The integration of child care services in Scotland

This paper describes the development of integrated child care services in Scotland with a particular focus on the role of residential child care provision. It discusses changes in Social Work Department policies and the impact this has had on their relationship with the Children's Hearings system. Recent research shows the pattern of use of residential and foster care in three Social Work Departments and issues in the development of residential services are identified. Three particular examples of service integration are described: residential outreach work; a centre for young people under an integrated management; and multi-agency youth strategies. Social work and education services in Scotland are in the process of radical change. In the context of the integration of child care services, the paper discusses the impact of local government reorganisation and changes in child care legislation.     

Chafee Educational and Training Voucher Programs: System Coordination in Rural New England

This paper explores service providers’ perspectives on a series of issues associated with systemic coordination in the implementation of the Chafee Educational and Training Voucher (ETV) Program in three relatively rural states. Findings derived from mail surveys (N = 105) and in-depth interviews (N = 17) with child welfare and educational service providers highlight challenges and innovations related to working with Chafee ETV eligible youth. Findings suggest that raising awareness of the Chafee ETV program’s provisions, improving access to concrete services, and facilitating collaboration among service providers may aid the transition to post secondary education for youth in out-of-home care.     

Educational risk,recidivism, and service access among youth involved in both the child welfare and juvenile justice systems

Dually-involved youth represent a population of youth who receive some level of supervision from both the child welfare and juvenile justice systems concurrently. The current study examined education-related risk factors, recidivism, referrals for services, and service access among dually-involved youth in Los Angeles County. Specifically, whether increased educational risk was associated with referrals to, and access of, educational services and supports and whether higher receipt of educational services reduced recidivism approximately six months post-disposition. Data for this study consisted of a sample of dually-involved youth (N = 131) who were adjudicated delinquent and also had a child welfare case open. An Educational Risk Index (ERI) was developed and included school attendance, credit deficiency, problem school behavior, and current grades. Results indicate that educational risk was negatively associated with mental health services accessed, demonstrating that those with higher educational risk accessed less mental health services. Educational risk, however, was not associated with increased educational service referrals or access, suggesting a possible mismatch in educational need and service referrals. Lastly, there were no significant differences between those that recidivated and those that did not recidivate in service access and educational risk.     

The role of interagency collaboration in facilitating receipt of behavioral health services for youth involved with child welfare and juvenile justice

Unmet need for behavioral health care is a serious problem for crossover youth, or those simultaneously involved with the child welfare and juvenile justice systems. Although a large percentage of crossover youth are serious emotionally disturbed, relatively few receive necessary behavioral health services. Few studies have examined the role of interagency collaboration in facilitating behavioral health service access for crossover youth. This study examined associations for three dimensions of collaboration between local child welfare and juvenile justice agencies - jurisdiction, shared information systems, and overall connectivity - and youths' odds of receiving behavioral health services. Data were drawn from the National Survey of Child and Adolescent Well-Being, a national survey of families engaged with the child welfare system. Having a single agency accountable for youth care increased youth odds of receiving outpatient and inpatient behavioral health services. Inter-agency sharing of administrative data increased youth odds of inpatient behavioral health service receipt. Clarifying agency accountability and linking databases across sectors may improve service access for youth involved with both the child welfare and juvenile justice systems.     

Serving immigrant families and children in New York City's child welfare system

This article describes the efforts and special initiatives of New York City's Administration for Children's Services to improve services to immigrant and English language learner populations. Children's Services convened an immigration issues advisory subcommittee, created special tools for child welfare staff, collaborated with legal agencies to assist foster children with immigration status adjustments, improved agency data collection, and launched an agency-wide training initiative on immigration issues. The challenges encountered by Children's Services offer important insight for child welfare agencies in other jurisdictions designing strategies to strengthen their services for immigrant communities.     

Exploring nonoffending caregiver satisfaction with a Children's Advocacy Center

This study is a case evaluation research report on one Children's Advocacy Center that provides a coordinated response to allegations of child maltreatment, particularly sexual abuse. The data come from a mailed survey of nonoffending caregivers measuring their satisfaction with services provided through the Children's Advocacy Center. The results indicate overall satisfaction with the Children's Advocacy Center; however, they also suggest that the forensic interview may be perceived or experienced as distinct from the ongoing investigative and legal processes. Recommendations are made to better assess nonoffending caregiver satisfaction with Children's Advocacy Center services and to encourage consumer driven service improvement.     

Barriers and facilitators of the transition to adulthood for foster youth with autism spectrum disorder: Perspectives of service providers in Illinois

The lack of established and well-evaluated models of coordination between child welfare agencies and other public institutions presents lingering challenges to preparing foster youth to make the transition to adulthood. This may be particularly true for foster youth with developmental disabilities who must exit child welfare systems and enter into adult service systems, if eligible. The qualitative study we present explores the barriers and facilitators of the transition to adult service systems from the perspectives of service providers. Due to the rising prevalence of autism spectrum disorder (ASD) in the general population, focus groups were specifically conducted to better understand the transition of foster youth with ASD. Barriers included perceptions of two separate systems and abrupt transitions; a lack of training, identification, and tracking of autism; and confusion about services and funding. Facilitators included persistence and professional relationship building, and consistent communication and information sharing. Implications for improving the transition to adult service systems are discussed.     

The New York City neighborhood-based services strategy

The New York City Administration for Children's Services (ACS) instituted a neighborhood-based services system through the realignment of all foster care, preventive, and protective services along community district lines. ACS, with its community partners, also formed neighborhood-based networks to improve service coordination and collaboration among key community stakeholders and to shape a multisystem strategy tailored to each district informed by child welfare data. Based on analysis of neighborhood-specific census tract child welfare data, ACS initiated the Community Partnership to Strengthen Families project to address the disproportionate number of foster care placements originating from a small group of high-need communities, including Manhattan's Central Harlem. This article describes examples of specific strategies based on the Central Harlem experience.     

Achieving permanency for LGBTQ youth

This article brings together two significant efforts in the child welfare field: achieving permanence for youth in out-of-home care and meeting the needs of lesbian, gay, bisexual, transgender and questioning (LGBTQ) youth. During the past several years, a national movement has taken place to assure all children and youth have a permanent family connection before leaving the child welfare system; however, LGBTQ youth are not routinely included in the permanency discussions. At the same time, efforts in addressing the needs of LGBTQ youth have increased, but permanency is rarely mentioned as a need. This article offers models of permanence and practices to facilitate permanence with LGBTQ youth and their families. It also offers a youth-driven, individualized process, using youth development principles to achieve relational, physical, and legal permanence. Reunification efforts are discussed, including services, supports, and education required for youth to return to their family of origin. For those who cannot return home, other family resources are explored. The article also discusses cultural issues as they affect permanence for LGBTQ youth, and, finally, addresses the need for ongoing support services to sustain and support permanency.     

Using GIS to enhance programs serving emancipated youth leaving foster care

This article describes a GIS prototype designed to assist with the identification and evaluation of housing that is affordable, safe, and effective in supporting the educational goals and parental status of youth transitioning from foster care following emancipation. Spatial analysis was used to identify rental properties based on three inclusion criteria (affordability, proximity to public transportation, and proximity to grocery stores), three exclusion criteria (areas of high crime, prostitution, and sexual predator residence), and three suitability criteria (proximity to health care, mental health care, and youth serving organizations). The results were applied to four different scenarios to test the utility of the model. Of the 145 affordable rental properties, 27 met the criteria for safe and effective housing. Of these, 19 were located near bus routes with direct service to post-secondary education or vocational training programs. Only 6 were considered appropriate to meet the needs of youth who had children of their own. These outcomes highlight the complexities faced by youth when they attempt to find affordable and suitable housing following emancipation. The LEASE prototype demonstrates that spatial analysis can be a useful tool to assist with planning services for youth making the transition to independent living.     

Foster care transition services for youth with disabilities: findings from a survey of county service providers

This study explores the transition services available for youth with disabilities in foster care and the collaboration among foster care transition programs with other types of providers. Findings from this survey of independent living coordinators working for child welfare agencies indicate that while youth with disabilities are being served through transition programs and these programs collaborate with other government agencies, there are few services targeted directly toward their needs, little collaboration with community-based agencies, and a need for more information sharing.     

The potential educational benefits of extending foster care to young adults: Findings from a natural experiment

Research has demonstrated the employment and earnings benefits accompanying educational attainment, and the relatively poor educational attainment and economic well-being of young people who transition to adulthood from foster care. Policymakers' concern over these poor outcomes has long been reflected in U.S. child welfare policy, most recently in the provisions of the 2008 Fostering Connections to Success Act allowing states to claim federal reimbursement for extending foster care from age 18 to age 21. While the policy of allowing youth to remain in foster care past age 18 has promise as a strategy for helping them continue their education, empirical evidence of its impact is lacking. Using data from a longitudinal study of youth (n = 732) who transitioned to adulthood from foster care, this study takes advantage of between-state policy variation in the age at which youth are required to leave care to assess the relationship between extended foster care and educational attainment at age 26. Distinguishing between not having obtained a high school diploma or GED, having only a high school diploma or GED, and having obtained at least one year of college, each additional year in care is associated with a 46% increase in the estimated odds that former foster youth will progress to the next level of educational attainment, controlling for a range of youth characteristics measured at ages 17–18. Background characteristics including youth's gender, race, employment, parenting, educational performance and aspirations, and indicators of behavioral health problems are also associated with educational attainment in early adulthood.     

Do youth in out-of-home care receive recommended mental health and educational services following screening evaluations?

For children in out-of-home care, a significant gap exists between those who need services and those who receive them. Screening all children in out-of-home care is recommended to reduce this gap. This study was designed to determine if recommendations from mental health and educational screening evaluations were related to service implementation for youth in out-of-home care. Screening evaluations were completed with 171 maltreated youth (ages 9 to 11) who had been placed in out-of-home care within the prior year. Written reports summarizing the findings were provided to children's caseworkers. Service utilization was assessed at baseline (T1; before screening reports were completed) and follow-up (T2; 9–12 months later) interviews. For children not already receiving services at T1, logistic regression analyses tested the association between T1 recommendations for services and new service implementation by T2. Mental health (youth-report) and educational (teacher-report) outcomes were analyzed separately. Screening evaluations identified 22% of children with unmet mental health needs and 36% with unmet educational needs at T1. Children who received a recommendation for new services (i.e., all of those with unmet needs) were more likely to receive mental health (OR = 2.50, p = .06) and/or educational (OR = 3.54, p = .04) services by T2 than children who did not receive recommendations for services. While recommendations increased the odds of receiving services, almost half of the children with unmet mental health needs did not receive services, and 84% of children with unmet educational needs did not receive services by T2. Much work remains to ensure youth receive needed services.     

Do they get what they expect?: The connection between young adults' future expectations before leaving care and outcomes after leaving care

This study examines the future expectations of young people in out-of-home placements in the last year before leaving care and the association between those expectations and their outcomes after leaving care. The study examines the hypothesis that care leavers with higher future expectations will have better outcomes in the areas of housing, educational achievements, economic status, adjustment to military service, and life satisfaction. The study was conducted through 277 interviews with the young adults at their last year in care and 236 interviews a year after they left care. Higher future expectations while in care were positively correlated with satisfaction in accommodation, economic status and educational achievements and adjustment to required military service after leaving care. These findings emphasize the role of future expectations as a source of resilience and motivation. They also illustrate the importance of designing programs that address care leavers' self-perception and future outlook and offer preparation in concrete areas as the youth transition to adult life.     

Improving Permanency: Caseworker Perspectives of Older Youth in Another Planned Permanent Living Arrangement

Researchers conducted focus groups with 52 child welfare caseworkers across five county child welfare agencies to understand their approach to working with and views about outcomes for youth in Another Permanent Planned Living Arrangement (APPLA). Analysis of the focus groups yielded five themes, including (a) youth and family factors contributing to APPLA as a case designation, (b) caseload intensity relative to this specific population, (c) perceptions of organizational support, (d) lack of focus on legal permanency, and (e) overemphasis on independent living services. The range of viewpoints from these child welfare professionals spoke to the complexities of addressing the needs for older youth in care and to identifying strategies to improve permanency outcomes for this population. The implications for practices that account for individual, organizational, and systemic factors impacting legal permanency for older youth are discussed.     

Understanding dissociation in relation to child trauma,mental health needs,and intensity of services in child welfare: A possible missing link

Abstract

While there is limited research on the role of dissociation among children and adolescents, emerging evidence links child trauma history, dissociation, risk behaviors, and other negative outcomes among youth. This study examined dissociation in relation to mental health needs and intensity of services among a large sample of youth in Illinois child welfare, upon entry into care and in residential treatment settings. The Child and Adolescent Needs and Strengths (CANS), a comprehensive, trauma-informed assessment strategy and information integration/planning tool was the primary measure. This study included two overall samples of child welfare-involved youth, ages 3–18: at entry into care (N?=?27,737) and in residential treatment (N?=?5,758). Findings indicated that rates of clinically significant dissociation were generally highest among younger youth (under age 14) and among youth with more cumulative and severe trauma. Dissociative youth were significantly more likely to exhibit several risk behaviors (e.g., fire setting and self-harm) and mental health symptoms (e.g., psychosis and somatization). Those youth with significant dissociation at entry into care were more likely to be psychiatrically hospitalized, placed into residential treatment, with greater likelihood of placement disruptions within the 2 years following entry into care. Implications of these findings are discussed in terms of the value of identifying and assessing dissociation and other trauma-related symptoms that may be less recognized but can be linked to high-risk behaviors and other negative outcomes within child welfare and across child-serving systems. Understanding dissociation may be an important component of training, service/treatment planning, and clinical care within child-serving systems.     

The invisibility of adolescent sexual development in foster care: Seriously addressing sexually transmitted infections and access to services

Adolescents residing in foster care are at higher risk for acquiring sexually transmitted infections (STIs) and human immune deficiency virus (HIV) compared to their non-foster care peers. A literature review was conducted to determine whether youth residing in foster care face different barriers to sexual health care compared to their peers in the general population and, if so, what those barriers are. The review revealed barriers common to adolescents in general as well as additional barriers specific to the ecosystem of adolescents in foster care. Systemic issues that decreased access to sexual health services included child welfare policies that were either missing or implemented without fidelity; complicated financial factors; barriers to service utilization; lack of collaboration between child welfare and medical professionals; and limited information provided to foster youth on their sexual health and development. Consent and confidentiality issues that foster youth face in seeking sensitive health services also need to be resolved. More research is needed on how to facilitate development of coherent policies and effective practices that promote sexual health care access for adolescents in foster care.     

The consequences of acculturation to service delivery and research with Hispanic families

The experience of working with Hispanic children and their parents is compared with the existing professional literature. Although the literature acknowledges partially the importance of acculturation, the consequences of acculturation to service delivery and working with Hispanics as research subjects are seldom addressed. These consequences are demonstrated in four areas: as a cause of family problems, in the attitudes of Hispanics toward speaking Spanish and English, in the status of folk healers in the Hispanic community, and in attitudes toward the delivery of human services. The failure to take into account the consequences of acculturation can contribute to the further underutilization of mental health services by Hispanic families.The research described in this article was funded by a grant from the Blowitz-Ridgeway Foundation.Special thanks to Laura L. Schmidt, M.A., Research Associate, and to Dora Maya, Ph.D., Program Director, VIVA Family Center, Children's Home and Aid Society of Illinois.     

Homelessness and aging out of foster care: A national comparison of child welfare-involved adolescents

The present study represents the first large-scale, prospective comparison to test whether aging out of foster care contributes to homelessness risk in emerging adulthood. A nationally representative sample of adolescents investigated by the child welfare system in 2008 to 2009 from the second cohort of the National Survey of Child and Adolescent Well-being Study (NSCAW II) reported experiences of housing problems at 18- and 36-month follow-ups. Latent class analyses identified subtypes of housing problems, including literal homelessness, housing instability, and stable housing. Regressions predicted subgroup membership based on aging out experiences, receipt of foster care services, and youth and county characteristics. Youth who reunified after out-of-home placement in adolescence exhibited the lowest probability of literal homelessness, while youth who aged out experienced similar rates of literal homelessness as youth investigated by child welfare but never placed out of home. No differences existed between groups on prevalence of unstable housing. Exposure to independent living services and extended foster care did not relate with homelessness prevention. Findings emphasize the developmental importance of families in promoting housing stability in the transition to adulthood, while questioning child welfare current focus on preparing foster youth to live.