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

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

Characteristics and factors impacting reunification outcomes among Vietnamese immigrant families in the child welfare system

Using a mixed methods approach, this study examined reunification processes and outcomes among Vietnamese immigrant families involved in the child welfare system. A quantitative design was used to describe characteristics and reunification outcomes of Vietnamese immigrant children and families who are involved in family reunification services. Qualitative methods were used to explore factors that may influence reunification outcomes among Vietnamese families.The quantitative portion of the study included an exploratory design using administrative data from one county in the Northern California. The quantitative sample (N = 32) included children entering the foster care system for 8 or more days between January 1, 2001 and December 31, 2007 from child welfare administrative data (CWS/CMS) which was merged with eligibility data (CalWIN) in order to obtain parent and child place of birth to determine country of origin. The qualitative study included an exploratory design using interview data from child welfare workers (N = 8) and Vietnamese immigrant parents who had successfully reunified (N = 7).Quantitative results indicated that the most common type of maltreatment leading to entry into care was caretaker absence or incapacity, an abuse category that is often used in cases of parental substance abuse. 53.8% of Vietnamese immigrant children in the quantitative sample reunified with their parents, which is close to the national rate of reunification. Qualitative findings pointed to the importance of the following factors within reunification: acculturation-related issues, parental substance abuse, child welfare worker cultural competency and issues related to service availability and effectiveness. Implications for social work practice and policy are discussed.     

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.     

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.     

Displacement,caregiving, and the ecological system of youth in foster care: a theoretical perspective

Children involved in the child welfare (i.e., foster care) system are at a greater risk for numerous negative outcomes in adolescence and adulthood (e.g., lower educational attainment, higher risk for a criminal record). For children in foster care who experience placement disruption (i.e., removed from a foster home and placed in another nonpermanent placement), the risks significantly increase. Informed by the ecological systems model, the authors propose a theoretical perspective to explain the unique aspects of a foster child’s development and discuss how this framework informs child welfare practice and intervention for foster children at risk for placement disruption. This perspective has the potential to provide a framework that has implications for foster caregivers and child welfare professionals and to inform future policies.     

Are maternal and community risk factors associated with the presence of asthma among children placed in foster care?

Objective

The occurrence of pediatric asthma has been associated with exposure to chronic stress. This study examined the relationship between maternal and community risk factors and asthma in a sample of maltreated children in foster care.

Method

Interviews were conducted with 365 maltreated children in foster care. Measures included youth/caregiver reports of asthma, an index of maternal risk based on data abstracted from child welfare records and community violence exposure.

Results

After controlling for demographic variables, maternal risk was associated with the presence of asthma (OR = 1.314, 95% CI = 1.09–1.58). Community violence exposure, however, was not related to the presence of asthma.

Conclusion

Maternal risk factors were significantly associated with the presence of asthma in a foster care population. Physicians who care for maltreated children in foster care should be particularly attuned to the presence of these additional risk factors that may place high-risk children at increased risk for chronic health problems.     

Prevalence and economic well-being of families raising multiple children with disabilities

This study estimates the prevalence of households raising more than one child with disabilities, and examines these families' economic well-being. Using pooled data from the 2004 and 2008 Survey of Income and Program Participation we compare households with multiple children with disabilities (n = 932) to households with one disable child (n = 3457) and to households with at least one child but none with disabilities (n = 21,378) on measures of material hardship. Three percent of U.S. households with children had more than one disabled child. Compared to other households with children, those with multiple children with disabilities were significantly more likely to have income below the federal poverty level and to report material hardships. The number of children with disabilities is an important contextual variable for studying the economic circumstances under which, care is provided to children with disabilities. Its implications for practice and policy are discussed.     

It takes a team: Improving placement stability among children and youth with Fetal Alcohol Spectrum Disorder in care in Canada

Concerted efforts have been devoted to improving placement stability for children in care. These efforts have been driven by evidence of negative outcomes for foster children who experience frequent placement changes. Of particular concern are significantly higher rates of placement disruptions among children in care who experience Fetal Alcohol Spectrum Disorder (FASD). This mixed methods study examines the impact of enhanced child welfare practice interventions on placement stability for 182 children in care who experience FASD. A quasi-experimental matched comparison group design was employed, where rates of placement change were compared between children in the Project Regions who received enhanced practice standards to those in the Comparison Regions who did not. The sample included 182 participants including 98 children and youth in care from the Project Region and 84 cases from the Comparison Region. The Project Regions reported considerably lower placement changes (M = .33) than the Comparison Region (M = .98). Logistic regression analysis revealed that worker contact was found to be predictive of placement stability. Specifically, as worker contact increased, the likelihood of placement change decreased [B = − .28, W (5.35, p = .02)]. In keeping with the adage that it takes a village to raise a child, one could add for children affected by FASD, that it takes a dedicated team to promote placement stability and better life trajectories.     

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

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

Foster children placed with or separated from siblings: Outcomes based on a national sample

This study examines a range of outcomes for children in foster care who have siblings, using a large, national U.S. database. Three types of sibling placements are defined: split (child has no siblings in the home), splintered (at least one sibling in the home), and together (all siblings in the home). The study analyzes records (n = 1701) from the National Study of Child and Adolescent Wellbeing, including Child Protective Services (CPS) and Long-term Foster Care (LTFC) samples. It contributes to the literature in its inclusive definition of siblings, use of three categories for sibling placement status, and use of outcome measures that include the perceptions of foster children. The study reports limited significant findings. Neither foster parents' nor youths' reports of behavioral problems differ by sibling placement status. As rated by teachers, academic performance in the group placed together exceeds that in both of the other groups. For children in kinship homes, teachers also reported less problematic internalizing and externalizing behavior for the splintered and together groups than for the split group. Children in the splintered group also responded more favorably than those in the split group to questions of closeness to the primary caregiver and liking the people in the foster family.     

Parental substance misuse and compliance as factors determining child removal: A sample from the Victorian Children's Court in Australia

Purpose

The current study explores the role of parental substance misuse in child protection cases and examines its impact as a factor in decisions on child removal in court orders.

Methods

A cohort of 273 child protection cases from the Victorian Children's Court was reviewed. This sample consisted of cases where children have been removed (Custody to Secretary Order, n = 142 cases) or remained with parents (Supervision Order, n = 131 cases). Data was extracted on parental substance misuse in single and two parent households as well as compliance with court-based and child protection directives.

Principle results

Parental substance misuse (PSM) was present in 51% of child protection cases sampled and among those, poly-substance abuse was common (67%). PSM was associated with Indigenous status; younger age of child at court appearance; having a court-proven case of emotional abuse, less compliance with child protection services and a longer time between notification to authorities and final court decision. In one parent households, only parental compliance is the primary factor underlying decisions of child removal. In two parent households, the decision to remove a child from the family home was ultimately driven by parental compliance, and to a lesser extent by PSM of illicit drugs and the number of parents misusing drugs.

Conclusion

PSM and non-compliance appear to be significant factors in delaying stability for the child through the granting of court orders which may involve child removal. There is a need, by child protection professionals, for prompt recognition of PSM and associated compliance/engagement issues in order to refer appropriate cases for further assessment and treatment in specialist drug treatment services. Early involvement with specialist drug treatment services provides the Court with an indication of compliance which is an important factor for making decisions that assist with achieving stability for the child.     

Factors impacting intention to leave in social workers and child care workers employed at voluntary agencies

Introduction

To ameliorate high turnover in child welfare, researchers have attempted to identify factors that lead to undesirable turnover. While this has been studied extensively, little attention has been paid to turnover based upon job roles. Like social workers in child welfare, the field of child care also experiences high turnover. Child care workers employed in child welfare settings are no exception. The current study seeks to understand differential factors that impact intent to leave for preventive and child care workers employed in child welfare agencies.

Materials and methods

Data for prevention workers (n = 538) were obtained from all preventive service programs under contract with the City. Data for child care workers (n = 222) were obtained from three voluntary agencies located elsewhere in the State. The instrument was a modified version of a survey developed to examine job satisfaction and potential turnover among public child welfare workers. Domains measured included job satisfaction, intention to leave, career commitment, and agency investment. Data were analyzed using bivariate analysis and Structural Equation Modeling (SEM).

Results

Child care workers had more positive perceptions of child welfare and planned to stay in child welfare longer. Despite this, prevention workers felt more invested in their work. Child care and prevention workers had different levels of satisfaction with their jobs although overall job satisfaction did not differ nor did their intention to leave. Tenure at the agency was predictive of career investment. Investment, perceptions of child welfare, satisfaction with nature of work, and contingent rewards were associated with career commitment. Commitment and satisfaction with supervision were the greatest predictors of intention to leave.

Discussion

There is a gap in literature addressing child care workers in child welfare, and future study of this group is needed. Child care workers are just as likely to intend to leave their jobs as prevention workers. For both groups, it appears that investment in their jobs increases commitment to the field which reduces intention to leave.     

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.     

Randomized trial of Promoting First Relationships: Effects on maltreated toddlers' separation distress and sleep regulation after reunification

This study investigates the impact of an attachment focused intervention, Promoting First Relationships (PFR), on sleep problems among toddlers in child welfare recently reunified with their birth parent. Recently reunified parent–toddler dyads (n = 43) were drawn from a larger random control trial. Toddlers (11–36 months) and their parents were assessed in two-hour research home visits at enrollment (baseline), and a 6-month post-intervention follow-up. Measures included parental report of sleep problems and research visitor observation of separation distress (using the Toddler Attachment Sort-45). The PFR intervention predicted fewer sleep problems, adjusting for a baseline measure of sleep problems and other covariates. A path model showed evidence of an indirect effect of PFR on sleep problems through declines in separation distress. An attachment focused intervention like PFR that reduces infant separation distress can lead to reductions in sleep problems.     

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.     

Replication of the KEEP foster and kinship parent training program for youth with externalizing behaviors

This article presents findings from Maryland KEEP, a replication of KEEP (Keeping Foster and Kinship Parents Trained and Supported), a foster and kinship parent training intervention. We examined child behavior change, changes in caregiver parenting style, and permanency and placement stability at baseline and then after the KEEP intervention. The KEEP intervention was provided to 65 foster and kinship parents providing care for children ages 4–12. Children who participated in the study were referred due to behavior problems, as reported by foster parents: they all scored in the clinical range for externalizing behavior on the Child Behavior Checklist (CBCL). Baseline and posttest analyses assessed for child behavior and parenting style changes. Permanency data, including placement moves and exits from child welfare were examined. Overall, foster and kinship parents reported significantly fewer child behavior problems at posttest; severity levels on the CBCL and scores on the Parent Daily Report decreased. However, there were not any changes in parenting styles from baseline to posttest. Placement stability significantly increased between baseline and post-KEEP intervention. The results provide support for the effectiveness of KEEP for a child welfare population with a high level of behavior problems and for the effectiveness of KEEP as a training program for foster and kinship parents.     

Connective complexity: African American adolescents and the relational context of kinship foster care

Attempts to address racial disproportionality in child welfare must include a focus on the benefits and challenges facing children in kinship care. African American children not only are overrepresented in the child welfare system, but also are placed disproportionately in kinship foster care. Using a sample of 18 African American adolescents ages 11 to 14, this article explores how the relational context of care experienced by adolescents in kinship foster care differs from that of adolescents in nonkinship foster family placements. Findings are presented regarding the stability of relationships as well as complex role dilemmas experienced by kinship youth as they relate to caregivers and birthparents in the child welfare context. Implications are given for practice with kinship families.     

Intention to leave in social workers and educators employed in voluntary child welfare agencies

Introduction

Individuals employed in child welfare settings can have a profound impact on children in care. Research shows that direct care staff can have an effect on emotional and physical outcomes for children with whom they work. This paper seeks to expand knowledge of the child welfare workforce by studying educators employed in child welfare settings and comparing their job satisfaction and intent to leave with that of prevention workers employed in similar settings.

Materials and methods

Data for prevention workers (n = 538) were obtained from workers employed at all preventive service programs under contract with a large municipality. Data for educators were obtained from voluntary agencies located elsewhere in the state (n = 139). The instrument was a modified version of a survey developed to examine job satisfaction and potential turnover among public child welfare workers. Domains measured included various aspects of job satisfaction, intention to leave, and whether workers regretted taking their jobs. Data were analyzed using bivariate analysis and structural equation modeling (SEM).

Results

While both educators and prevention workers varied on different domains of job satisfaction, their overall satisfaction did not differ nor did their intention to leave their jobs. Satisfaction with contingent rewards, the nature of the work and opportunities for promotion along with not regretting taking one's job were predictive of thinking about leaving one's job. Thinking about leaving was predictive of taking concrete steps towards actual leaving.

Discussion

While people both prevention workers and educators report different levels of job satisfaction and work conditions in their agencies, job title itself has less to do with a worker's intention to leave, as measured by both thinking about leaving and taking steps towards actively looking for a new job, than other factors. Larger contextual factors may be at play in workers' decisions to stay employed. Suggestions are made for reducing turnover intentions along with suggestions for further study to clarify the role of organizational factors in workers' intention to leave.