The relationship between parent immigration status and concrete support service use among Latinos in child welfare: Findings using the National Survey of Child and Adolescent Well-being (NSCAWII)

The underutilization of concrete services by immigrants is widely documented across several service sectors, yet evidence is lacking on the use of such services among immigrants reported to child welfare for the purposes of reducing maltreatment. It has been suggested that Latino immigrants involved with the child welfare system may face steep challenges to receiving needed services due to issues surrounding legal status, language and cultural barriers. The purpose of this study was to determine whether referral to and receipt of concrete services by Latino families reported to child welfare agencies, was associated with legal immigration status. The sample included children of Latino parents who participated in the second National Survey of Child and Adolescent Well-being (NSCAWII), who remained in the home following a child welfare investigation (n = 561). Over a third (37%) of Latino families were referred for at least one concrete service, yet only 17% received any. Weighted logistic regression models showed that families in which the primary caregiver was undocumented had significantly lower odds (OR = .24) of receiving services once referred. Families who had trouble paying for basic necessities (OR = 7.52), those with active domestic violence in the home (OR = 4.98), and those receiving ongoing child welfare services (OR = 4.52) had increased odds of referral for services by the caseworker. The odds of receiving services increased when the primary caregiver was unemployed (OR = 5.24), when there was domestic violence in the home (OR = 4.59), and with the receipt of child welfare agency services (OR = 8.83). There appears to be an unmet need for concrete services among Latinos investigated by child welfare, as demonstrated in the gap between overall service referral and receipt. A parent's legal status may be one reason for that unmet need, implying that children of undocumented parents are less likely to have basic needs met to mitigate economic stress and reduce maltreatment risk upon contact with child welfare. Policy recommendations and implications for child welfare practice are discussed.     

Ethnic disproportionality in the child welfare system: A Norwegian national cohort study

This study of Norwegian child welfare clients examined the extent to which ethnic disparities in involvement with the child welfare system can be attributed to ethnic differences in sociodemographic background. Using logistic regression models and a unique dataset constructed by linking child welfare records to national administrative registers for the 1993–1994 birth cohorts, we computed ethnic disparities in the odds of child welfare involvement at age 6–12 (N = 122,894), both before and after adjustments for sociodemographic background. Compared with ethnic Norwegian cohort peers, non-Western children had twice the unadjusted odds of entering the child welfare system (odds ratio = 2.13). However, the data also indicated pronounced ethnic disparities in eight sociodemographic correlates of child welfare involvement. When adjustments for these background factors were modeled, we found no ethnic differences in the odds of child welfare involvement. Our findings suggest that the association between ethnicity and child welfare involvement is confounded by differences in socioeconomic status, maternal social assistance, family size and family structure.     

Mental health outcomes among child welfare investigated children: In-home versus out-of-home care

BackgroundChild welfare has increasingly focused on alternatives to out-of-home (OOH) placement. In-home services, such as parent training, have increased and more maltreated children remain in-home. Yet, little is known about the effect on mental health of maintaining vulnerable children in-home vs placement in stable OOH care.ObjectiveTo evaluate and compare difference in mental health among children investigated by child welfare and who remained in-home vs. those who were placed in stable OOH care.Design/methodsWe examined a cohort of children (aged 1.5–18 years) from a nationally representative sample of children investigated by child welfare using the National Survey of Child and Adolescent Well-Being II (NSCAW II). We compared changes in mental health functioning over 18 months for children who remained in-home with parent training versus those placed in stable OOH care.ResultsAmong the 749 children in our sample, baseline characteristics of children who remained in-home with parent training and those placed in stable OOH care were similar. Among school-aged children placed in stable OOH care, mental health problems decreased from 26% to 13% (p = .003). This differed significantly from school-aged children who remained in home, for whom mental health problems increased (50% decrease stable OOH care vs. 23% increase in home; p = .007). Among pre-school aged children, mental health problems increased in both settings, particularly stable out-of-home care (p = .008).ConclusionsFor school aged children with a history of maltreatment, mental health outcomes improve following stable OOH placement, yet worsen when remaining in-home with parents. Pediatricians should be watchful for mental health problems among children who remain home after maltreatment and should advocate for high-quality stable OOH care when it is necessary. Child welfare may need to monitor the outcomes of children remaining at home more closely and provide more intensive preventive and treatment services to families.     

Drivers of change: Examining the effects of gender equality on child nutrition

India has the world's highest burden of child undernutrition. Lack of income is considered as one of its primary causes. However, evidence suggests that despite steady economic growth and investments in social services directed towards child welfare, undernutrition rates continue to rise. Thus indicating, that there are other societal factors impacting child undernutrition. Previous studies indicate that countries with higher gender inequality have worse health outcomes for women and children. India, particularly in the northern states, has deep-rooted gender biases, leading to disproportionately worse outcomes for women and children. This study uses cross sectional data from the India National Family Health Survey Round-3 (NFHS-3) to examine the immediate and underlying effect of gender inequality on child nutritional status. The sample includes urban married women between 15 and 49 years (N = 9092) who have at least one living child between 0 and 5 years. Findings highlight the significant effect of autonomy and health related awareness on child nutritional status, when the relationship is mediated by maternal health. Implications for policy and practice are provided.     

Family Diversity and Child Health: Where Do Same‐Sex Couple Families Fit?

Increasing family diversity during the past half century has focused national attention on how children are faring in nontraditional family structures. Much of the limited evidence on children in same‐sex couple families suffers from several shortcomings, including a lack of representative data. We use the National Health Interview Survey (2004–2012) and the National Survey of Children's Health (2011–2012) to identify children in different‐sex married and cohabiting families, never and previously married single‐parent families, and same‐sex couple families. Considering important characteristics such as the child's race or ethnicity and adoption status, household socioeconomic standing, family stability, and parent health, we examine the relationship between family type and parent‐rated overall child health. The results suggest that poorer health among children in same‐sex couple as well as different‐sex cohabiting couple and single‐parent families appears to be largely the product of demographic and socioeconomic differences rather than exposure to nontraditional family forms.     

Contact with birth family in intercountry adoptions: Comparing families headed by sexual minority and heterosexual parents

Contact between adoptive families and birth families in the context of intercountry adoption, as well as adoption by sexual minorities (e.g., lesbians and gay men), represent understudied topics. In the current study, we examine the extent and type of contact with birth family in intercountry adoptive families headed by heterosexual and sexual minority parents. Data were drawn from the Modern Adoptive Families project, a nationwide, non-random survey of adoptive parents' beliefs and experiences that was conducted from 2012 to 2013. The current sample consisted of 479 families headed by heterosexual parents (H) and 38 families headed by sexual minority women (SM) whose oldest adopted child was younger than 18 years of age and who had been placed from another country. Although no family type difference was found in contact with birth family prior to or at the time of placement (H = 9.6%; SM = 13.2%), sexual minority respondents reported a higher level of contact with one or more members of their children”s birth families following adoptive placement than did heterosexual respondents (SM = 28.9%; H = 14.4%), as well as currently (SM = 21.1%; H 9.8%). They also reported more contact with their children”s birth mothers than did heterosexual parents, although no family type differences were found for contact with other birth family members. Policy and practice implications are discussed.     

Recovery coaches and the stability of reunification for substance abusing families in child welfare

Substance abuse is a long-standing challenge for child welfare systems. Parental substance abuse disrupts family stability, family cohesion, and jeopardizes the well-being of children. In the current study we test an intervention to improve child welfare outcomes for substance abusing families, specifically the probability of families achieving a stable (at least 12 months) reunification. The intervention was an integrated case management model where recovery coaches were appointed to substance abusing parents associated with an open foster care placement. A diverse group of families (n = 1623) were randomly assigned to either a control group (services as usual) or an experimental group (services as usual plus a recovery coach). Multinomial logistic regression indicated that substance abusing parents associated with a recovery coach were significantly more likely to achieve a stable reunification as compared with similar families in the control group.     

Family group conferencing in Dutch child welfare: Which families are most likely to organize a family group conference?

Aim of the present study was to identify which families involved in child welfare are willing to organize a Family Group conference (FGc; phase 1) and which are most likely to complete a conference (phase 2). Data were used of a Dutch randomized controlled trial (N = 229). First, the proportion of families willing to organize an FGc and actually completing a conference was determined. Then, for each of the phases, reasons for dropout according to parents, child welfare workers and FGC-coordinators were assessed and categorized and family characteristics were linked to completion rate. Results showed that 60% of the families (137 families) were willing to organize an FGc and 27% (62 families) eventually completed a conference. Reasons for dropout were lack of motivation, high-conflict divorce situations and need for other professional care. Broken and/or newly formed families were less likely to complete a conference, whereas families with indications for child maltreatment were more likely to complete a conference. Future research is needed to examine other possible explanations for the relatively low success rate, such as attitude of child welfare workers towards FGC and the lack of understanding of the aim of FGC by child welfare workers and families.     

Services use by children and parents in multiproblem families

BackgroundMultiproblem families are multi-users of psychosocial and health care services, but little is known about factors associated with their care utilization in the general population. The aim of this study was to assess which factors were associated with the overall and psychosocial care use of two members—i.e., child and parent—of each multiproblem family.MethodsDuring well-child visits or psychosocial care, we identified 354 children and their parents who had problems in several life domains (response 69.1%). We used multivariate stepwise backward logistic regression analyses to identify the factors related to their use of overall and psychosocial care.ResultsA child's overall care use was associated with greater social support from family and friends (odds ratio, OR, 95% confidence interval, CI; OR = 1.05, CI = 1.01–1.08) compared to less perceived social support; and with more psychosocial problems in the child (OR = 1.84, CI = 1.04–3.24). Child's psychosocial care use was more likely among older children (OR = 1.94, CI = 1.20–3.15); greater social support by family and friend (OR = 1.03, CI = 1.00–1.06); more psychosocial problems (OR = 1.75, CI = 1.04–2.97); and when there were more parenting concerns (OR = 1.19, CI = 1.06–1.33). Parental overall and psychosocial care use was more likely when the family experienced a higher number of life events (OR = 1.27, CI = 1.17–1.38, and OR = 1.39, CI = 1.25–1.55).ConclusionsCare use in multiproblem families is related to family factors as well as psychosocial problems. It may be possible to use these family risk factors to identify such families early, whose intensive care use is possibly explained by the relationship with inadequate use of social support.     

Practitioner views on the core functions of coaching in the implementation of an evidence-based intervention in child welfare

Despite coaching being identified as an important implementation strategy, scant information is available on the core functions of coaching, and few empirical studies are specific to coaching in the child welfare setting. This study explored practitioners' perceptions of the core functions of coaching by using semi-structured focus groups with coaches (n = 13) and interviews with coachees (n = 11) who were delivering Parent Management Training, Oregon (PMTO) model to families of children in foster care. Four themes were identified as the core functions of coaching: (1) supporting practitioners via strengths-oriented feedback; (2) promoting skill-building via collaboration and active learning strategies; (3) problem-solving for appropriate use and adaptation of the EBI with real-world cases, and (4) providing an accountability mechanism for high fidelity implementation. Collectively, this study's findings build knowledge on the core functions of coaching, which may be a critical strategy for integrating evidence-based interventions (EBI) into usual practice in child welfare settings. The findings suggest that this implementation strategy is more than a simple extension of training. Coaching was viewed as vital for supporting practitioners full adoption of the intervention in their day-to-day practice, fitting an EBI to the complex needs of child welfare families, and ensuring high-quality implementation. Also identified were some unique aspects of PMTO coaching, such as a strict strengths-orientation and observation-based feedback via mandatory video recordings of client sessions. Further research is needed to explore different coaching techniques, protocols, and formats to examine whether certain features promote a more effective path to implementation and, ultimately, client outcomes.     

Peer mentoring services,opportunities, and outcomes for child welfare families with substance use disorders

Peer recovery support services (PRSS) in child welfare are being provided by peer mentors in sustained recovery from substance use disorders (SUD) to parents with acute SUD. Previous retrospective interviews demonstrate that peer mentors engage parents in family-centered systems of care through relationships and empowerment. However, the specific profile of services provided is unknown. Personnel challenges and opportunities for persons in recovery serving as peer mentors are described in the literature without understanding the frequency of both. As enthusiasm for hiring peer mentors grows, it is important to understand the specific services provided, the risks and opportunities associated with hiring individuals in recovery, and the impact of mentor services on outcomes. This knowledge can assist in developing training, implementation guides, policies, job expectations, and program evaluation strategies. This is a prospective study of 28 family mentors providing PRSS services to 783 families with child maltreatment and parental SUD over 8 years in a family-centered integrated program with SUD treatment providers. We describe mentor services overall, during the early engagement period, in rural and urban settings, and test the association between services and child/parent unification status at case closure; we identify the proportion of peer mentors that experienced employment challenges and career advancement opportunities. Results demonstrate the complexity of service provision overall and in differing contexts. Face to face visits with children were associated with greater likelihood of parent/child unification at case closure and 64.3% of peer mentors experienced career advancement opportunities. The implications of these findings are discussed.     

Parent perspectives on adoption preparation: Findings from the Modern Adoptive Families project

Preparing prospective adoptive parents for receiving a child into their family is an important task for child and family professionals. This study uses data from the recent Modern Adoptive Families survey to understand parent perspectives on their preparation for adoption. Logistic regression (n = 917) and qualitative thematic analysis of adoptive parents' comments about their adoption preparation were conducted to understand aspects of the preparatory experience that were satisfactory (n = 623) or dissatisfactory (n = 283). Child emotional and behavioral problems significantly predicted parent dissatisfaction with adoption preparation. Major themes for satisfactory aspects of preadoption services included receiving information about adoption in general and, more specifically, about clinical and special populations, and parenting tools and strategies. In addition, parents identified opportunities to connect with others touched by adoption and access to specialized post-adoption services as helpful. Conversely, parents expressed dissatisfaction when information was lacking or withheld, when they had quality concerns with the worker or agency, and when there was a dearth of services and supports following adoption. Implications of these findings include the need for adoption mental health competent training for adoption professionals to better support families preparing for or experiencing adoption.     

Children's subjective well-being in rural communities of South Korea and the United States

The study examined subjective well-being of 10- to 12-year-old children from rural South Korea (n = 489) and rural United States (n = 1286) using the Children's Worlds Survey within the framework of the ecological, relationship-based model of children's subjective well-being. Applying Structural Equation Modeling to the analysis, a large proportion of the variance was explained and children's subjective well-being was predicted in both countries by microsystem factors of family relationships, parent involvement, and school quality, and individual factors of age (younger), and gender (male). Additional microsystem factors predicting subjective well-being were neighborhood quality in South Korea, and peer relationships in the United States, which may reflect contextual influences of collectivistic (South Korea) and individualistic (United States) macrosystems.     

Expanding the conceptualization of re-entry: The inter-play between child welfare and juvenile services

Re-entry in child welfare is traditionally viewed as a child exiting to permanency and then reentering the child welfare system. Using this approach is effective for understanding child welfare practice from a single-system lens, but gives an incomplete picture of how children may move between related child serving systems. The present study expands the definition of re-entry by examining re-entry for 2259 children who either return to the child welfare system or move into the juvenile justice system after reunification from foster care. When measuring a broader concept of re-entry (into either system) the rate of re-entry went from 18% to 25% - a 33% increase. Regression analyses further suggested that many of the risk and protective factors associated with standard child welfare reentry were also predictive of multisystem re-entry such as having previous child welfare experience (OR = 1.79, p < 0.000), and child behavior as a factor at removal (OR = 1.75, p < 0.000). Findings of this study support the need to continue increasing the conceptualization of re-entry to be more inclusive of related systems as well as continuing to focus research efforts on understanding effective practices within child serving systems so that re-entry into either system is mitigated.     

An intensive mental health home visiting model for two at-risk early childhood populations

This study examined proximal outcomes of a mental health home visiting model for two populations at risk for child maltreatment: families with young children referred by child protective services (CPS) and at-risk pregnant women (Prenatal) referred by community agencies. Family- and caregiver-level outcomes were measured using the Family Assessment Form (FAF). Families (n = 215) showed significant improvement in all eight family functioning factors over the course of their participation in mental health home visiting services. Initially, CPS-referred families (n = 84) scored higher on the FAF measure of Interactions between Caregivers, indicating greater conflict between caregivers in the family. Prenatal referred families (n = 131) were at greater risk initially on Housing. Prenatal-referred families demonstrated greater risk reduction on measures of Supports to Caregivers, Developmental Stimulation, Caregiver Personal Characteristics and Housing. In addition, all families demonstrated significant improvements in functioning on 11 of 12 items comprising the Caregiver Personal Characteristics factor. Overall, CPS-referred families scored at higher risk on items reflecting externalizing problems, while Prenatal-referred families showed greater improvement on items reflecting internalizing problems. This model was successful in reducing risk factors and promoting protective factors for CPS-referred and Prenatal at-risk families. Implications and future directions are discussed.     

Cost effectiveness of a school readiness intervention for foster children

ObjectiveMany young children in foster care suffer from emotional and behavior problems due to neglect and abuse. These problems can lead to difficulties in school, and functioning in school is linked to long-term health and development. Early intervention to reduce emotional and behavioral issues can help children successfully transition to school, which can improve long-term outcomes. However, communities need information on relative costs and benefits associated with programs to make informed choices. The objective of this study was to assess cost effectiveness, over 12 months, of the Kids in Transition to School (KITS) intervention compared to usual services available to children in a foster care control group (FCC).MethodRandomized controlled trial of 192 children in foster care entering kindergarten who were randomized to KITS (n = 102) or FCC (n = 90). KITS includes school readiness groups and parent training over 4 months. Main outcomes were days free from internalizing symptoms (IFD), days free from externalizing behavior (EFD), intervention costs, public agency costs, and incremental cost effectiveness.ResultsKITS significantly increased IFD and EFD compared to FCC. Average total cost of the intervention was $932 per family. The intervention did not significantly impact usual services. Average incremental cost effectiveness was $64 per IFD and $63 per EFD.ConclusionsThe cost of KITS is comparable to, or less than, similar programs, and the intervention is likely to provide significant emotional and behavioral benefit and improvement in school readiness for young children in foster care.     

The temporal structure of intergenerational exchange: A within-family analysis of parent–child reciprocity

Previous studies of parent–child reciprocity have focused either on the long term (generalized exchange over the life course) or on the short term (concurrent exchange in later life). The purpose of this research was to investigate the linkage between both temporal patterns of reciprocity within an integrative conceptual framework. We assessed whether long-term and short-term reciprocity operated as interdependent mechanisms that initially selected and subsequently relieved intergenerational caregiving relationships. We used data from the Asset and Health Dynamics Among the Oldest Old study (AHEAD) provided by frail, single-living parents of at least two children (N = 1010 respondents comprising 3768 parent–child dyads). Fixed-effects conditional logit models estimated between-sibling differences in assistance provided to parents, measured by instrumental help (i.e., assistance with IADLs) and hands-on care (i.e., assistance with ADLs). Key predictors were two measures of financial transfers given to children referring to longer and shorter recall periods. Receiving earlier and current financial transfers increased adult children's propensity to support their parents in later life. The effect of earlier transfers pertained to help rather than care whereas the reverse was true for the effect of current transfers. We found no evidence for a linkage between long-term and short-term reciprocity. Overall, the results indicate that adult children might balance long-term support accounts relative to their siblings, suggesting an intra-generational orientation on equity.     

Internalizing and externalizing behavioral problems of American Indian children in the child welfare system

Children involved in the child welfare system display elevated or clinically significant behavioral problems. However, there is a dearth of literature on the behavioral problems of American Indian children following child welfare involvement. Grounded in Patterson's Family Adjustment and Adaptation Response theory, this study fills that gap. Baseline, 18-month, and 36-month follow-up data from the National Survey of Child and Adolescent Well-being were utilized. The sample (n = 3498) consisted of American Indian, African American, and Caucasian children ages 2–16 at baseline (M = 8.13 years old, SD = 3.85) and 51.7% were female. Nearest neighbor propensity score matching analyses were used to estimate the effect of race on clinically significant internalizing and externalizing behavioral problems. Findings suggest that although externalizing behavioral problems do not differ based on race after controlling for other important factors, internalizing behavioral problems do differ. American Indian children are more likely to display clinically significant internalizing behavioral problems.     

Food neglect and maltreatment re-report

This study examines the time to re-report following the close of a maltreatment investigation for cases involving food neglect. Data on families of children 0 to 17 involved in Child Protective Services (CPS) investigations from a merger of the 2010 cohort of the National Survey of Child and Adolescent Well-Being (NSCAW II) and the National Child Abuse and Neglect Data System (NCANDS) were used (n = 3580). More than half of the families had a history of CPS involvement, a third received CPS services, and one-in-ten families had their child place in out-of-home care following an investigation. After controlling for other types of maltreatment allegations and multiple covariates, families investigated for food neglect had a greater chance of being re-reported for a subsequent CPS investigations in a shorter length of time than families without an allegation of food neglect. While only a small percentage of families had a food neglect allegation, problems adequately feeding a child - whether due to severe poverty, inattentiveness, or abusive negligence - placed a family at a higher risk of a future CPS investigation.