Physical and mental health changes in aging foster parents: Do child behavioural problems hasten declines?

This study examined foster parent physical and mental health over time. It was hypothesized that increased severity and frequency of child behavioural problems, whether externalizing or internalizing, would be associated with poorer health over time, especially for foster parents ≥60 years of age. Data from the baseline and Wave 2 interview of the 2010 National Survey of Child and Adolescent Well‐Being were used. The final analytic sample included kin and nonkin foster parents who had custody of a foster child for both waves of data collection (n = 962). Ordinary Least Squares regression models with lagged dependent variables showed that foster parents ≥60 had deteriorating physical health over time, but caregiver age alone had no association with worsening mental health. However, parents ≥60 caring for children with externalizing behavioural problems had significantly improved physical health. Mental health of parents ≥60 significantly diminished if child externalizing or internalizing problems worsened. Findings indicate that for aging foster parents, externalizing child behaviours may stimulate physical activity and improved physical health, yet any type of child behavioural problem can deteriorate mental health functioning.     

Parental Reactions to Toddlers' Negative Emotions and Child Negative Emotionality as Correlates of Problem Behavior at the Age of Three

Parent‐reported reactions to children's negative emotions and child negative emotionality were investigated as correlates of internalizing and externalizing behaviors. Children (N = 107) and their parents participated in a short‐term longitudinal study of social development. Mothers and fathers independently completed questionnaires assessing parental reactions to their child's negative emotions and child negative emotionality at Time 1 (33 months) and child behavior problems at Time 2 (39 months). Child negative emotionality was significantly related to greater internalizing and externalizing behavior. Maternal and paternal punitive reactions were related to greater internalizing behavior, but only for boys with high levels of negative emotionality. Results indicate that child temperament and child gender may be important moderators of the relation between parental emotion socialization and child internalizing problems during the toddler and early preschool years.     

Caregiver depression and child behaviour problems: A longitudinal mixed effects approach

Caregiver mental health has a powerful influence on child well‐being. Both maternal depression and paternal depression predict behaviour problems in young children. However, little is known about the nature of this link over time. The present study leveraged a large sample of at‐risk families to examine the impact of maternal and paternal depression on trajectories of child behaviour from age 3 to 15. Data came from the At‐Home substudy of the Fragile Families and Child Well‐Being Study, which observed a cohort of children born 1998–2000 in 20 large American cities (N = 1,090). Multiple imputation by chained equations addressed missing data to maximize available information without biasing models. Linear mixed effects models tested the association between caregiver depression and child behaviour over 12 years; interaction models tested whether this association changed as children transitioned into adolescence. Results showed caregiver depression is related with increases in both child internalizing and externalizing problems, and these relationships strengthened over time. Findings inform risk trajectories of distinct behavioural problems, shedding light on the development of child psychopathology and highlighting opportunities for intervention.     

Assessing low‐income African‐American pre‐schoolers' behaviour problems in relationship to community violence,inter‐partner conflict,parenting, informal social support and social skills

This study examined the relations among community violence exposure, inter‐partner conflict and informal social support and the behaviour problems of pre‐schoolers, and explored how mothers' parenting skills and children's social skills may mediate the child outcomes associated with such exposure. Participants were 185 African‐American mothers and female caregivers of Head Start children who completed study measures in a structured interview. Path analyses revealed that greater inter‐partner conflict was associated with more internalizing and externalizing child behaviour problems. Positive parenting was associated with fewer internalizing and externalizing behaviours. Higher levels of child social skills were associated with fewer internalizing and externalizing behaviour problems. Child social skills fully mediated the relationship between community violence and externalizing behaviours as well as between informal support and externalizing behaviours. Social skills partially mediated the relationships between positive parenting and externalizing behaviours. No mediating effect was found on the relationships between inter‐partner conflict and child behaviour problems. Implications of the findings for intervention and future research are discussed.     

Recognizing complex trauma in child welfare‐affected mothers of colour

Child welfare‐affected mothers of colour live with the deleterious effects of complex trauma unrecognized by the child welfare system. Child welfare system instead focuses on mothers' more overt functional difficulties, facilitating a misalignment between mothers' felt needs and mandated services. Qualitative data from a mixed‐methods study were used to explore the phenomenon of complex trauma in 20 urban‐dwelling mothers using a combined interpretive phenomenological and directed content analysis. Mothers experienced chronic and compound exposure to traumatic events. Themes of interpersonal violations of trust and pervasive mistrust of others, revictimization, absence of appropriate mental health treatment, and maternal growth emerged. Implications for utilizing a trauma‐informed approach for policy and practice are discussed.     

Caseworkers as a source of hope leading to perceptions of academic success for transitional age foster youth

Research among adolescent samples has consistently demonstrated that a hopeful mindset is associated with resilience and global well-being. Further, research suggests that hope is influenced from an early age from connections with supportive caregivers. However, because older youth in the child welfare system may lack supportive caregivers, alternative sources of hope may be needed. To test a theory that supportive child welfare caseworkers can serve as external sources of hope, we conducted a cross-sectional study of youth in the child welfare system from a single state (N = 149). Using surveys with established scales to measure the variables of interest, the study tested a structural equation model of (1) youth's external hope in their caseworker as a driver of (2) internal hope in themselves leading to (3) more positive perceptions of academic success. Perceptions of academic success were chosen as the final consequence of the model because academic success has been linked to many other variables of well-being across the lifespan. The results indicate that the proposed structural model fits the data well (χ² = 327.9, df = 150; P < 0.001; root-mean-square error of approximation [RMSEA] = 0.09 [90% confidence interval – CI: 0.076, 0.103]; comparative fit index [CFI]: 0.920; standardized root-mean-square residual [SRMR]: 0.05). The results indicate that youths' hope in themselves had origins in external hope in the caseworker. Moreover, the final consequence was an increase in perceptions of academic success. Such results have implications by revealing how case management services can positively influence foster youths' hope and thereby influence their academic success.     

Searching for the right track – managing care trajectories in child welfare

This paper examines caseworkers' efforts to plan and find appropriate interventions for troublesome young people. Strauss's concept of trajectory is applied to analyse how Swedish caseworkers shape and manage the evolving care trajectories using assessments for young people in secure accommodation, i.e. institutional youth assessments. The empirical material consists of surveys to 82 caseworkers concerning 85 institutional youth assessments and interviews with 16 of these caseworkers. The findings reveal ongoing care trajectories that are out of control where the assessments are seen as an opportunity of change for the youths. Diagnoses, confirmations and plans for action are provided through the assessments and used by the caseworkers in negotiations for resources. Three orientations of contributions to the caseworkers' management of care trajectories were found, all reflecting the many uncertainties of child welfare work: child centred, professional and discharge of liability. In conclusion, the caseworkers searched for the right measures to manage change and achieve youth compliance, but it was also a matter of managing professional and organizational contingencies and passing on responsibility.     

Promoting family well‐being and social cohesion: The networking and relational approach of an innovative welfare service in the Italian context

This evaluation study examined a Family Services Centre (FSC) operating in a socio‐culturally deprived suburban area of Southern Italy to explore how promoting innovative practices to meet increasingly complex family needs. The research used a case study approach and a mixed‐methods design: the service's documents underwent a documentary analysis; users' trends and satisfaction levels were examined using quantitative data; service's identity and changes in the perceptions of professionals were analysed by qualitative techniques. Overall, the data highlighted the fact that the FSC can be considered an effective prevention instrument: its family support practices, oriented to the ASPIRE model, ensure accessibility, empowerment and a strengths‐based approach. Thanks to its strengthened mediator role, client participation and caseworkers' ideas, it represents an environment conducive to the development of innovation in social practices, influencing local social policies regarding child and family welfare. Despite its changes, the FSC still promotes family well‐being and social cohesion within the community with its innovative multilevel and multimethod approach. Considerations and lessons learned by this case study could stimulate decision makers and social practitioners to reflect on innovative models to meet families' needs.     

Incorporating self‐determination into substance abuse prevention programming for youth transitioning from foster care to adulthood

Youth transitioning from foster care to adulthood are at higher risk for alcohol and substance abuse disorders than general population youth. At the same time, these youths are often recipients of strong clinical intervention, often at levels considered unnecessary, for other mental health or behavioural challenges. Because of this, there is sometimes resistance from providers to offer services such as substance abuse prevention programming as it may be seen as contributing to youths' overclinicalization, stigmatization, or retraumatization. Using thematic content analysis, this qualitative study analysed focus groups with community stakeholders providing recommendations on support services for youth transitioning from foster care to adulthood to derive strategies for delivering substance abuse prevention programming in a way that enhances youth self‐determination. Findings were organized by self‐determination theory's 3 key psychological needs: autonomy, competence, and relatedness. All three needs were represented in stakeholder recommendations, which were translated into strategies for bolstering youths' achievement of each need. Strategies include a mix of those already present in motivational interviewing‐based brief substance abuse prevention interventions as well as more unique strategies that are much less frequently employed but that may better meet the needs of youth with foster care experience.     

The mental health status of Latino children in the public child welfare system: a look at the role of generation and origin

As the number of Latino children in public child welfare continues to grow, it is necessary to understand how their mental health is faring. The paper examines emotional and behavioural needs among Latino children who had contact with the public child welfare system. The purpose of this longitudinal study was twofold: to examine the severity of emotional and behavioural problems, and to assess the predictive role of generation status and Latino origin. Latent growth models were completed using the National Survey on Children and Adolescent Well‐Being. The predictive model for the externalizing CBCL scale revealed that generation status and Latino origin were significant predictors. At baseline, Puerto Rican children exhibited higher rates of externalizing problems compared with Mexican children. Over time children who were first/second generation tended to have lower scores compared with the third‐plus generation children. Implications for practise are discussed.     

Do social work education,job description,and cultural competence foster child‐welfare caseworkers' therapeutic alliances?

We explored whether the strength of caseworkers' engagement with families in the child‐welfare system was associated with the caseworkers' academic degrees, job responsibilities and environments, and/or ethnicity. We extracted data from a national data set describing 1,714 caseworkers. Results confirmed significant association between caseworkers' confidence in their engagement with families and (a) master's‐ and bachelor's‐level social work education, (b) adequate supervision at work, (c) cultural‐diversity training, (d) job focus (screening/investigation, out‐of‐home placement, or reunification), and (e) homogeneous race/ethnicity of caseworker and client.     

Grandparent support and mental and behavioural health in middle childhood

This study explored the significance of grandparents in middle childhood and assessed the level of grandparental support provided to children in relation to other social network members. The association between grandparental support and grandchildren's mental and behavioural health was also examined. We conducted structured interviews with 120 grade 4 and 5 learners (mean age = 10.41 years) from four schools in Cape Town, South Africa. Results indicated that subsequent to parents, children perceived grandparents as the most important and close relationship category. Furthermore, grandparents provided the highest levels of support to grandchildren after parents. Grandmothers provided more support than grandfathers. No associations between grandparental support and children's internalizing and externalizing behaviours were found. However, results revealed that grandparental support was positively associated with children's prosocial behaviour, independent of child gender, and the amount of support provided by other relationship categories (p = .04). Findings underscore a need for research to move beyond the nuclear family when considering potential influences on children's well‐being.     

Caregiver involvement in behavioural health services in the context of child welfare service referrals: a qualitative study

Human service agencies serve a growing number of adults with behavioural health needs. Despite these agencies' key role in identifying need and facilitating services, many individuals do not receive care or end services prematurely. Few studies have explored the experiences of families referred to behavioural health services by such agencies or the extent to which families' perceptions of service need align with those of treatment providers and frontline workers. This study presents findings from a qualitative study of caregivers involved with child welfare agencies who were referred to behavioural health services. Researchers reviewed agencies' case records and conducted in‐depth interviews with 16 caregivers, 9 child welfare caseworkers and 12 behavioural health treatment counsellors. Findings suggest that when deciding to engage in services, caregivers weigh not only their individual and family behavioural health needs but also potential agency intervention, including loss of child custody. Many professionals reported that involvement with a child welfare agency hindered the caregiver's disclosure of behavioural healthcare needs. Implications for managers and practitioners are discussed.     

Child‐centric or family focused? A study of child welfare workers' perceptions of ethnic minority children in England and Norway

This paper analyses child welfare workers' perceptions of ethnic minority children in England and Norway based on in‐depth interviews with 52 child welfare workers in 2008. We employ a child‐centric theoretical framework to explore up to what extent workers focus on minority children in their perceptions. We found that about half of our study participants (n= 27) did so, and many more in Norway than England. They perceived many risks and problems for minority children related to their ethnicity, including children's biculturalism and language skills, parenting methods, unequal treatment and racism, lack of social inclusion, and problems in school. Norwegian workers displayed a broad needs perception and embraced a change‐orientated perspective and held parents accountable for their children's educational success and social inclusion. English workers had a narrower approach, focusing on protecting children. We discuss how the cross‐country differences may be related to different welfare state and child welfare paradigms.     

Black‐White Biracial Children's Social Development from Kindergarten to Fifth Grade: Links with Racial Identification,Gender, and Socioeconomic Status

In this study, we investigated trajectories of Black‐White biracial children's social development during middle childhood, their associations with parents’ racial identification of children, and the moderating effects of child gender and family socioeconomic status (SES). The study utilized data from parent and teacher reports on 293 US Black‐White biracial children enrolled in the Early Childhood Longitudinal Study‐Kindergarten Cohort (ECLS‐K). Growth curve models suggested increasing trajectories of teacher‐reported internalizing and externalizing behaviors between kindergarten and fifth grade. Parents’ racial identification of children predicted child externalizing behavior trajectories such that teachers rated biracially identified children's externalizing behaviors lower relative to those of Black‐ and White‐identified children. Additionally, for White‐identified biracial children, the effect of family SES on internalizing behavior trajectories was especially pronounced. These findings suggest that in the USA, how parents racially identify their Black‐White biracial children early on has important implications for children's problem behaviors throughout the elementary school years.     

Effects of Placement Changes on Health Insurance Stability Among a National Sample of Children in the Child Welfare System

ABSTRACT

Children in the child welfare system have entitlements to health insurance coverage—critical because of their considerable physical and mental health needs—based largely on their placement status. This study conducted path and transitions analyses on data from the National Survey of Child and Adolescent Well-Being (3,801 children followed-up for 3 years) to examine the interplay between placement changes and insurance stability. Children maintained in-home at Wave 1 had significantly lower odds of being insured (OR = 0.7); children transitioning from out-of-home placement to in-home care had significantly lower odds of maintaining insurance coverage (OR = 0.6). Child welfare workers working with children maintained in-home and those being reunified should safeguard the children's insurance status. Policy makers should consider extension of categorical eligibility to all children presenting to child welfare agencies in order to assure access to needed services for these vulnerable children.     

Patterns of family service needs and caregiver–child relationships among families at risk of child welfare involvement

Caregivers at risk of involvement in the child welfare system report high levels of need for multiple types of services, and their children have high levels of mental health need. Caregivers from families with more service needs, as well as unmet needs, are less likely to be engaged with child welfare services and may have diminished capacity to care for their child. This study takes a family‐centered approach by using latent class analysis to identify patterns of both caregiver and child service needs among families at risk of child welfare involvement. Using data from the LONGSCAN consortium (N = 957), we identified 4 classes of service needs among child welfare‐involved families. We then examined differences between the 4 classes based on demographics, maltreatment histories, unmet service needs, and caregiver–child relationship. The caregivers were split fairly evenly among the 4 classes: low needs, medical needs, poverty support, and high needs. There were significant differences between classes on assessed variables, with higher levels of needs associated with diminished caregiver–child relationships.     

Associations of Internalizing and Externalizing Problems with Facial Expression Recognition in Preschoolers: The Generation R Study

Altered patterns of facial expression recognition (FER) have been linked to internalizing and externalizing problems in school children and adolescents. In a large sample of preschoolers (N = 727), we explored concurrent and prospective associations between internalizing/externalizing problems and FER. Internalizing/externalizing problems were rated by parents at 18 and 36 months using the Child Behavior Checklist. FER was assessed at 36 months using age‐appropriate computer tasks of emotion matching and emotion labeling. Internalizing problems were associated with emotion‐specific differences at both ages: at 18 months they predicted more accurate labeling of sadness; at 36 months they were associated with less accurate labeling of happiness and anger. Externalizing problems at both ages were associated with general FER deficits, particularly for matching emotions. Findings suggest that in preschoolers, internalizing problems contribute to emotion‐specific differences in FER, while externalizing problems are associated with more general FER deficits. Knowledge of the specific FER patterns associated with internalizing/externalizing problems can be proven useful in the refinement of emotion‐centered preventive interventions.     

Within- and between-person associations among internalizing and externalizing problems during middle childhood

Internalizing and externalizing problems are likely to co-occur in childhood and are related to concurrent and prospective mental health outcomes. We examined the longitudinal relations among internalizing and externalizing problems during middle childhood utilizing the Random Intercept – Cross Lagged Panel Model. We investigated three research questions: (1) how overall levels of internalizing and externalizing problems are related, (2) whether internalizing and externalizing problems predict each other longitudinally, and (3) whether girls and boys show different longitudinal associations among internalizing and externalizing problems. Mother-reported internalizing and externalizing problems were used through first to sixth grade (N = 1364). Results showed positive random intercepts and positive within-time correlations of internalizing and externalizing problems. Further, internalizing problems predicted externalizing problems at the within-person level. Although previous research mostly has shown a significant effect from externalizing problems to internalizing problems, the current study shows that when within- and between-person variance are disentangled, internalizing problems also may predict externalizing problems.     

Parental emotion regulation strategies and parenting quality predict child internalizing symptoms in families experiencing homelessness

Adaptive emotion regulation (ER) in parents has been linked to better parenting quality and social–emotional adjustment in children from middle‐income families. In particular, early childhood may represent a sensitive period in which parenting behaviors and functioning have large effects on child social–emotional adjustment. However, little is known about how parent ER and parenting are related to child adjustment in high‐risk families. In the context of adversity, parents may struggle to maintain positive parenting behaviors and adaptive self‐regulation strategies which could jeopardize their children's adjustment. The current study investigated parents' own cognitive ER strategies and observed parenting quality in relation to young children's internalizing and externalizing problems among families experiencing homelessness. Participants included 108 primary caregivers and their 4–6‐year‐old children residing in emergency shelters. Using multiple methods, parenting and parent ER were assessed during a shelter stay and teachers subsequently provided ratings of children's internalizing and externalizing difficulties in the classroom. Parenting quality was expected to predict fewer classroom internalizing and externalizing behaviors as well as moderate the association between parent ER strategies and child outcomes. Results suggest that parenting quality buffered the effects of parent maladaptive ER strategies on child internalizing symptoms. The mediating role of parenting quality on that association was also investigated to build on prior empirical work in low‐risk samples. Parenting quality did not show expected mediating effects. Findings suggest that parents experiencing homelessness who use fewer maladaptive cognitive ER strategies and more positive parenting behaviors may protect their children against internalizing problems.