Foster and Residential Care Reassessed: A Research Perspective

SUMMARY. Professionals in Britain and many other countries have long been concerned about whether children in need, who have to live away from their parents, are best placed in foster or residential settings. The issue has become particularly significant in recent years in view of the adverse publicity surrounding residential childcare. This paper summarises recent British research findings on the role and impact of foster and residential care for children and young people in need. It demonstrates that research conclusions often do not support commonly held public and professional views, particularly regarding the contribution of residential care.     

Safeguarding disabled children in residential settings: what we know and what we don't know

Research in America, Canada, Australia and Britain has revealed that disabled children are particularly vulnerable to abuse. Their likelihood of attending residential institutions, their dependency on others for personal care and the lack of opportunities for them to alert others to maltreatment or comprehend the nature of abusive acts all increase levels of risk. Over the last decade, there has been increasing public and professional concern about the abuse of children in residential establishments, resulting in a number of inquiries. However, the abuse of disabled children in residential settings has received little attention. Despite residential schools, care homes and respite care being widely used by disabled children, there is a paucity of knowledge regarding the standards of child protection in these establishments. This article explores the research literature revealing the vulnerability of disabled children to abuse when living away from home, what measures can be taken to help protect them and the limitations of available data as a basis for planning child protection measures. Copyright © 2002 John Wiley & Sons, Ltd.     

Are children safer with kin? A comparison of maltreatment risk in out-of-home care

Safety, or the absence of maltreatment, is the primary mandate of the child protection services (CPS) system, both for children living at home and those living away from home. Yet, few research studies have examined maltreatment in out-of-home care due to the low incidence rate and data limitations. This study used statewide administrative data to estimate the association between placement type and experiencing a maltreatment investigation or substantiation in out-of-home care. Over 6% of informal TANF-funded kinship placements experienced an investigation alleging maltreatment by an out-of-home caregiver, compared with just over 3% for formal kinship care and non-relative foster care. However, the monthly risk of maltreatment was lowest in informal kinship care because these placements tended to endure longer before maltreatment occurred. Substantiated maltreatment during an out-of-home placement was rare across all placement types. For both investigated and substantiated maltreatment, risk was highest in the first 3 months.     

State commitment to home and community-based services: effects on independent living for older unmarried women

This study examines the impact of state variation in commitment to the provision of home and community-based services on the living arrangement outcomes of older unmarried females with functionallimitations. We combine data from the 1990 U.S. Census of Population (PUMS) with state-level information on long-term care home and community- based service expenditures, nursing home bed availability, and Medicaid nursing home costs from a special report that compares state variation in long-term care systems. Using multilevel logistic regression modeling techniques, we find that the risk of institutionalization compared to community living arrangements is reduced as spending for home and community-based services at the state level increases. We discuss these findings in light of policy changes during the 1990s.     

The Role of Return Home Welfare Interviews in Responding to the Needs of Young Runaways

When children and young people run away from home or care it is most often indicative of problems in their lives. Reporting on the findings of a recent evaluation, this study considers the role, delivery and impact of ‘return home welfare interviews’ (RHWIs) in identifying children and young people in need. It concludes that RHWIs function as an effective screening mechanism and can be facilitative in creating multiple pathways for referral to appropriate services. It challenges assumptions about the unsuitability of the police in undertaking RHWIs and highlights the importance of context, training and appropriate resourcing to the success of police delivery.     

“I want to be there when he graduates:” Foster parents show higher levels of commitment than group care providers

Group care is a frequent placement for adolescents placed in out of home care when their birth parents' care is deemed unsafe. In the present study, we assessed whether foster parents show greater commitment to children than group care providers. Given that group care represents a number of living arrangements, we considered both shift care (where staff work shifts and do not live with the children) and cottage care (where staff live for extended periods of time with the children in a group living context). Commitment was assessed using the This Is My Child Interview (adapted for adolescents). Thirty-one foster parents, 18 shift workers, and 28 cottage care providers were interviewed. As predicted, foster parents showed higher levels of commitment than both shift care workers and cottage care providers, and the associations held when children's externalizing behaviors and the number of children the caregivers had cared for were controlled. The results suggest that foster care promotes greater commitment among caregivers than other out of home placements, and add to other findings that favor foster care as the out of home placement of choice for adolescents.     

Independent Living: gender, violence and the threat of violence

In what ways is independent living for young adults with disabilities compromised by violence and its threat? A qualitative study of 42 young adults with severe physical disabilities explored their perceptions and concerns about independent living, access to services and the meeting of needs. Young women especially experienced difficulties about leaving home, because of their own and their parents' fears about vulnerability; some who did leave home experienced highly restricted social lives because of anxiety about neighbourhood violence. Few had established partnerships, but violence and sexual abuse from partners emerged as an issue for which there is little policy. Control and abuse within caring relationships are serious issues for those who need personal care. Violence and lack of protection may undermine independent living, especially for women.     

Street children and crime in the UK: a case of abuse and neglect

It is claimed that many incidences of children running away from home and residential care involve issues around violence, bullying and child abuse and neglect. Surveys show that between 14 and 20% of children run away from home for at least one night and that 2% run away 10 times or more from home or a care setting. The potential reasons for running away are discussed together with the increased possibility for further victimization, delinquency and criminal behaviour. Four ‘streetwork projects’ that provide information and support to young runaways in the UK are described and their limitations discussed. It is proposed that counselling should be a part of intervention with street children and that trained counsellors/psychotherapists should be available free to these young people with social and emotional difficulties outside the usual health/social service provision. © 1998 John Wiley & Sons, Ltd.     

What Can We Say Regarding Shared Parenting Arrangements for Swedish Children?

ABSTRACT

Joint physical custody (JPC) refers to children living alternatively and about equally with both parents after a parental separation or divorce. The practice has been debated in relation to child well-being because of the frequent moves imposed on children and the potential stress from living in 2 homes. This study describes the background to the high frequency of Swedish children in JPC and the results from research on Swedish children’s well-being in this living arrangement. Children in JPC report better well-being and mental health than children who live mostly or only with 1 parent. No Swedish studies have found children’s health to be worse in JPC than in sole parental care from child age of 3 years and beyond. The existing literature cannot, however, inform us about the mechanisms behind the findings. The risks of selection effects into living arrangements are plausible. For this purpose, longitudinal studies are warranted.     

A comparative approach to public chiidcare for children living away from home in germany and england

An analysis of the quantitative dimension of public chiidcare services shows that in Germany more than twice as many children receive help away from home than in England. Moreover, there is a great discrepancy in the relative use of foster and residential care, which illustrates a different placement policy in the two countries. This paper analyses reasons and possible explanations for the different use of chiidcare services. The influence of professional standards, as well as the pressure to constrain expenditure, are discussed and compared. Finally, a comparative analysis is used to illustrate and evaluate the consequences of patterns of placement in the two countries.     

Paid personal assistance services:an exploratory study of working-age consumers' perspectives

This study examined the experiences of individuals who use paid personal assistance services (PAS). Structured interview data were collected from a convenience sample of 24 working-age individuals from diverse backgrounds recruited from Centers for Independent Living in nine states. Respondents described their general satisfaction with current paid PAS, but many reported previous experiences with poor care related to the low wages, lack of training of PAS providers, and an inadequate supply of providers. Respondents reported many unmet needs because of a shortage of hours provided by state programs and the lack of help with daily living activities, transportation, childcare, and social activities. The respondents strongly preferred consumer-directed care.     

Care for vulnerable and disadvantaged children in the Czech Republic

The problematic issue of care for vulnerable and disadvantaged children in the Czech Republic, highlighted in this article, stems from the large number of children in institutional care. Workers from the Department for Social and Legal Child Protection (OSPOD) may get involved if there are factors in the family jeopardising the child's healthy development that cannot be improved, and institutional care may be recommended. This article discusses factors that influence and many times complicate the worker's job and are often the reason for an adversely high number of children living without a family. Attempts to reunite children with their biological families are complicated by the fact that the family situation rarely improves. Therefore children returning to live with their own families face the same conditions they were previously removed from. A more positive option for some children placed in institutional care is adoption or long-term foster care. However, many children continue to spend their whole childhood in a care home. The authors describe the care system in the Czech Republic and point out its weaknesses and some controversial facts. They also discuss and evaluate the ‘National Action Plan’, a government policy document, which articulates aspirations and obligations for all government departments and organisations involved in the Czech childcare system.     

Readiness for independent living of adolescents in youth villages in Israel

Most Israeli children who spend their youth away from their birth parents live in youth villages. The majority of these children come from either the geographical or social periphery of Israel. Since the 1990s the youth villages have specialized in absorbing immigrants mainly from the former Soviet Union (FSU) and Ethiopia. The paper reports on a survey conducted among the professional staff in the youth villages. This study explores their perceptions of the readiness for independent living of adolescents on the verge of leaving youth villages and examines how readiness is associated with individual and familial characteristics. A structured questionnaire was mailed to youth villages asking professionals to anonymously complete the survey. The total sample include reports on 1256 adolescents who spent in the current setting on average 3.3 (SD = 1.8) years. For many of them this was the first out-of-home placement. Generally, workers have a favorable assessment of the youths' readiness for independent living. Still, they report that many of the youths do not have any of the necessary skills for independent living. Additionally, there are sub-groups that are more disadvantaged and at greater risk because they lack skills for a successful transition from care. The findings indicate that youth of Ethiopian origin are more disadvantaged with regard to skills related to school, the job market, finances, interpersonal relationships and normative behaviors, whereas youths from FSU present fewer skills pertaining to military service. The findings emphasize the important role Israeli youth villages have in supporting underprivileged adolescents in acquiring basic skills for adult life and suggest guidelines as to which sub-groups and in which area programs should be developed.     

The high cost of neglecting children: The need for a preventive policy agenda

Millions of children in the United States suffer from poor care and inadequate services due to neglectful national social policy. More than 13 million children live in poverty and its negative consequences, at great individual and social cost. This paper outlines the need to seriously advocate for a preventive policy approach to child welfare and presents a blueprint for individual and collective political action. The cost-effectiveness and social benefits of preventive policies are demonstrated. Social workers understand the value of prevention in working with children and families, and are needed to advocate on the policy-making level for a preventive policy agenda.     

Parental substance misuse and statutory child protection in England: Risk factors and outcomes

Parental substance misuse is a significant child welfare issue and associated with increased risk of child maltreatment. The aim of the present study was to understand what social care outcomes children who live with parental substance misuse have, and to assess factors associated with those social care outcomes over a two-year period. The paper reports on a retrospective longitudinal study of 299 children all living with parental substance misuse and referred to one local authority in England. Data were collected from children's social work case files about procedural social care outcomes and factors which may be associated with those outcomes. Using cluster analysis, a new typology of children's longitudinal trajectories through the children's social care system was developed, consisting of five distinct types. Analysis indicated that some children received too little intervention from children's social care despite ongoing concerns, while other children were potentially unnecessarily caught up in the social care system. Factors associated with children having the poorest outcomes were: caregiver instability resulting from substance misuse, parenting capacity and household instability. The study's findings indicate that some children who live with parental substance misuse are at significant risk of harm, but others are not and may be better supported through non-statutory services such as early help.     

Policy and practice: non‐governmental organisations and the health delivery system for displaced children in khartoum,Sudan

The civil war in Sudan and natural disasters have led to the displacement of many people of whom 2.2 million live in and around Khartoum, half of whom are under the age of 18. These children, living in barren, remote areas, must find ways to survive and meet their basic needs of food, shelter, health and education. This article focuses on the work of an international organisation working in health services for displaced people in one of the camps in Khartoum in order to argue the case for a rights‐based approach to health care, for separate provision of services to adolescent mothers, for education on sexual and reproductive health for children before they become sexually active, and for sexual and reproductive health services and education for adolescent boys and men. This article concentrates on health education, in particular sexual and reproductive rights and how gender‐based differences impact on the health and well‐being of children. By concentrating almost exclusively on pregnant and lactating women and children under five, the organisation may reduce the possibility of successful outcomes for women and may not contribute to the reduction of sexually transmitted diseases, early pregnancy and related morbidity and mortality. Copyright © 2009 John Wiley & Sons, Ltd.     

Violence Experiences in Care: Some Methodological Remarks based on the Finnish Child Victim Survey

The article examines violence experienced by children in substitute care and at home based on the survey results of the Finnish Child Victim Survey carried out in schools in 2008. The focus is on physical and psychological violence in conflict situations. Of the 13 459 respondents, pupils between 12 and 16 years of age, 233 children reported living in care or having lived in care. Children living in care were asked the same questions as children living at home about violence experienced by their care‐taking adults. The analysis compares the answers between those two groups and examines them in relation to information about children's psychosocial problems and measures of emotional wellbeing.

‘The focus is on physical and psychological violence in conflict situations’

According to the study, children report more physical and psychological violence by adults in their homes than children do in residential homes or foster homes. Substitute care is not, however, free of violence. Children with psychosocial problems experienced more violence at home than in substitute care. The article suggests a more thorough conceptual and methodological analysis of abuse in care. The conceptual and methodological tools employed should be sensitive to the particular nature of abuse in care and the studies should pay attention to a variety of forms and practices of violence. Copyright © 2011 John Wiley & Sons, Ltd.     

Foster care placement change: The role of family dynamics and household composition

Sibling co-placement and kinship care have each been shown to protect against the occurrence of placement change for youth in substitute care. However, little is known about the effects of different combinations of sibling placement and relative caregiver status on placement change. Nor does the field fully understand how family dynamics may differ in these households. Utilizing data from the Supporting Siblings in Foster Care study, this paper examines family dynamics across four typologies of living composition, and tests the effects of living composition membership on the odds of experiencing a placement change over an 18-month period of time. Findings suggest that across living composition typologies, children who were placed separately from their siblings in non-relative care were more likely to be older, have more extensive placement histories, and experience more placement changes both prior to and during the study than were children in other living composition groups. Family living composition was found to influence the occurrence of placement change. Specifically, children co-placed in kinship care were least likely to experience movement; however, sibling co-placement in non-relative care was also protective. Results reveal the need to conduct additional research into the experiences of children in different family living arrangements, and tailor case management services and supports to children in substitute care accordingly. Implications and future directions are discussed.     

Commentary: Barriers to a Sustained Restraint-Free Environment

A restraint-free culture is becoming a standard practice in the provision of long-term care services for older people, a standard by which licensure and accreditation agencies evaluate providers. Although most health care providers initiate restraint-elimination processes, many fail to achieve the intended result or sustain the practice because of a variety of barriers. Faltering organizations find themselves faced with monumental changes in administrative and supervisory staff, substantial recruitment and retention crises, and inadequate attention to a culture of continuous learning, teamwork, and leadership skill building. This article informs policy makers about the barriers to achieving and sustaining a restraint-free environment and suggests public policy agendas and processes to improve conditions for the aging population.