Mental health service utilization and time to care: A comparison of children in traditional foster care and children in kinship care

Existing research indicates that children who are involved with the child welfare system and placed in various forms of out-of-home care experience emotional and behavioral problems. It is also suggested that children placed in kinship care are less likely to receive mental health services than children placed in non-kinship foster homes. This study sought to compare children in non-kinship foster homes to children in kinship care to determine their receipt of mental health services and the time it took for children in kinship care to receive mental health services compared to children in non-kinship foster homes. Using a Cox regression, researchers determined that children in kinship care had a 14% lower likelihood of receipt of mental health services compared to their counterparts in non-kinship foster placements.     

Behavior Problems of Sexually Abused Children in Foster Care

Research has shown that sexually abused children display a number of behavior problems. Many of these children are placed in substitute care, especially foster homes. The current project was undertaken to measure foster parents' perceptions about the behavior problems of sexually abused children in their care. Two studies were completed. The first was a large survey of foster parents in a Midwestern state. The second study utilized a sample of foster parents to complete a standardized behavior inventory which has previously been used in child sexual abuse research. The types of behavior problems described by foster parents and implications for future research are discussed.     

A Study of Adopted Children,Their Environment,and Development: A Systematic Review

The study explores the developmental consequences for children who have been adopted. The comparison group is comprised of their non-adopted siblings or children in foster homes or group care. A search in scientific databases resulted in more than 3,300 hits about adoption. Among these, 56 fulfilled the selection criteria from 17 studies across more than 2,000 adoptees and controls. Adopted children scored higher on IQ, school-performance, and lack of behavioral problems than their non-adopted siblings or peers who stayed behind in orphanages or foster homes. The results from OECD countries were similar to those from studies in Chile, Lebanon, and India.     

Selective Campaigning for Foster Homes: An Empirical View

Experts on child welfare agree that it is vastly more desirable to care for children separated from natural parents in foster homes than in institutions. However, a shortage of foster homes has been a perennial problem in virtually every community in which they are needed. It would appear that, to the extent to which potential foster parents do exist in a community, this shortage could be attributed to inadequate and/or misdirected publicity.     

Attitudes of special foster parents and residential staff towards children

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

Understanding Responses to Foster Care: Theoretical Approaches

Foster children making the transition from birth to foster homes or from foster homes to foster homes often present problematic behaviors. Limitations of attachment theory and reactive attachment disorder are presented, and three alternative approaches for understanding behaviors exhibited in foster settings are presented: conservation of resources, child alienation model, and developmental trauma disorder.     

Separation and loss: Assessing the impacts on foster parent retention

Foster family homes are utilized as the primary substitute care arrangement for over one-quarter million dependent children annually in the United States. An unsuccessful retention of foster family homes permeates the country's foster care system, thus requiring a determination of the major factors which contribute to foster parent retention or loss. To this end, a comparative census survey of a statewide foster parent population was conducted. When respondents from currently licensed homes were compared with those previously licensed on factors pertaining to the separation and loss experience, significant differences were found in two major dimensions: (1) training and (2) agency services and supports. Both dimensions were indicated to be viable factors of foster parent retention.     

Policy and practice for response to foster families when child abuse or neglect is reported.

For reasons discussed in this article, it is in the nature of family foster care that allegations of abuse and/or neglect in foster homes will arise. How an agency acts before, during, and after these eventualities has long-lasting implications for the well-being of foster children and of foster parents and their own children, as well as for foster home recruitment.     

Influence of Age on Transracial Foster Adoptions and Its Relation to Ethnic Identity Development

In the United States, ethnic minorities are disproportionately represented in the foster care system and underrepresented among potential adoptive parents. The need to find permanent homes for foster children has led to an increase in the controversial practice of transracial adoption (TRA), wherein ethnic minority children are placed in adoptive homes with Caucasian parents. While many child welfare scholars and dependency stakeholders support TRA as a positive alternative to foster care, others are concerned that such adoptions may inhibit the ethnic identity development of transracially adopted children. This article documents the large number of ethnic minority children who are adopted through TRA prior to the onset of ethnic identification and how age influences which children are adopted out of foster care. The findings indicate that young ethnic minorities are significantly more likely to be adopted through TRA compared to older children, an effect especially prominent among African Americans. Implications for the child welfare system are discussed.     

Post-permanency discontinuity: A longitudinal examination of outcomes for foster youth after adoption or guardianship

For over two decades, federal policies and case practices in child welfare have shifted to prioritize legal permanence for children in foster care, and increasing numbers of children have been placed in permanent adoptive or guardianship homes. Despite this change, little research has examined the long-term stability of legally permanent adoptive and guardianship homes for former foster youth. This study used child welfare administrative records to track a population of 51,576 children in Illinois who exited foster care through adoption or guardianship for ten years or until the age of majority. Univariate and bivariate analyses were conducted to describe the population, and a multivariable Cox proportional hazards model was estimated to examine the relationship between child age and discontinuity, controlling for several pre-placement characteristics. Results indicated that the vast majority (87%) of children did not experience post-permanency discontinuity. In addition, African American children and children who had more moves in foster care had a higher hazard of discontinuity, while children placed with siblings and children who spent three or more years in foster care had a lower hazard of discontinuity. Study findings also indicated that prevention efforts should be targeted at families with adolescents. This study contributes significantly to the scant literature on long-term outcomes for adoptive and guardianship families, and suggests several areas for future research.     

Urban American Indian/Alaskan Natives compared to non-Indians in out-of-home care

Historically, American Indian/Alaskan Native (AI/AN) children have been disproportionately represented in the foster care system. In this study, nationally representative child welfare data from October 1999 was used to compare urban AI/AN children to non-Indian children placed into out-of-home care. Compared to non-Indian children, urban AI/AN children were older, were more often male, came from poorer homes, and were more frequently placed into group homes/ residential placements. Urban AI/AN caregivers had a greater prevalence of alcohol abuse and mental health problems compared with non-Indian caregivers.     

The Youngest Victims of Violence: Examining the Mental Health Needs of Young Children Who Are Involved in the Child Welfare and Juvenile Justice Systems

Children placed in the state’s custody due to neglect, abuse or maltreatment are one of America’s most vulnerable populations. Seventy-five percent of child victims of maltreatment are under the age of 12. Not only is their suffering a problem, these children are also at increased risk for delinquent behavior later in life. While research has documented the potential long-term consequences of child abuse and neglect, the mental health needs of young children involved in the foster care and juvenile justice systems have been largely overlooked. This study examined the social, emotional and behavioral difficulties of 670 children, age 3–11, who were involved in the child welfare and juvenile justice systems. Children in this study were living in residential treatment facilities, group homes, foster care homes or were receiving intensive home-based services. To assess the children’s mental health needs caregivers completed the parent form of the Strengths and Difficulties Questionnaire (Goodman, Journal of Child Psychology and Psychiatry 38:581–586, 1997). The findings indicated a high prevalence of mental health problems, with 81 % of the children in the sample having a total difficulties score in the borderline or abnormal range and 90 % of the children having borderline or abnormal scores on at least one of the subscales (conduct, emotional, peer or attention problems). When characteristics such as gender, race and age were considered significant differences were found among boys and girls, Caucasian and minority children, and age groups. The findings highlight the importance of mental health assessment and interventions that are gender and culturally sensitive and developmentally appropriate.     

Enhanced services and stipends for foster parents: effects on retention rates and outcomes for children.

Current national trends show that although the number of available foster homes is shrinking, the number of children and adolescents being cared for in the family foster care system is growing. This study demonstrates the significant benefits to both foster parents and the children in their care of providing enhanced services and stipends to foster parents.     

Children with problematic sexualized behaviors in the child welfare system

This study assessed the utility of the Child Sexual Behavior Inventory (CSBI) in a child welfare sample. In this study, 97 children from ages 10 to 12 from either foster boarding homes or a residential treatment center participated. Researchers interviewed foster parents or primary therapists about children's sexual behavior, traumatic events, clinical symptoms, and their attitudes toward the child. Findings revealed that problematic sexualized behaviors were more prevalent in the residential treatment center (RTC) sample than they were in a normative sample. The pattern of associations between sexual behavior problems, traumatic events, and clinical syndromes in both the RTC and the foster boarding home (FBH) samples was similar to what has been found in samples in which biological custodial parents were the respondents. Analyses comparing youth who met the criterion for having problematic sexualized behaviors and youth who did not meet the criterion revealed that the two groups differed on clinical symptoms, prior traumatic events, and negative reports by caregivers. Results confirm the utility of the CSBI measure for this population and highlight several important clinical and programmatic concerns for addressing problematic sexual behavior in children in the child welfare system.     

Carers of Children: A Comparative Study of the Practices of Residential and Foster Carers

SUMMARY. This article takes further the themes outlined in Children & Society, Volume 3(1) of examining the practices of special foster and residential caregivers in terms of the management of daily and other recurrent social events, and the methods used by caregivers to control children. Data are also presented on the role activities of caregivers and their interactions with children. Care practice in the special foster homes was generally found to be significantly more child-oriented than in the children's homes, and possible explanations for this are considered. Evidence is presented which serves to counter the tendency, in the wake of recent controversy surrounding children's homes, to scapegoat caregivers and children for shortcomings in residential care. The article has important implications for residential caregivers and foster care workers; and also for administrators and other child welfare professionals such as |field social workers, educational psychologists and psychiatrists.     

Out-of-home maltreatment: An analysis of risk in various settings for children

Abuse and neglect of children in out-of-home care are common, but comparisons of relative risk among such facilities are rare. Data from Indiana for the period 1984–1990 permit an examination of maltreatment in various settings and computations of rates of physical and sexual abuse and neglect. Findings suggest that children in daycare homes and centers and schools are less likely to be maltreated than those in foster homes, residential homes, or state institutions and hospitals. These differences in risk may reflect variation in staff morale and turnover, different ages and experiences of children, alternative emphases on custody, control or nurturance by the home or institution, and different approaches to substantiating abuse. However, in three of the seven out-of-home settings, there are higher rates of maltreatment than for children in their own homes. Some implications of these findings are explored.     

Reviews

This paper presents the findings of a study of Aboriginal children whom the South Australian Department of Aboriginal Affairs placed in foster homes between 1954 and 1966. It is an attempt to follow up one of the many problems expressed by social workers in Adelaide during a study of Aborigines and their use of social agencies.     

Parent Management Training, Relationships with Agency Staff, and Child Mental Health: Urban Foster Parents' Perspectives

Many foster parents are ill prepared to meet the behavioral needs of children placed in their homes. Research suggests they lack training in evidence-based behavioral interventions and feel unsupported by child welfare professionals. Given the complex needs of foster children and increased rates of placement disruption for foster children with behavior problems, implementation of effective interventions is essential. However, little is known about foster parents' receptivity to these types of interventions. In this qualitative study, we examine urban foster parents' perceptions of the specific elements of parent management training (PMT), an evidence-based treatment for disruptive behaviors that teaches parents to improve desired behaviors and decrease oppositional behaviors by rewarding positive behaviors (positive reinforcement) and responding to negative behaviors with mild, consistent punishments such as timeout or a privilege removal. We present data from four focus groups (N = 38). While the questions focused on parent's perceptions of PMT, responses often related to parent interactions with agency staff. Four strong themes emerged from the data. First, foster parents discussed a need for more support and training in how to address children's behaviors, but also had concerns that some PMT discipline techniques would be ineffective based on their past experiences with foster children. Second, they described how staff communication skills and allegations of child abuse could affect parents' motivation to continue fostering. Third, they expressed a need for more detailed information about children's histories and visits with biological families as the lack of information contributed to difficulty in meeting foster children's needs. They suggested that joint training of foster parents and staff in the intervention could improve their ability to work together to support the child's positive behaviors. Finally, parents reported little involvement in child mental health services and doubted the effectiveness of the mental health services their foster children received.     

Foster home licensing and risk of reentry to out-of-home care following family reunification

Family reunification without subsequent reentry is the primary permanency goal for children placed in foster care. While a number of placement-level factors have been examined for their effect on subsequent reentry to care, no study to date has considered foster care licensing. The current study uses statewide administrative data to construct a cohort of foster care youth who entered care between 2009 and 2012 and were reunified by the start of 2013 (N = 7752) to investigate the association between types of foster care and the probability of reentry to foster care up to two years following reunification. We focus specifically on the licensing status of foster homes, and employ propensity score analysis to address selection bias in placement type. A propensity-weighted cox proportional hazard model revealed that youth placed in licensed relative care (LRC) homes and licensed non-relative care (LNC) homes were more likely to reenter foster care than those youth placed in unlicensed relative care (URC) homes during their first spell of foster care.     

Comparing the health status of low-income children in and out of foster care

Children in foster care face poverty, family dysfunction, neglect, and abuse, with high rates of chronic health, emotional, and developmental problems. This study compared the overall health status of a group of children entering foster care with a group of Medicaid-eligible children living with their parents, matched for age and gender. It identified significantly more health and developmental problems in children in foster care than in the comparison group. Possible contributors to the higher percentage of problems among foster care children may be that the foster children have more problems related to the underlying risk factors resulting in placement, or that the foster care physicians conducted a more comprehensive assessment or had lower clinical thresholds. Further research is necessary to identify and treat the problems of this high-risk group.