavioral problems by child age: A propensity score analysis

When a child must be removed from the family home, placement with a relative is often sought because kinship care is the least restrictive and most family-like out-of-home placement. Although kinship care has become a preferred option in most U.S. child welfare systems, this preference is often based on “soft evidence” rather than rigorous evaluation of the risks and benefits of kinship care. Therefore, an evaluation of the impact of kinship care on child behavioral problems is needed to guide child welfare practice and policy. In addition, given that children of different ages and in different developmental stages are likely to have varying placement experiences, the evaluation of kinship care should explore the effect of kinship care on child behavioral problems across age groups. To fill these knowledge gaps, we compare the behavioral problems of 584 children in kinship care with those of 470 children in non-kinship care. Moreover, we examine the impact of kinship care on behavioral problems in 2 age groups: younger children (0 to 5 years) and older children (6 to 17.5 years). The analysis uses data from Waves 1 and 2 of the National Survey of Child and Adolescent Wellbeing, and applies propensity score methods to account for selection bias. Results show that older children in kinship care had significant lower levels of externalizing, internalizing, and total behavior problems. However, for younger children, the effects of kinship care on child behavioral problems did not reach statistical significance. The implications for practice, research and policy are discussed.     

Trends in infants reported to child welfare with neonatal abstinence syndrome (NAS)

BackgroundSubstance abuse among caregivers is a known risk factor for child maltreatment, and some of these children subsequently come to the attention of the child welfare system. The recent opioid epidemic has led to rising numbers of women who use opioids during pregnancy and infants born with neonatal abstinence syndrome (NAS), raising the question of whether there has been a consequent rise in the numbers of these infants reported to the child welfare system. The purpose of this study is to examine the trend in the number and percentage of infants reported to the child welfare system with neonatal abstinence syndrome (NAS) from 2004 to 2014, and determine whether the trend is distinct from the trend in the percentage of infants reported with fetal alcohol spectrum disorder (FASD).MethodsWe analyzed National Child Abuse & Neglect Data System (NCANDS) data on reports of infants (aged <1 year) with NAS between 2004 and 2014. Due to state differences in data collection and data quality across the study period, the sample included reports from 10 states. We utilized a Generalized Estimating Equations (GEE) model approach to examine the trend over time in the percentage of NAS and FASD cases reported to child welfare in our 10 state sample. Year was used as an identifying variable and Substance Type was repeated over time and clustered by State.ResultsThe number of reports of infants with NAS for the 10 states was the lowest at 3073 in 2009 and highest at 4806 in 2014. The average percentage of cases of NAS reported rose from 4.72% in 2004 to 9.19% in 2014. The results of the GEE revealed a significant main effect of Substance Type (p = 0.015) and Year (p = 0.009), indicating that overall, averaged across time, the percentage of NAS reports was greater than the percentage of FASD reports and averaged across substance type, the percentage of substance-related reports increased over time.DiscussionNAS reports increased significantly over time, most pronounced between 2010 and 2014, while the trend for FASD reports did not show significant change over the study period. Moreover, the child welfare reports data obtained from the 10 state sample aligned with national NAS incidence data. Although recent efforts to curb prescribing and other means of supply have been implemented, it remains to be seen whether the large rise seen will continue or be ameliorated by these public health initiatives. However, overall these findings suggest that immediate efforts are needed to prepare the child welfare system for this trend, as well as to treat opioid addiction among women of child bearing age.     

Psychotropic medications in child welfare: From federal mandate to direct care

Background and objectiveChildren in the welfare system are prone to uncoordinated and unmonitored mental health care, including psychotropic medications. To address these issues, federal legislation mandated that state child welfare agencies improve the coordination and oversight of psychotropic medications. However, there is no clear guidance on how to improve these practices, particularly at the level of direct care. We aimed to identify specific areas for improvement through state-wide surveys of four groups.MethodsWe surveyed all known members of four groups working directly with children in foster care in one small northeastern state. Respondents included 209 foster and adoptive parents, 169 child welfare staff, 84 mental health therapists, and 33 clinical prescribers. Survey items addressed practices and perceptions related to sharing of information and cross-system communication and monitoring of medication effects and side effects.ResultsNearly two in five foster and adoptive parents reported not regularly receiving information about the purpose or side effects of psychotropic medications, and they disagreed among themselves on who was primarily responsible for monitoring safety and effectiveness. One-third of child welfare staff and two-thirds of mental health therapists reported that information about psychotropic medications is not regularly shared with the child's provider team. Half of clinical prescribers reported not regularly communicating with child welfare staff.ConclusionsWe identified specific areas for improvement related to communication, sharing of information, monitoring, and role clarification. Strategies to improving these activities are key to ensuring the safe and effective use of psychotropic medications in this population.     

African American Men,Child Welfare,and Permanency Planning

Summary

Like social services generally, child welfare and permanency planning services have failed to incorporate African American men as significant and serious participants in the service delivery process. Child welfare and permanency planning services have marginalized African American men such that children fail to benefit from the inclusion of these men in the service delivery process. This incomplete and inappropriate approach to permanency planning specifically, and to child welfare services more generally, is a disservice to African American children. Corrective measures are proffered to promote greater inclusion of African American men in child welfare and permanency planning services.