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.     

Specialized foster care and group home care: Similarities and differences in the characteristics of children in care

Until recently, foster children who presented special medical or behavioral problems were largely served in group care environments. Specialized (or “treatment”) foster care has recently been developed to serve some of these challenging children. Although growing evidence points to the special needs of children in foster care, much is still unknown about how children placed in various out-of-home care settings differ from one another. The growth of specialized foster care as an alternative placement to group care, calls for examination of how children in these settings compare on demographic, educational, health, and behavioral characteristics. A cross-sectional mailed survey was distributed to all group care and specialized foster care agencies in a large state to address topics related to children's characteristics. Comparisons point to two groups of very difficult children, with unique mental health and health needs.     

Foster home licensing and risk of reentry to out-of-home care following family reunification

Family reunification without subsequent reentry is the primary permanency goal for children placed in foster care. While a number of placement-level factors have been examined for their effect on subsequent reentry to care, no study to date has considered foster care licensing. The current study uses statewide administrative data to construct a cohort of foster care youth who entered care between 2009 and 2012 and were reunified by the start of 2013 (N = 7752) to investigate the association between types of foster care and the probability of reentry to foster care up to two years following reunification. We focus specifically on the licensing status of foster homes, and employ propensity score analysis to address selection bias in placement type. A propensity-weighted cox proportional hazard model revealed that youth placed in licensed relative care (LRC) homes and licensed non-relative care (LNC) homes were more likely to reenter foster care than those youth placed in unlicensed relative care (URC) homes during their first spell of foster care.     

Children's participation in foster care placements

This article presents results from a study of the birth children of foster carers and their experiences of growing up with foster siblings. Data were gathered from focus groups (17 participants), discussion groups (16 participants), a questionnaire (684 responses) and eight individual interviews. The children's participation in the fostering placements is in focus. Accounts from the children show that several of them participate in care-giving activities in everyday life. Their participation in the official assignment is however limited and can lead to children taking on responsibility with no support from adults. The tension between children's agency and position in society is addressed. The study shows how power relations between children and adults come into play, how both children and adults (re)-produce positions where children's rights to have a say in questions that concern them are not reflected within fostering processes.     

Foster fathers performing gender: the negotiation and reproduction of parenting roles in families who foster

ABSTRACT

Foster care research and social work practice tend to focus on how women look after children living in foster care. This focus has limited our understanding of what it is that men do within foster caring families and they are automatically assigned secondary or breadwinning roles. Families who foster involve some form of renegotiation of roles to care for children they foster. While foster caring arrangements are internationally diverse, foster carers often work with social workers. It would therefore seem important for social workers to understand how foster carers negotiate their parenting roles. This paper reports findings from seven main caring foster-fathers who took part in a wider study involving twentythree foster-fathers. The evidence provided by these foster-fathers demonstrate they are highly motivated to care for children and, alongside delivering traditional parenting roles, they negotiate new, non-traditional parenting roles as foster-fathers. These new roles, taken on by foster-fathers, often challenge stereotyped masculinity while they also concurrently enact parenting norms. This study applied Judith Butler’s work on performing gender to foster caring families to theorise on the process whereby foster-fathers negotiate diverse masculinities and continue to reproduce gendered relations in foster caring families.     

Hot Jobs in Cool Places. The Material Cultures of New Media Product Spaces: The Case of South of the Market, San Francisco

This paper explores the localization of new media production in San Francisco. It is contextualized within a debate about the material culture of cyberspace. Much rhetoric has been expended in 'reading off' idealized 'online' worlds into probable 'off-line' worlds: the 'death of geography' is a case in point. The case is made for a corrective to both the idealist-culturalist, and the materialist techno-economic, accounts of cyberspace that accords an opportunity for both to infuse one another. The paper uses the concept of the material cultural practice of making products, underpinned by the notion of product space, to argue in favour of a co-construction of the 'off-' and 'online' worlds. The case study illustrates the point of how the most ecstatic 'online' community is rooted in a particular space and place, and how 'off-line' practices are essential to its 'online' presence.     

Levels of burden and satisfaction among Spanish foster carers

The aim of this study was to analyse the levels of burden and satisfaction among foster families in Spain, as well as the relationships between these variables and characteristics of the foster children and their carers. Participants were 86 foster families (comprising 71 foster fathers and 86 foster mothers) and the 104 children who they were fostering (56 boys and 48 girls). The instruments used were the Zarit Burden Interview and a questionnaire on foster carers' satisfaction with the preparation and support they had received. The results revealed low levels of burden among the families. Levels of burden were directly correlated with the amount of time the children had spent in residential care and with the age of foster fathers, and inversely correlated with how long the child had been with the current foster family. Higher levels of burden were reported by carers whose foster child was academically delayed. Regarding satisfaction, the highest ratings corresponded to items referring to the work of professionals, while the lowest were given for items concerning the information that foster families had received about the child's personality and the material and financial support available to them. The implications of the findings for professional practice are discussed.     

The economics of adoption of children from foster care

Federal initiatives since 1996 have intensified the efforts of states to achieve adoption for children in foster care. For many waiting children, the path to adoption is long. The authors offer an economic analysis of adoption from foster care, with an emphasis on the reasons why achieving the goal of adoption for all waiting children may be so difficult. The authors then estimate the determinants of adoptions from foster care across the states using data for fiscal years 1996 and 1997. Adoption assistance subsidy rates stand out as the most important determinant of adoptions from foster care, followed by use of alternatives (e.g., intercountry adoption). Adoptive matching on the basis of race does not appear to prevent adoptions from foster care in the aggregate, leaving flaws in the matching process, such as a lack of information and difficulty using the Interstate Compact on the Placement of Children (ICPC), as a primary reason why children wait.     

Open Adoption and Post-Adoption Birth Family Contact: A Comparison of Non-Relative Foster and Private Adoptions

This study used data from the National Survey of Adoptive Parents (NSAP) to compare post-adoption contact in families with non-relative private domestic and foster care adoptions. This study is the first to use a nationally representative sample to examine and compare the extent of post-adoption contact in both private and foster adoptions. The results suggest that children adopted from foster care were less likely to experience post-adoption contact with their birth families than children adopted privately despite the fact that they were more likely to have lived with their birth families.     

Kin and non-kin foster care—findings from a National Survey

This article uses national data to look at the differences between children in kinship and non-kinship care arrangements. Three groups are compared: children in non-kin foster care, children in kinship foster care, and children in “voluntary” kinship care. Children in voluntary kinship care have come to the attention of child welfare services, are placed with kin, but unlike those in kinship foster care, these children are not in state custody. Findings suggest that children in the kin arrangements faced greater hardships than those in non-kin care. They more often lived in poor families and experienced food insecurity. They were more likely to live with a non-married caregiver who was not working and did not have a high school degree. And fewer kin than expected received services to overcome these hardships. In addition, nearly 300,000 children lived in voluntary kinship care arrangements; these children are of particular concern because they are not in state custody and therefore may or may not be monitored by a child welfare agency.     

The experiences and outcomes of children in foster care who were removed because of a parental disability

The purpose of this study is to examine the experiences and outcomes of children in the foster care system in the United States who were removed from their homes at least partially in relation to their parent's or caretaker's disability. This study uses administrative data from the 2012 year of the Adoption and Foster Care Reporting System (AFCARS), the federal reporting system that collects case-level data on all children in foster care through state and tribal IV-E agencies. While this administrative dataset doesn't collect data on parental disability, it does collect data on parental disability as a removal reason for children in foster care. In 2012, 19.0% of children in foster care had parental disability indicated as at least one removal reason, and 5.18% had parental disability indicated as their sole removal reason. Logistic regression was used to explore how a removal reason of parental disability correlated with removal manner, type of placement, location of placement, current case plans, discharge reasons and termination of parental rights. T-tests were used to compare children with and without parental disability as a removal reason in regards to number of placements, age at removal, length of time since last removal, length of stay in current placement, and total days in foster care. As foster children could have multiple removal reasons, analyses were conducted separately for children with parental disability as at least one removal reason, and those with parental disability as their sole removal reason. Findings indicate that children who have parental disability as a removal reason have different experiences in child welfare and different child welfare outcomes than those without parental disability as a removal reason. While the AFCARS removal reason of parental disability is not a proxy for parental disability, the study points to a need for closer attention to parental disability within the child welfare system to ensure appropriate services and supports, as well as fair treatment.     

Attachment Behavior of Children Adopted Internationally at Six Months Post Adoption

The purpose of this pilot study was to describe attachment behavior in children adopted internationally at six months post adoption. Twenty-two children and their adoptive mothers were observed at home for completion of an attachment measure. Mothers also completed a questionnaire on their child's preadoption care. Comparisons of children low and high in attachment security suggested that low secure children showed predominantly ambivalent attachment behavior or that they were still in the process of forming an attachment. Children having foster versus orphanage care prior to adoption differed in quality of preadoption care and in certain attachment behaviors, but not in overall attachment security.     

Mental health interventions for children in foster care: A systematic review

Children in foster care have high rates of adverse childhood experiences and are at risk for mental health problems. These problems can be difficult to ameliorate, creating a need for rigorous intervention research. Previous research suggests that intervening with children in foster care can be challenging for several reasons, including the severity and complexity of their mental health problems, and challenges engaging this often transitory population in mental health services. The goal of this article was to systematically review the intervention research that has been conducted with children in foster care, and to identify future research directions. This review was conducted on mental health interventions for children, ages 0 to 12, in foster care, using ERIC, CINAHL, PsycINFO, PubMed, ProQuest's Dissertation and Theses Database, Social Services Abstracts, and Social Work Abstracts. It was restricted to interventions that are at least “possibly efficacious” (i.e., supported by evidence from at least one randomized controlled trial). Studies were evaluated for risk of bias. Ten interventions were identified, with diverse outcomes, including mental health and physiological. Six interventions were developed for children in foster care. Interventions not developed for children in foster care were typically adapted to the foster context. Most interventions have yet to be rigorously evaluated in community-based settings with children in foster care. Little research has been conducted on child and family engagement within these interventions, and there is a need for more research on moderators of intervention outcomes and subgroups that benefit most from these interventions. In addition, there is no consensus regarding how to adapt interventions to this population. Future research should focus on developing and testing more interventions with this population, rigorously evaluating their effectiveness in community-based settings, determining necessary adaptations, and identifying which interventions work best for whom.     

Social Suffering and Embodied States of Male Transnational Migrancy in San Francisco,California

Through the analysis of a social program for migrant and homeless labourers, this article focuses on embodiment, suffering, and the changing nature of masculinity in a specific Latino migrant population in San Francisco. It highlights particular aspects of personhood while relating migrant narratives of this singular “lonely” population to aspects of current political economy and articulations of social suffering. It explores how spatial and temporal conditions such as “shifting suffering,” “being stuck,” being betrayed, and “conformarse” (conforming) highlight embodied states of changing masculinity and transnational migrancy. Through an examination of belonging and exclusion, continuities as well as discontinuities of representations, self-validation, and a nostalgia for a possibility of a future that cannot be and a present that still remains, this article presents a much-needed ethnography of embodied affects emerging in different arenas of transnational migrancy.     

Medical Muddle

Nanette Gartrell, MD, is a psychiatrist and researcher whose investigations have documented the mental health and psychological well-being of lesbian, gay, bisexual, and transgender (LGBT) people over the past four decades. Nanette is the principal investigator of an ongoing longitudinal study of lesbian families in which the children were conceived by donor insemination. Now in its 27th year, this project has been cited internationally in the debates over equality in marriage, foster care, and adoption. Previously on the faculty at Harvard Medical School and the University of California, San Francisco, Nanette is currently a Visiting Distinguished Scholar at the Williams Institute, UCLA School of Law. In 2013, Nanette received the Association of Women Psychiatrists Presidential Commendation Award for “selfless and enduring vision, leadership, wisdom, and mentorship in the fields of women's mental health, ethics, and gender research.” At the age of 63, Nanette experienced a 3 ½ month period of intractable, incapacitating dizziness for which there was never a clear diagnosis.     

Socioemotional characteristics of minors in foster care: A comparison between the estimation of parents,teachers and children

During the child's first few years, it's of fundamental importance the presence of a strong emotional base as long as it creates the possibility to open themselves to physical and social world with confidence, and as it acts as a facilitator of cognitive development. For this reason, if the family cannot ensure such base, social services are forced to resort to foster care, a resource that has a lot of difficulties, leading to different implications in the development of the child and of the foster family. It is therefore important to analyze in depth the socio-emotional variables that characterize children who are in a situation of foster care in order to provide adequate assistance to optimize their development. For this 32 minors in foster care, 31 foster parents and 28 teachers from the city of Valencia, were administered the BASC. The results highlight that parents are evaluating children, in general, worse than tutors. Specifically they consider children more aggressive, they detect more behavioral and attention problems and recognize in them a greater tendency to externalize the problems, while the teachers consider these children as with more social and adaptive skills. There were no significant differences between the scores of parents, teachers and children. High levels of psychopathology (which are clinically significant in various cases) and the fact that host parents evaluate minors as more problematic, are indicators of parents' and minors' need of support from public organizations.     

Behavioral health service use and costs among children in foster care

This article compares behavioral health service use and cost for foster care versus nonfoster care children; children before, during, and after foster care placement; and successfully reunified versus nonsuccessfully reunified foster care children. Behavioral health service costs for children in foster care were higher than for children not in foster care. Children in foster care used more services during their foster care placement than before placement and after discharge. Nonsuccessfully reunified children received a significantly larger quantity of services than those successfully reunified.     

The Letterbox Club book gifting intervention: Findings from a qualitative evaluation accompanying a randomised controlled trial

It is now widely accepted that reporting the results of randomised controlled trials should encompass a complimentary focus on both outcome measures and process measures. Reflective of the current thinking, this article reports on the findings from a qualitative evaluation that accompanied a randomised controlled trial of the Letterbox Club; a book gifting intervention for children in foster care. Outcome measures used in the trial have recently been reported on (Mooney, Winter, & Connolly, 2016). Findings showed no significant effects in terms of improvements to children's literacy skills and/or enjoyment of reading. Through in-depth interviews with 20 foster children, their carers and the programme developer, the qualitative evaluation focused on how and why the intervention did not achieve greater impact. Findings illustrate differences between the ‘hoped for’ outcomes of the intervention, and carer/child levels of engagement with and experiences of the programme. In order to move the programme forward and begin to explore the findings, a logic model is suggested which accounts for the current findings regarding the use and lived experiences which carers had with the packs. Wider implications for the conduct of these types of randomised controlled trials are discussed.     

Effects of foster care placement on biological children in the home

This project used questionnaires to investigate the effects of foster care on biological children in the foster home setting. In southeast Iowa, 52 foster parents and 51 biological children voluntarily responded. Approximately 77% of the foster parents were concerned about the effects of foster care on their biological children—in particular, that biological children felt left out of the family unit. The majority of the foster parents stated that sharing of parental attention should be discussed with biological children before beginning, and both parents and children felt that pretraining sessions for biological children would help their adjustment to foster care.     

Concept mapping the needs of grandmothers who take care of their grandchildren in formal foster care in Flanders

Concept mapping was used to identify the needs of grandparents who take care of their grandchildren in formal foster care in Flanders (Dutch speaking part of Belgium). One hundred and nine grandmothers were asked to describe their needs in response of the question: “What do you need to be a good foster parent for your grandchild(ren)?” Next, the unique responses were sorted by 41 grandmothers, and analyzed using multidimensional scaling and cluster analysis. Furthermore, grandmothers were asked to indicate the degree of importance of each statement. Twenty-eight unique responses were grouped into eight clusters. In descending order of importance these clusters referred to the parenting relationship with their grandchild, parenting conditions, support and trust in the future and the child's schooling, collaboration with and support from the foster care agency, material conditions, social support from the wider context, respite care, and contact arrangements. Their needs resemble the needs of regular foster parents, with the exception of some specific needs related to their specific situation, such as feeling ‘out of step’ with innovations and new technologies, health issues, finding a balance between the grandparent role and foster parent role, and the need for a positive and reassuring vision of the future.