Promoting birth parents' relationships with their toddlers upon reunification: Results from Promoting First Relationships® home visiting program

Birth parents, once reunified with their child after a foster care placement, are in need of in-home support services to prevent reoccurrence of maltreatment and reentry into foster care, establish a strong relationship with their child, and enhance child well-being. Few studies have addressed the efficacy of home visiting services for reunified birth parents of toddlers. This study reports on the findings from a randomized control trial of a 10-week home visiting program, Promoting First Relationships® (Kelly, Sandoval, Zuckerman, & Buehlman, 2008), for a subsample of 43 reunified birth parents that were part of the larger trial. We describe how the elements of the intervention align with the needs of parents and children in child welfare. Although the sample size was small and most of the estimates of intervention effects were not statistically significant, the effect sizes and the pattern of results suggest that the intervention may have improved both observed parenting sensitivity and observed child behaviors as well as decreased parent report of child behavior problems. Implications are that providing in-home services soon after a reunification may be efficacious in strengthening birth parents' capacity to respond sensitively to their children as well as improving child social and emotional outcomes and well-being.     

Preparing and Partnering with Families to Support the Adoption of Children from Foster Care

ABSTRACT

This investigation evaluated the effectiveness of a pre-placement education and preparation curriculum (PREP) for prospective foster/adoptive parents in improving attitudes toward children with prenatal substance exposure and their substance-using birth parent and increasing willingness to adopt these children. Participants included 1,836 prospective parents seeking adoption through foster care who received three 3-hour sessions of PREP. Prospective parents completed questionnaires assessing their knowledge about important issues involved in adopting a child from foster care, attitudes, and willingness to adopt children with a variety of characteristics. Changes from pre- to post-intervention were examined. Results indicated significant increases in self-reported knowledge; significantly more positive attitudes toward substance-abusing parents and children with prenatal substance exposure; and significantly increased willingness to adopt children with a variety of potential difficulties, including children with serious behavior problems, attention deficit hyperactivity disorder, and a biological history of mental illness. In sum, findings suggest that prospective adoptive parents who attended the PREP sessions felt better prepared by the end of training with regard to issues related to adoption of high-risk foster children with special needs, particularly those with prenatal substance exposure.     

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.     

Parenting groups for parents whose children are in care

Excluding very severe child abuse cases, biological parents are usually encouraged to maintain contact with their children in care. Parent‐child contact is often considered important because it can maintain the child's psychological identity and well‐being. It can also maintain parent‐child attachment and in some cases facilitate reunification. Improving parenting skills is viewed as an important method by which contact between children and their biological parents can be enhanced. However, mainstream parenting groups are often unsuitable for parents whose children are in care for a number of reasons. There is stigma involved with having children in care, such parents have very complex lives and there are reduced opportunities to practise skills learnt with their children. Groups designed specifically for parents whose children are in care appear to be a promising approach to improving the quality of contact between these parents and their children. This paper will review group‐based approaches to working with biological parents whose pre‐school‐aged children have been placed in care. The paper will also report the findings of a research project designed to identify key facilitators and barriers to parental involvement in a group‐based programme which includes contact between parents and their children who have been placed in care. Copyright © 2009 John Wiley & Sons, Ltd.     

Parenting stress of grandparents and other kin as informal kinship caregivers: A mixed methods study

Informal kinship caregivers provide the majority of out of home care to children who can no longer safely stay with their biological parent. Yet their parenting challenges are understudied since they are often left out from child welfare and other service systems. This mixed methods study, using a survey and focus groups of grandparent and other kin, examined predictors and sources of parenting stress. Quantitative findings suggested that the kinship family's needs and the caregiver's health and emotional well-being adversely affected parenting stress. Grandparent caregivers experienced an elevated level of parenting stress compared to other kin caregivers. Qualitative findings suggested that financial strains, concerns over children's behavior, navigating service systems and difficult relationships with birth parents contributed to their stress. It appeared that grandparent caregivers faced special challenges due to generational gaps, guilt and concerns over birth parents.     

Parents' views of adoption disruption

In-depth, semi-structured interviews were carried out with 12 couples and 3 single adoptive parents whose adoptions of special needs children, aged 4 to 17, had disrupted, that is, terminated prior to legal finalization. The disruption was highly stressful and painful for most parents. Six themes emerged in the interviews: (a) the inability of the children to attach to the adopting families, (b) the childrens' difficulties in letting go of birth families, (c) the parents' expectations of a less difficult child, (d) the impacts of unresolved infertility issues on the adoptive process, (e) gaps in information and child history and (f) the importance of worker expertise and support. The benefits of long-term foster care for some children are discussed.     

An intensive perinatal mentalisation-based intervention for women at risk of child removal and the role of restorative relationships

Pregnant women with a history of child removal are at greater risk of being found unsuitable to care for their new babies. Neglect, showing a lack of capacity to provide for the child's physical and/or emotional needs, is the most frequent reason why infants are removed from their parents' care. Parents with a history of child removal have often been themselves subject to maltreatment as children and suffer the sequelae of relational trauma which then becomes a barrier to establishing nurturing relationships with their own children. Attachment, and particularly mentalisation-based, parenting interventions focus on restoring relationships by developing parents' capacity to reflect upon their own internal mental experiences as well as those of the child, helping them to better understand themselves and their children. The DAISY programme is an intensive perinatal attachment and mentalisation-based intervention for pregnant women with a history of child removal, aiming to improve mothers' mentalising capacities and care proceeding outcomes. This article uses a case study to describe the programme's model and mechanisms of change. Additionally, we present preliminary observations about the programme's delivery and impact from the perspective of one of its practitioners.     

Remaining home: Well-being outcomes and co-occurring parental substance use following a maltreatment investigation in middle childhood

PurposeThe purpose of the study is to understand differences in child well-being related to parental substance use among children ages 6–12 who were investigated for maltreatment but not removed from their homes. Children with a substance-using parent in the home are compared to those without a substance-using parent in the home.MethodsLongitudinal data from waves 1 and 3 of the second National Study of Child and Adolescent Well-Being (NSCAW II) are used. NSCAW II is a national sample of families with children and youth aged birth to 17.5 investigated by child protective services (CPS). A subset of the data (analyzed with domain analysis methods) is used for this study (n = 575). Eight well-being outcomes from four domains (cognitive development, physical health, psychological/behavioral development and social/emotional competence) are analyzed.FindingsWe hypothesized that (among children investigated for maltreatment and not removed from home) children whose parents used substances would exhibit lower mean levels of well-being at thirty-six months follow-up compared to those whose parents did not use. Unexpectedly, we found no significant differences in well-being levels between children with parents in the home using substances and those without.ConclusionsChildren with substance-using parents may be able to remain at home over an extended period after investigation, while maintaining well-being levels similar to children at home with parents not using substances. If an effective safety plan can be put in place, this option may provide a path to maintaining safety, permanency and well-being for such children without placement in out-of-home care.     

Do Foster Parents and Care Workers Recognize the Needs of Youth in Family Foster Care with a History of Sexual Abuse?

Children in family foster care have the right to participate in decisions regarding their life, however, adults often advocate on behalf of children. This Q methodological study explored whether shared perspectives among foster parents and care workers resemble shared perspectives of youth regarding the psychosocial needs experienced by youth with a history of sexual abuse. Participants sorted a set of statement cards according to what they thought was most important for youth. By-person factor analyses examined how the Q sorts of foster parents and care workers related to those of youth. The results showed that foster parents mostly recognized the group of youth who value an instrumental relationship with their carers, while care workers mostly recognized the group of youth who value support of both foster and birth parents with regard to their preparation for independent living. The two youth groups characterized by ambivalence and autonomy were barely recognized. Results are discussed in light of the expected roles of foster parents and care workers, and youth’s contact with birth parents. Lastly, this study highlights the importance of youth participation, because youth offer unique and varying perspectives about their needs.     

Communicating with parents

It is difficult to help a child whose parents are unavailable to the professional working with the child. Parents whose children have problems tend to be fearful of being judged and criticized. Anger or expressions of guilt may mask their fears about their own inadequacies and problems. All parents need to be listened to and understood before professionals can help the children. Communicating this understanding to the parents requires more than works. Listening, enabling parents to talk and talking with parents often needs to be supplemented by actions concrete services and even by play to enable the parents to trust enough to want to learn how to be better parents. Foster parents must also be drawn into a cooperative effort to help children in their care.This is an excerpt from the bookWork With Children to be published by Human Sciences Press in February 1979. This selection deals with communicating with parents, for until that is accomplished, there is no chance to communicate with children.     

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.     

“No Matter What I Do They Still Want Their Family”: Stressors for African American Grandparents and Other Relatives

Grandparents and other relatives increasingly assume the role of primary caregiver to minor children. This study interviewed family members caring for children whose parents were not available due to parental incarceration, other involvement in the criminal justice system, and substance abuse-related issues. Interviews with 25 African American women examined the impact of caregiving including stress and depression. Stress included caregiver issues related to finances, time allocation, care responsibilities, and concerns about the absent parent, as well as issues specific to the children related to school concerns, child behavior, and emotional problems. These stresses were examined along with caregiver depression scores using the Center for Epidemiological Studies Depression Scale, which indicated more depression related to caregiver illnesses, older caregivers, and care for older and a larger number of children. This study suggests that caring for these children is both challenging and stressful, and caregivers are at risk for depression and other mental health concerns. Health and service providers should carefully assess the needs of caregivers when determining the needs of families where children are under care of nonparental relatives. Family-based services are needed that include caregiver supports as well as support for children.     

Kinship Care Providers: Designing an Array of Supportive Services

Kinship care, the placement of children with their relatives, has become an integral part of the child welfare system in the United States. It is also becoming a more established way of meeting the needs of children in care in other western countries (Greeff, 1999). However, kinship care did not emerge as a child welfare issue until the late 1980s, and only recently has it become a part of the formalized system for out-of-home care (Hegar & Scannapieco, 1995). Since that time, many states have come to rely more heavily on placements with relatives to meet the needs of children removed from parental custody. For example, California has placed approximately 51% of the foster care population in kinship care, while Illinois has placed 55% (GAO, 1999).Discussion about the reasons for the increases in kinship care has been widespread (Brooks & Barth, 1998; Gleeson, 1999; Harvey, 1999; Hegar & Scannapieco, 2000). Regardless of the impetus behind the increased use of kinship care, states must now incorporate kinship foster care into the traditional foster care system in order to qualify them for federal funding (O'Laughlin, 1998). The Personal Responsibility and Work Opportunity Reconciliation Act of 1996 amended federal law to require that states give priority to relatives when deciding with whom to place children who are in the foster care system (GAO, 1999).The apparent paradigm shift from traditional foster parents to kinship care parents (Hegar, 1999) requires that agencies use both different approaches to assessment (Scannapieco & Hegar, 1996) and provide different types of intervention and services. Adapting placement services to the needs of kinship care providers is the focus of this article.     

Predicting Permanency Intentions Among Kinship Caregivers

This study examines kinship caregivers’ (n = 830) experiences and their perceptions of the children (n = 1,339) in their care in order to predict permanency intent. Permanency intent is a caregiver’s expressed intent to adopt the child in his or her care or to provide permanent, legal guardianship. The results of this study reveal that most caregivers’ permanency choice is guardianship and not adoption. However, binary logistic regression results uncovered six factors (i.e., thorough explanation of case plans, decreases in caregiver emotional stress, decreases in child depression, child lack of communication with birth parent, caregiver providing care for a sibling group, decreases in run-away behavior) that predict that a caregiver will adopt the child in his or her care. Policy, practice, and research implications are noted.     

Subsequent child protection contact for a cohort of children reported to child protection prenatally in one Australian jurisdiction

Repeated reporting to child protection is common. One approach to early intervention is for jurisdictions to receive and respond to child protection concerns raised before children are born. Despite this, little research has comprehensively examined subsequent child protection contact for those first reported prenatally. This study aimed to examine the subsequent child protection contact for up to a two-year period for a cohort of children who were reported about prebirth. Child protection administrative data were extracted for 640 children reported for a concern about an unborn child in a single jurisdiction during 2014. Data about child protection contacts included reports, investigations, substantiations and out-of-home placements for children reported prenatally. Of the 640 children, 79% reported about prenatally also had contact with child protection between birth and age two. From birth and up to age two, children reported prenatally had between zero and 21 reports. Twenty-two per cent of the children reported prenatally were removed from their birth parents and placed in out-of-home care prior to age two. These findings highlight the importance of intervening and supporting families prior to and during pregnancy to reduce harm to children and reduce the need for contact with child protection.     

The Abused and Neglected Foster Child: Determinants of Emotional Conflict and Oppositional Behavior

Behavioral and emotional problems have been observed in emotionally vulnerable children in foster care under certain circumstances. A common pattern involves the unpredictable appearance of a previously absent or unavailable natural parent. Such an occurrence precipitates the reawakening of the child’s ambivalent feelings toward both natural and foster parents as well as their fears of abandonment. This frequently leads to behavior that is oppositional and difficult to manage. If the foster parents find the child’s behavior unmanageable, and if they are not provided with appropriate professional support during this difficult period, a crisis often follows that precipitates the child’s removal from the foster home. Individual, familial, and systemic contributions to this dilemma are discussed" This article emphasizes the origins and nature of the intrapsychic dilemma faced by these children. Particular emphasis is placed on the manifestations of a conflict of loyalty, in the child, and its relationship to the oppositional behavior of these children in foster care. Additional considerations include the impact of inconsistent parenting, abuse and neglect by the natural parents, the assumption of a parental role by the child and a concomitant renunciation of the child’s dependency needs, as well as an examination of the role of the foster parent’s fantasy of what it will be like to parent a traumatized child.     

Parent-Child Interaction Styles Between Gay and Lesbian Parents and Their Adopted Children

SUMMARY

While myths exist that call into question the parenting ability of gay and lesbian parents as well as the impact of such parenting on children in their care, there is an ever increasing body of literature that clearly demonstrates the capabilities of these parents with their birth children. However, there continues to be a dearth of research on gay and lesbian adoptive parents and their children. To address this deficiency in the literature, this article explores the parenting styles of gay and lesbian adoptive parents and strengths of their children between the ages of 5–9 years (N = 94), using scores from the Parent-as-a-Teacher Inventory and the Behavioral and Emotional Rating Scale. Results illustrate that the gay and lesbian adoptive parents in this sample fell into the desirable range of the parenting scale and their children have strength levels equal to or exceeding the scale norms. Finally, various aspects of parenting style significantly predicted the adoptive parents' view of their child's level of care difficulty which subsequently predicted the type and level of strengths assessed within their adopted child. Recommendations for practice, policy and future research are highlighted.     

“It's really overwhelming”: Parent and service provider perspectives of parents aging out of foster care

Rates of pregnancy and parenthood among current and former foster youth are two to three times higher than non-foster youth peers. Repeat pregnancies among young mothers aging out of foster care also occur at higher rates than peers not involved with the child welfare system. Furthermore, mothers aging out of foster care demonstrate high levels of parenting stress and risk for child maltreatment. Indeed, this population is in significant need of help; however, beyond anecdotal evidence, little is known about the needs and day-to day experiences of this population. In order to tailor interventions to meet the needs of parents aging out, the perspectives of stakeholders must be taken into account. Using qualitative data gathered from separate small group interviews with parents aging out and service providers, this study examined participants' perceptions of parents' daily experiences, strengths, and needs. Findings indicated that parents aging out face overwhelming adversity and stress with little outside financial, emotional, or parenting support from family or friends. Yet, parents also expressed motivation to be good parents, resilience, and the desire to gain effective parenting skills. Although similar themes arose among parent and provider interviews, perceptions differed. Parents expressed hope and optimism in providing for their children while providers expressed systemic failure in preparing parents for independent living. Based on these findings, we conclude that parenting interventions specific to parents aging out may need to address three fundamental and key components: basic needs, social support, and effective parenting techniques.     

Romanian Adoptees and Pre-adoptive Care: A Strengths Perspective

Ninety-one parents of 120 adopted Romanian children who were part of a longitudinal study were surveyed to determine perceptions of their relationships with their children, their adoption experiences, and the children’s strengths. The Behavioral and Emotional Rating Scale (BERS) was used and parents were easily able to rate their children’s emotional and behavioral strengths. Levels of parent–child relationship satisfaction were the most consistent predictors of child emotional and behavioral strength. The child’s age at the time of the survey was a significant predictor of strengths, indicating overall that younger children had more perceived strengths. Parents identified fewer strengths among children with longer histories of institutional care. The importance of a strong parent–child relationship and resilience after a history of early institutional care are discussed.     

Perceptual difference of child neglect among Korean parents and children: Implications for child welfare policy

This study examined the perceptual differences in child neglect among Korean parents and children. The data were collected from a convenient sampling of 321 Korean parents and 294 children using the case statements developed by Giovannoni and Becerra (1979). The statements consisted of examples of child neglect in the following seven domains: (1) emotional neglect; (2) lack of supervision; (3) medical neglect; (4) educational neglect; (5) neglect of personal hygiene; (6) nutritional neglect; and, (7) drug/alcohol use. Findings showed that both Korean parents and children consider child neglect moderately serious while Korean children consider child neglect situations significantly more serious. Korean parents perceive emotional neglect as the most serious child neglect domain whereas Korean children perceive drug/alcohol use as the most serious domain of child neglect. Gender variation among Korean children indicates that girls are more likely to perceive the emotional neglect and lack of supervision domains more seriously than boys. The implications of the study offer valuable insights into policy development and program planning efforts in reducing the child neglect among Korean parents and children. Additionally, the findings of the study will likely contribute to the existing body of knowledge in the area of child neglect among Korean children and parents.