Developmental outcomes after five years for foster children returned home, remaining in care, or adopted

A substantial proportion of children who enter foster care in the US are infants or toddlers and will exit from foster care before they have been in care for long, either returning home or to adoption. These first years of involvement may predict a significant amount about children's longer term development so understanding developmental outcomes after five years is valuable to understanding if child welfare services (CWS) are serving the intention of promoting the well-being of children. A subsample of 353 infants (less than 13 months of age when investigated by CWS) and subsequently placed into foster care were selected from the National Survey of Child and Adolescent Well-Being. After 66 months, these infants had been reunified, adopted, or were still in foster care. Bivariate comparisons were completed. Statistical controls for maltreatment type and severity, demographic traits, and current caregiver education were implemented to help clarify the role of terminal child welfare placement, current caregiver behaviors, and household income, on eight linear regression models of developmental outcomes. Results support the longstanding tenet of child welfare services policy that remaining in foster care is less developmentally advantageous than having a more permanent arrangement of return home or adoption.     

Predictors of foster care exits to permanency: A competing risks analysis of reunification, guardianship, and adoption

Although foster care is intended to be temporary, and policy explicitly requires permanency outcomes, many children experience lengthy stays and exit foster care without a permanent family. This study sought to identify which child and placement characteristics were important predictors of exit to three types of permanency outcomes: reunification, guardianship, and adoption. A sample of 3351 children who entered foster care in 2006 was observed for 30 to 42 months. Permanency outcomes were analyzed using competing risks survival analysis. Children exited foster care to different types of permanency at different rates and frequencies. Reunification occurred most quickly and frequently. Guardianship was second in terms of median duration but third in frequency. Adoption was the second most common exit but had the longest median duration. One in four children remained in foster care or exited without permanency. While patterns varied by type of permanency, three major categories of important predictors were identified: 1) demographic characteristics of age at entry and race, 2) clinical needs related to children's disabilities and mental health problems, and 3) continuity and connections represented by kin placements, sibling placements, early stability, and absence of runaway events. Implications for practice, policy, and research are discussed.     

Concluding commentary: Varied perspectives on child welfare

A fuller understanding of the child welfare system requires its examination from multiple perspectives, as is demonstrated in this special issue. Until recently, the perspectives of mothers involved in child protection and whose children had been placed in foster care had been particularly neglected. This special issue contributes to progress in the research literature in this regard. Questions are raised about the nature of the interactions between the mothers and the child protection system, and the compatibility of those interactions with effective service delivery. This commentary concludes with the suggestions that we seek better ways to structure the child welfare system, and that a social movement composed of parents involved in that system, children in foster care, caseworkers and administrators, and researchers, all united as allies, might be necessary to effect such change.     

Adult well-being of foster care alumni: Comparisons to other child welfare recipients and a non-child welfare sample in a high-risk,urban setting

Research has shown that children placed in foster care fall below population norms on many indicators of well-being. Yet few studies have been designed to distill the effects of foster care from conditions that precede foster care. Based on the available evidence, it is also uncertain whether the purported effects of foster care are lasting. This study used data gathered prospectively from an economically disadvantaged, urban cohort to examine whether foster care is associated with decreased educational and economic attainments as well as increased criminality in adulthood. Individuals who were placed in foster care after an indicated allegation of maltreatment were compared to three naturally occurring groups: (a) maltreatment victims who did not reside in foster care, (b) individuals without an indicated maltreatment allegation who were raised in a household with a Child Protective Services (CPS) record, and (c) individuals without an individual or household record of CPS involvement. Using multiple estimation procedures, we found that all participants with a CPS record fared worse in adulthood than their peers without a CPS record. Despite their poor outcomes, foster children functioned as well as other CPS recipients who did not reside in foster care. Our findings indicate that caution is warranted when attributing dysfunction observed in foster children to the effects of foster care. Implications for prevention and intervention within the context of child welfare are discussed.     

Health outcomes for adults in family foster care as children: An analysis by ethnicity

Studies have linked the experience of child abuse or adversity to health problems in adulthood, and researchers have long documented health problems affecting children in foster care. Yet, the adult health outcomes of maltreated children placed in foster care have not been sufficiently isolated. Although information on transitioning youth and young adults is now beginning to emerge, the impact of ethnicity on adult health outcomes has been largely ignored. Given the overrepresentation of ethnic minority children in foster care and the national disparities in the health of ethnic minorities, this study examined the relationship between ethnicity and physical health outcomes for African American, Hispanic, and White adults who experienced family foster care as children. Logistic regression models indicated that ethnicity was not a significant predictor of physical health (p > .05). However, gender and age were associated significantly with their physical health outcomes.     

Family Foster Care,Kinship Networks,and Residential Care of Abandoned Infants in Egypt

While infant abandonment has occurred in all segments of society, on all continents, and across all generations, the motivations for this practice are varied and depend upon the social norms of a specific geographic region at a given point in time. Western approaches addressing the care of abandoned infants focus on terminating parental rights and placing the child in an adoptive home. The child assumes the family name and is privy to all rights and responsibilities as biological children. In Egypt, Islamic family law does not allow for adoption of an infant by a nonbiological individual. Nor does the country of Egypt allow assignment of guardianship or fostering of a child by a non-Egyptian parent. Therefore, models of care cannot simply be transferred from one context to the other, although they may learn from each other. Egypt's system of family foster care, kinship networks, and residential (institutional) care are models that are consistent with the cultural values and customs of this population. The family foster care model and kinship networks have been shown to provide the most positive psychosocial outcomes for the child. The purpose of this article is to compare and contrast culturally acceptable approaches to caring for abandoned infants in Egypt.     

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.     

The invisibility of adolescent sexual development in foster care: Seriously addressing sexually transmitted infections and access to services

Adolescents residing in foster care are at higher risk for acquiring sexually transmitted infections (STIs) and human immune deficiency virus (HIV) compared to their non-foster care peers. A literature review was conducted to determine whether youth residing in foster care face different barriers to sexual health care compared to their peers in the general population and, if so, what those barriers are. The review revealed barriers common to adolescents in general as well as additional barriers specific to the ecosystem of adolescents in foster care. Systemic issues that decreased access to sexual health services included child welfare policies that were either missing or implemented without fidelity; complicated financial factors; barriers to service utilization; lack of collaboration between child welfare and medical professionals; and limited information provided to foster youth on their sexual health and development. Consent and confidentiality issues that foster youth face in seeking sensitive health services also need to be resolved. More research is needed on how to facilitate development of coherent policies and effective practices that promote sexual health care access for adolescents in foster care.     

It's good to know that you got somebody that's not going anywhere: Attitudes and beliefs of older youth in foster care about child welfare-based natural mentoring

This exploratory study is the first to investigate the attitudes and beliefs of older adolescents in foster care toward the implementation of a child welfare-based natural mentoring intervention designed to promote enduring, growth-fostering relationships between youth at risk of emancipation and caring, supportive nonparental adults from within the youth's existing social network. Six focus groups were conducted with 17 older youth in foster care attending a specialized charter high school for young people in out-of-home care in a large, urban city in the Northeast United States. Focus group data were transcribed and analyzed using a conventional content analysis approach. The following significant themes emerged related to natural mentoring for older foster youth emancipating from care: (1) need for permanent relationships with caring adults, (2) youth conceptions of natural mentoring, (3) unique challenges related to natural mentoring for youth in foster care, (4) role of a natural mentoring intervention in child welfare, and (5) challenges for implementing a child welfare-based natural mentoring intervention. Overall, our findings suggest that these young people are cautiously optimistic about the potential of a child welfare-based natural mentoring intervention to promote their social and emotional wellbeing. Future studies are needed to better understand the experiences of older foster youth with an actual natural mentoring intervention, including challenges, opportunities, and outcomes.     

Abused children and foster care—the need for specialist resources

Estimates vary on how many abused and neglected children are admitted to care and how many children in care are there because of abuse and neglect. Nevertheless, it is important to examine their special needs and the problems they present to carers. Although research findings are difficult to interpret, there is enough evidence to show that abused and neglected children in care have special needs in three particular areas: education, health and social behaviour. The evidence is available from research into children in care and research into child maltreatment. Children in care run the risk of disrupted educational careers; abused and neglected children have additional problems in school. Many children in care have a patchy and neglected medical history; abused and neglected children are seriously at risk of further ill-health. Abused and neglected children have been shown to have behaviour problems that jeopardize their relationships with peers and adults; they run the risk of placement breakdown. Foster care of abused and neglected children is a specialist and demanding task, requiring knowledge of, and sensitivity to special needs. Because many abused and neglected children return to their parents, foster carers also need to include the natural family in their task. High expectations of these foster carers, however, should not lead to exploitation but rather an enhancing of fostering assessment, preparation, support and training.     

Child Protection Workers’ Perceptions of Foster Carers and the Foster Care System: A Study in Queensland

Abstract

Child protection workers are key players in the statutory system for the protection of children and young people. For this reason, their perceptions of the operation of the system are important. This study, conducted in Queensland, Australia, explored the views of child protection workers regarding foster carers and the foster care system. The present study revealed the difficulties the child protection workers encountered in engaging with foster carers. These difficulties were due to the structure of the child protection system and the conflicts experienced by workers in balancing the needs of children and young people, their primary clients and the carers of those children and young people. Several recommendations for policy and practice are made.     

Critical factors of intensive family work connected with positive outcomes for child welfare clients

Mechanisms producing positive change in troubled families were analysed. The study aimed to answer the questions: What kind of case and client outcomes does intensive family work (IFW) produce for child welfare clients? From the perspective of family workers, what kind of critical factors for positive child, parent and family outcomes can be identified? The study used child welfare case files of 35 families with 93 children from one social office and interviews with 20 family workers and IFW managers in 5 municipalities in Finland. The shades of worries scale was used in evaluating the change in each family's situation. The case outcome measures for children included changes in the child's status in open care, short-term placement or foster care. During IFW, positive changes took place in 23 families out of 35 (66%). Twenty-seven children from 16 families did not continue as child welfare clients. Eleven children were placed into foster care during IFW and two years after it. The critical processes for outcomes included time, trust building and engagement, practical help, facilitating communication and guaranteeing the best interest of the child. IFW was considered effective for positive outcomes for the majority of families with complex needs.     

Administrative case reviews: Improving outcomes for children in out-of-home care

For nearly three decades foster care review has been required and practiced in the United States. It is well established that foster care review was designed with the intent to reduce the time children spend in foster care and increase permanent placements for children. This article presents that foster care review, as practiced in Colorado, is a social work intervention and quantitative results of this study demonstrate that as an intervention, timely administrative case review is an effective social work intervention related to improving child welfare outcomes for the children and families served in Colorado. The major findings show that timely administrative case review and increased levels of review attendance (mother, father, Guardian ad litem's, and foster parents) are predictors of the child welfare outcomes of permanency and length of time in out-of-home care. Bivariate results indicate a median length of stay approximately 10.76 months longer for children who do not consistently receive timely case reviews. Additionally, the results show that timely care review moderates the underlying casework process related to caseworker contacts, demonstrating that a child's length of stay differs depending on the level of timely case review. In essence, the administrative case review process in Colorado is effectively achieving its goal and is an effective intervention for improving the lives of children in foster care.     

Lights,camera, action: The images of foster care in the movies

Movies often reflect public perceptions. The portrayal of foster care in movies provides insight regarding beliefs and attitudes children, parents, and others bring with them as they interact with the foster care system. The study focus was to identify images of foster care portrayed in 37 nondocumentary movies produced in the United States and Canada between 1921 and 2012. Using Framing Theory, an iterative review process was used to derive three dominant images presented to audiences: child entrance into foster care, a broken foster care system, and life in foster care. Movie images generally misrepresented the realities of foster care in the United States, highlighting the importance of those involved in child custody and providing a more realistic image of foster care.     

Prevalence,experiences, and characteristics of children and youth who enter foster care through voluntary placement agreements

A voluntary foster care placement (sometimes referred to as a voluntary placement agreement) is an agreement, entered into without court involvement, between a state or county child welfare agency and a child's parents to place a child into out-of-home placement. When a child enters foster care through this type of placement, state and federal programs that cover children who enter child welfare due to a court order become the custodians of the voluntarily-placed-child's placement, care, and supervision. In this cross-sectional, exploratory study, data from the Adoption and Foster Care Reporting System (AFCARS) was used to examine the characteristics and experiences of children who enter foster care through a voluntary foster care agreement, and to compare them with those of children who enter foster care through a court order. Findings indicate that children who are placed through a voluntary placement agreement differ from children who enter through a court order in their personal characteristics, as well as in their placement settings, length of placement, and manner of discharge from foster care. This study provides a baseline for future research into this area of child welfare practice.     

The relationship of placement experience to school absenteeism and changing schools in young,school-aged children in foster care

Background

Chronic school absenteeism and frequent school changes, particularly among younger children, may be antecedents for the high rates of school failure and subsequent dropout among youth in foster care. However, the relationship of foster care experience to absenteeism and school change has not been well studied.

Objective

This study examined the association of placement experience with absenteeism and changing schools among 209 urban children in foster care enrolled in public elementary schools.

Methods

A cohort of children aged 5 to 8 years who entered non-relative or kinship foster care from 2006–2008 were followed longitudinally for 2 years from entry into foster care. Children residing in foster care were categorized at the end of the study as early stable, late stable, or unstable, if they achieved a permanent placement prior to 45 days, between 45 days and 9 months, or failed to do so within 9 months, respectively. Children who reunified home were classified as a fourth category. Poisson regression, controlling for baseline factors, was used to compare days absent and number of schools attended across categories of placement experience.

Results

Among the 209 children, 51% were male, 79% were African American, and 55% were initially placed with kin. One third of children reunified home; among children who did not reunify, one half was early stable, and a third was unstable. Adjusted rates of school absenteeism increased in stepwise fashion as children's placements became more unstable; children with unstable placements were 37% more likely to be absent than those with early placement stability (p = 0.029). Children who reunified during the study demonstrated the highest rates of absenteeism; however, there was no significant difference in absenteeism before or after reunification. Number of schools attended increased as stability worsened, with the standardized rate of schools attended reaching 3.6 schools (95% CI 3.1–4.1) over a two year period among children in unstable placements.

Conclusions

The relationship between placement experience and school absenteeism and school change illustrates the need to better coordinate the educational experience of high-risk children in foster care. The secondary finding of high absenteeism among children in the process of returning home illustrates that educational challenges for youth may be equally if not more concerning among the greater majority of youth in child welfare who remain home with birth parents.     

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 Impact of Historical Trauma and Mistrust on the Recruitment of Resource Families of Color

ABSTRACT

The Multiethnic Placement Act of 1994 and the Interethnic Adoption Provisions of 1996 (MEPA-IEP) require states to diligently recruit “potential foster and adoptive families that reflect the ethnic and racial diversity of children in the state for whom foster and adoptive homes are needed” (42 U.S.C. §622b(3)(9)). Nationally, 53% of the children in foster care and 55% of the children waiting to be adopted are children of color (Adoption and Foster Care Analysis and Reporting System, 2014). Recruitment of resource families of color has historically presented challenges. This article critically examines the diligent recruitment efforts of an urban county targeting Black/African American, Latino, and Native American communities through a critical race theory lens. Although there was an overall increase in resource families, the racial and ethnic representation of resource families to children in care within the county improved for Latinos yet declined for Black/African Americans and Native Americans. Theoretically, these results indicate that the historical mistrust of communities of color toward the child welfare system is a barrier to successful recruitment of resource families from these communities.     

Making visits better: the perspectives of parents,foster parents,and child welfare workers

Mothers of children recently placed in foster care, foster mothers, and child welfare workers participated in semistructured, clinical interviews focusing on the challenges of parent visitation with young children. Mothers described their feelings of grief, trauma, and rage about the forced separation from their children and stressed the importance of emotional expression and communication during visits. Child welfare workers described the complexities of supporting emotionally close parent-child interactions while monitoring and assessing parental behavior during visits. Foster mothers described the importance of preparing children for visits and the difficulties of supporting the children afterward. Implications of understanding mothers', foster mothers', and child welfare workers' perspectives on enhancing the quality of visits with young children are discussed.     

Child development in foster family care – what really counts?

Previous research has demonstrated that children who grow up in foster family care – along with other child welfare recipients – manage less well in adulthood compared to those children who do not. Given this challenge, this integrative literature review locates the critical factors that either positively or negatively affect a child’s development in foster family care. The articles were analysed using theory-driven content classification in relation to Bronfenbrenner’s bioecological framework on child development. The results of the review suggest that there is a wide range of factors that could impact on a child’s development in foster family care. Child­related factors such as the child’s age, gender, behavioural or mental health problems, etc. were mentioned most often in the data. Micro­environmental factors are also essential to a child’s development. Linkages taking place between two or more of the child’s circumstances, such as the relationship between the child’s birth and foster families and between the foster family and the social worker, were also identified as being influential. Service usage and political and legislative factors, as well as attitudes towards children in care, were also indicated to be strongly influential. It is suggested that the factors identified in this review should be carefully considered as important aspects of care for fostered children and care documentation.