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.     

Cost analysis of the strengthening families program in reducing time to family reunification among substance-affected families

Decision makers typically face uncertainty in determining whether the outcomes of promising child welfare interventions justify the investment. Despite repeated calls for cost analysis in child welfare, original studies that evaluate the costs and effects of child welfare programs have been limited. Moreover, no cost analyses have focused on family reunification programs that address the needs of substance-affected families. The purpose of this study was to evaluate the costs and effects of a federally funded implementation of the Strengthening Families Program (SFP), a 14-week family training curriculum, on time to reunification with a substance-involved child welfare population. Based on event history analysis, we find the typical child participating in SFP spends 190 fewer days in out of home care when compared to a propensity score matched comparison group of children in out-of home care receiving treatment as usual. Re-entry rates between the two groups were not significantly different at follow-up. At an average out-of-home care rate of $86 per child per day in this state, SFP saves approximately $16,340 per participating child in out-of-home care costs. From a cost–benefit perspective, every $1 invested in SFP yields an average savings of $9.83 in this Midwestern demonstration.     

Planning to Plan: A Process to Involve Child Welfare Agencies in Disaster Preparedness Planning

In the aftermath of Hurricane Katrina when child welfare officials in Louisiana reported they did not know the whereabouts of all their children in foster care, disaster planning in public child welfare became a new area of concern. This article reports on a process of engaging seven public child welfare agencies in planning for disasters that could affect child safety and service delivery. The Washington Metropolitan Area Disaster Planning Project used a strengths-based approach to help agencies responsible for protecting and serving children in foster care and families at risk of abuse and neglect develop plans to augment and continue service delivery and responsiveness in the aftermath of a natural or man-made disaster. The processes of gathering information on disaster responsiveness, interviewing community and professional informants, developing a template to guide disaster planning within the agencies, and implementing a tabletop exercise are described. As a result of this consultation effort agencies became aware that disaster planning at the state and county levels had proceeded without child welfare at the table, that the increase in need for child welfare services during a disaster was not recognized by disaster professionals, and that practicing disaster responsiveness is necessary to assure readiness.     

Improving Relationships in Child Welfare Practice: Perspectives of Foster Care Providers

Foster parents care for our nation’s most vulnerable children and adolescents. Their ability to provide care is impacted directly and indirectly by their interactions with public child welfare agencies and workers. This study examines the perspectives of 1095 foster parents in a southwestern state in the U.S. regarding what they believe child welfare workers are doing well and their suggestions for ways to improve relationships between foster care providers and child welfare workers. Foster parents commended caseworkers who were responsive to their needs and provided ongoing concrete and emotional support, and believed there was a need for improved communication and enhanced teamwork. Foster parents consistently acknowledged an overwhelmed child welfare system and the impact on child welfare workers and child welfare-involved families. Understanding the perspectives of foster parents can improve relationships between child welfare workers and foster parents, improve recruitment and retention efforts of foster parents, prevent disruption of children from foster homes due to license closure, and improve the overall well-being of child welfare-involved children and families.     

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.     

WELFARE LEAVERS AND RETURNERS

This study investigates a random sample of people who left welfare and a similar sample who returned to welfare in a mid-Atlantic state in 2002. Findings show that child-care difficulties are important barriers to employment and that they are bound together with other conditions of poverty such as adverse neighborhood conditions and other deprivations. Child care provision becomes difficult when neighborhoods are infested with drugs or guns or when caregivers must spend too much time finding the means to pay bills or rent and put food on the table. For the poorest groups, all these conditions negatively impact quality of life. The study's findings suggest social policy revisions that emphasize programs to improve the children's neighborhood environment and means of socialization, supplement caregivers’ income to levels sufficient to pay for child care, and remove inadequacies or inconsistencies in government child care provision.     

Do children in foster care receive appropriate treatment for asthma?

Asthma is the most common childhood chronic disease, and children in foster care have the highest rates of chronic conditions of any studied child population. The purpose of this study is to determine whether there are disparities in asthma management and health care utilization between children in foster care and other children covered by Medicaid in the state of Illinois. We use performance measures developed by the state child welfare system as well as those developed by the National Committee on Quality Assurance and used throughout the country. The study sample was drawn from linked administrative data on children in foster care and paid Medicaid claims. In order to determine the influence of living arrangement setting within the child welfare system, children in foster care were further grouped according to whether they lived in a stable home setting, a stable congregate care setting, or other living arrangement. We found that children living in home settings performed better on most performance measures than income-eligible Medicaid children. In contrast, children with asthma living in congregate care were particularly vulnerable as reflected in poor asthma care measurements and high utilization of hospitalizations despite positive performance on indicators of medication use. This population presents a significant challenge to the child welfare and health care delivery systems.     

From Foster Care to Adoption and Guardianship: A Twenty-First Century Challenge

For nearly four decades, child welfare policy and practice have focused on the achievement of legal permanence for children in foster care. Although federal child welfare policy has resulted in the movement of children from state custody to legally permanent adoptive or guardianship families, little is known about the quality and enduring nature of these placements. A significant challenge of the twenty-first century child welfare system is how to ensure the well-being of children currently living with adoptive parents or guardians. This paper discusses child welfare policy and trends related to post-permanency well-being, including the decrease in Title IV-E foster care caseloads nationwide and the simultaneous increase in Title IV-E adoptive and guardianship caseloads. We highlight the needs of a twenty-first century child welfare system, including increased federal efforts to ensure child permanence and well-being after legal adoption or guardianship has been achieved, as well as more rigorous longitudinal and interdisciplinary research focused on the post-permanency adjustment of children and their families.     

Early childhood interventionists' perspectives on serving maltreated infants and toddlers

A 2003 amendment to the Child Abuse Prevention and Treatment Act (CAPTA) required states to create developmental screening programs for maltreated infants and toddlers. Programs authorized under Part C of the Individuals with Disabilities Education Act (IDEA) were directed to work with state and local child welfare authorities to develop the screening program. They were also to ensure that additional assessment and intervention was provided when needed. The degree to which this mandate has been implemented varies widely between state and local programs. Some early intervention experts and Part C program administrators have expressed concerns about providers' willingness to serve families referred from child welfare, but there has been no systematic research on this issue. The Professional Interventionist CAPTA Survey (PICS) is a newly developed measure of early childhood intervention providers' perceptions of their responsibilities under CAPTA. The first aim of this study was to conduct analysis of the PICS using a national sample of providers. This study also reports the perceptions of early childhood interventionists about their responsibilities under CAPTA and examines the relationship between worker characteristics and how they perceive these responsibilities. The PICS appears to be useful for examining early childhood intervention providers' responses to CAPTA.     

Transition without status: the experience of youth leaving care without Canadian citizenship

The origins of the project reviewed in this chapter lie in discussions with a Toronto agency that has a mandate to serve youth in transition from the care of the Children's Aid Society. This service system, also known in various jurisdictions as child welfare, child protection, or foster care, includes among its clients children and youth who are living in Canada without legal Canadian status. This could have occurred because the child arrived alone and was taken into care on arrival or because the child arrived with a family but was taken into care before status was obtained. While the child is in care, this lack of status is relatively inconsequential in that health, educational, and other services are provided through the Children's Aid Societies. Once the transition is made from care, the youth's vulnerability increases dramatically if legal status has not been obtained. Health services, educational opportunities, and legal employment are often beyond reach, and the youth is subject to deportation. The major objectives of the project were to explore the national and international literature to discover the dimensions of this issue, interview youth and service providers to gain insight into their experience, and discover ways to minimize the number of youth who leave care without having obtained status.     

Considering the best interests of infants in foster care placed separately from their siblings

This article offers a perspective on the child welfare practice of placing infants and their siblings in foster care using the theoretical frameworks of attachment and infant mental health. The authors highlight issues for child welfare workers to consider when determining if moving an infant or young child from one home to another for the purpose of placing him with his siblings would cause trauma or disruption; and also issues to consider when determining the infant or young child's best interest when separated from siblings. First, the authors summarize the literature regarding attachment relationships and attachment disruptions. Then, they review outcome studies of children residing in foster care who are placed with their siblings and of those who are placed separately. Finally, the authors conclude with specific recommendations for child welfare workers to aid in making such difficult decisions about placing infants in foster care.     

Preparing young people in Canada for emancipation from child welfare care

Reviewing preparation-for-independence programs operating in Canada at present yields a number of observations. 1. A well-developed range of preparation-for-independence programs exists across Canada despite regional differences in both mandate and resources. 2. The resources, however, do not meet the need. There are not enough for each young person to be assured of getting what he or she needs for a successful transition. 3. Failure to develop an adequate resource will be costly in the long run. Those whom child welfare, in its parenting role, fails to prepare for independence and support adequately during the transition will most likely come to the attention of social services again either as social assistance recipients before adult welfare, or as parents and families requiring the services of the child welfare system within which they themselves grew up. 4. At the field level, effective solutions have been demonstrated. What remains to be achieved is the development of both political will and financial commitment on the part of the government to support the maintenance of existing programs, and the proliferation of an adequate range of additional programs. It must be ensured that all children for whom the state assumes responsibility benefit from an adequately supported transition into productive adulthood. As pointed out in a literacy program proposal prepared by the Pape Adolescent Resource Centre in Toronto: Unless the problems were addressed effectively, the probability was that the teens would be discharged from children's aid society care without the ability to support themselves in the community either economically or practically. In the absence of familial or institutional supports, a street life awaited them. Many had begun to apprentice for that reality. [Martin 1986: 2] Where the state has intervened to rescue a youth from inadequate parenting, the obligation exists for the state to properly complete the undertaking.     

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.     

Upping the ante: relative caregivers' perceptions of changes in child welfare policies

Thirty-five caregivers of related children who were in the custody of the child welfare system were interviewed individually or in focus groups as the state child welfare system implemented new federal and state policies encouraging these caregivers to adopt or assume guardianship of the children in their care. Interviews were transcribed and analyzed using qualitative methods. Issues of concern included emergency entrance into caregiving; the simultaneous satisfaction and burden of caregiving; obstacles to caregiving, adoption, or guardianship; complex changes in family dynamics following placement of children; sources of support; and caution regarding adoption or guardianship. The caregivers also offered recommendations for the child welfare system. Policy, practice, and research implications are discussed.     

Protective supervision: An inquiry into the relationship between child welfare and the court system

Protective Supervision, in most states, is defined in statute as an option in which the child is allowed to remain in the home of high-risk parents under the authority of the court, with supervision provided by the child protection system. Protective Supervision provides states an option to fulfill the federal mandate, as expressed in its guidance on the Child and Family Services Review, to assure that children are safely maintained in their homes whenever possible and appropriate. Nevertheless, there is a paucity of published work on this option. Further, the relationship between child protection and the judicial system, implicit in Protective Supervision, is rarely examined. In response to this dearth of information, an exploratory study was undertaken in Minnesota, funded by the Minnesota Department of Human Services. Data were derived from focus groups in every region of the state, with both child protection and judicial system participants. This study offers insights into the complicated nature of the partnership between two complex systems — child welfare and the court system. Currently, there is wide variation in how Protective Supervision is understood and practiced. However, where there is mutual respect between child welfare and the courts, Protective Supervision offers a useful tool.     

Health care policies for children in out-of-home care

Placement in out-of-home care is one intervention used to protect children from abuse and neglect. While children are in such care, it is the child welfare agency's responsibility to ensure that their health needs are met. The study reported here examined health care policies and services for children in 46 state child welfare agencies. Virtually all states had some sort of written policies regarding health care for children in out-of-home care. Half, however, reported having no information management system to record health care data, and only six of the 23 had computerized systems. Most states fell short of meeting the standards set by the Child Welfare League of America for the health care of children in out-of-home care.     

Harnessing the potential of administrative data to inform child welfare programming with dynamic visualization methodologies

The majority U.S. states maintain administrative databases to collect information on the entry, movement, and exits of youth in the foster care system, yet the power of these data to inform continuous improvement efforts remains largely untapped. This underutilization ignores the vast potential inherent in longitudinal child welfare data to better understand the trajectories of youth in care and the effectiveness of the services they receive. To help promote the use of administrative data to inform child welfare programming, this paper provides an overview and demonstration of a Feedback Improvement System with web-based visualization technology to illustrate child- and agency-level child welfare data from the state of Utah. The procedures and system design elements used to obtain, process, and display the feedback data are detailed. Recommendations for designing and implementing web-based feedback systems for child welfare agencies are provided.     

Does formal integration between child welfare and behavioral health agencies result in improved placement stability for adolescents engaged with both systems?

National survey data were used to assess whether child welfare agency ties to behavioral health care providers improved placement stability for adolescents served by both systems. Adolescents initially at home who were later removed tended to have fewer moves when child welfare and behavioral health were in the same larger agency. Joint training of child welfare and behavioral health staff was negatively associated with numbers of moves and numbers of days out of home.     

Mandatory Reporting and Child Exposure to Domestic Violence: Issues Regarding the Therapeutic Alliance with Couples

Some child welfare legislation have recently expanded the definition of ‘a child in need of protection’ to include child exposure to intimate partner violence. Such legislation places clinicians in the challenging position of determining whether a situation falls under their duty to report. The current paper examines a case example in which there was child exposed to intimate partner violence, the clinician made a report to child welfare authorities and attempted to maintain the therapeutic alliance with the couple in treatment. The couple viewed contacting child welfare authorities as a crisis situation both in their marriage and in their family. Practice principles for clinicians are suggested.