Intergenerational families in child welfare: Assessing needs and estimating permanency

Much of the empirical literature on intergenerational child maltreatment focuses on the mechanisms that explain how maltreatment is transmitted across generations. Few studies have examined child protective service outcomes associated with intergenerational families. The current study addresses this gap in the literature. This study compares 1196 caregivers, most of whom are single African American females, and 2143 children from first and second generation child welfare-involved families. All families have a history of substance abuse. We sought to understand how first and second generation families differ with regard to social and economic status indicators, as well as whether intergenerational child welfare involvement is associated with permanency outcomes. Our findings indicate that second generation families experience significantly more risk factors at the time of case opening, and are two-thirds as likely to be reunified as compared with first generation families. The singular effects of generation status disappeared, however, once the interaction between mental health diagnosis and second generation status was entered into the model, suggesting that it is not just being intergenerationally involved in the child welfare system that reduces the chance of reunification, but rather second generation caregivers have more mental health problems that are associated with a lower likelihood of reunification.     

Patterns of child maltreatment referrals among Asian and Pacific Islander families

Much of the available data on Asian American families who become involved with the child welfare system relies on global ethnic categories, such as the category Asian/Pacific Islander. To explore the diversity of experience that is hidden by such categories, this article analyzes two years of child maltreatment referrals for Asian and Pacific Island families in Washington state. The study findings show that considerable variation exists within the Asian and Pacific Islander population with regard to child protection referrals. Although Asian Americans as a whole were less likely to be referred to child protective services than other groups, the within group picture that these data capture is considerably more complex. Some Asian/Pacific Islander ethnic groups, particularly those which have experienced higher levels of social and economic stress, were more at risk of child welfare involvement than other groups. Such findings underscore the need for child welfare policies and practice that are sensitive to the considerable variability within the Asian/Pacific Islander community.     

Economic predictors of child maltreatment in an Australian population-based birth cohort

A correlation between socioeconomic disadvantage and child maltreatment has long been observed, but the drivers of this association are poorly understood. We sought to estimate the effects of economic factors on risk of child maltreatment after adjusting for other known influences using the Australian Temperament Project, a population-based birth cohort of 2443 individuals and their parents. We used logistic regression to estimate associations of childhood economic factors (parental education, occupation, and unemployment; type of housing; and retrospective perception of poverty) with retrospective reports of perceived child maltreatment (physical abuse, sexual abuse, emotional abuse, neglect, and witnessing of domestic violence), controlling for demographic factors, parental mental health and substance use, and child health. We then used these estimates to approximate the proportions of child maltreatment—population attributable fractions—that are theoretically preventable by addressing childhood economic disadvantage. Economic factors were associated with all types of child maltreatment. For the most part, these associations diminished only partially when controlling for noneconomic confounders, supporting hypotheses of causal relationships. Jointly, economic factors were significant predictors of physical abuse, sexual abuse, and witnessing of domestic violence but not of emotional abuse or neglect. Retrospective perceptions of childhood poverty were, in particular, strongly associated with most forms of child maltreatment but not with sexual abuse after accounting for other economic factors. We estimated that 27% of all child maltreatment was jointly attributable to economic factors. These findings suggest that strategies that reduce economic disadvantage are likely to hold significant potential to reduce the prevalence of child maltreatment.     

Lost in transition: Illicit substance use and services receipt among at-risk youth in the child welfare system

This study examined the use of mental health and substance abuse services among adolescents in the child welfare system (CWS) who reported use of illicit substances. 1004 adolescents age 11–15 years at baseline were followed for 5–7 years, over five waves of data collection. Shortly after the investigation for maltreatment (baseline), 69.1% of youths using illicit substances received mental health and/or substance abuse outpatient specialty services. By the last follow-up, during the transition to adulthood, only 21.5% of young adults using illicit substances received outpatient specialty services. Youth who used illicit substances were more likely to receive outpatient and inpatient specialty services than non-users at the time of contact with the CWS (mostly baseline), but this difference faded over the follow-up period. By 5–7 years follow-up, there was no significant difference in specialty services receipt for illicit substances users versus non-users. Predictors of outpatient service use at most waves were having Medicaid, mental health needs, and having recently seen a school counselor or primary care physician. Among illicit substance users transitioning to adulthood, African American youths were less likely to receive outpatient specialty services than White youths. These findings reveal a need for more attention to illicit substances use among youth in the CWS, better cross agency integration, and special attention to the needs of transition-age youth to better connect them with services as they age out of the CWS.     

Social control correlates of arrest behavior among homeless youth in five U.S. cities

This study identified homelessness, substance use, employment, and mental health correlates of homeless youths' arrest activity in 5 cities. Two hundred thirty-eight street youth from Los Angeles, Austin, Denver, New Orleans, and St. Louis were recruited using comparable sampling strategies. Ordinary least squares (OLS) regression results reveal that being arrested for criminal activity is associated with length of homelessness, history of juvenile detention and incarceration, receiving income from theft, substance abuse, and mental illness. Arrests are also associated with interactions between lack of formal employment income and receiving income from theft and between drug and alcohol abuse/ dependency. Understanding the health and situational factors associated with homeless youths' delinquent activity has implications for providing more comprehensive health, mental health, and substance abuse services.     

Exploring racial and ethnic differences in recreational drug use among gay and bisexual men in New York city and Los Angeles

Reported rates of recreational drug use among gay and bisexual men are currently rising. Although there has been much empirical research documenting current trends in drug use among gay and bisexual men, little research has empirically contrasted differential rates across urban epicenters, while even less has addressed racial or ethnic variation (between and within cities). This knowledge is essential both for the development of effective culturally-sensitive health education prevention/services and for understanding drug use prevalence among urban epicenters. Using the men's data gathered from large-scale gay, lesbian, and bisexual (GLB) community events in New York and Los Angeles in the fall of 2003 and spring of 2004 (N = 2,335), this study explored racial and ethnic variance in the use of methamphetamine, cocaine, MDMA/ecstasy (methylenedioxy-methamphetamine), ketamine, GHB (gamma-hydroxy-butyrate), marijuana, and nitrate inhalants (poppers) among gay and bisexual men both between and within cities (NYC and LA). Levels of recent drug use were fairly consistent between New York City and Los Angeles; however there was some between and within city racial and ethnic variance. In particular, Asian/Pacific Islander men were among those least likely to report use of some drugs. Findings suggest substance use in the gay community permeates geographic boundaries in addition to some racial and ethnic boundaries such that interventions targeting drug-using gay and bisexual men should appropriately attend to racial and ethnic diversity within communities.     

Typologies of Violence Among Youth Who Encounter Child Welfare Systems

This study explored patterns of violent delinquent behaviors using latent class analysis (LCA). The study sample consisted of 1,013 11- to 17-year-olds who participated in Wave 1 of the second National Survey of Child and Adolescent Well-Being (NSCAW II). LCA was used to identify distinct patterns of violent delinquent behavior among youth involved in the child welfare system. The study found a model consisting of the two following classes: violent and normative. The study also examined how exposure to domestic violence, youths’ mental health, and youths’ substance abuse function as characteristics of the latent classes. Results showed members of the violent class were significantly more likely to report clinically significant depression and substance abuse. Racial differences did exist, showing members of the violent class were more likely to be Black than members of the normative class. The study found no differences on whether members of each class had been physically or sexually abused, experienced physical neglect, been exposed to domestic violence, or having a substance abusing parent, or a substantiated child maltreatment investigation. Results from this study could illuminate opportunities for prevention and intervention resources.     

Substance-abusing parents and their children in termination of parental rights cases in Israel

Parental substance abuse significantly increases the risk of child maltreatment and loss of custody. If parental capacity due to substance abuse cannot be rehabilitated within a limited time period and if the child cannot be safely returned to his/her home, the state, in various jurisdictions, is empowered to initiate termination of parental rights proceedings. Despite the connection between substance abuse and termination of parental rights, the research literature in this area is limited. Based on a sample of 212 rulings in favor of termination of parental rights by Israeli courts, the present study examines factors that differentiate substance-abusing from non-substance-abusing parents. The findings indicate that substance-abusing parents constitute a unique high-risk group among parents whose parental rights were terminated. This group is characterized by a higher cumulative risk that includes mental health issues with an emphasis on personality disorders and emotional problems, criminal records, child neglect and maternal single parenthood. All these factors, as well as the overall number of risk factors in a particular case, were found to predict substance-abusing parenthood. A discussion of the findings and their implications for social work practice with families involved in the child welfare system follows.     

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

ABSTRACT

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

Child care burden and the risk of child maltreatment among low-income working families

Studies suggest that a substantial proportion of low-income working mothers experience work disruptions and parental stress related to child care, which may lead to increases in the risk of physical and psychological abuse and neglect of children. However, little research has examined the relationship between child care burden and the risk of child maltreatment among low-income working families. Using the Fragile Families and Child Wellbeing Study 3-year data, this study explores how child care burden is associated with the risk of child maltreatment (physical aggression, psychological aggression, and neglectful behavior) among low-income working mothers. We find that instability in child care arrangements is likely to increase mothers' physical and psychological aggression, while not having someone reliable for emergency child care is likely to increase mothers' neglectful behaviors. Findings also show that the risk of child maltreatment related to child care burden measures is more significant for single mothers than married mothers. Potential policy implications are discussed.     

Prevention of child maltreatment in high-risk rural families: A randomized clinical trial with child welfare outcomes

Few studies have specifically examined prevention of child maltreatment among higher-risk populations in rural communities. The overarching goal of this study was to conduct a randomized clinical trial of SafeCare augmented for rural high-risk population (SC+) compared to standard home-based mental health services (SAU) to examine reductions in future child maltreatment reports, as well as risk factors and factors proximal to child maltreatment. Parents (N = 105) of young children (5 years or less) who had identifiable risk of depression, intimate partner violence, or substance abuse were randomized to SC+ or SAU. Participants randomized to SC+ were more likely to enroll (83% vs. 35% for SAU) and remain in services (35 h vs. 8 h for SAU). SC+ (for participants who successfully completed services) may have had limited impact on child welfare reports during service provision. Further, SC+ had fewer child welfare reports related to DV than SAU. Parent self-reports of parenting behaviors, risk factors, and protective factors did not demonstrate significant sustained program impact. Limitations include power constraints related to sample size. Promising next steps entail future trials with larger sample sizes examining service compliance and further augmentation of SafeCare to bolster service impact and address risk and protective factors.     

Effect of child protective services system factors on child maltreatment rereporting

This study examined how child protective services (CPS) systems respond to initial and subsequent reports in the context of child maltreatment rereporting and to what extent CPS system factors are associated with the risk of rereporting after controlling for abuse type and child and family factors. This study followed 67,243 families who were reported to the CPS agencies in seven counties in Florida for child abuse and neglect over a period of 5.4 years and found that 14,218 families had one or more child maltreatment rereports. Key findings include that CPS system factors were significantly different from initial report to subsequent reports. Five CPS system factors, reporting source, contact by CPS workers, investigative level at intake, postinvestigation services, and duration ofCPS involvement were significantly associated with the risk of child maltreatment rereporting. Multivariate analyses found that CPS system factors were substantially different for three categories ofrereporting, unsubstantiated rereports, substantiated rereports, and recurrence reports. Interpretations and implications for practice are discussed.     

Dosage matters: The relationship between participation in the Nurturing Parenting Program for infants, toddlers, and preschoolers and subsequent child maltreatment

This article uses statewide data on caregivers of young children referred to the Nurturing Parenting Program (NPP) for allegations of abuse and neglect to examine the relationship between program dosage and subsequent maltreatment. At six months after participating in the program, caregivers who attended more sessions were significantly less likely to be reported for child maltreatment, holding other factors constant. At two years after participating, caregivers attending more sessions were significantly less likely to have a substantiated maltreatment incidence, controlling for other characteristics of families associated with maltreatment. These findings demonstrate the program is associated with preventing short-term allegations and longer-term substantiated incidences of maltreatment for a child welfare population. By demonstrating the importance of participation in the NPP, we increase the evidence about effective parent education programs for this population.     

The moderating effect of substance abuse service accessibility on the relationship between child maltreatment and neighborhood alcohol availability

This study investigates how the relationship between dense concentrations of alcohol retailers and high rates of child maltreatment may be moderated by the presence of substance abuse service facilities. Using a cross-sectional design, the study utilized data from Bergen County, New Jersey on child maltreatment reports, alcohol-selling retailers, substance abuse service facilities, and the United States Census. Findings indicate child maltreatment rates were higher in neighborhoods with lower socioeconomic status and those with greater alcohol outlet density. Neighborhoods with easily accessed substance abuse service facilities had lower rates of child maltreatment. Additionally, the relationship between child maltreatment and alcohol outlet density was moderated by the presence of substance abuse service facilities. The study findings highlight the relevance of making primary prevention approaches readily available and using multi-sector collaboration to reduce child maltreatment.     

Depressive Symptoms and Their Association With Adverse Environmental Factors and Substance Use in Runaway and Homeless Youths

We used diathesis‐stress and stress‐sensitization models to determine whether family maltreatment, street‐related traumatic events, stressful life events, and substance use were associated with depressive symptoms in runaway and homeless youths (RHY) in Los Angeles. Greater severity of depressive symptoms was significantly related to family maltreatment, being exposed to more traumatic stressors during homelessness, and current substance use compared to no substance use. Family maltreatment was also found to moderate the relationship between traumatic stressors and depressive symptoms. Importantly, cumulative exposure to the investigated risk factors at varying levels was associated with more severe depressive symptoms. Using a trauma‐informed approach to screen for RHY at risk of depression may pave the way for secondary prevention of major depression in RHY.     

Services for maltreated children: variations by maltreatment characteristics

Mental health services were the most frequently recommended service for maltreated children known to a child protective service agency, but more than one-fourth of the children with serious behavioral problems did not receive referrals for such services. Children with long histories of maltreatment were more likely to be referred for some services, especially out-of-home care. Gaps in services remain, underscoring a need for research focused on the need for interventions targeted to maltreated children involved with child protective service agencies.     

When Home Is Still Unsafe: From Family Reunification to Foster Care Reentry

Reuniting children with their families is the preferred outcome of foster care, yet many children reunited with their families reenter foster care. This study examined how parental substance abuse and mental health problems, and the time allotted for reunification, are associated with reentry risk. We used a complete cohort of children who entered the Texas foster care system in fiscal years 2008 and 2009 to identify the risk of foster care reentry within 5 years of reunification using selection‐adjusted multilevel survival analysis. Approximately 16% of reunified children reentered care within 5 years. Substance abuse and mental health problems predicted higher rates of reentry. Reunification after 12 months was associated with increased reentry risk overall, but not among children commonly exempted from federal permanency timelines. Permanency guidelines that restrict the length of time to achieve reunification may have the unintended consequence of pushing reunification before maltreatment risks have been resolved.     

Using child welfare assessments and latent class analysis to identify prevalence and comorbidity of parent service needs

Data collected through Illinois's Integrated Assessment (IA) program—an assessment and service coordination program incorporating clinical assessments of both parents following a child's placement in foster care—offers a unique opportunity to examine the service needs of parents within a family context. Between January 2007 and June 2010, integrated assessments were completed with 4089 families in which at least one parent participated in the assessment. Utilizing these data, this study employs a Latent Class Analysis approach to identify the patterns of service needs of parents with children entering foster care. Latent class models were generated for mothers and fathers who participated in comprehensive family assessments based on identified service needs. Models revealed “low need” and “high need” classes among both mothers and fathers. A distinct class characterized by substance abuse needs emerged among fathers and a similar class among mothers was characterized by both substance abuse and mental health needs. A mental health needs class was identified among fathers while a similar class among mothers was characterized by both mental health needs as well as trauma symptoms. In examining the distribution of classes among families where both parents were present, the largest groups of families were those in which both parents fell into the “low need” classes, those in which the father fell into the “low need” class and the mother fell into the “substance abuse and mental health” class, and those in which both the mother and the father fell into the “substance abuse” classes. Implications for case assignment practices, father engagement, and addressing comorbid service needs are discussed.