Early truancy intervention: Results of an evaluation using a regression discontinuity design

This study evaluates the effectiveness of a truancy reduction program. A Regression Discontinuity design was used to assess attendance outcomes for 700 children. Approximately half received a case management intervention, while the other half received a warning letter, only. Truancy rates in the control group remained at the pre-intervention levels, while truancy in the treatment group significantly declined (p < .01). Successful case closure was associated with a reduction in truancy (p < .001). The intervention was less effective with non-White children and with those who had been previously retained. Findings substantiate continued support for the intervention; however, additional resources should include culturally-responsive treatment approaches and academic enrichment programs.     

Using portable computers in home visits: Effects on programs, data quality, home visitors and caregivers

Collecting and using high-quality data related to participant outcomes are critical for monitoring program quality in home visitation programs for child abuse and neglect prevention, as well as for efforts to improve effectiveness and use limited funds efficiently. An evaluation was conducted to determine the impact of using portable computers to record data from standardized screening tools during home visits. Six home visiting agencies participating in the Early Years Home Visitation Outcomes Project of Wisconsin implemented computerized screenings with wireless uploading of data to a state public health database. Using portable computers saved agencies time and money on all four screening tools tested, with significant cost savings (p < 0.05) on three of the four tools, as compared to paper-and-pencil administration of screenings and manual data entry. The average time used per screening dropped between 9 and 63 min, saving agencies between $2 and $14 per screening administration. Screening completion was also higher when portable computers were used for data capture. There was little effect on home visitors' perceptions of the ease of data collection or their interactions with families being served. The use of portable computers to collect standard screening data holds promise for the field of home visitation.     

Lighthouse Independent Living Program: Predictors of client outcomes at discharge

This study examined clinical risk factors and their association with client outcomes at discharge among 385 emancipating foster youth in Cincinnati, Ohio, who entered the Lighthouse Independent Living Program during the period 2001-2005. These youth averaged 18 years of age and remained in the program an average of 10 months. At the time of discharge at age 19, 58% of these young adults had completed high school, 32% were employed, and 38% were living independently; 11% had achieved all three aforementioned outcomes. An exploratory principal components factor analysis of nineteen dichotomous risk factor items assessed by clinical staff at the time of admission yielded four types of risk: mental health problems, delinquency issues, teen parenting, and cognitive impairment. Logistic regression analysis revealed a number of significant relationships between each of these four clinical risk factors and client outcomes after adjusting for demographic and program characteristics. Those with mental health problems were only half as likely as others to have attained all three outcomes. Parenting youth were only half as likely to have completed high school or to be employed as others. Those with delinquency issues were only one-fourth as likely than others to be independently housed at discharge. Finally, older youth and those remaining in the program longer showed more favorable outcomes than others. Implications for child welfare policy and practice pertaining to independent living are discussed.     

Child protection and out-of-home placement experiences of preschool children born to mothers enrolled in methadone maintenance treatment during pregnancy

Children born to opiate-dependent women engaged in methadone maintenance treatment are at high risk of child welfare concern. However, few studies have examined the early child protection service (CPS) contacts of this group or the risk factors that place some but not other mother–infant dyads at increased risk of serious concern resulting in the removal of the child from the family home. As part of a prospective longitudinal study based in New Zealand, 73 women enrolled in methadone maintenance treatment during pregnancy and 54 non-methadone maintained comparison mothers were recruited during pregnancy and interviewed close to delivery, 18-months and 4.5-years. At each follow-up evaluation, detailed life history methods were used to describe children's family circumstances and all CPS contacts. By 4.5-years postdelivery, methadone maintained mothers were ten-times more likely to have been investigated by child protection services than comparison mothers (59% v. 6%, p < .001). Of these contacts, almost half (44%) resulted in the removal of the child from the family home compared to no comparison children (p < .001). These children were most frequently placed before age 1, with an average of 1–2 caregiver changes (range: 0–7). In addition to maternal methadone maintenance treatment during pregnancy (p < .001), significant independent predictors of child out-of-home placement included maternal depression (p = .01), maternal history of child custody loss (p = .02), and to some extent, high levels of family socioeconomic adversity (p = .06). Findings highlight the complex psychosocial needs of this high-risk group, as well as the need for careful monitoring and parenting support following hospital discharge.     

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.     

Foster children placed with or separated from siblings: Outcomes based on a national sample

This study examines a range of outcomes for children in foster care who have siblings, using a large, national U.S. database. Three types of sibling placements are defined: split (child has no siblings in the home), splintered (at least one sibling in the home), and together (all siblings in the home). The study analyzes records (n = 1701) from the National Study of Child and Adolescent Wellbeing, including Child Protective Services (CPS) and Long-term Foster Care (LTFC) samples. It contributes to the literature in its inclusive definition of siblings, use of three categories for sibling placement status, and use of outcome measures that include the perceptions of foster children. The study reports limited significant findings. Neither foster parents' nor youths' reports of behavioral problems differ by sibling placement status. As rated by teachers, academic performance in the group placed together exceeds that in both of the other groups. For children in kinship homes, teachers also reported less problematic internalizing and externalizing behavior for the splintered and together groups than for the split group. Children in the splintered group also responded more favorably than those in the split group to questions of closeness to the primary caregiver and liking the people in the foster family.     

Developmental outcomes after five years for foster children returned home, remaining in care, or adopted

A substantial proportion of children who enter foster care in the US are infants or toddlers and will exit from foster care before they have been in care for long, either returning home or to adoption. These first years of involvement may predict a significant amount about children's longer term development so understanding developmental outcomes after five years is valuable to understanding if child welfare services (CWS) are serving the intention of promoting the well-being of children. A subsample of 353 infants (less than 13 months of age when investigated by CWS) and subsequently placed into foster care were selected from the National Survey of Child and Adolescent Well-Being. After 66 months, these infants had been reunified, adopted, or were still in foster care. Bivariate comparisons were completed. Statistical controls for maltreatment type and severity, demographic traits, and current caregiver education were implemented to help clarify the role of terminal child welfare placement, current caregiver behaviors, and household income, on eight linear regression models of developmental outcomes. Results support the longstanding tenet of child welfare services policy that remaining in foster care is less developmentally advantageous than having a more permanent arrangement of return home or adoption.     

Effectiveness of smoking cessation program for male adolescents in South Korea

The objective of this study was to implement and verify the effectiveness of a smoking cessation program based on a cognitive behavioral model, composed of six sessions. Participants included 80 male middle school students who smoked. They were divided into experimental (n = 35 students) and comparison (n = 45 students) groups, and the smoking cessation program was conducted in the experimental group. Results of self-report scales for smoking behaviors and urinary cotinine and CO levels before and after the program were statistically analyzed with mixed regression including factors for group, time, and a group-by-time interaction. The results indicated that the group effect, time effect, and group-by-time interaction effect were significant for the nicotine dependency. The variation patterns in the two groups became significantly different over time as nicotine dependency drastically decreased in the experimental group, whereas those in the comparison group showed little change from pre-program examination to post-program examination. Significant time effects were observed for smoking cessation efficacy and urinary cotinine levels, reflecting increased smoking cessation efficacy and decreased cotinine levels in both groups across time. The results suggest that this six-week smoking cessation program in male adolescents in South Korea was valid to implement.     

Benefits and costs associated with mutual-help community-based recovery homes: The Oxford House model

We used data from a randomized controlled study of Oxford House (OH), a self-run, self-supporting recovery home, to conduct a cost-benefit analysis of the program. Following substance abuse treatment, individuals that were assigned to an OH condition (n = 68) were compared to individuals assigned to a usual care condition (n = 61). Economic cost measures were derived from length of stay at an Oxford House residence, and derived from self-reported measures of inpatient and outpatient treatment utilization. Economic benefit measures were derived from self-reported information on monthly income, days participating in illegal activities, binary responses of alcohol and drug use, and incarceration. Results suggest that OH compared quite favorably to usual care: the net benefit of an OH stay was estimated to be roughly $29,000 per person on average. Bootstrapped standard errors suggested that the net benefit was statistically significant. Costs were incrementally higher under OH, but the benefits in terms of reduced illegal activity, incarceration and substance use substantially outweighed the costs. The positive net benefit for Oxford House is primarily driven by a large difference in illegal activity between OH and usual care participants. Using sensitivity analyses, under more conservative assumptions we still arrived at a net benefit favorable to OH of $17,830 per person.     

Psychopathology,physical complaints and health risk behaviors among youths who were victims of childhood maltreatment: A comparison between home and institutional interventions

Based on investigations of child maltreatment by Child Protective Services (CPS), several children who are identified receive some kind of individual or familial intervention. However, the literature has shown conflicting results in regard to the later functioning of the children who are target of different protective measures in different settings, compared to other youths who receive no intervention. We assessed childhood adversity, psychopathology, physical complaints and health risk behaviors among youths who received one of two different protective interventions during childhood (home vs. institutionalization group), and we compared them with youths who receive no intervention (comparison group). In total, 216 youths participated, with ages ranging from 14 to 23 years (M = 17.05 years, SD = 1.8 years; 105 males, 111 females), including 136 youths that were contacted based on their CPS records completed during their childhood, and 80 youths from the community without CPS identification.     

Evaluation of a group-based social skills training for children with problem behavior

This study evaluated a group-based training program in social skills targeting reduction of problem behaviors in N = 161 children between 7 and 13 years of age. The effects of the intervention were tested in a quasi-experimental study, with a follow-up assessment 12 months after an optional continuation camp. At the post-test, both the experimental and control group showed less social problems and internalizing problems, whereas only the experimental group showed a small and positive change in social anxiety. After a 12 month follow-up, a subsample of the experimental group (children who followed a continuation camp) showed large positive changes for all outcome measures, except for externalizing problems, showing a small effect.     

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.     

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.     

Risk and protective factors for residential foster care adolescents

Based on Jessor's (1998) Problem Behavior Theory, this study investigated the relationship between risk and protective factors and adolescent psychopathology and adjustment. For this purpose, adolescent girls (n = 69) and boys (n = 71) living in residential foster homes in the city of Tehran, responded to an adapted version of the Adolescent Health and Development Questionnaire, Jessor, 1998) and their foster home caregivers rated the adolescents' internalizing/externalizing problems and prosocial behavior with the Strengths and Difficulties Questionnaire (SDQ, Goodman, 2001). This study identified several influential aspects at the levels of the individual, foster home, peers and community that serve as a direct risk and protective factors, and also documented indirect pathways of gender, individual, foster home, peers and community influence.Three main patterns, protective, protective and enhancing, and protective but reactive seemed to characterize most of the risk by protective factor interactions. The risk and protective factors associated with foster home adolescents' mental health are broadly in line with previous published findings. Based on the present findings, the extension of universal intervention programs designed within the framework of PBT and which address multiple targets seems justified to be used with foster care home adolescents.     

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.     

Cultural diversity competencies in child and youth care services in Portugal: Development of two measures and a brief training program

Few researchers have examined the training of child care workers in cultural diversity competencies, despite the growing number of ethnic minority children and youth in residential care. The present paper reports two studies. In study 1, we aimed to adapt and develop two measures of cultural diversity competencies—a self-report questionnaire and an objective measure based on a case vignette (n = 51). In study 2, we proposed a brief training program. A quasi-experimental design (n = 30) was used, with cultural competencies being evaluated before and after the training. Results revealed that (1) child care workers tended to over-estimate their self-perceived competence and that (2) the experimental group was more capable of including cultural elements in their definition of strategies and relational aspects of intervention after a brief training than the group that received no training (control). Implications of this study are discussed for further development of cultural diversity competencies in professionals working in residential child care.     

Stepping Down and Stepping In: Youth's Perspectives on Making the Transition from Residential Treatment to Treatment Foster Care

Older youth preparing to emancipate from the foster care system are often served in residential treatment settings where they have limited opportunities to practice skills for independent living in a community setting. Stepping these youth down to less restrictive environments such as treatment foster care is a growing trend, especially for youth with mental health issues. Yet, few studies have explored the youth's perspective on making this transition. This study utilized qualitative interviews with youths who were participating in a treatment foster care intervention study (n = 8) to gain their perspectives on the process of transitioning from residential care. Youths were interviewed right before they exited residential care and two months after placement in the new foster home. Youths reported hopes for gaining family in the new home as well as fears of placement disruption. Findings point to the need to enlist youths in discussion and problem solving about difficulties they anticipate in the new home and expectations for their relationship with the new foster parents. In addition, the struggles described after two months in the home point to the need for youths to build specific skills to better manage ongoing relationships with foster parents and for foster parent training on how to help build these skills.     

Planned treatment and outcomes in residential youth care: Evidence from Sweden

A recurring theme in evaluations of Swedish residential youth care is that treatment is often unplanned. Using a data set of teenagers placed in youth care in 1991 (N = 357), we show that planned treatment — in the sense of a known expected duration of treatment — is strongly positively associated with treatment outcomes. In the short term, teenagers with planned treatment are 32% less likely to experience a treatment breakdown and 25% less likely to be reassigned to other forms of residential care after completed treatment. In the long term, teenagers with planned treatment are 21% less likely to engage in criminal behavior and 40% less likely to be hospitalized for mental health problems. The results are robust to controlling for a rich set of potentially confounding factors: Even though observable pre-treatment teenager characteristics explain about one fifth of the variation in criminal behavior 5-10 years after treatment, they have almost no predictive power for whether treatment is planned or unplanned.     

A multi-site study of the ACT Raising Safe Kids program: Predictors of outcomes and attrition

The present study examined the factors related to attrition and treatment outcomes in the ACT-Raising Safe Kids (ACT-RSK) program. ACT-RSK is a family violence and child abuse prevention program for parents and caregivers of young children. Sixty parents or caregivers of children aged 9 years or younger completed the ACT-RSK group program and the research measures. The study took place at 7 community-based sites in the midwestern United States. Program completers were significantly older than noncompleters, suggesting that parent age relates to attrition from this program. Pre/post comparisons indicated increased nurturing behavior, decreased harsh parenting, and decreased negative discipline, as well as decreased child behavior problems following completion of the ACT-RSK program. Parent age predicted children's outcomes, indicating better results for the children of older parents/caregivers. In addition, pre-test harsh parenting scores predicted children's outcomes, suggesting that families with relatively higher initial levels of parental psychological aggression and corporal punishment had more robust child outcomes following completion of the program.