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.     

Socioemotional Problems Among Young Children in Out-of-Home Care: A Comparison of Kinship and Foster Care Placement

This study examined socioemotional problems among children age 0 to 5 years in formal kinship and foster care across a northeastern state. Findings revealed that more than one third of children in both types of care showed socioemotional problems. More children were placed in kinship care when they lived in rural settings, were biracial, or spent time in the neonatal intensive care (NICU) after birth. Unique child and maltreatment characteristics predicted socioemotional problems scores for each placement type. Among children in kinship care, being biracial, spending time in the NICU, and being referred to child welfare for either caregiver substance abuse or neglect were related to socioemotional problems. When children were in foster care, spending time in the NICU, being referred to child welfare for child neglect, or being referred for intimate partner violence were all related to socioemotional problems. The results have implications for child welfare policy and practice, especially in light of increased efforts to place children with kin.     

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.     

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.     

Kinship care for children in the UK: messages from research,lessons for policy and practice1

This article presents a comprehensive overview of kinship care, or as it is also known, family and friends care, paying particular attention to the UK child welfare, legal, policy/practice contexts. The aim of the article is to raise awareness, and provide information, about a hitherto largely invisible, yet expanding placement option being widely used in child welfare systems in the UK, in Europe and elsewhere. The article places kinship care within a UK and European child welfare legal context, including the European Convention on Human Rights 1998 [Articles 8 and 14] and European kinship care developments are also highlighted. It contains the main findings of a kinship care research study conducted by the author, based on interviews with children and young people living with kinship carers, as well as with the kinship carers. Following an examination of theoretical and policy issues, the article examines ways forward for developing and supporting kinship care. In the final section, and based on the research findings and literature review, a new paradigm for child welfare is introduced. It is argued that this new paradigm is necessary in order for kinship care practice and policy to develop within a supported and sustainable family support framework.     

Medical complexity and placement outcomes for children in foster care

ObjectiveMedical complexity threatens placement stability and permanency outcomes for children in foster care (FC). This study aimed to characterize for US children in FC: 1) medical complexity, using number of diagnosed types of disability as a proxy; 2) demographic and removal characteristics based on level of complexity; and 3) whether increasing levels of complexity were associated with foster care placement outcomes.MethodsThe analysis included children in FC, ages 0–21 whose disability status was clinically assessed and documented (n = 538,695). Using data from the FY 2014 Adoption and Foster Care Analysis and Reporting System, medical complexity was categorized (0–4 +) based on 5 disability types: emotional, hearing/vision, intellectual, physical, and other. Bivariate analyses (χ² tests, Kruskall-Wallis) compared the distribution of demographic and removal characteristics among complexity groups. Multiple logistic regression evaluated relationships between medical complexity and placement outcomes, including length of stay in FC, placement stability, and permanency.ResultsTwenty-three percent of the sample had 1 disability type, 7% had 2, 3% had 3, 1% had 4 +, and 67% had no disability. Children with increasing complexity were more likely to be older, older on FC entry, male, Black, non-Hispanic, placed in a group home or institution, have abuse, neglect, and/or child disability/behavior as reason for removal, and have poor placement outcomes.ConclusionChildren in FC with greater medical complexity are at risk for undesirable placement outcomes. By recognizing and addressing the unique needs of this vulnerable population, pediatric providers and child welfare staff may identify strategies to improve placement outcomes.     

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

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

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.     

Concurrent child history and contextual predictors of children's internalizing and externalizing behavior problems in foster care

This study contributes to current research on the behavior problems of children in foster care by analyzing a more comprehensive set of concurrent child history and contextual predictors. Kinship home status and sibling status (i.e., whether the sibling is a biological sibling to the foster child) were evaluated as moderators of significant associations. Data were collected at the baseline of a foster parent training intervention program prior to any intervention services using parent phone interviews (N = 310, 51.6% male, M age = 7.57 years). Two linear hierarchical regressions were used to evaluate each set of predictors' association with behavior problems as well as each individual predictor's contribution. Results indicated that as a set, the contextual variables predicted a significant and unique amount of variability in the child's internalizing and externalizing behavior scores, whereas the child history variables did not. Specifically, the child's placement in a non-kinship home, being in a non-ethnically matched child-parent pair, higher parent stress scores, a greater number of prior group home placements, and higher internalizing behavior scores for the child predicted higher child externalizing scores. Higher parent stress scores, higher focal sibling externalizing behavior scores, and higher externalizing behavior scores for the child predicted higher internalizing scores for the child. The association between focal sibling externalizing behavior scores and child internalizing scores was moderated by kinship home status, such that there was a stronger association between the focal sibling's externalizing score and the child's internalizing score if the child was in a kinship compared to a non-kinship home. Implications for intervention services are discussed, particularly the importance of assessing the child's foster home environment when addressing the child's behavior problems.     

Factors Associated with the Decision-Making Process in Kinship Diversion

During the past two decades, child welfare professionals have given kinship care priority as the preferred least restrictive, most family-like placement option when a child has to be removed from his or her family. However, the available literature lacks investigation into what factors drive the decision to use kinship care, specifically an understanding of why some children are diverted from child welfare system (CWS) into unpaid kinship arrangements while other children enter the traditional foster care system. This study uses baseline (Wave 1) data from the National Survey of Child and Adolescent Well-being II (NSCAW II), which provides information about children and caregivers in different types of kinship care. The data were analyzed using multinomial logistic regression based on the multiple imputed data files using NSCAW II weights. Results show important predictors of a child being diverted into private kinship care included the child’s age, caseworker’s educational background, and caseworker’s assessment of harm level. Important predictors of a child being diverted into voluntary kinship care included the maltreatment type, family structure, caseworker’s educational background, and caseworker’s assessment of risk level. Differentiating between the types of kinship diversion has important implications for practice and policy. Examining a variety of factors can help child welfare scholars develop a comprehensive understanding of the decision-making processes used in selecting kinship diversion for out-of-home placements.     

Kinship care in Australia

Kinship care is the fastest growing form of out‐of‐home care placement in Australia. It is now a more common form of placement than foster care in some Australian states and is the most common form of placement for Indigenous children nationally. This paper reviews national data and reports ?ndings from a state (New South Wales) study of the experience of kinship carers, children and workers. Relative carers, children and child welfare caseworkers were found to identify psychological bene?ts, family obligation and criticism of other forms of care as reasons for preferring kinship care. Legislation and policy, particularly the Aboriginal Child Placement Principle, are also identi?ed as factors contributing to the rise in kinship care. Concern for the high levels of stress among carers and the low levels of monitoring of children's safety and well‐being are discussed and a stronger policy and practice response from government agencies is proposed. Indications of new policy and programme responses are demonstrated by several recent initiatives at state and national levels. Copyright © 2004 John Wiley & Sons, Ltd.     

Factors affecting adoption in Wales: Predictors of variation in time between entry to care and adoptive placement

In the UK, there has been an increasing emphasis in recent years on reducing the delay in making permanent placements for children who cannot remain living with their birth parents. Adoption is one such plan for permanence. This study examined those factors that predicted a lengthier care episode for a national sample of children recently placed for adoption. The data was drawn from the Wales Adoption Study. This is a mixed methods study that analysed information from the adoption reports of all children placed for adoption over a 13 month period during 2014 and 2015 (n = 374). Children were aged between 0 months and 6 1/2 years on entry into care. On average, the time between entering care and moving into an adoptive placement was 528 days. The results of the regression analysis showed that four child-related factors were associated with a longer wait in care before being placed for adoption. These were developmental delay, externalizing behaviour, serious and enduring health problems/disability and exposure to domestic violence. The procedural factors examined showed no association with length of time to placement. The findings from this study make a substantial contribution to further developing what is known about the timeliness of adoption within the current UK context. The implications for policy and practice are discussed.     

Mental health services for children and caregivers remaining at home after suspected maltreatment

ObjectiveBehavioral problems are common among children remaining at home after suspected maltreatment, but the effectiveness of current mental health services to improve these behavioral problems is unknown. The objective was to determine whether receipt of child and caregiver mental health services was associated with improvements in behavioral problems in maltreated children remaining at home.MethodsWe retrospectively analyzed Second National Survey of Child and Adolescent Well-being data. We included 1117 children ages 2–17 remaining at home after a maltreatment investigation, excluding children with missing outcome, covariate, or survey weight data. We compared mean Child Behavioral Checklist (CBCL) change scores from baseline to 18 months between children who did and did not receive mental health services, before and after adjusting for child, caregiver, and child welfare agency factors using survey-weighted linear regression.ResultsNearly one-quarter (22.6%) of children and 16.0% of caregivers received mental health services. Children receiving services had worse unadjusted baseline and 18-month CBCL scores than children not receiving services (all P < 0.001). Adjusted CBCL change scores revealed behavioral worsening among children receiving services but improvement among children not receiving services (all P < 0.001). However, children had improved behavior, regardless of their own service receipt, if their caregivers received services and reported an absence of depression at 18 months.ConclusionsChildren receiving mental health services had worse behavioral changes than children not receiving services. Caregiver receipt of services was associated with improved child behavior, suggesting that a family-centered approach may be most influential in improving behavioral outcomes among this population.     

Aggressive behaviors among Korean children in out-of-home care: The role of placement characteristics

Using data from the Korean Panel Study on Children in Out-of-Home Care, this study examined the impact of placement characteristics on aggressive behaviors among children in out-of-home care by placement type. The sample was divided into three groups based on placement type: institutional care (n = 118), group homes (n = 95), and foster care (n = 212). Results from hierarchical multiple regression analyses indicated that the length of stay in out-of-home care significantly influenced aggressive behaviors amongst children in institutional care, such that increased duration of out-of-home care decreased the level of aggressive behaviors. Perceptions of stigma/discrimination also significantly influenced aggressive behaviors displayed by children in institutional and foster care. Children with a higher perception of stigma/discrimination were more likely to exhibit severe aggressive behaviors than were their counterparts. On the other hand, placement characteristics had no significant influence on aggressive behaviors of children in group homes. The study findings suggest that children's mental health problems and disabilities should be considered during the placement procedure and interventions focusing on decreasing stigmatization should be developed and provided for children in out-of-home care.     

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.     

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.     

Achieving Permanence in Foster Care for Young Children: A Comparison of Kinship and Non-Kinship Placements

ABSTRACT

A number of child welfare policies have reinforced the use of kinship care as the most preferred placement for foster children, reflecting the philosophy that maintaining children within their own extended family system contributes to their stability and well-being. Given the growing utilization and legislative emphasis on kinship care along with the push for an immediate implementation of permanency plans for children in foster care, this study examines how the permanency goal under the 1997 Adoption and Safe Families Act (ASFA) is being implemented and achieved. The reunification and permanency placement (adoption or legal guardianship) outcomes of children in relative and non-relative care are analyzed, focusing on the experiences of young children. Based on public child welfare agency data from 2000 to 2003, child, case, and placement variables are explored to identify which set of factors best explains case outcomes. The present study identifies the total length of foster placement (kinship and non-kinship), the length of family maintenance services, and the number of placement changes as the most important variables in determining family reunification and permanent placement (legal guardianship and adoption) outcomes for young children.     

Perspectives: Former foster youth refining the definition of placement moves

Research has demonstrated that children who experience numerous moves in foster care are more likely to exhibit behavioral problems and less likely to achieve reunification or permanency. However, current knowledge about how placement move transitions impact children is extremely limited.This study used qualitative methods to explore how former foster youth define a placement move. Results indicated that placement moves can be defined by: 1) Time and relationships; 2) Packing and leaving; 3) Loss of property; 4) Returning home; 5) Type of placement; and 6) Decision-making process. An alternative definition of a placement move is offered and implications for child welfare policy, research and practice are provided.     

Kinship Care and Public Child Welfare: Challenges and Opportunities for Social Work Education

Abstract

The growing practice of arranging and financing “foster placement” of abused and neglected children with relatives provides an opportunity to redefine relationships between extended families and the child welfare system. The dilemmas and possibilities presented by kinship care as a child welfare service challenge schools of social work to provide intellectual leadership and to prepare social workers for changing child welfare practice. The author's ideas concerning responses to this challenge focus on key mandates of the Council on Social Work Education's Curriculum Policy Statement and on five principal curriculum areas in social work education.