Case file coding of child maltreatment: Methods,challenges, and innovations in a longitudinal project of youth in foster care

State social service agency case files are a common mechanism for obtaining information about a child's maltreatment history, yet these documents are often challenging for researchers to access, and then to process in a manner consistent with the requirements of social science research designs. Specifically, accessing and navigating case files is an extensive undertaking, and a task that many researchers have had to maneuver with little guidance. Even after the files are in hand and the research questions and relevant variables have been clarified, case file information about a child's maltreatment exposure can be idiosyncratic, vague, inconsistent, and incomplete, making coding such information into useful variables for statistical analyses difficult. The Modified Maltreatment Classification System (MMCS) is a popular tool used to guide the process, and though comprehensive, this coding system cannot cover all idiosyncrasies found in case files. It is not clear from the literature how researchers implement this system while accounting for issues outside of the purview of the MMCS or that arise during MMCS use. Finally, a large yet reliable file coding team is essential to the process, however, the literature lacks training guidelines and methods for establishing reliability between coders. In an effort to move the field toward a common approach, the purpose of the present discussion is to detail the process used by one large-scale study of child maltreatment, the Studying Pathways to Adjustment and Resilience in Kids (SPARK) project, a longitudinal study of resilience in youth in foster care. The article addresses each phase of case file coding, from accessing case files, to identifying how to measure constructs of interest, to dealing with exceptions to the coding system, to coding variables reliably, to training large teams of coders and monitoring for fidelity. Implications for a comprehensive and efficient approach to case file coding are discussed.     

Academic resilience and caring adults: The experiences of former foster youth

As a result of being removed from their homes and moving between different placements and schools, foster youth can experience high levels of stress and challenges as they struggle to cope with such extreme emotional turbulence. The experience of trauma and instability in turn, can have consequences on foster students' academic progress. As it is seemingly uncommon for foster youth to matriculate to postsecondary education, this study examines how successful foster youth transitioned out of care and furthered their education at an academically rigorous institution. From high-achieving former foster students, this study uncovers their experiences while in out-of-home care that helped them enroll in a university, including how adult supporters provided guidance, emotional support, and stability, which allowed students to move out of their negative past experiences. Adults' willingness to assist youth and be a part of their lives provided students with a transformative academic and social emotional environment, furthering their ability to persist through high school and gain acceptance to a top-tier university.     

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.     

Natural mentoring among older youth in and aging out of foster care: A systematic review

Due to their histories of caregiver maltreatment, living instability, and potential attachment challenges associated with out-of-home care, older foster youth represent a particularly vulnerable group of adolescents at increased risk for a number of poor well-being outcomes. However, research supports the notion that a relationship with a competent, caring adult, such as a mentor, may serve protectively for vulnerable youth, and a nascent yet growing body of literature suggests that naturally occurring mentoring relationships from within youth's social networks are associated with improved outcomes among young people in foster care during adolescence and the transition to adulthood. This systematic review is the first to comprehensively identify, synthesize, and summarize what we currently know from nearly a decade of theories, concepts, and research findings pertaining to natural mentoring among adolescent youth in foster care. A bibliographic search of seven databases and personal outreach to mentoring researchers and practitioners through a national listserv yielded 38 English-language documents from academic sources and the gray literature pertaining to natural mentoring among older foster youth. We identified quantitative studies that have been conducted to test the theories and hypotheses that have emerged from the qualitative studies of natural mentoring among youth in foster care. Together, this literature suggests that natural mentoring is a promising practice for youth in foster care. Based on our findings from the systematic review, we make practice recommendations to encourage the facilitation of natural mentoring within child welfare contexts and outline an agenda for future research that more rigorously investigates natural mentoring among older youth in foster care.     

Exploring the Experiences of Lesbian,Gay, Bisexual,and Questioning Adolescents in Foster Care

This article is based on the findings from a subset of gender identity and sexual orientation questions from The Casey Field Office Mental Health Study (CFOMH). It aims to contribute the experiences of youth in the care of Casey Family Programs to the increasing body of research on lesbian, gay, bisexual, transgender, or questioning (LGBTQ) youth in foster care, as well as inform future studies in this area. The CFOMH study interviewed 188 adolescents ages 14 to 17 who were receiving foster care services from Casey Family Programs in 2006. The experiences in care of youth who identified as LGBQ (n = 10) are presented in narrative form, along with data from all youth in care (N = 188) regarding their perceptions of the foster care environment for LGBTQ youth. These findings are intended to underscore the need to conduct a larger, more in-depth study of the experiences of LGBTQ youth in foster care and the environment that foster care provides for them.     

Ethnic Identity Development Among Adolescents in Foster Care

Because past research indicates that stronger ethnic identity is related to better outcomes in areas such as academic achievement and mental health, it is important to provide youth in foster care with opportunities to develop their ethnic identity. Using data from in-person interviews with 188 youth aged 14–17 in foster care (88.7% response rate), this paper explores two areas related to ethnic identity: (1) youth perceptions about their own ethnic identity, and (2) attitudes about ethnic identity development specific to the experience of being in foster care. Results suggest that black youth and Hispanic/Latino youth have a stronger sense of ethnic identity than white youth. Most youth are interested in learning more about their ethnic background. Understanding how youth in foster care identify ethnically and understanding their beliefs related to ethnic identity may lead to the enhancement of services provided to youth across child welfare, education, and mental health systems.

Voices of former foster youth: Supportive relationships in the transition to adulthood

As the adolescent development literature has recognized the importance of social supports in the transition to adulthood, child welfare research, policies, and programs have turned their attention to the relational needs of youth emancipating from the foster care system. This study builds on the extant literature on social support among transitioning foster care youth; it goes beyond the sole identification of relational networks, to explore how youth actually utilize their network members, and the overall quality of their support system. This study collects data from twenty qualitative interviews with foster youth, ages 18–21. We analyze the data using consensual qualitative research methods in order to develop core themes around shared youth experiences. We found that while foster youth did identify a wide network of both formal and informal supports during their transition to adulthood, there were “holes” in the form of support, especially appraisal and instrumental support, provided by informal network members. Additionally, an unrealistic perception of supportive and permanent relationships may be contributing to poor outcomes in emerging adulthood. Implications for policy and practice are discussed.     

“No One Acknowledged My Loss and Hurt”: Non-death Loss,Grief, and Trauma in Foster Care

How do youth in foster care experience non-death loss? Drawing upon the theories of ambiguous loss, symbolic loss, and disenfranchised grief, this applied theoretical article integrates research findings to address how youth experience loss, grief, and trauma in foster care. Youth’s reports illustrate experiences of non-death loss, the impact of non-death loss on psychological and emotional well-being, and how non-death losses are disenfranchised and enfranchised within the foster care system. Recommendations are made that child welfare agencies consider how their practices and policies can be enhanced to meet the needs of grieving youth in foster care.     

Foster youth and drug use: Exploring risk and protective factors

Substance use and misuse experiences of foster youth remain an under-researched area. Given that early use of drugs is said to be a common factor among 90% of those who develop substance misuse problems in their lifetime, this is an important area of academic study (Dennis, White, & Ives, 2009). By drawing upon primary empirical data from a mixed-methods study, this paper addresses an important gap in the literature and seeks to provide an improved understanding of foster youth, drug use and vulnerability. A total of 261 foster youth, who had exited care, contributed to a quantitative survey, and a further 35 provided qualitative narratives of their lived experience. Key risk factors including experience of homelessness, school exclusion and living setting are identified as strong influences that predict high levels of drug use among foster youth. Targeted social support and interventions in the form of pre-leaving care in the context of a strong practitioner/youth relationship are suggested to help ameliorate poor outcomes to obviate the problem of substance misuse among foster youth.     

Building evidence to promote educational competence of youth in foster care

Although the academic difficulties of students living in foster care are well documented, few studies have examined factors influencing academic achievement of youth in foster care. This article reports the results of a study of educational competence in a sample of 152 foster youth in one midwestern state. Using five standardized instruments, the study explored predictors of reading ability of youth in foster care. Multiple regression analyses indicated that four factors--aspiration for higher education, placement in kinship care, participation in extracurricular activities, and drug use--accounted for 39% of the variance in reading ability scores. The article discusses implications of these findings for practice, research, and policy development.     

Strategies for engaging foster care youth in permanency planning family team conferences

The present study examines strategies conference facilitators used to engage foster care youth in decision-making in the context of permanency planning family team conferences. Data collection included observations of permanency planning family team conferences, followed by interviews with foster care youth and conference facilitators. Data analysis focused on gaining a deeper understanding of how facilitators incorporate youth into decision-making, with a specific focus on the strategies they employed. Four strategies were identified in the analysis: creating a safe space, encouraging the youth voice, re-balancing power, and establishing a personal connection. The study's policy and practice implications, limitations and areas of further research are presented.     

The Guardian Professions Program: Developing an advanced degree mentoring program for California's foster care alumni

Higher education continues to be an elusive social space for too many children and youth in the United States foster care system. Yet a four-year pilot project in California has demonstrated that former foster youth can surmount the detrimental effects of childhood adversity to complete their undergraduate degrees and, with additional preparation, advance to graduate degree programs. Building on the success of campus support programs throughout the state, the Guardian Professions Program (GPP) at the University of California Davis employed a research and implementation framework based on Participatory Action Research (PAR) and made use of surveys, qualitative interviews and ethnographic data to develop the model. In this article the authors describe and analyze the GPP, an initiative that pioneered the use of online technology to assist seventy-four former foster youth successfully gain a level of educational success that is not often associated with this demographic. Not all children and youth who are involved in the child welfare system will have the interest or determination to pursue a university education and undertake an advanced degree. However, services and academic assistance for those students who have the aptitude can promote higher education as a path to achievement and self-sufficiency.     

Happily Ever After? The Journey From Foster Care to Adoption

Providing the foster child with a forever family through adoption is often seen as a happy ending to the long and painful journey through foster care. This qualitative study explores this complex journey from foster care to adoption from the perspective of 30 young adults aged 18 to 25 who were adopted from the foster care system after the age of 8. The results indicate that the foster and adoption experience for these youth cannot be compartmentalized when trying to understand the impact adoption has had on their overall sense of self. Implications for future research to explore the emerging concept of foster/adoptive identity for older youth adopted through the foster care system are provided.     

Family Reunification of Youth in Foster Care with Complex Mental Health Needs: Barriers and Recommendations

This study presents findings of a formative evaluation of an innovative pilot program designed to reunify and reintegrate foster youth with complex mental and behavioral needs in residential treatment centers or therapeutic foster care with their families in the community. Data collection methods included in-depth structured case file reviews and semi-structured interviews with the youth, as well as their caregivers, Child Protective Services caseworkers, and pilot program staff. The participants provided important insights regarding system, program, and case-level barriers to the successful reunification of these youth back into the community. Training, practice, and policy recommendations are discussed.     

Better Futures: A validated model for increasing postsecondary preparation and participation of youth in foster care with mental health challenges

Higher education participation rates of young people in foster care are dramatically lower than their level of postsecondary education aspiration. Increasing attention to this disparity has stimulated policy and practice enhancements, however rigorously validated models for promoting postsecondary preparation and participation have not existed for young people in foster care, including those with mental health conditions. This article describes Better Futures, which is the first such model to be experimentally validated as effective for increasing the higher education participation and other related outcomes of young people in foster care with mental health challenges. Better Futures features a four day on-campus Summer Institute, coaching provided to youth by older peers who are in college and have shared experiences around foster care and/or mental health, and workshops that bring together youth, coaches and guest speakers for information sharing and mutual support. This article includes the theoretical and component features of the Better Futures model, findings related to intervention fidelity, participants' evaluation of the program, and discussion of implications for future model refinement and research.     

Employment outcomes of former foster youth as young adults: The importance of human, personal, and social capital

In spite of a prevailing policy focus, little is known about the employment outcomes of former foster youth during early adulthood and the factors associated with those outcomes. We explore how former foster youth who aged out of care in Illinois, Wisconsin, and Iowa are faring in the labor market at age 24 and what explains variability in employment and wages for these youth. We utilize multilevel models to analyze youth's employment using four waves of the Midwest Study. Our findings point to a critical need to better understand and address barriers to education, causes of substantial racial disparities, and characteristics of family foster homes that facilitate youths' employment. We find that youth who remain in care past age 18 attain higher educational credentials which translate into better employment outcomes. This research also highlights the need for policies directed at current and former foster youth who become early parents.     

Underserved parents,underserved youth: Considering foster parent willingness to foster substance-using adolescents

Adolescents involved with foster care are five times more likely to receive a drug dependence diagnosis when compared to adolescents in the general population. Prior research has shown that substance use is often hidden from providers, negating any chance for treatment and almost guaranteeing poor post-foster care outcomes. There are virtually no studies that examine the willingness (and its determinants) to foster youth with substance abuse problems. The current study conducted a nationally-distributed survey of 752 currently licensed foster care parents that assessed willingness to foster youth overall and by type of drug used, and possible correlates of this decision (e.g., home factors, system factors, and individual foster parent factors such as ratings of perceived difficulty in fostering this population). Overall, willingness to foster a youth involved with alcohol and other drugs (AOD) was contingent upon the types of drugs used. The odds that a parent would foster an AOD-involved youth were significantly increased by being licensed as a treatment foster home, having fostered an AOD-involved youth in the past, having AOD-specific training and past agency-support when needed, and self-efficacy with respect to positive impact. Surprisingly, when religion played a large part in the decision to foster any child, the odds of willingness to foster an AOD-involved youth dropped significantly. These results suggest that a large proportion of AOD-involved youth who find themselves in the foster care system will not have foster families willing to parent them, thereby forcing placement into a variety of congregate care facilities (e.g., residential treatment facilities, group homes). Specific ways in which the system can address these issues to improve placement and permanency efforts are provided.     

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.     

Can Machine Learning Create an Advocate for Foster Youth?

ABSTRACT

Statistics are bleak for youth aging out of the United States foster care system. They are often left with few resources, are likely to experience homelessness, and are at increased risk of incarceration and exploitation. The Think of Us platform is a service for foster youth and their advocates to create personalized goals and access curated content specific to aging out of the foster care system. In this article, we propose the use of a machine learning algorithm within the Think of Us platform to better serve youth transitioning to life outside of foster care. The algorithm collects and collates publicly available figures and data to inform caseworkers and other mentors chosen by the youth on how to best assist foster youth. It can then provide valuable resources for the youth and their advocates targeted directly toward their specific needs. Finally, we examine machine learning as a support system and aid for caseworkers to buttress and protect vulnerable young adults during their transition to adulthood.     

Sexual and reproductive health policies for foster youth in California: A qualitative study of child welfare professionals' experiences and perceptions of policies

Child welfare professionals and foster parents increasingly suggest the importance of establishing clear and consistent policies and procedures to address the sexual and reproductive health of youth in foster care. The present study examines the content and context of such policies across 18 California counties through a search of publically available county policy documents, and surveys and expert interviews with child welfare professionals (N = 22). A policy framework for agenda setting and policymaking was used to guide the data collection and analysis process. Child welfare professionals were aware of multiple sources of information, support and services for foster youths' sexual and reproductive health, though few practiced in counties with formal policies that outline the resources and support that youth should receive. Participants demonstrated widespread recognition that issues of youth sexual and reproductive health were significant; posing challenges to youth, foster parents and child welfare staff. Identified policy solutions included: 1) training for social workers and foster parents; 2) collaborative partnerships with public health nurses and community providers; 3) data tracking and monitoring of outcomes to assess youth needs and evaluate the impact of programs and policies; and 4) involvement by advocacy organizations in defining problems and advocating for improved services and support for youth in care. Social workers largely perceived that support from child welfare administrators and policy leaders is necessary to prioritize this issue and initiate policy formation. Additional research is needed to further examine the impact of policy mandates on social workers, foster parents and youth in foster care.