Disentangling over-representation of parents with disabilities in the child welfare system: Exploring child maltreatment risk factors of parents with disabilities

The study explores the risk factors for child maltreatment and self-reported child maltreatment among a population-based sample of parents with disabilities. Drawing on a nationally-representative, population-based data file that oversampled people of color, income-adjusted odds ratio tests were conducted to establish population differences among parents with and without limitations in activities of daily living (ADLs). Results suggest that parents with disabilities were more likely to report many of the risk factors associated with child maltreatment than parents without disabilities, including witnessing interpersonal violence as a child; experiencing violence, neglect or a foster care stay as a child; mood or substance use disorders; and engaging in or receiving interpersonal violence as an adult. Before controlling for income, parents with disabilities had only a negligibly higher rate of engaging in violence against their children. After controlling for income, parents with disabilities were 2.5 times more likely to engage in violence against their children. Parents with disabilities who did engage in violence against their children had greater amounts of some of the child maltreatment risk factors in comparison to parents with disabilities who did not engage in violence, particularly their own childhood experiences of maltreatment, witnessing of interpersonal violence as a child, childhood stays in foster care, and experiences with interpersonal violence as an adult. Findings add to the understanding of the risk factors for child maltreatment that are related to the collateral effects of having a disability, and through the use of income-adjusted data, help disentangle why parents with disabilities are over-represented in the child welfare system. The findings highlight the need for the child welfare system to increase its disability competence in working with both children and parents with disabilities.     

Crisis nursery effects on child placement after foster care

The results of a study of the relationship between receiving crisis nursery services and the placement outcomes for young children leaving the child welfare system in Illinois are reported in this paper. The placement outcomes for children leaving foster care whose families received crisis nursery support prior to the children's placement in foster care is compared to the placement outcomes for children whose families received only foster care services. The children in two samples were identified by matching crisis nursery children's data from FY 2006 with children's data in the Illinois Child Abuse and Neglect Tracking System and Children Youth and Services Information System databases. After children served by crisis nursery and foster care services were identified, a comparison group of children with like-characteristics whose families received only foster care services was identified using propensity score matching. The children were followed until their out-of-home placement was terminated or until June 30, 2009. The placement outcomes and the length of stay were compared for the two groups. Using logistical regression analysis the results showed that children whose families received crisis nursery services prior to foster care placement were twice as likely to be reunited with their biological families (birth or extended family members) when compared to children whose families received only foster care services. The difference in the length-of-stay in foster care was not statistically significant when the two groups were compared. This preliminary study using administrative data shows that receiving crisis nursery services may have positive effects on the children's ultimate placement outcome after foster care. Additional research is needed to further explore the relationship between placement outcome and crisis nursery services.     

Reunification outcomes among Mexican immigrant families in the child welfare system

This study examined reunification outcomes among Mexican immigrant families involved in the child welfare system, and compared characteristics of Mexican-origin and non-immigrant children involved in the child welfare system. An exploratory retrospective longitudinal design using administrative data from two counties in Northern California was utilized. The quantitative sample (N = 2152) included children entering the foster care system for 8 or more days between January 1, 2001 and December 31, 2007 in the two participating counties. Child welfare administrative data (CWS/CMS) were merged with eligibility data (CalWIN) in order to obtain parent and child place of birth and citizenship status. Quantitative measures drawn from the merged CWS/CMS and CalWIN dataset included the following: demographic characteristics, immigrant characteristics, case characteristics and reunification outcomes. Results indicated that a significantly higher proportion of Mexican immigrant families (70.7%) were reunified than non-immigrant families (43.1%). Significant correlates of reunification among Mexican immigrant families included the following: mothers with authorized citizenship status (vs. unauthorized citizenship status), mothers whose primary language was Spanish (vs. English), and children with two or fewer placements (vs. three or more placements). Differences between Mexican-origin and non-immigrant children were that Mexican-origin children were older on average than non-immigrant children, and they were more likely to experience physical abuse, sexual abuse or emotional abuse; they were also more likely to be placed in foster care or a group home (vs. relative care). Implications for social work practice and policy are discussed.     

Improving access to health care for foster children: the Illinois model

Children in foster care have lower health status than do their peers and limited access to health care. The Illinois Department of Children and Family Services developed HealthWorks, a separate primary care preferred provider system for children in foster care. This study compared claims data for children in HealthWorks with children not enrolled in HealthWorks and with children in Aid to Families with Dependent Children (AFDC) who had never entered foster care. Children enrolled in HealthWorks were more likely than were other children to receive all of the services except general inpatient hospitalizations. They had greater odds of receiving general exams and physicians' services and were more likely to visit the emergency room than children who were not enrolled. They were more likely to receive all of the measured services when compared with children receiving Medicaid through AFDC.     

Use of court-appointed advocates to assist in permanency planning for minority children

Despite federal law on reuniting children in care with their families, minority children remain in dependency longer and are more likely to be placed in long-term foster care than white children. This article describes a program of volunteer, court-appointed advocates to assist in cases of abuse and neglect involving minority families, and an outcome study. Significantly fewer children were placed in long-term foster care and significantly more children were placed in adoptive families than in a comparison group of families.     

Prevalence of children with disabilities in the child welfare system and out of home placement: An examination of administrative records

This article explores the prevalence and characteristics of children with disabilities within the child welfare system using administrative data from the State of Minnesota. This study finds that more than a fifth (22%) of children with substantiated maltreatment are labeled in administrative records as having a disability, and more than one quarter of children (27.9%) over age five. The most common type of disability among children with substantiated maltreatment was emotional disturbance, while other common disabilities included intellectual and developmental disabilities and learning disabilities. Using logistic regression, this study finds that children with substantiated maltreatment with disabilities were about two times more likely to be in out of home placement than children with substantiated maltreatment without disabilities.     

Early care and education arrangements and young children's risk of foster placement: Findings from a National Child Welfare Sample

A primary goal of the U.S. child welfare system (CWS) is to maintain children investigated for maltreatment in their parents' homes whenever safely possible. This study explores the possibility that early care and education (ECE) services (e.g., child care, preschool, day care) can help the CWS achieve this goal by using a nationally representative sample of children referred to CWS for suspected maltreatment to measure the relationship between ECE receipt and the likelihood that 0–5 year olds in the CWS will be placed in foster care approximately 18 months later. Specifically, logistic regression analyses explore the relationship between: (1) regular ECE participation (yes/no), and (2) type of ECE arrangement (Head Start, other center- or home-based ECE, family/friend/relative ECE, other ECE, and multiple types of ECE) and foster placement risk. After controlling for multiple socio-demographic characteristics and foster placement risk factors, children who received ECE (yes/no) were no less likely to be placed in foster care than children who received no ECE. However, when exploring type of ECE arrangement, children who received Head Start were 93% less likely to be placed in foster care than children with no ECE. Children who participated in multiple types of ECE were almost seven times more likely to be placed in foster care than children with no ECE. These results suggest that Head Start may help maltreated children avoid foster placement and that experiencing multiple types of ECE is a risk factor for foster placement. It is recommended that caseworkers routinely assess the ECE service history and needs of families with young children who come in contact with the CWS, paying attention to the type and number of ECE services used.     

The gift of kinship foster care

This study examines kinship foster care as a gift relationship. Reunification rates and replacement rates into non-related foster care are analyzed within the statistical framework of competing risks to examine the effects of reciprocity, payment, empathy, and duty on the dynamics of kinship foster care. The study makes use of a unique set of survey data on 983 kinship foster children in Cook County, Illinois. Survey responses are linked to computerized administrative records from the Illinois Department of Children and Family Services to create a 5-year longitudinal file on placement changes from June 30, 1994 to June 30, 1999. Children whose parents were reported as regularly visiting and working toward regaining custody (reciprocity) were more likely to be reunified and less likely to be replaced than children whose parents were reported as non-cooperative with visitation and service plans. Controlling for reciprocity, children were also less likely to be replaced if caregivers retained the full foster care subsidy (payment), reported a good relationship with the child (empathy), and grew-up in the American South and attended church regularly (duty). The sensitivity of these findings to alternative specifications of the competing risks of foster care replacement and kinship transfers is reported.     

Comparison of role perceptions of white and African American foster parents

The number of U.S. children entering foster care is increasing faster than the number of available foster parents. Of particular concern are the growing number of African American children in foster care and the lack of African American foster parents to care for them. This study compares role perceptions of African American and white foster parents and provides information on recruiting African American foster parents. These foster parents are more likely than their white counterparts to feel responsible for facilitating the relationship between foster children and birthparents. They are more likely to accept responsibility for the roles of agency partner and emotional developer of the child. Implications include the need for agencies to develop recruitment models that are sensitive to the qualities African American families can bring to the foster parent role.     

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.     

Open Adoption and Post-Adoption Birth Family Contact: A Comparison of Non-Relative Foster and Private Adoptions

This study used data from the National Survey of Adoptive Parents (NSAP) to compare post-adoption contact in families with non-relative private domestic and foster care adoptions. This study is the first to use a nationally representative sample to examine and compare the extent of post-adoption contact in both private and foster adoptions. The results suggest that children adopted from foster care were less likely to experience post-adoption contact with their birth families than children adopted privately despite the fact that they were more likely to have lived with their birth families.     

Directions for developmental screening in child welfare based on the ages and stages questionnaires

Many young children investigated for maltreatment have developmental problems qualifying them for early intervention services, yet only a portion of these children receive such services. To address this gap, all children ages 0-3 with child welfare (CW) substantiated maltreatment in Pennsylvania are screened for developmental and socioemotional problems using the Ages and Stages Questionnaires (ASQ). This study views screening results for over 500 children to address whether children's substantiation status, living situation, and administering worker as CW or early intervention (EI) predicts screening rates. Bivariate and logistic regression analyses were used. Results showed that 22% of children scored in the problem-range of at least one developmental area and 18% scored in the problem-range of social-emotional concerns warranting EI referral. Results of bivariate analyses showed that children who spent time in the NICU were more likely to have developmental concerns. Socioemotional concerns were related to child race, foster care living situation, child as the subject of the referral, and physical neglect. Older children and children whose referral involved lacking basic needs showed both developmental and socioemotional concerns. There were no significant differences in screening results of children with substantiated versus unsubstantiated maltreatment. Children whose screening was conducted by EI were more than three times as likely to show developmental concerns compared with those screened by CW. Child welfare workers need more support when conducting developmental screening, and policies that limit screening to children with substantiated maltreatment or to children in out-of-home care should be reconsidered.     

Competencies and problem behaviors of children in family foster care: variations by kinship placement status and race

Formal kinship foster care is an increasingly common form of out-of-home placement, and several important distinctions between kinship care and non-relative foster care have been identified. The present study evaluated the behavior of kinship foster children in comparison to non-relative foster children and children in the general population. A geographically and ethnically diverse sample of foster children (N=240) was assessed for competence and problem behaviors using the Child Behavior Checklist (CBCL: Achenbach, 1991). Kinship foster children closely resembled children in the general population but differed significantly from their counterparts in non-relative foster care, who consistently scored lower on competence and higher on problem behaviors. Substantial proportions of non-relative foster children were in the clinical range on most CBCL measures, but kinship foster children were no more likely than children from the general population to score above clinical cut-offs. Differences between kinship and non-kinship foster children became less dramatic after accounting for child race and gender, which were both associated with kinship status. Child race had a strong main effect for almost all types of problem behaviors, with children of color showing significantly less problematic behavior. Discussion of these results centers on potential explanations for the observed variations in child behavior by kinship status and race.     

A qualitative analysis of child protective services practice with children with developmental disabilities

The purpose of this study was to examine Child Protection System (CPS) practice with children with developmental disabilities. This study used an emergent design, ethnographic interviews, purposive sampling, inductive data analysis, and grounded theory building. Ethnographic interviews were conducted with foster families, administrators, intake screeners, special investigators, and workers in one local CPS office. Participants expressed concern about the ability to identify disabilities, placement options, services to meet complex needs of children with disabilities, training and support for families, collaborative arrangements with other agencies, and disability training for CPS workers. Findings suggest strategies for improving CPS practice for children with developmental disabilities.     

In their own words: Overcoming barriers during the transition to adulthood for youth with disabilities who experienced foster care

The transition to adulthood can be especially challenging for youth who experience the foster care system. These challenges are magnified for youth with disabilities, who account for at least 40–47% of all children in foster care (Powers et al., 2012). In order to move from a deficit-based to a strength-based approach, this qualitative study focused on understanding the lived experience of transitioning to adulthood for alumni of foster care with disabilities. Semi-structured interviews were conducted with seven young adults who had exited care over a six-month time period. Participants described their journeys from foster care to independence and articulated a vision for a successful adulthood. Key themes that emerged included a desire for stability and personal fulfillment in adult life. Participants also identified common barriers encountered including unmet mental health needs and lack of disability awareness or the implications of mental health diagnosis. Personal strengths that helped overcome those barriers included resilience, advocacy, and self-determination.     

Patterns and Predictors of Early Care and Education for Children in Foster Care

Patterns and predictors of center-based early care and education (ECE) of children in foster care were examined. Participants included 192 pre-Kindergarten age children in foster care. Foster parents reported demographics, ECE and other service use. Foster care history data was abstracted from case files. High rates of attendance in ECE prior to Kindergarten, including Head Start, other center-based ECE, or both were found. Children who attended Head Start were younger when first placed in foster care. Children who attended other center-based ECE services were more likely to live with kinship foster parents and foster families with higher incomes. Latent class analysis of ECE quantity, quality, type, and duration revealed three patterns: part-time Head Start, part-time other ECE, and full-time mixed ECE. Child and foster family characteristics predicted these patterns, illustrating distinct groups with potential implications for the development of children in foster care.     

The effects of adoption openness and type on the mental health,delinquency, and family relationships of adopted youth

ABSTRACT

Analyzing the 2007 National Survey of Adoptive Parents, this study examines the impact of open adoption, demographics, and other factors on adopted children’s mental health, delinquent behavior, and family relationships. Specifically, we compare findings for youth in private and public (i.e., foster care) adoptions and identify key similarities and differences between predictors of children’s well-being across these two types of adoption. We find that youth in open foster care adoptions are more likely to receive an attachment disorder diagnosis than those in closed foster care adoptions but are also more likely to have family relationships characterized by trust and adoptive parents’ willingness to recommend adoption to others. Further, we find children in both public and private adoptions who are older at placement are more likely to have posttraumatic stress disorder diagnoses. For children in private adoptions, no statistically significant predictors affected youths’ delinquency outcomes or family relationships, with the exception of parents of private adoptees in households characterized by lower levels of poverty indicating they would be more likely to recommend adoption to others. The implications of the key findings are discussed with regard to service provision for multiple types of adoptive families.     

Behavioral health service use and costs among children in foster care

This article compares behavioral health service use and cost for foster care versus nonfoster care children; children before, during, and after foster care placement; and successfully reunified versus nonsuccessfully reunified foster care children. Behavioral health service costs for children in foster care were higher than for children not in foster care. Children in foster care used more services during their foster care placement than before placement and after discharge. Nonsuccessfully reunified children received a significantly larger quantity of services than those successfully reunified.     

Receipt of independent living services among older youth in foster care: An analysis of national data from the U.S.

Fifteen years has passed since the Chafee Foster Care Independence Program was created under the Social Security Act, which marked an increased role of the U.S. federal government in supporting foster care youth to independence. It was not until the National Youth in Transition Database (NYTD) was launched in 2010 that all 50 states reported standard data on receipt of the 13 types of Chafee independent living services. This paper, which draws on the first two years of NYTD data, analyzes Chafee service receipt across the U.S. among youth in foster care (ages 16–21). About half of the 131,204 youth included in this analysis received at least one type of Chafee service, and considerable variation existed in the proportion of youth that received each of the 13 specific types of services. Females were more likely than males to receive all but one type of service, and African Americans were less likely to receive most of the services. An interaction effect indicated that Black youth were significantly less likely to receive services in large urban areas than other racial/ethnic groups. Young people with disabilities or medical/psychological conditions were generally more likely to receive services than youth without disabilities. Youth in large urban regions receive fewer services than youth residing in other areas, and substantial variation exists between states in proportions of service recipients. Recommendations are made for targeting services, future data collection, and research, including suggestions on ways to improve measurement of Chafee services.     

The child welfare response to serious nonaccidental head trauma

Serious nonaccidental head trauma (NHT) can leave permanent neurological damage in children who survive abuse. This study reports on child welfare's handling of NHT cases compared with cases of physical abuse and head trauma due to neglect with regard to placement in foster care, reunification with family, and safety issues. The results show that workers placed children with NHT in foster care immediately after the abuse but treated them no differently than other physically abused children regarding reunification.