Children in Foster Care and the Development of Favorable Outcomes

Young foster children have invariably faced a variety of risks that are strongly linked to long-term deficits in functioning across multiple developmental domains. Despite these risks, however, some children demonstrate more favorable outcomes and exhibit adaptation and the development of assets. In the present study, the relationship of early childhood factors (e.g., maltreatment history, placement history, parenting practices, environmental stress, developmental status, and attachment behavior) to the development of favorable outcomes in middle childhood was examined in a sample of foster children who had been in foster care in preschool (N = 35). Favorable outcomes were defined as demonstrations of emotion regulation and school adjustment during middle childhood. Developmental status (particularly attention and executive functioning) and a lack of environmental stress during early childhood foster care experiences had a significant positive relationship with the development of emotion regulation and school adjustment in middle childhood.     

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

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

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

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

Protective factors among families with children at risk of maltreatment: Follow up to early school years

The purpose of this study is to explore both risk and protective factors of child maltreatment among at risk elementary school children. This study used data from the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN), following a cohort of 405 children from age 4 to age 8. Multivariate logistic regression revealed that children attending preschool irregularly (OR = 2.98; 95% CI: 1.08-8.26), families with a high level of life events (OR = 2.68; 95% CI: 1.12-6.41), and mothers with a history of childhood maltreatment (OR = 2.26; 95% CI: 1.07-4.76) were more likely to have a child maltreatment report. In contrast, mothers who were married (OR = 0.19; 95% CI: 0.06-0.64), mothers who attained 12 or more years of education (OR = 0.09; 95% CI: 0.02-0.34), and family with high level of social support (OR = 0.29; 95% CI: 0.11-0.80) were less likely to have a child maltreatment report. For mothers who had not graduated from high school, adequate social support reduced the risk of child maltreatment by a factor of two. The provision of adequate social support should be incorporated into child maltreatment prevention programs, particularly those targeting at risk families.     

The assessment of drawings from children who have been maltreated: a systematic review

This paper presents a systematic review that aims to identify studies using drawing techniques with maltreated children. The paper first introduces the relevant developmental theory relating to children's drawings and its application to practice. Studies using drawing techniques with maltreated children were identified from both the research and practice literature. These were summarized and compared. The evidence from the studies appears relatively inconclusive as to the value of children's drawings for the identification of possible maltreatment, although they do apparently help in aiding recall of important events. Drawings are widely used to assess maltreatment and neglect of children. However, researchers advocate caution in generalizing and interpreting drawings from children with differing experiences. Copyright © 2002 John Wiley & Sons, Ltd.     

School-based early intervention and child well-being in the Chicago Longitudinal Study

Chicago Child-Parent Centers provide comprehensive education and family support services to young, low-income children. Using data from 1,539 children in the Chicago Longitudinal Study, preschool participation was associated with significantly higher levels of school readiness, achievement, and educational attainment, and with lower rates of child maltreatment, juvenile delinquency, special education placement, and grade retention. Every dollar invested in the preschool program returned 7.14 dollars to society at large. School-age intervention also provided economic returns that exceeded costs. Findings provided strong evidence that large-scale, public, early interventions can enhance children's well-being. The authors recommend greater investments in programs with elements similar to the Child-Parent Centers.     

Child welfare supervised children's participation in center-based early care and education

Research suggests that early care and education (ECE) services, particularly center-based ECE, may help prevent child maltreatment and also mitigate some of the negative developmental outcomes associated with child maltreatment. There is also preliminary evidence to suggest that ECE could reduce the likelihood that maltreatment allegations will be substantiated by child welfare authorities and/or result in children being placed in out-of-home care. However, little is known about rates of ECE participation among children receiving child welfare services, nor the factors that determine ECE participation for this population. Data from the first wave of the National Survey of Child and Adolescent Wellbeing II, a nationally representative sample of children referred to the United States (U.S.) child welfare system (CWS) for suspected maltreatment, were used to measure the frequency with which 0–5 year olds participate in center-based ECE. Additionally, logistic regression analyses explored the effects of maltreatment type, substantiation, and children's living arrangements (i.e., with parents, relatives, or foster parents) on this outcome, controlling for a range of child and family covariates associated with ECE participation in the general population. Results indicate that less than a third of 0–5 year olds receiving child welfare services in the U.S. are participating in center-based ECE. Among the various categories of maltreatment type measured, being reported to the CWS for suspected physical abuse was associated with decreased odds of center-based ECE participation; however, other types of maltreatment, substantiation, and living arrangement were unrelated to center-based ECE participation. These findings suggest that, despite recent efforts by the U.S. federal government to promote ECE participation for CWS-supervised children, the vast majority of young children in the U.S. CWS are not receiving center-based ECE, and physically abused children are particularly disadvantaged when it comes to accessing these services.     

Child maltreatment dynamics among immigrant and U.S. born Latino children: Findings from the National Survey of Child and Adolescent Well-being (NSCAW)

Latino children are the largest and fastest growing ethnic minority group in the United States, and the proportion of child maltreatment victims who are of Latino ethnicity has been growing since 2000. However, our knowledge of the characteristics, maltreatment patterns, and risk factors associated with maltreatment among immigrant and U.S. born Latino children and their families has been incomplete. The goals of this study are to establish the national prevalence of immigrant and U.S. born Latino children who come to the attention of child welfare systems in the United States; to expand our knowledge regarding the role of nativity in child maltreatment patterns among Latinos; and to determine if disparities in child maltreatment patterns and risks exist among Latino families using data from the National Survey of Child and Adolescent Well-being. Despite considerable risks, data indicate that immigrant Latino children are slightly underrepresented among children who present to child welfare systems when compared to the general population. Moreover, no significant differences were observed between immigrant children and U.S. born children with regard to substantiation patterns. However, significant differences emerged between the two groups in risk factors and maltreatment type, warranting further investigation.     

The early home environment and developmental outcomes for young children in the child welfare system

The quality of the early home environment is predictive of young children's subsequent cognitive, academic, and behavioral functioning. Limited research has focused on the effects of the early caregiving environment on the functioning of young children involved with the child welfare system. This study investigated the influence of children's home environments (i.e., number of children in the home, number of moves the child experienced, level of cognitive stimulation, and level of emotional support) during the first 2 years of life on their preschool developmental outcomes (i.e., cognition, language, social skills, and behavior problems).As anticipated, a high-quality early home environment promoted the well-being of preschool children who had entered the child welfare system as infants. Children who lived with greater numbers of children incurred more compromised cognitive, language, behavioral, and social outcomes. No significant associations emerged between the total number of placements and developmental outcomes; children who remained in the same home during infancy (typically the birth family home) had more compromised developmental outcomes in every domain except behavioral problems.Both cognitive stimulation and emotional support in the home predicted higher cognitive and language scores, decreased behavioral problems, and increased social skills. Early out-of-home placement and lack of emotional support interacted to predict children's behavioral problems. These findings are considered in the context of extant research and policy relevant to young children in the child welfare system.     

Maltreatment of children with developmental disabilities: An ecological systems analysis

The purpose of this review is to understand the risk factors for maltreatment of children with developmental disabilities. Using the Bronfrenbrenner's (1976, 1977) ecological systems framework, the authors examine how socio-demographic characteristics (age, gender, and special education), micro- (parent-child relationship and domestic violence), exo- (parenting stress, parents' social support, and area of residence), and macrosystems level (culturally defined parenting practices) factors influence or inhibit maltreatment of children with disabilities. The authors highlight major implications for practice and policy for maltreated children with disabilities.     

Parental Depression and Child Outcomes: The Mediating Effects of Abuse and Neglect

Using longitudinal data on 1,813 children and parents from a nationally representative child‐welfare sample, National Survey of Child and Adolescent Well‐Being (NSCAW), this study investigated physically abusive and neglectful parenting as mediating the effects of parent depression on child mental health by developmental stage. Findings from latent growth models indicated that parental depression had a significant impact on child outcomes for all youths, but of the 2 types of parenting behaviors, only neglectful parenting mediated the relationship for preschool and school‐aged children. Neither parenting behavior mediated the effects of parental depression for adolescents.     

An evaluation of the effects of an integrated services program for multi-service use families on child welfare and educational outcomes of children

The purpose of the study was to evaluate a program that provides integrative case management for families dependent on at least two government services (e.g., child welfare, disability, chemical dependency, vocational rehabilitation). In the current study, we focused on effects of services on children's educational and child welfare outcomes two years after program exit. Children enrolled in the program were compared to a community comparison sample through propensity score matching. None of the group differences was significant. However, outcomes related to child maltreatment (number of child maltreatment reports accepted by Child Protective Services and out-of-home placements) improved dramatically within two years after exit. Outcomes in the education area were less uniformly positive. On the one hand, children's attendance was high and school mobility was low. In addition, there was a significant reduction in the number of children receiving special education services two years after exit. Nevertheless, a third of the children were still receiving special education services two years after exit, and their academic performance on standardized reading and math tests was quite poor. Thus, the intensive case management model was related to successful outcomes in an area directly targeted by the program (child maltreatment), but the gains did not generalize to another domain that was not an explicit focus of the program (academic achievement).     

Age Variation in Performance Among Preschool Children in a Sexual Abuse Prevention Program

The purpose of this study was (a) to determine whether preschool age children could be taught sexual abuse prevention skills and concepts, and (b) to determine if any variation in performance exists as a function of the age of the child. Over 1300 preschool children ages 3-to-6-years were pretested and either participated in the prevention program or a control program. Children were posttested on knowledge and skill gains. Children who participated in the prevention program demonstrated greater knowledge of prevention skills and concepts compared to age matched controls. The benefits of participation in prevention program varied across age groups. Multiple comparison of posttest means indicated that trained 4-, 5-, and 6-year-olds demonstrated significantly greater knowledge of prevention skills and concepts than 3-year-olds. Trained 6-year-olds demonstrated significantly greater knowledge than trained 4-year-olds. The results indicate that preschool age children can be taught prevention skills and concepts. However, benefit from participation in prevention programs varies with age.     

A cumulative ecological–transactional risk model of child maltreatment and behavioral outcomes: Reconceptualizing early maltreatment report as risk factor

The current analysis was designed to critically examine the tendency to focus on child maltreatment as a unique risk factor and test the resulting assumption of a direct causal relationship between early maltreatment and later behavioral problems. The variation seen in behavioral outcomes among children reported for maltreatment early in life led us to hypothesize that the cumulative level of risk facing children and their families can, at least in part, account for that variation in outcome. Participants were 242 mothers of predominantly at-risk newborn infants who were interviewed shortly after giving birth. The State Central Registry of Maltreatment was then reviewed over each child's first four years of life to assess for early maltreatment. Following the neonatal interviews, mothers completed the Child Behavior Checklist when their children were 4, 6, 8, 10 and 12 years-of-age. Although early maltreatment report does appear to be important to early child functioning, the cumulative level of risk more strongly predicts long-term clinical behavioral difficulty. High-risk children who were not reported for maltreatment by age 4 demonstrate greater behavioral problem trajectories than did low-risk children with a maltreatment report. Maltreatment itself may be best conceptualized as an important, but not singularly so, risk factor for later behavioral problems. In focusing directly on reported maltreatment, our child protective systems may be paying too little attention to what else is going wrong in the lives of children and targeting intervention efforts in the wrong direction. When it comes to early maltreatment our child protective policy and practice need to broaden their lenses to include greater emphasis on overall family functioning, stress and well-being. Early maltreatment, it seems, may be a symptom of more profound problems in the early environments of our most vulnerable children, rather than the problem itself.     

Maltreatment prevention through early childhood intervention: A confirmatory evaluation of the Chicago Child-Parent Center preschool program

Increased recognition of the consequences associated with child maltreatment has led to greater emphasis on its prevention. Promising maltreatment prevention strategies have been identified, but research continues to suffer from methodological limitations and a narrow focus on select prevention models. This investigation uses data from the Chicago Longitudinal Study to examine mediating mechanisms that link the Chicago Child-Parent Center preschool program to a reduction in overall child maltreatment and, more specifically, child neglect. We use structural equation modeling to test child, family, and school measures hypothesized to mediate the effects of CPC participation on maltreatment and neglect. Results indicate that a substantial proportion of the program's impacts can be accounted for by family support processes, including increased parent involvement in school and maternal educational attainment as well as decreased family problems. The CPC program's association with reduced school mobility and increased attendance in higher-quality schools also significantly mediated its effects on maltreatment and neglect. Further, a decrease in troublemaking behavior contributed modestly to mediating the program's association with maltreatment but not neglect. We discuss the implications of these results for the field of maltreatment prevention.     

Psychological Symptoms of Sexually Victimized Children and Adolescents Compared With Other Maltreatment Subtypes

The differential effects of sexual victimization and other forms of maltreatment on psychological functioning are not well understood. A sample of sexually victimized children and adolescents (N = 70; 6.3–17.9 years) and a group of youth with a history of nonsexual maltreatment (N = 108; 6.7–16.9 years) were compared using measures of mental health and psychosocial functioning. Assessments included standardized clinical interviews on individual maltreatment history and current psychopathology as well as questionnaires on behavioral and emotional symptoms, including posttraumatic stress symptoms. The results from this study suggest that the risk of experiencing any current mental disorders was independent of type of maltreatment. The risk of meeting the criteria for a current diagnosis of major depression, however, is greater among youth with a history of maltreatment that includes sexual victimization. The significant impact of sexual victimization on posttraumatic stress symptoms was found to be nonsignificant after controlling for age and gender effects. The results indicate that the outcomes of child maltreatment depend on type of maltreatment, but age and gender must be taken into account.     

Why should child welfare pay more attention to emotional maltreatment?

A significant body of research indicates that emotional maltreatment (EMT) is harmful to children, resulting in long-term negative impacts on emotional and behavioral development. The child welfare system's focus on physical abuse, physical neglect, and sexual abuse has led a relative lack of attention to EMT. Reported rates of EMT vary widely across states – ranging from 0.2% to 44.9% in a recent national report on child maltreatment – indicating that it is not being measured consistently. This paper uses data collected by the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN) to (1) describe the nature and characteristics of emotional maltreatment experienced by 846 LONGSCAN youth across time, and (2) describe the relation between four subtypes of emotional maltreatment (psychological safety and security, acceptance and self-esteem, autonomy, and restriction) and child trauma symptoms and risk behaviors at age 18. Exposure to EMT was related to increased trauma symptoms and risky behaviors. EMT is common, identifiable, harmful, and potentially preventable; and a better understanding of it will help to inform the provision of effective child welfare and mental health services to children and their families. Findings suggest a need for greater understanding of parental behaviors, and the motivations behind them, that result in emotionally harmful outcomes for children, as well as a better understanding of appropriate interventions for children who experience various types of EMT.     

Predictors of child protective service contact between birth and age five: An examination of California's 2002 birth cohort

This study utilizes population-level birth data to describe those children who may be at greatest risk of maltreatment during the first five years of life. Based on a unique dataset constructed by linking California's administrative child welfare data to statewide vital birth records, a cohort study design was employed to track reports of maltreatment involving children born in 2002. Twelve variables captured in the birth record were selected for analysis. Generalized Linear Models were used to estimate adjusted risk ratios (RR) for each independent variable. Predicted probabilities of CPS contact were computed based on the count of risk factors present at birth. Results suggest that many of the associations previously observed between birth variables and subsequent maltreatment have sustained value in foretelling which children will be reported to CPS beyond infancy. Of the 531,035 children born in California in 2002, 14% (74,182) were reported for possible maltreatment before the age of five. Eleven of the twelve birth variables examined presented as significant predictors of contact with child protective services.     

Self-reported and case file maltreatment: Relations to psychosocial outcomes for youth in foster care

The aim of the current study was to explore the relation between maltreatment and psychosocial outcomes for youth in foster care, and how this relation differs according to reporter type (self-report or case file). Participants included 285 children and adolescents and their caregivers who completed self-report questionnaires about lifetime maltreatment and psychosocial adjustment. Youths' case files containing lifetime maltreatment reports were obtained from Division of Social Services (DSS), and were coded for physical and sexual abuse, emotional maltreatment, and neglect using the Modified Maltreatment Classification System (MMCS; English & LONGSCAN Investigators, 1997). Crosstabs analysis was used to summarize proportions of youth whose caregivers reported clinically significant internalizing and externalizing and average to high adaptive functioning within groups of youth who had a) neither self-reported nor case file maltreatment, b) only case file maltreatment, c) only self-reported maltreatment, and d) both case file and self-reported maltreatment for each maltreatment type (physical and sexual abuse, emotional maltreatment, and neglect). Results showed that externalizing symptoms differ according to reporter type for physical and sexual abuse, and that internalizing symptoms differ according to reporter type for sexual abuse. Implications for methodology in maltreatment research are discussed.     

The role of child care in supporting the emotion regulatory needs of maltreated infants and toddlers

Infants and toddlers who experience physical abuse and/or neglect are at a severe risk for disruptions to emotion regulation. Recent prevention and treatment efforts have highlighted center-based child care as an important setting for providing support to the needs of these children, as child care centers are already an existing point of entry for reaching high-risk families. Guided by ecological theory, this review draws on the maltreatment and child care literatures to consider the opportunity for child care centers, specifically teacher-child interactions within the classroom, to support the unique regulatory needs of maltreated infants and toddlers. Existing research on the effects of child care for children facing other types of risk, as well as research with maltreated preschool children, provides a foundation for considering the role child care may play for infants and toddlers, whose emotion regulation skills are just emerging. More research is needed regarding teachers' roles in facilitating effective emotional experiences in the classroom that meet the unique needs of maltreated children. Additionally, early childhood teacher training that focuses on infant/toddler mental health and a trauma-informed perspective of care, as well as structuring child care centers as communities of support for high risk families, all may aid child care centers in better serving this vulnerable population.