The transition from in-home services to out-of-home care: A Danish register-based study

Objective

This register-based study describes the transition from in home-based care to placements in out-of-home care. It also describes whether children who enter care directly differ from children who enter care after episodes of in home-based care.

Method

The study includes all children who entered the child protection system of a larger regional social service system in Denmark from 1993 to 2006 (N = 9961). Graphs of cumulative incidences were used to describe transitions into out-of-home care within two years after in home-based care started. Cox regression models are used to estimate the impacts of child and parental characteristics. In addition, Chi² tests are used to identify differences between children who enter care directly and children who receive in home-based care.

Results

Results indicate that the majority of children do not enter out-of-home care but that risks differ among age groups. Covariates did not predict transitions into out-of-home care for those who entered in-home care after becoming teenagers. Especially for those who entered in-home care before entering their teens, the psychiatric histories of the mothers and the children predicted the transitions into out-of-home care. Immigration background was a protective factor for those who entered in-home care as pre-scholars. Depending on the age group, low birth weight, children's fathers' and mothers' psychiatric histories, and single parentship were all characteristics more likely to be associated with children who entered care directly. Children who entered care directly differed from children who entered care within two years after an in home-based service had been initiated on covariates that described psychiatric history.     

Establishing a mental health service for young children in out-of-home care: The Gumnut Clinic for 0 to 5 year olds in Western Sydney

Objective

Children aged 0 to 5 years in out-of-home care represent a vulnerable population at high risk of social, emotional and developmental problems, yet there are few services specifically addressing their psychological needs. This paper is the first of two concerning the establishment of The Gumnut Clinic, a specialist mental health assessment clinic in Western Sydney for this population. The current paper provides the rationale for the development of the clinic and detail of the referral and assessment processes.

Method

The paper describes the establishment of The Gumnut Clinic at Redbank House in Sydney, Australia, the approach to assessment of these young children and their carers, and the challenges encountered.

Conclusions

Young children are overrepresented in child protection and out-of-home care services. Their social, emotional and developmental needs are under-recognized. Development of a specialist mental health service is a step towards improving health outcomes for these children.     

The relationship of placement experience to school absenteeism and changing schools in young,school-aged children in foster care

Background

Chronic school absenteeism and frequent school changes, particularly among younger children, may be antecedents for the high rates of school failure and subsequent dropout among youth in foster care. However, the relationship of foster care experience to absenteeism and school change has not been well studied.

Objective

This study examined the association of placement experience with absenteeism and changing schools among 209 urban children in foster care enrolled in public elementary schools.

Methods

A cohort of children aged 5 to 8 years who entered non-relative or kinship foster care from 2006–2008 were followed longitudinally for 2 years from entry into foster care. Children residing in foster care were categorized at the end of the study as early stable, late stable, or unstable, if they achieved a permanent placement prior to 45 days, between 45 days and 9 months, or failed to do so within 9 months, respectively. Children who reunified home were classified as a fourth category. Poisson regression, controlling for baseline factors, was used to compare days absent and number of schools attended across categories of placement experience.

Results

Among the 209 children, 51% were male, 79% were African American, and 55% were initially placed with kin. One third of children reunified home; among children who did not reunify, one half was early stable, and a third was unstable. Adjusted rates of school absenteeism increased in stepwise fashion as children's placements became more unstable; children with unstable placements were 37% more likely to be absent than those with early placement stability (p = 0.029). Children who reunified during the study demonstrated the highest rates of absenteeism; however, there was no significant difference in absenteeism before or after reunification. Number of schools attended increased as stability worsened, with the standardized rate of schools attended reaching 3.6 schools (95% CI 3.1–4.1) over a two year period among children in unstable placements.

Conclusions

The relationship between placement experience and school absenteeism and school change illustrates the need to better coordinate the educational experience of high-risk children in foster care. The secondary finding of high absenteeism among children in the process of returning home illustrates that educational challenges for youth may be equally if not more concerning among the greater majority of youth in child welfare who remain home with birth parents.     

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.     

Predictors of out-of-home placement following residential treatment

Objective

There is a lack of research examining predictors of out-of-home placement (OOHP) following residential treatment (RT). The current study examined how various child and family factors predict OOHP at discharge and 6-months post-discharge for a RT sample.

Methods

Three hundred and eighty-three children (11.92 years, SD = 2.63, 293 boys) with serious mental health disorders were assessed using the Brief Child and Family Phone Interview (BCFPI) and placement information forms at admission, discharge, and 6-months post-discharge from RT.

Results

OOHP at discharge was predicted by older age, OOHP at admission, child welfare involvement, deliberate self-harm, a history of physical abuse, neglect, witnessed domestic violence, and a poor family situation (p < .05). At 6-months post-discharge, OOHP was predicted by dual diagnosis, OOHP at admission, child welfare involvement, neglect, and witnessed domestic violence (p < .05).

Conclusions

Pre-treatment factors are predictive of OOHP following RT. Identifying these key predictors and developing permanency planning options for children to promote stability and consistency is essential. A systemic evidence-based approach is imperative in promoting resilience for children at risk of OOHP, including family intervention and collaboration with the community.     

Mental health service utilization in children adopted from US foster care,US private agencies and foreign countries: Data from the 2007 National Survey of Adoption Parents (NSAP)

Aims

In this analysis, we (1) described the rate of mental health service utilization for children from domestic foster care adoption, domestic private adoption, and international adoption and (2) analyzed the effect of common risk factors on mental health service utilization.

Data

As part of the 2007 National Survey on Adoptive Parents (NSAP), parents with children 5–17 years old (N = 1722) were asked if their children had received mental health services and how helpful these services were. Parents also provided data on the children's demographics and likelihood of pre-adoption adversity (e.g., abuse).

Results

For boys, mental health services were utilized by 52.4% of domestic foster care adoptees, 41.0% domestic private adoptees, and 40.0% of international adoptees. For girls, the corresponding rates were 36.3%, 24.8%, and 30.9% respectively. Parents reported that the services were very helpful for about half of the children. Logistic regression analyses showed that adoptees from domestic foster care were more likely than international adoptees to have received mental health services, but there was no difference between domestic private adoptees and international adoptees. Older age at placement, older age at assessment, having special health care needs, and being male all increased the odds for having received mental health services.     

Is program structure related to stigma and community acceptance of justice-involved adolescents?

Objective

The aim of the study is to examine the impact of diversion program characteristics on social stigma of delinquent adolescents in Jordan.

Method

A street survey of adults was conducted in Amman, Jordan. Respondents were randomly assigned to read one of four vignettes involving a delinquent adolescent who participated successfully in one of four types of juvenile justice interventions: detention center placement; diversion with counseling; diversion with counseling plus victim apology and restitution; and diversion with counseling plus family-based apology and restitution. Respondents reported their willingness to accept the adolescent as a member of their child's school, as a friend of their child, as a spouse for their child, and as a future employee. Seventy seven percent of adults approached participated (N = 137).

Results

Respondents reported greater willingness to accept the adolescent when he participated in any of the three diversion programs compared to the detention center condition (β = .80, p < .05). However, there were no differences among the diversion program types (i.e., counseling only, counseling plus individual restorative justice, counseling plus tribal restorative justice) in acceptance levels. Regardless of intervention type, the perception that the adolescent had ‘learned his lesson’ was associated with greater acceptance and with heightened expectations of future success.

Conclusion

Intervention characteristics can influence public stigma in the Middle East. For justice involved youths, interventions that increase perceptions that youth have learned their lesson is a crucial ingredient to stigma reduction efforts. Social work interventions with delinquent adolescents and their families need to incorporate stigma management strategies that convey lesson-learning as a key intervention outcome.     

Delinquent and aggressive behaviors in early-adopted adolescents: Longitudinal predictions from child temperament and maternal sensitivity

Background

160 early-adopted children were followed from infancy to adolescence. Central question was whether early and concurrent parenting and child temperament predicted adolescent delinquent and aggressive behaviors.

Methods

Structural equation modeling was used to test the relations between early and concurrent observed maternal sensitivity, mother reported effortful control and teacher reported delinquent and aggressive behaviors.

Results

This longitudinal adoption study showed that lower effortful control, concurrent as well as 7 years earlier, predicted higher levels of delinquency in adolescence and aggression in middle childhood and in adolescence. Lower levels of effortful control in infancy predicted higher levels of maternal sensitivity in adolescence which in its turn predicted less adolescent delinquent behavior.

Conclusions

The findings suggest that effortful control is an important predictor of both aggressive and delinquent behaviors. Maternal sensitivity also plays a role in the development of delinquent behavior, buffering a lack of effortful control, but is not related to aggression at age 14. It is important to note that these relations were found in a sample of parents and their genetically unrelated adopted children.     

Intention to leave in social workers and educators employed in voluntary child welfare agencies

Introduction

Individuals employed in child welfare settings can have a profound impact on children in care. Research shows that direct care staff can have an effect on emotional and physical outcomes for children with whom they work. This paper seeks to expand knowledge of the child welfare workforce by studying educators employed in child welfare settings and comparing their job satisfaction and intent to leave with that of prevention workers employed in similar settings.

Materials and methods

Data for prevention workers (n = 538) were obtained from workers employed at all preventive service programs under contract with a large municipality. Data for educators were obtained from voluntary agencies located elsewhere in the state (n = 139). The instrument was a modified version of a survey developed to examine job satisfaction and potential turnover among public child welfare workers. Domains measured included various aspects of job satisfaction, intention to leave, and whether workers regretted taking their jobs. Data were analyzed using bivariate analysis and structural equation modeling (SEM).

Results

While both educators and prevention workers varied on different domains of job satisfaction, their overall satisfaction did not differ nor did their intention to leave their jobs. Satisfaction with contingent rewards, the nature of the work and opportunities for promotion along with not regretting taking one's job were predictive of thinking about leaving one's job. Thinking about leaving was predictive of taking concrete steps towards actual leaving.

Discussion

While people both prevention workers and educators report different levels of job satisfaction and work conditions in their agencies, job title itself has less to do with a worker's intention to leave, as measured by both thinking about leaving and taking steps towards actively looking for a new job, than other factors. Larger contextual factors may be at play in workers' decisions to stay employed. Suggestions are made for reducing turnover intentions along with suggestions for further study to clarify the role of organizational factors in workers' intention to leave.     

Parental substance misuse and compliance as factors determining child removal: A sample from the Victorian Children's Court in Australia

Purpose

The current study explores the role of parental substance misuse in child protection cases and examines its impact as a factor in decisions on child removal in court orders.

Methods

A cohort of 273 child protection cases from the Victorian Children's Court was reviewed. This sample consisted of cases where children have been removed (Custody to Secretary Order, n = 142 cases) or remained with parents (Supervision Order, n = 131 cases). Data was extracted on parental substance misuse in single and two parent households as well as compliance with court-based and child protection directives.

Principle results

Parental substance misuse (PSM) was present in 51% of child protection cases sampled and among those, poly-substance abuse was common (67%). PSM was associated with Indigenous status; younger age of child at court appearance; having a court-proven case of emotional abuse, less compliance with child protection services and a longer time between notification to authorities and final court decision. In one parent households, only parental compliance is the primary factor underlying decisions of child removal. In two parent households, the decision to remove a child from the family home was ultimately driven by parental compliance, and to a lesser extent by PSM of illicit drugs and the number of parents misusing drugs.

Conclusion

PSM and non-compliance appear to be significant factors in delaying stability for the child through the granting of court orders which may involve child removal. There is a need, by child protection professionals, for prompt recognition of PSM and associated compliance/engagement issues in order to refer appropriate cases for further assessment and treatment in specialist drug treatment services. Early involvement with specialist drug treatment services provides the Court with an indication of compliance which is an important factor for making decisions that assist with achieving stability for the child.     

Externalizing problems in young foster children: Prevalence rates,predictors and service use

Objective

Examining the prevalence of externalizing problems, their predictors and mental health service use for these problems by foster children and foster parents in a representative group of foster children aged 3 to 12 in Flanders.

Method

Survey data were collected on 212 foster children, who had been in the foster family for approximately four months. Foster parents filled out a Child Behavior Checklist to measure foster children's externalizing problems. Foster care workers reported on several potential risk variables for externalizing problems and on foster children's and foster parent's mental health service use. Predictors of externalizing problems were identified from a large number of variables using the method of purposeful selection of variables in linear regression.

Results

40.6% of the foster children had externalizing problems. Foster children who were placed because of behavioral problems had more externalizing problems. Only 20.9% of the foster children with externalizing problems and only 13.9% of their foster parents received professional help.

Conclusions

This study showed that externalizing problems are prevalent in this young foster care population, that it is hard to predict which foster children had externalizing problems, and that foster children and their foster parents rarely receive services for these problems. These findings call for a standard protocol of assessment of foster children's externalizing problems. Moreover, from a preventive viewpoint, guidelines are needed to systematically link young foster children with externalizing problems and their foster parents to appropriate services.     

Factors impacting intention to leave in social workers and child care workers employed at voluntary agencies

Introduction

To ameliorate high turnover in child welfare, researchers have attempted to identify factors that lead to undesirable turnover. While this has been studied extensively, little attention has been paid to turnover based upon job roles. Like social workers in child welfare, the field of child care also experiences high turnover. Child care workers employed in child welfare settings are no exception. The current study seeks to understand differential factors that impact intent to leave for preventive and child care workers employed in child welfare agencies.

Materials and methods

Data for prevention workers (n = 538) were obtained from all preventive service programs under contract with the City. Data for child care workers (n = 222) were obtained from three voluntary agencies located elsewhere in the State. The instrument was a modified version of a survey developed to examine job satisfaction and potential turnover among public child welfare workers. Domains measured included job satisfaction, intention to leave, career commitment, and agency investment. Data were analyzed using bivariate analysis and Structural Equation Modeling (SEM).

Results

Child care workers had more positive perceptions of child welfare and planned to stay in child welfare longer. Despite this, prevention workers felt more invested in their work. Child care and prevention workers had different levels of satisfaction with their jobs although overall job satisfaction did not differ nor did their intention to leave. Tenure at the agency was predictive of career investment. Investment, perceptions of child welfare, satisfaction with nature of work, and contingent rewards were associated with career commitment. Commitment and satisfaction with supervision were the greatest predictors of intention to leave.

Discussion

There is a gap in literature addressing child care workers in child welfare, and future study of this group is needed. Child care workers are just as likely to intend to leave their jobs as prevention workers. For both groups, it appears that investment in their jobs increases commitment to the field which reduces intention to leave.     

Characteristics and factors impacting reunification outcomes among Vietnamese immigrant families in the child welfare system

Using a mixed methods approach, this study examined reunification processes and outcomes among Vietnamese immigrant families involved in the child welfare system. A quantitative design was used to describe characteristics and reunification outcomes of Vietnamese immigrant children and families who are involved in family reunification services. Qualitative methods were used to explore factors that may influence reunification outcomes among Vietnamese families.The quantitative portion of the study included an exploratory design using administrative data from one county in the Northern California. The quantitative sample (N = 32) included children entering the foster care system for 8 or more days between January 1, 2001 and December 31, 2007 from child welfare administrative data (CWS/CMS) which was merged with eligibility data (CalWIN) in order to obtain parent and child place of birth to determine country of origin. The qualitative study included an exploratory design using interview data from child welfare workers (N = 8) and Vietnamese immigrant parents who had successfully reunified (N = 7).Quantitative results indicated that the most common type of maltreatment leading to entry into care was caretaker absence or incapacity, an abuse category that is often used in cases of parental substance abuse. 53.8% of Vietnamese immigrant children in the quantitative sample reunified with their parents, which is close to the national rate of reunification. Qualitative findings pointed to the importance of the following factors within reunification: acculturation-related issues, parental substance abuse, child welfare worker cultural competency and issues related to service availability and effectiveness. Implications for social work practice and policy are discussed.     

Downward spiral: The impact of out-of-home placement on paternal welfare dependency

In this article, we test how out-of-home placement affects men's labor market attachment, and in so doing we provide a novel parallel to existing research on how fatherhood affects men, which focuses almost exclusively on a child's arrival. Using population panel data from Denmark that include all first time fathers whose children were placed in out-of-home care from 1995 to 2005, we find that having a child placed in care is associated with up to a 4 percentage point increase in welfare dependency. Having a child placed in out-of-home care appear to aggravate conditions that likely necessitated the out-of-home placement to begin with, thereby likely necessitating longer duration of out-of-home placements. Thus, out-of-home placements have substantial secondary costs for parents and society.     

Online programs as tools to improve parenting: A meta-analytic review

Background

A number of parenting programs, aimed at improving parenting competencies, have recently been adapted or designed with the use of online technologies. Although web-based services have been claimed to hold promise for parent support, a meta-analytic review of online parenting interventions is lacking.

Method

A systematic review was undertaken of studies (n = 19), published between 2000 and 2010, that describe parenting programs of which the primary components were delivered online. Seven programs were adaptations of traditional, mostly evidence-based, parenting interventions, using the unique opportunities of internet technology. Twelve studies (with in total 54 outcomes, N_tot parents = 1615 and N_tot children = 740) were included in a meta-analysis.

Results

The meta-analysis showed a statistically significant medium effect across parents outcomes (ES = 0.67; se = 0.25) and child outcomes (ES = 0.42; se = 0.15).

Conclusions

The results of this review show that web-based parenting programs with new technologies offer opportunities for sharing social support, consulting professionals and training parental competencies. The meta-analytic results show that guided and self-guided online interventions can make a significant positive contribution for parents and children. The relation with other meta-analyses in the domains of parent education and web-based interventions is discussed.     

Long-term changes in parenting and child behavior after the Home-Start family support program

Background

The intervention Home-Start is a wide spread program in a number of countries, among which the Netherlands. In Home-Start, trained volunteers visit families with young children in need of support once or twice a week to help them to deal with problems in family life and parenting. Little is known, however, about the effects of Home-Start. This study describes short-term and long term changes in families that participated in Home-Start.

Methods

Three groups of families with young children (at the start mean age 1 1/2 years) were followed over a period of four years. One of the groups of families participated in the Home-Start family support program in the first 6.6 months of this period. The two other groups were (1) a randomly selected community sample and (2) a group of families with elevated parenting stress and a need for support. Data were collected at the beginning of the study, (after median 1.4 months), directly after the intervention (median 6.6 months) and at two follow-up occasions (respectively, median 12.5 and 49.2 months after the first measurement). At the last measurement, data were available for 33, 45 and 34 families respectively.

Results

Multilevel analysis showed more positive changes in parental wellbeing, competence and behavior (more consistent behavior and less rejection) during the intervention period in the Home-Start group than in the two other groups. At the three year follow up, the Home-Start group showed, compared to the other groups, more improvements in parenting (more responsiveness), but also diminished child externalizing and internalizing behavior problems (less oppositional defiant behavior, affective problems and anxiety problems).

Conclusions

Home-Start seems a promising family support intervention that deserves to be studied more extensively.     

Risk factors and services for child maltreatment among infants and young children

Objectives

Child maltreatment (CM) causes injury in large numbers of U.S. children. This study uses a large, multi-state dataset of child protective services reports for infants and young children under five years of age to examine risk factors and the effects of services in confirmed maltreatment investigations and recurrence over five years.

Methods

The Child Files of the National Child Abuse and Neglect Data System (NCANDS) for 2003-2007 were used to study confirmed CM reports to child protective services (CPS) using regression models and survival analysis among a cohort of children first reported during 2003.

Results

There were 1.2 million confirmed maltreatment reports to state child protective services agencies in 22 states during 2003-2007 in NCANDS, including 177,568 infants and young children under five years. 19.3% had a second confirmed CM report within 5 years. White race, inadequate housing and receiving public assistance were associated with significantly increased risk of CM recurrence. Infants and young children received more services and had less recurrence than did older children.

Conclusions

Infants and young children have different risk factors and receive different services than do older children in the CPS system. We need additional research to further assess and better target services for the special needs of infants, young children and their families if we are to protect them and reduce future child maltreatment.     

The relationship between problematic internet use and interpersonal cognitive distortions and life satisfaction in university students

Objective

The aim of the study was to analyze the relationship between problematic internet use by college students and interpersonal cognitive distortions and life satisfaction.

Methods

A total of 418 students, 260 females and 158 males, studying in different departments of the Fatih Faculty of Education, Karadeniz Technical University, participated. The Online Cognition Scale, Interpersonal Cognitive Distortions Scale, Life Satisfaction Scale and Personal Information Form were used as instruments.

Results

A significant positive correlation was determined between problematic internet use and interpersonal cognitive distortions (r = .33, p < .01), and a negative one with life satisfaction (r = − .21, p < .01). Interpersonal cognitive distortions, life satisfaction and gender account for 21% of total variance (F₍₃₄₁₃₎ = 37.30, p < .05). Findings revealed that males exhibit more problematic internet use than females, which subjects with a pessimistic perception of events have a higher level of problematic internet use than those with an optimistic perception and that subjects who always feel lonely exhibit greater problematic internet use than those who never or only sometimes experience feelings of loneliness.

Conclusions

Interpersonal cognitive distortions, life satisfaction and gender were significant predictors of problematic internet use. Problematic internet use exhibits significant variations according to gender, perception of events and feelings of loneliness.     

Child-centered approach in the context of the assessment of children in need: Reflections of child protection workers in Estonia

Objective

This article describes empirical results on how practitioners understand the concept of child-centered approach and how it is applied in practice, extending knowledge of the unresearched phenomena in Estonian child protection practice.

Method

A small-scale study included twenty child protection workers from different regions in Estonia, exploring the child-centered approach in assessment practices through in-depth semi-structured interviews.

Results

Results indicate that child-centered approach in the child protection workers' practice is characterized, firstly, by doing work for the child, and less by working with the child, including the fact that some practitioners are somewhat unclear about the meaning of child-centered principle. Majority of the participants underscored the importance of child involvement and partnership in the decision-making process, nevertheless, their case reflections showed that most of them did not include the child in the assessment.

Conclusions and implication for practice

Findings highlight several challenges in Estonian child protection system and suggest a need to find ways to support child protection workers' competence and confidence to conduct comprehensive assessments based on the child-centered approach, including the child in the assessment process.     

Reunification in a complete entry cohort: A longitudinal study of children entering out-of-home care in Tasmania,Australia

The aim of this study was to examine the nature and predictors of family reunification patterns in Australia. Using a large representative sample, this study extends previous studies based on older, often smaller samples and encompasses a period in which kinship care comprised a substantial proportion of out-of-home care placements. Analyses were based on a sample of 468 children who entered care for the first time in the State of Tasmania between January the 1st 2006 and December 31st 2007. Administrative data and case-worker interviews were used to obtain information concerning children's demographics, family backgrounds and placement movements over 2–4 years. The results showed that around 50% of children had gone home after 2 years, but that 79% of returns occurred in the first 6 months. Reunification was slower for younger children, those in kinship care, and amongst children from families affected by poverty, substance abuse and for a cluster children with the highest prevalence family risk factors. The study contributes to international knowledge concerning the importance of assessing the multiplicity of risk factors in family reunification research and the implications of kinship care for the increased stability, but higher retention, of children in out-of-home care.