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.     

Risk factors for mental health diagnoses among children adopted from the public child welfare system

Children awaiting adoption through the child welfare system often have “special needs,” or characteristics that make securing an adoptive home for them challenging. A subset of these youth experiences significant psychiatric symptomatology, which may pose a problem for the stability of the adoptive placement. Clinicians and policymakers require information about precursors to mental health difficulties in order to plan effectively for the placement of these children.This study examines potential child and biological family risk factors for the presence of a DSM-IV mental health diagnosis among 368 children placed for adoption by a special needs adoption program between February 1997 and April 2005 using logistic regression within the Generalized Estimating Equations (GEE) framework. A significant proportion of the children and biological parents in our study experienced serious adversity prior to adoptive placement. Older age at adoptive placement, white race, male gender, having more than one placement, and a history of sexual abuse are significant predictors of the presence of a mental health diagnosis in the logistic regression model. Biological parent incarceration is significantly associated with the absence of a mental health diagnosis.Adoptive placement is a key transition for youth who have often experienced significant loss and trauma prior to placement. Support of the adoptive family and youth can be critical to ensuring placement stability and may be especially salient for youth with documented mental health diagnoses and corresponding behavioral problems, which put children at increased risk for placement disruption. More work is needed to understand the interplay of risk and protective factors for mental health difficulties among youth adopted from the child welfare system, including how these are affected by child welfare policies, informal procedures, and resources to produce varying outcomes for children in peril.     

Social work intervention with Bedouin-Arab children in the context of blood vengeance.

Blood vengeance is a culturally specific phenomenon that can place Bedouin-Arab children at high risk of neglect. This case study examines the psychological and social implications of vengeance on children, the children's coping strategies, and the role of social work. The social work function includes nonauthoritarianism, strategies for forming a positive helping alliance, and various forms of culturally sensitive assessment and intervention. The study therefore yields insight into bridging the emic-etic gap in conceptualizing and responding to child neglect in a non-Western society.     

THE MOTHER AS CONSUMER:

The historical context of the emergence of the "mother as consumer" is the subject of this article. The newly formed children's clothing industry and its trade press (1917-1929) serve as entry points into this investigation. The focus is on examining several nodes of intersection among the domestic sphere of mothers and children, the involvement of mothers in child welfare efforts, and the strategies of some in the merchant class to capture the "mother trade" by exhorting consumption on behalf of children. An ideology of maternal consumption served to adjudicate the integration of the sacred sphere of mothers and children with the profane world of the marketplace by recasting motherhood as consumer practice.     

Aggression: A characteristic of physically abused latency-age children

Aggression is a primary characteristic of physically abused children noted in the literature. The development of aggression in the normal child is traced and viewed in relation to the maltreated child. Some special dynamics of the abuse situation are identified and the affects on the perception of the abused child are suggested. Examples of abused children's aggressive behaviors in treatment groups are cited to illustrate both the overt and covert rage and anger which is present. Selected social work interventions utilized with these children are described.     

Group therapy with sexually molested children

It should be stressed that the young children's group was only a part of the overall treatment approach that forms the family context of the Child Sexual Abuse Treatment Program. Because the therapists also work with entire families, they have come to accept that the child is not the only victim. Often the mothers and fathers in this program were themselves victims of sexual assaults when they were children, and have carried this victim roles with them into adulthood. A child growing up in this family system will learn the victim role well. Her denial and/or fear of sexual aggression, as well as her role models for parenting, will perpetuate the cycle and make the sexual abuse of her own children a distinct possibility. The play therapy treatment seeks to break this cycle and restore the young child victim's self-respect by teaching new skills and providing different role models. The therapy seeks to help her tap her own power to become an adequate adult. Such therapeutic "undoing" or self-reconstruction is a long process which probably takes as many paths as there are victims. Adults victimized as children frequently report periods of repression and denial, and it is likely that direct treatment of the child victim, when the incest comes to light, mitigates against development of such repression. The natural healing process must be respected. The child needs time to integrate the experience and its painful aftermath. Changing and healing do not take place all at once, or after one period of intervention. Therefore one important aspect of such therapeutic work is to give the child victims the tools to reach out for help and support in the future, when the pain of this early childhood experience may once again be an obstacle to growth.     

An Assortative Adoption Marketplace: Foster Care,Domestic, and Transnational Adoptions

Among sociologists of the family, there has been relatively little attention paid to child adoption. When it is mentioned, many characterize the process as a universal family form. The goal of this review is to complicate this subject by disaggregating adoption into three different market segments: foster care, domestic, and transnational. Specifically, the paper argues that adoption is an assortative process that stratifies parents and children. Of the members of the adoption triad (e.g. the birthmother, adoptive parent(s), and adopted child), prospective adoptive parents possess the greatest degree of choice when deciding which market segment to pursue. However, their options are often tempered by strict eligibility requirements and financial restraints. Drawing broadly on the extant sociological and child welfare literature, the bulk of the review is devoted to identifying and analyzing how these social forces funnel parents and children into forever families. I pay particular attention to the demographic profiles of children and adoptive parents, including how transracial adoption factors into foster care, domestic, and intercountry adoptions.     

Parent Involvement in Head Start and Children's Development: Indirect Effects Through Parenting

The authors examined the extent to which parent involvement in Head Start programs predicted changes in both parent and child outcomes over time, using a nationally representative sample of 1,020 three‐year‐old children over 3 waves of the Family and Child Experiences Survey. Center policies that promote involvement predicted greater parent involvement, and parents who were more involved in Head Start centers demonstrated increased cognitive stimulation and decreased spanking and controlling behaviors. In turn, these changes in parenting behaviors were associated with gains in children's academic and behavioral skills. These findings suggest that Head Start programs should do even more to facilitate parent involvement because it can serve as an important means for promoting both parent and child outcomes.     

Some theoretical considerations on confidential adoptions part III: The adopted child

In all cases of newborn adoption where placement is made directly into the permanent adoptive home, the adoptive parents become the psychological parents for that child. While adopted children do have separate psychological and genetic parents, the capacity for intimacy, identity, and a cohesive sense of self develops through the consistent empathic attachment between the adoptive parents and the child. We discuss the adopted child's psychological development through infancy, pre-oedipal, oedipal, latency, and adolescence and focus on the child's intrapsychic tasks at each developmental phase. We note how development is different for the adopted child and how this development would be diminished or enhanced by the direct or subtle indirect involvement in an open or confidential adoption. Open adoptions appear to have the risk of serious interference at each developmental phase. Confidential adoptions appear to provide the child with the psychological protection for the unfolding of development. There is a new trend in the field of child welfare toward openness in adoption, which purports to change traditional confidential adoptions. We discuss the crucial aspects of the intrapsychic difference for an adopted child experiencing an open or confidential adoption.And so they wrangled before the King... Kings II, Ch. VThis paper was presented to the National Committee for Adoption Convention, October, 1982; the First International Conference on Pediatric Social Work, August, 1982; and to the Child Care Association of Illinois Convention, April, 1982. All authors have the M.A. degree     

Non word Repetition and Reading Skills in Children Who Are Deaf and Have Cochlear Implants

Reading skills in hearing children are closely related to their phonological processing skills, often measured using a nonword repetition task in which a child relies on abstract phonological representations in order to decompose, encode, rehearse in working memory and reproduce novel phonological patterns. In the present study of children who are deaf and have cochlear implants, we found that nonword repetition performance was significantly related to nonword reading, single word reading and sentence comprehension. Communication mode and nonverbal IQ were also found to be correlated with nonword repetition and reading skills. A measure of the children's lexical diversity, derived from an oral language sample, was found to be a mediating factor in the relationship between nonword repetition and reading skills. Taken together, the present findings suggest that the construction of robust phonological representations and phonological processing skills may be important contributors to the development of reading in children who are deaf and use cochlear implants.     

Evaluation of what parents know about their children's drug use and how they perceive the most common family risk factors

Research on family risk factors for addictive behaviors in young people has not paid a great deal of attention to parents' knowledge of their children's addictive behaviors and of the family risk factors that affect such behaviors. The aim of this work is to compare knowledge about these two aspects in two groups of parents that differ regarding their children's declared drug use. The research was carried out with a sample of 309 schoolchildren and their families, divided into two groups: one of 154 families with children defined as non-Drug Users and another of 155 families with children defined as Drug Users. The results show that parents with children who consume drugs tend to strongly underestimate their children's use. Moreover, they overestimate the control they exercise over them and appear to be more familiarized with the use of drugs, if we compare them with parents of non-Drug Users. It is suggested that these results may be relevant for the planning of strategies that increase motivation in families with drug-risk children to participate in prevention programs.     

Relationships between maternal adult attachment security, child perceptions of maternal support, and maternal perceptions of child responses to sexual abuse

This study assessed the relationships between maternal adult attachment style, children's perceptions of maternal support following disclosure of sexual abuse, and maternal perceptions of children's behavioral and emotional responses to sexual abuse among African-American child sexual abuse victims aged 4 to 12 (n=96) and a comparison group of non-abused subjects (n=100). Mothers with insecure attachment styles reported significantly higher rates of internalizing behaviors in their sexually abused children than did securely attached mothers. Among mothers of non-abused children, those with insecure adult attachment styles reported significantly higher rates of externalizing behaviors shown by their children in comparison with mothers with a secure adult attachment style. Mothers with insecure adult attachment styles also reported higher rates of overall behavior problems in their non-abused children that approached statistical significance. Sexually abused children's perceptions of maternal support were not related to maternal attachment style nor to child functioning. Contrary to our prediction, mothers of sexually abused children did not show lower rates of secure attachments when compared to mothers of non-sexually abused children. Our findings indicate that fostering parent- child attachment is important in order to decrease the risk for behavior problems and symptomatology in sexually abused children.     

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.     

Latino caregiver psychosocial factors and health care services for children involved in the child welfare system

Children in the child welfare system have a high prevalence of health problems, making pediatric health service use critical. Latino children represent a growing proportion of the child welfare system, and are at increased risk for health problems. Many have argued that Latino caregivers can provide Latino children with the least disruptive out-of-home placement, but little is known about how caregiver factors might relate to health services utilization or child health status within this population. This study assessed relationships between caregiver psychosocial factors, health care service utilization, and health status for children in the child welfare system. This sample featured 48 Latino caregivers involved in child welfare. Logistic regression models were used to test for relationships between caregiver psychosocial factors and appointment adherence and child health status. Problem-focused coping was positively related to well-child status. No psychosocial factors were related to medical appointment adherence. Case workers may help improve child health outcomes by promoting problem-focused coping skills among Latino caregivers.     

Interactive Media for Child Care and Counselling: New Resources,New Opportunities

SUMMARY

A familiar children's story in the UK–Bruce's Story, about the adventures of a puppy moving into the unknown world as he grows up–is converted into a multimedia program designed to help children in out of home care talk (or write) about their own experiences coming into the child welfare system and into foster and adoptive families.     

Preschool-Age Adopted Chinese Girls’ Behaviors That Were Most Concerning to Their Mothers

Children's behavioral difficulties are a major source of parental concern. The goals of the current study were to (1) describe preschool-age adopted Chinese girls’ behaviors that were most concerning to their adoptive mothers and (2) examine the relation between children's concerning behaviors and parent/child demographics. Qualitative data from 422 mothers on 480 adopted Chinese girls (M = 44.2 months, SD = 15.2) were collected using three sequenced methods (i.e., open-ended question, follow-ups, and a focus group discussion). These girls were adopted at 3 to 60 months of age (M = 13.8, SD = 8.0) and had lived in the adoptive homes for at least 6 months (M = 30.2, SD = 14.4). Data analysis showed that 242 (57.3%) mothers (representing 274 girls) reported one to three concerning behaviors per child (total = 323 concerns), including behaviors that indicated attachment problems (107 or 33.1%), poor social skills (46 or 14.2%), language/speech problems (42 or 13%), sleep problems (29 or 9%), health/physical problems (24 or 7.4%), and problems in other areas (e.g., potty training) (75 or 23.2%). Further analysis showed that the mothers with prior experience of raising adopted children, but not biological children, were more likely to report concerning attachment behaviors than first-time mothers.     

Street children: Causes,consequences, and innovative treatment approaches

"Children are travelers, newly arrived in a country ofwhich they know nothing." (John Locke) Street children represent a rapidly growing socio-educational challenge affecting both the developing and industrialized nations of the world. At risk for physical, emotional, social, and cognitive violation, these children are in need of interventions that appropriately address their needs in the context of their environment, and build upon the positive survival skills that they have developed as a result of street life. This paper explores the causes, and consequences of this growing phenomenon. It seeks to make known the global dimensions of the physical, social, mental and developmental health consequences of street life for the child. It offers possible occupational therapy intervention strategies and opportunities for working with street children which transition them from youth to mainstream adult and citizenship in the world.     

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.     

Understanding contextual effects on externalizing behaviors in children in out-of-home care: Influence of workers and foster families

The expression of externalizing behaviors of children in-care can be influenced by a multitude of factors. The current study examined the simultaneous levels of influence of workers and foster families on children's externalizing behaviors in those receiving out-of-home care. A cross-classified multilevel model was used to partition variance in children in-care's externalizing scores into worker, foster family and child-specific levels of influence. The extent to which processes are explained by worker and foster-family level predictors was examined. Assessment and Action Record (AAR) data from the Ontario Looking after Children (OnLAC) project were analyzed. The sample included data from 1063 children between 10 and 17 years of age (M age = 13 years, 6 months, SD = 2.08 years). While individual differences in children's externalizing behaviors were primarily attributable to child-specific effects (72%), 10% and 18% of the variance can be explained by worker and foster family influences respectively. Worker education accounted for substantial differences seen between workers where more difficult children were monitored by workers with less educational attainment. Furthermore, foster-family level predictors also explained variance in children's externalizing behaviors. Relative to children in foster care, those in kinship care displayed significantly lower levels of problem behaviors while children in group care displayed significantly higher levels. Higher levels of parental negativity within the foster family and the experience of more differential parental negativity relative to siblings were significantly associated with more externalizing behaviors. Lastly, children who were more satisfied with their placement displayed significantly lower levels of problematic behaviors. These results suggest that children in-care can be conceptualized within a multilevel framework.     

The vicissitudes of adoption for parents and children

This paper attempts to illustrate how adoption is understood by children according to their developmental stages within the context of their families. Illustrations of children's thought processes and inner fantasies are presented in the form of interviews and observations. The inner thoughts and experiences of adoptive parents are also presented, from the time of the application process through infancy, toddlerhood, school age and adolescence. A major thesis is that adoptive parents who are comfortable with their own feelings about the birthparents and the child's specific history are more able to provide an atmosphere where the child feels valued when she asks questions or communicates fantasies about her story. In this manner adoption is integrated into the child's growing self-esteem and, as time goes on, the adoption becomes less important.The author wishes to thank Lynn Borenstein, L.C.S.W. for her helpful suggestions. Marilyn Silin, M.A. is on the faculty of The Institute for Clinical Social Work.