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.     

Quality improvement learning collaborative to examine foster care guidelines

Learning collaboratives (LC) are an important method of implementing quality improvement by serving as laboratories to translate research into practice and sharing knowledge. We created a Foster Care Learning Collaborative (FCLC) of 11 foster care health sites to share best practices on providing health services for children in foster care. Using a collaborative approach involving monthly conference calls, we invited each health site to present specific health care delivery issues for the purpose of developing collaborative quality improvement projects regarding the delivery of healthcare to children placed into foster care. For health sites providing primary care (n = 8 of 11 sites), we examined adherence to two American Academy of Pediatrics (AAP) guidelines for children entering foster care: a) the initial health screen, and b) the comprehensive medical evaluations. At least four distinct types of health care models that provide either direct primary care or administrative oversight for children in foster care were identified: 1) medical home sites (n = 3); 2) foster care evaluation/intake sites (n = 2); 3) specialized primary care sites (n = 1); and, 4) state administrative programs (n = 2). Data from the six direct primary care sites (n = 586 children) and two state administrative models (n = 3855 children) was collected. The time-frame for the initial health screen was adjusted to 7 days after entry and adherence (31%) was comparable among primary care sites. Adherence to AAP guidelines regarding completion of a comprehensive medical evaluation within 30 days of intake varied among medical homes (30%–86%), intake models (23%–33%), specialized primary care site (43%), and state models (43%–73%). No site was fully compliant with the AAP guideline for universal comprehensive medical evaluation within 30 days, and there is variation within and among care models. A foster care learning collaborative identified significant variability in adherence to a commonly accepted guideline for timely access to healthcare for children placed into foster care. The LC c model offers the opportunity to evaluate best practices, identify barriers to care, and provide objective feedback for improvement.     

Use of a Parent Management Training Intervention with Urban Foster Parents: A Pilot Study

The development of effective interventions for foster children with behavior problems is essential given the consequences of behavior problems for children's placement stability and permanency outcomes. This article presents findings from a pilot study of an intervention providing parent management training (PMT) and support to foster parents in groups and home visits. The intervention was an adaptation of the KEEP (Keeping Foster Parents Trained and Supported) group intervention, provided in a large urban child welfare agency serving predominantly African American foster parents. The study used an intent-to-treat design, with 25 foster parents of 31 children (ages 4-12) in specialized foster care assigned to either an intervention or treatment as usual control group. Longitudinal outcomes were analyzed using random effect regression models. Over time, children's behavior problems were significantly lower in the intervention group relative to the control group, and the effect of the intervention was partially mediated by parents' understanding of how to appropriately use the intervention parenting skills. These results provide support for the effectiveness of KEEP with urban foster children with significant behavior problems.     

"Reasonable efforts": toward implementation in permanency planning

The "reasonable efforts" criterion for provision of services to the families of children in foster care and to the families of children at risk of entering foster care is designed to provide for external, and presumably more objective, monitoring by a court of the quantity and quality of these services. A standard of "reasonable effort" applicable to all cases in the two populations of concern is both impractical and probably unethical. Legally there must be a case-by-case determination of "reasonable efforts" that will weigh the unique elements of each case. It is hoped that the working guideline proposed here will provide a basis in child welfare practice for minimizing potentially great variations in court decisions. The guideline begins with a list of problems, verified via an adversarial review, as to why the child(ren) entered foster care or is at risk of doing so, followed by the establishment of the relevance of proffered services to those problems, followed by documentation of a sustained effort to facilitate the use of those services.     

Homelessness and Children's Use of Mental Health Services: A Population-Based Study

This study examined whether children who become homeless differ from other low-income children in their mental health service use before and after their first homeless episode, and to what extent homelessness is associated with an increased likelihood of mental health service use. Differences between children with and without new onset of sheltered homelessness in the use of mental health services emerged following homelessness and widened over time. Sheltered homelessness and foster care placement history were associated with increased odds of receiving inpatient and ambulatory mental health services. Findings underscore the importance of collaborations between homeless assistance, foster care, and mental healthcare in efforts to mitigate family homelessness and collateral needs among homeless children.     

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.     

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.     

Does allocation to a control condition in a Randomized Controlled Trial affect the routine care foster parents receive?

‘Strengthening Foster parents in Parenting’ (SFP) is a support program for foster parents who care for foster children with externalizing problem behavior. Its effectiveness was examined with a Randomized Controlled Trial (RCT). In this paper, we examine the treatment as usual (TAU) that was offered in the control condition of this RCT. For this purpose, the TAU from the SFP control group was compared with TAU provided to a similar group of foster parents outside any RCT.Our results show that TAU is diverse and varies widely. Furthermore, being part of the control condition was positively associated with both the counseling frequency from the foster care services and with external help-seeking behavior (finding and using additional support).In order to prevent condition contamination in future trials, TAU should be clearly described and standardized, and treatment fidelity should be carefully monitored.     

Family group decision making and disproportionality in foster care: a case study

Research on the disproportionate number of children of color in the child welfare system suggests that we should focus on key decision points such as investigations, substantiations, and placements to understand how experiences of children vary by race and ethnicity. This article describes one community's efforts to use Family Group Decision Making in placement decisions to reduce disproportionality in foster care by diverting children from regular foster care services and keeping them within their extended families.     

A study of 185 foster children 5 years after placement

This study's findings are similar to those of other studies. The majority of children who enter foster care return to their families within a relatively short time. A small group, because of the severity of their problems or those of their parents, need extended care. This group of children, over time, form the hard core of foster care placements. Our findings also bear out those of others that the foster care experience is a relatively stable one for children, with the majority having one or two placements while in care. Clearly, the need for and use of foster care is frequently misunderstood. The methodology used in research studies has gradually improved, adding to objective knowledge about this aspect of the child welfare system. Longitudinal studies, such as Jenkins [1967], Fanshel and Shinn [1978], and the one reported here, point to the need for deeper, more refined studies that examine not only the going and coming of children in foster care but the professional service component that can make foster care a constructive experience for children placed in it. Meyer issued an intelligent and timely challenge to the field of child welfare to give up "debates about permanency" and, if it is not too late, to "retrieve child welfare from the control of lawyers and MBAs" [1984: 499]. If the profession of social work can more clearly define the components of foster care service and can differentiate among the children needing care those who can best be served by this type of placement, then the field will be well on its way to offering an appropriate service for certain children. Attempts to denigrate a potentially helpful service for needy children simply destroy one aspect of a complex system. A wide range of services is necessary to serve all children appropriately. Without this kind of continuum, children are more likely to receive inappropriate services and to be placed at risk.     

Foster care in India: An exploratory survey of the community perceptions and prospects for implementation of foster care in a developing nation: A study in Udaipur,Rajasthan, India

This study was conducted in order to assess the prospects for implementing foster care as an alternative to the dominant system of institutional care available to orphaned and abandoned children in India. 653 families in urban Udaipur participated in a mixed-methods based assessment of receptivity to foster and adoptive care. The majority of those who responded reported receptivity to the idea of foster care as an alternative to institutional care. However, analyses demonstrated that respondents also perceived barriers to implementing systematic foster care, particularly with regard to family recruitment due to problems securing family and community support for participation. The results are discussed in light of governmental calls for non-governmental organization and other stakeholders to institute alternatives to foster and adoptive care. The results of this study have applied significance for organizations and practitioners seeking to implement care alternatives for orphan and abandoned children in India.     

Attitudes of special foster parents and residential staff towards children

This paper compares the attitudes of special foster parents and residential staff towards children in their care. The exercise was carried out as part of a comparative study of care practice in ‘special’ foster homes (accommodating children traditionally considered too old or difficult for fostering) and ordinary community or children's homes. Overall, care practice in the foster homes was significantly more child oriented than in the children's homes. This finding cannot, however, be explained in terms of attitudinal differences between foster parents and staff. Staff attitudes generally appeared more conducive to the provision of child oriented care than those of the foster parents.     

Selfobject functions of the family: Implications for family therapy

The application of Self-Psychology theory to family functioning adds to our models of understanding and intervention in family therapy. This article develops a theory of the family as a supraordinate selfobject and explores diverse clinical applications of the theory. The family as a selfobject matrix enhances the self development of the child by the provision of continuity through the maintenance of proximity over time, and by an enhanced quality and quantity of selfobject responsiveness for the individual. This application of Self Psychology theory has wide implications for family therapy with children in foster care, family therapy with elderly couples coping with dementia in one spouse, and family therapy as a component of treatment with suicidal adolescents.     

Transitioning youth: Policies and outcomes

The primary policies and outcome studies regarding youth transitioning from foster care and young adults who have aged out of foster care over the past quarter of a century are reviewed. Although several policies have increased services and funding for this population, overall, their outcomes have not significantly improved. In terms of educational achievement, employment, and well-being, many continue to fare poorly in young adulthood. Further policies and practice improvements may need to be implemented. The population of youth transitioning has far outpaced the funding available, state and program eligibility requirements may be eliminating the most vulnerable from services, in many states there is an inadequate provision of basic needs such as housing and healthcare, the expectations of self-sufficiency for this population now exceed societal norms, and the restrictions and placement instability associated with many older adolescents in care may be in contrast to their developmental needs. In order to more fully address the needs of youth transitioning from foster care, child welfare policies and practices may need to focus more attention on the relational and social development of youth while in foster care. Furthermore, during young adulthood, policies and practices may need to provide greater safety nets and resources to this population.     

The economics of adoption of children from foster care

Federal initiatives since 1996 have intensified the efforts of states to achieve adoption for children in foster care. For many waiting children, the path to adoption is long. The authors offer an economic analysis of adoption from foster care, with an emphasis on the reasons why achieving the goal of adoption for all waiting children may be so difficult. The authors then estimate the determinants of adoptions from foster care across the states using data for fiscal years 1996 and 1997. Adoption assistance subsidy rates stand out as the most important determinant of adoptions from foster care, followed by use of alternatives (e.g., intercountry adoption). Adoptive matching on the basis of race does not appear to prevent adoptions from foster care in the aggregate, leaving flaws in the matching process, such as a lack of information and difficulty using the Interstate Compact on the Placement of Children (ICPC), as a primary reason why children wait.     

Chinese adoption: practices and challenges.

The majority of children in China who are the subject of protective services are either abandoned or disabled. Recent reform efforts in China's child welfare practices have focused on the importance of providing safe, permanent families for children in lieu of long-term institutional care. Although challenges still exist, adoption and foster care are increasingly being seen as viable alternatives for these children.     

Foster Parents Speak: Preferred Characteristics of Foster Children and Experiences in the Role of Foster Parent

Foster parents play a pivotal role in the child welfare system. A study that employed focus groups with foster parents was conducted at a private foster care agency with the initial purpose of understanding the characteristics of foster children that foster parents both preferred and not preferred. In the qualitative research tradition, their answers addressed the topic of characteristics and expanded to provide additional data on their experience as foster parents. Using theme analysis, the following themes were generated: foster care as service; foster parents' preferences of foster children's characteristics; foster parents do not feel valued or trusted; increased caseworker and foster parent partnership; problems in the foster care and related systems; and focus group as support. Implications for research and practice are forwarded.     

Correlates of the Randolph Attachment Disorder Questionnaire (RADQ) in a Sample of Children in Foster Placement

This study examined mental health and attachment problems in children in foster care. This study also obtained data concerning the validity of the Randolph Attachment Disorder Questionnaire (RADQ). Children were selected according to length of time in placement and age and screened for mental health symptoms using the Child Behavior Checklist and the RADQ. The findings showed that children in foster care have reported symptoms within the range typical of children not involved in foster care. The conclusion is that the RADQ has limited usefulness due to its lack of specificity with implications for treatment of children in foster care.