Are maternal and community risk factors associated with the presence of asthma among children placed in foster care?

Objective

The occurrence of pediatric asthma has been associated with exposure to chronic stress. This study examined the relationship between maternal and community risk factors and asthma in a sample of maltreated children in foster care.

Method

Interviews were conducted with 365 maltreated children in foster care. Measures included youth/caregiver reports of asthma, an index of maternal risk based on data abstracted from child welfare records and community violence exposure.

Results

After controlling for demographic variables, maternal risk was associated with the presence of asthma (OR = 1.314, 95% CI = 1.09–1.58). Community violence exposure, however, was not related to the presence of asthma.

Conclusion

Maternal risk factors were significantly associated with the presence of asthma in a foster care population. Physicians who care for maltreated children in foster care should be particularly attuned to the presence of these additional risk factors that may place high-risk children at increased risk for chronic health problems.     

Negligence in placement and supervision of children in foster care: Are social workers liable?

Social workers may be monetarily liable for negligent performance of placement and supervision of children in foster care. In states where the state retains sovereign immunity those professional activities may be considered ministerial rather than discretionary functions and so not entitled to the immunity from suit which the state enjoys. Careful attention to designated procedures may protect the worker from allegations of negligence.     

The education of children and adolescents in out-of-home care: a problem or an opportunity? Results of a longitudinal study

The education of children in care is an issue that often falls into a no man’s land in which responsibility always seems to be attributed to the other ‘department’. Furthermore, all too often, teachers, educators and foster parents find themselves working with these children with no support, as if they were isolated cases. The aim of this study is to get to know the school situation of children in different types of out-of-home care: residential, kinship and non-kinship care. Systematic data on the school situation of 11–16-year-olds (on class attendance, school behaviour, academic results and guidance towards post-compulsory education) were gathered over a period of 5 consecutive school years. A 3-year longitudinal study on the same items (N?=?391) was made and time-series data were gathered for 5 years (N?=?1841). Results show that the in-care population is at a clear disadvantage and inequality of opportunities compared to the general population in relation to their educational pathways and outcomes; the most disadvantaged being the population in residential care. Recommendations are included, posing the challenge that what has to date been considered a ‘problem’ should become an opportunity for these children.     

Placement of children in out-of-home care in Québec,Canada: When and for whom initial out-of-home placement is most likely to occur

This study contributes to the growing child protection placement literature by providing the first Canadian provincial longitudinal study examining when and for whom initial out-of-home placement is most likely to occur. Anonymized clinical-administrative child protection data were merged with the 2006 Canadian Census data for the province of Québec, and the final dataset included 127,181 children investigated for maltreatment for the first time between April 1, 2002 and March 31, 2010. Cox proportional hazard results indicate that the vast majority of investigated children do not experience a placement, but for the others, placement tends to occur immediately following the maltreatment investigation with only a slight increase in risk over time. The increased risk of placement for younger children aged 0 to 9 years was statistically explained by a combination of male gender, behavioral problems, parents' high risk lifestyles, hospital referral, the number of investigations and neighborhood area socioeconomic disadvantages. The increased risk of placement for older children aged 10 to 17 years was statistically explained by a combination of behavioral problems, police reporting, the number of investigations and neighborhood area socioeconomic disadvantages. Neighborhood area socioeconomic disadvantages significantly contributed to the increased risk of out-of-home placement for all children, but this factor is most influential when it comes to younger children.     

Does fathers' involvement in services affect mothers' likelihood of reunification with children placed in foster care?

Social science literature shows associations between fathers' involvement with their children and beneficial developmental outcomes of those children. A related but smaller body of research in the child welfare services arena has found measures of father involvement to be positively associated with beneficial child welfare outcomes, including child's reunification with parent after placement in foster care. However, the pathway by which father involvement affects reunification likelihood has not been determined. This study builds on the existing body of literature by testing a theoretical basis for the relationship between father involvement (measured as service use) and mothers' reunification in a model controlling for family structure. I find that fathers' involvement in services improves mothers' likelihood of reunification, independently of family structure. Results suggest that agency efforts to involve fathers in services make sense both when the aim is to prepare the father for possible custody, and when the aim is to reunify the mother.     

Participation in decision-making in out-of-home care in Australia: What do young people say?

Drawing on qualitative research with 28 young people in Australia, this article explores children and young people's views and experiences of participation in decision-making while in out-of-home care. It initially examines the value of participation, before focusing on two key questions. First, do young people feel they had the opportunity to participate in decisions made about their lives during their time in out-of-home care? Second, on which issues do children and young people in care want to have a say?     

A cumulative ecological–transactional risk model of child maltreatment and behavioral outcomes: Reconceptualizing early maltreatment report as risk factor

The current analysis was designed to critically examine the tendency to focus on child maltreatment as a unique risk factor and test the resulting assumption of a direct causal relationship between early maltreatment and later behavioral problems. The variation seen in behavioral outcomes among children reported for maltreatment early in life led us to hypothesize that the cumulative level of risk facing children and their families can, at least in part, account for that variation in outcome. Participants were 242 mothers of predominantly at-risk newborn infants who were interviewed shortly after giving birth. The State Central Registry of Maltreatment was then reviewed over each child's first four years of life to assess for early maltreatment. Following the neonatal interviews, mothers completed the Child Behavior Checklist when their children were 4, 6, 8, 10 and 12 years-of-age. Although early maltreatment report does appear to be important to early child functioning, the cumulative level of risk more strongly predicts long-term clinical behavioral difficulty. High-risk children who were not reported for maltreatment by age 4 demonstrate greater behavioral problem trajectories than did low-risk children with a maltreatment report. Maltreatment itself may be best conceptualized as an important, but not singularly so, risk factor for later behavioral problems. In focusing directly on reported maltreatment, our child protective systems may be paying too little attention to what else is going wrong in the lives of children and targeting intervention efforts in the wrong direction. When it comes to early maltreatment our child protective policy and practice need to broaden their lenses to include greater emphasis on overall family functioning, stress and well-being. Early maltreatment, it seems, may be a symptom of more profound problems in the early environments of our most vulnerable children, rather than the problem itself.     

Transracial mothering and maltreatment: are black/white biracial children at higher risk?

The number of people identifying as biracial is rapidly growing, though little is known about the experiences of interracial families. Previous work indicates that biracial children may be at elevated risk of entering the child welfare system. This could underscore additional risks faced by these families. This document includes data from the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN), a project funded by the Administration on Children, Youth, and Families, U.S. Department of Health and Human Services, and distributed by the National Data Archive on Child Abuse and Neglect. LONGSCAN data were used to examine familial risks associated with child maltreatment. White mothers of white children were compared to white mothers of biracial children with the hypothesis that interracial families would have less social and community support. Results showed that the women were similar in terms of mental health and parenting behaviors. There were no differences in maternal age, employment status, or presence of a partner. However, mothers of biracial children were poorer, had more alcohol use, and decreased social support. They experienced more intimate partner violence and lower neighborhood satisfaction. Findings have implications for intervention programs focused on reducing social isolation within interracial families.     

Caregiver perceptions of children in their care and motivations for the care work in children's homes in Ghana: Children of God or children of white men?

The perceptions and motivations that workers have in their work and work environment are important determinants of the quality of work they do. For people who work in residential institutions where children who have lost the care of their parents receive care, these perceptions and motivations become a crucial part in determining the quality of services or care the children are given. This study set out to explore the perceptions and motivations of caregivers in the institutional context in Ghana. Adopting a qualitative, phenomenological approach, data were collected from 35 caregivers in two children's homes in Ghana through participant observations, focus group discussions and in-depth interviews. It emerged that caregivers perceived the children in their care first as children of God and then as children of white men and were predominantly motivated by their religious convictions to keep doing ‘the work of God’. Other motivations included personal life situations and economic aspects of the job. Implications for the workers and children in this environment are discussed.     

Who will care for older people? A case study of working with destructiveness and despair in long-stay care

Abstract

The reduction of services for older people is illustrated in a case study of a long-stay NHS service which has been transferred to a private, profit-making company. The effects of cuts in this service are most keenly felt in the very poor conditions of employment now offered by the company to new carers. Other illustrations of cuts are described in attempts to make savings on food or incontinence pads. The difficulties for staff, patients, their relatives, or indeed society at large, in challenging such destructiveness, may be understood in terms of the particular vulnerability of older people to projections of a dreaded infantile dependency and helplessness, in a society in the grip of a destructive narcissism which views ordinary human needs as a weakness.     

Whose responsibility? Resilience in families of children with developmental disabilities

Families with children with disabilities are at higher risk of stress, financial disadvantage and breakdown. In recent decades, research and policy have shifted focus from these problems to a strengths-based approach, using concepts such as family resilience. By definition, resilience is the ability to cope in adverse circumstances, suggesting a reliance on the individual. If this is the case, then to what extent does ‘family resilience’ place another burden of responsibility onto families? Whose responsibility is family resilience? This paper begins to answer this question using interviews with parents of children with developmental disabilities based in New South Wales, Australia.     

Allegations of maltreatment and delinquency: Does risk of juvenile arrest vary substantiation status?

There exists a healthy debate about the process and value of substantiation in child welfare. Much of this debate focuses on understanding whether substantiated and unsubstantiated allegations of maltreatment share equal risk of recurrence. In the current study we seek to advance this debate by extending the analyses to focus specifically on the risk of juvenile delinquency. We also seek to determine whether the relationship between substantiation and delinquency varies by race and gender. Our sample includes 38,223 youth between 5 and 16 years of age from Los Angeles County. We use propensity score matching to create relatively equivalent groups and use Cox Regression to model the risk of juvenile arrest. The results indicate that the relative risk ratio of arrest is 2.2 times greater for youth associated with a substantiated report of maltreatment as compared with similar youth associated with an unsubstantiated report of maltreatment. Older youth, and African American youth are also at an increased risk of juvenile arrest. These findings indicate that the process of substantiation is not without merit - as investigators and supervisors are clearly able to distinguish cases based on individual risks and strengths.     

Telephone communication with children as part of the self‐care arrangement: A research note

Children in self‐care (latchkey) arrangements have been portrayed as a population at risk, and this has recently led to research investigations, social policy discussions, and legislative proposals. This study examines selected characteristics of mother, child, and family, and the amount of time children spend in self‐care, for their influences on the use of the telephone to communicate with children in self‐care. The analysis builds on earlier studies that indicate the importance of time, child's age, and mother's employment for understanding the growing phenomenon of self‐care. The results of multiple regression analyses are presented and discussed. As expected, the age of the child is the most important variable in predicting the length of time spent in self‐care. The age of the child and the length of time spent in self‐care are the strongest predictors of telephone communication with children in self‐care arrangements.     

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

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

Are urge incontinence and aging risk factors of erectile dysfunction in patients with male lower urinary tract symptoms?

Introduction: Several studies have indicated that erectile dysfunction (ED) patients also suffer from lower urinary tract symptoms (LUTS). We investigated a group of men with LUTS and assessed their sexual function with the aim of being able to predict ED risk factors and introduce ED treatments earlier for this patient group.

Methods: International Prostate Symptom Score (IPSS), Overactive Bladder Symptoms Score (OABSS) and Sexual Health Inventory for Men (SHIM) score were obtained from 236 men with LUTS at their first out-patients visit. Clinical parameters such as body mass index, prostate volume, residual urine volume and prostate specific antigen were also evaluated. The relationship between the SHIM score and other clinical data was analyzed.

Results: According to the SHIM score, ED in men with LUTS was severe 15%, moderate 19%, moderate to mild 28%, mild 17%, normal 7% and data was incomplete in 14%. Based on the results of a multivariate analysis, aging (p?p?=?0.024) were significantly correlated to severe and moderate ED. Furthermore, among OAB symptoms score items, urge urinary incontinence was a risk factor for severe and moderate ED (p?=?0.005).

Conclusion: Aging and OAB (notably urinary urge incontinence) are risk factors for severe and moderate ED in men with LUTS.     

Do children in foster care receive appropriate treatment for asthma?

Asthma is the most common childhood chronic disease, and children in foster care have the highest rates of chronic conditions of any studied child population. The purpose of this study is to determine whether there are disparities in asthma management and health care utilization between children in foster care and other children covered by Medicaid in the state of Illinois. We use performance measures developed by the state child welfare system as well as those developed by the National Committee on Quality Assurance and used throughout the country. The study sample was drawn from linked administrative data on children in foster care and paid Medicaid claims. In order to determine the influence of living arrangement setting within the child welfare system, children in foster care were further grouped according to whether they lived in a stable home setting, a stable congregate care setting, or other living arrangement. We found that children living in home settings performed better on most performance measures than income-eligible Medicaid children. In contrast, children with asthma living in congregate care were particularly vulnerable as reflected in poor asthma care measurements and high utilization of hospitalizations despite positive performance on indicators of medication use. This population presents a significant challenge to the child welfare and health care delivery systems.     

Is prior parental criminal justice involvement associated with child maltreatment? A systematic review

Parental criminal justice involvement is prevalent in the United States and potentially associated with a range of negative outcomes for children including child abuse and neglect. However, the association between prior parental criminal justice involvement and child maltreatment is not well understood. This paper reviewed the existing literature regarding maltreatment victimization among children of parents with prior criminal justice involvement. Results from ten reviewed studies demonstrated an association between prior parental criminal justice involvement and child maltreatment, but did not provide sufficient evidence to determine whether parental criminal justice involvement is an independent risk factor for child maltreatment or of the specific mechanisms through which this association occurs. Recommendations for future research include use of multivariate analysis methods that account for variations in the type and timing of parental criminal justice involvement and child maltreatment. Implications for practice include the development of strategies to address the adverse family contexts commonly found among these parents and children.     

Do bullied children have poor relationships with their parents and teachers? A cross-sectional study of Swedish children

Parents and teachers play an important role in helping victims of bullying to prevent, cope with and end bullying. Despite that, victims' relationships with adults have often been overlooked in previous research. The aim of this study was to investigate bullied and not bullied children's perception of the quality of their relationship with teachers and parents and to examine if there were any differences in the perception associated with bullying frequency or type of victimization. Data came from the Swedish Health Behavior in School-aged Children (HBSC) survey from 2013/14, which included 7867 students aged 11, 13 and 15. A multi-level multinomial logistic regression model was created to estimate association between the type of bullying victimization and the quality of relationships with parents and teachers. The result showed that bullied children had poorer relationships with parents and teachers than nonvictims. Victims had higher odds of finding it difficult to talk to parents about things bothering them, of feeling that the family was not listening to what they had to say, and of having low confidence in their teacher. Frequent cyber victims had the highest AdjOR (2.09–3.37) compared with non-victims to have poor quality relationships with teachers and parents.     

A study of disabled children and child protection in Scotland — A hidden group?

This paper is based on analysis of data collected for a study, commissioned by the Scottish Government, which examined child protection work with disabled children. At a conceptual level, the paper draws on Goffman's frame analysis and on different models of disability. Focus groups were conducted with five Child Protection Committees (40 individuals) and semi-structured interviews with a further 21 practitioners from social work, education, health services, third sector organisations and the police. The findings show that, for various reasons, abuse of disabled children may go undetected. Where it is suspected, effective action does not always follow, for example, where practitioners over-empathise with parents. When child protection work is undertaken, disabled children may remain relatively invisible in terms of participation and professional focus. It is suggested that the ways in which practitioners and managers “frame” disabled children has implications for how abuse is responded to and how well these children are protected. Participants also “framed” disability in different ways, and it is suggested that a social relational model seems particularly applicable. In conclusion, in many respects disabled children experiencing abuse may remain absent from or to some extent hidden within child protection services in Scotland. While some creative work is taking place, considerable changes are required to make child protection services accessible to all disabled children, sensitive to their needs and respectful of their rights.