Family Functioning and Satisfaction of Former Residents of a Non-Therapeutic Residential Care Facility: An Exploratory Study

ABSTRACT

Recently there has been a resurgence in discussions among government policy-makers regarding the use of non-therapeutic residential care as an alternative to kinship and family foster care. If informed decisions are to be made regarding foster care alternatives, evaluation is needed of how children fare in residential care facilities. This study looks at the family relationships and life satisfaction of 76 adults who resided in a residential care facility as children. The overall positive results suggest that the negative reputation of non-therapeutic residential care facilities may not be wholly deserved. The authors hope that this information can assist social workers and policy-makers in making important decisions about the appropriate use of residential care with our country's future population of foster care children.     

Parental substance abuse and the development of children in family foster care

To determine the impact of parental substance abuse on children, the cognitive skills and behavior ratings of 268 school-age children placed in family foster care were examined. As a group, the children in family foster care presented with low average cognitive skills and made significant improvement in cognitive functioning during placement. The children with prenatal exposure to drugs scored significantly lower in cognitive skills at the beginning of placement but made significantly more progress than the other children during placement. Behavior ratings by the foster parents and teachers revealed that 29% of the children had scores in the significant range, and the children exposed prenatally to drugs had a higher incidence of behavior problems at school compared to family foster care peers. Recommendations for further study of these factors and for enhancing outcomes for children in care are provided.     

Effectiveness of a group-based academic tutoring program for children in foster care: A randomized controlled trial

The consistently poor educational achievement of children in foster care has been associated with many negative outcomes including long term poor adult adjustment (e.g., higher rates of suicide, criminality, and substance abuse). The current study was undertaken to improve foster children's academic skills through academic remediation. Across this two year randomized study, 91 children in out of home foster or kinship care, between grades 1 and 8 inclusive, completed the study. One-half were randomly assigned to the 30-week direct-instruction small group tutoring condition, while the other half served as wait-list controls. A statistically significant increase in standard scores was found on reading decoding, spelling and mathematic skills for the children who received tutoring, but no differences were obtained on sentence comprehension. Significant effect sizes, in the small to moderate range, were also found in support of the tutoring condition across these three domains. The implications of these positive findings as they relate to improving educational achievement among children in foster care are discussed.     

Displacement,caregiving, and the ecological system of youth in foster care: a theoretical perspective

Children involved in the child welfare (i.e., foster care) system are at a greater risk for numerous negative outcomes in adolescence and adulthood (e.g., lower educational attainment, higher risk for a criminal record). For children in foster care who experience placement disruption (i.e., removed from a foster home and placed in another nonpermanent placement), the risks significantly increase. Informed by the ecological systems model, the authors propose a theoretical perspective to explain the unique aspects of a foster child’s development and discuss how this framework informs child welfare practice and intervention for foster children at risk for placement disruption. This perspective has the potential to provide a framework that has implications for foster caregivers and child welfare professionals and to inform future policies.     

Why do children resist or obey their foster parents? The inner logic of children's behavior during discipline

This article discusses a study of children's perspectives on disciplinary conflicts with their foster parents. Most children accept parental authority, but they also defend their personal autonomy and loyalties to peers. In this study, only birthchildren told real-life stories about fierce resistance to get their own way. Fierce resistance among foster children was motivated by inner conflicts and confusion. Obedience among foster children often derived from fear of punishment or a feeling of impotence. The authors discuss the theoretical and pedagogical implications of these findings.     

Foster Parents' Understanding of Children's Problematic Attachment Strategies

ABSTRACT

Foster mothers and biological mothers were interviewed regarding their understanding of children's insecure attachment strategies and their knowledge of foster care issues. In addition, parent sensitivity was assessed and case workers in the foster care system reported on foster mothers' effectiveness. As expected, foster mothers reported significantly more attachment-related difficulties with their foster children than biological mothers reported with their natural children. Foster mothers were not significantly different from biological mothers in their understanding of attachment strategies, knowledge about foster care issues, or sensitivity. Case workers' reports of foster parent effectiveness were significantly related to foster parents' knowledge about foster care issues but were not significantly related to parents' understanding of attachment strategies. We discuss the importance of sensitivity to attachment issues among foster parents.     

Competencies and problem behaviors of children in family foster care: variations by kinship placement status and race

Formal kinship foster care is an increasingly common form of out-of-home placement, and several important distinctions between kinship care and non-relative foster care have been identified. The present study evaluated the behavior of kinship foster children in comparison to non-relative foster children and children in the general population. A geographically and ethnically diverse sample of foster children (N=240) was assessed for competence and problem behaviors using the Child Behavior Checklist (CBCL: Achenbach, 1991). Kinship foster children closely resembled children in the general population but differed significantly from their counterparts in non-relative foster care, who consistently scored lower on competence and higher on problem behaviors. Substantial proportions of non-relative foster children were in the clinical range on most CBCL measures, but kinship foster children were no more likely than children from the general population to score above clinical cut-offs. Differences between kinship and non-kinship foster children became less dramatic after accounting for child race and gender, which were both associated with kinship status. Child race had a strong main effect for almost all types of problem behaviors, with children of color showing significantly less problematic behavior. Discussion of these results centers on potential explanations for the observed variations in child behavior by kinship status and race.     

Nutritional status of foster children in the U.S.: Implications for cognitive and behavioral development

ObjectiveChildren in foster care are at greater risk for poor health, physical, cognitive, behavioral, and developmental outcomes than are children in the general population. Considerable research links early nutrition to later cognitive and behavioral outcomes. The aim of this narrative review is to examine the prevalence of poor nutrition and its relation to subsequent health and development in foster children.MethodRelevant studies for inclusion were identified from numerous sources (e.g., PubMed, Google Scholar, and reference sections). Inclusion criteria were studies published between 1990 and 2016 of (i) the nutritional status of children in foster care or (ii) the nutritional status of children exposed to early adversity (e.g., low-income and internationally adopted children) or (iii) the developmental effects of poor nutrition and micronutrient deficiencies.ResultsTwo key findings that have adverse implications for cognitive development emerged: (i) the prevalence of anemia and iron-deficiency anemia is higher among foster children than among the general population of children in the U.S., and (ii) the developmental demands of catch-up growth post-placement may lead to micronutrient deficiencies even after children have begun sufficient dietary intake of these nutrients. Moreover, there is a paucity of recent studies on the nutritional status of children in foster care, despite the multiple factors that may place them at risk for malnutrition.ConclusionAttention to nutritional status among care providers and medical professionals may remove one of the possible negative influences on foster children's development and in turn significantly alter their trajectories and place them on a more positive path early in life. Recommendations for further research, policy, and 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.     

Decision-making skills of emerging adults aging out of foster care

This study examines the decision-making skills of emerging adults that have aged out of foster care and transitioned to independent life. Emerging adults face a wide variety of life-direction determining decisions and those aging out of foster care experience even more significant transitional issues. Youth aging out of foster care may lack the requisite decision-making competencies for coping with these challenges. This study compares the decision-making skills of foster care alumni to a group of similar individuals who were not involved in the child welfare system. Using a validated quantitative survey instrument, 29 foster care alumni and 29 demographically similar non-fostered participants described their general decision-making skills and elaborated on their personal experiences of reaching the age of majority. Statistical analyses of group differences indicate foster alumni score lower on overall decision-making skills and the decision-making process. In anecdotal comments, foster alumni tended to focus on their experience of leaving the foster system, while the non-fostered population elaborated on what it was like to become a legal adult. This study suggests that youth aging out of the foster care system may need support with the aspects of decision-making relating to the generation of alternatives and inferential reasoning about decision consequences as one way to augment and improve the transitional services designed to prepare foster youth for independent life.     

“It's really overwhelming”: Parent and service provider perspectives of parents aging out of foster care

Rates of pregnancy and parenthood among current and former foster youth are two to three times higher than non-foster youth peers. Repeat pregnancies among young mothers aging out of foster care also occur at higher rates than peers not involved with the child welfare system. Furthermore, mothers aging out of foster care demonstrate high levels of parenting stress and risk for child maltreatment. Indeed, this population is in significant need of help; however, beyond anecdotal evidence, little is known about the needs and day-to day experiences of this population. In order to tailor interventions to meet the needs of parents aging out, the perspectives of stakeholders must be taken into account. Using qualitative data gathered from separate small group interviews with parents aging out and service providers, this study examined participants' perceptions of parents' daily experiences, strengths, and needs. Findings indicated that parents aging out face overwhelming adversity and stress with little outside financial, emotional, or parenting support from family or friends. Yet, parents also expressed motivation to be good parents, resilience, and the desire to gain effective parenting skills. Although similar themes arose among parent and provider interviews, perceptions differed. Parents expressed hope and optimism in providing for their children while providers expressed systemic failure in preparing parents for independent living. Based on these findings, we conclude that parenting interventions specific to parents aging out may need to address three fundamental and key components: basic needs, social support, and effective parenting techniques.     

Key factors and characteristics of successful resource parents who care for older youth: A systematic review of research

There is growing recognition that competent, committed resource parents are a critical component to the effective delivery of foster and adoptive services for teens placed in out-of-home-care. This study implemented a systematic review process to identify the personal characteristics, skills and abilities of successful resource families that maximize foster and adoptive parent retention and maximize placement permanency of teens placed in out of home care. Starting with an extensive search of the literature across the last two decades and outreach to locate studies, the authors systematically analyzed research that used permanency and placement stability as the primary dependent variables and personal characteristics/attributes, knowledge, skills and abilities as independent variables. Of the 838 total documents identified, 48 were original research studies that focused on one or more of these variables. Although rigorous and systematic, this research was hampered by differing definitions, samples, measures, and the type of analysis utilized among these studies. Personal characteristics that promoted permanency and placement stability included having a tolerance for rejection, flexible expectations, having a sense of humor, having a belief in a higher power, belief in self-efficacy, having higher education, having sufficient economic resources, having healthy family and marital functioning, having access to support systems, and being motivated to foster/adopt. Knowledge, skills, and abilities resources families acquired that promoted permanency and placement stability included the ability to communicate effectively, maintain attentiveness to the parent/child relationship (i.e. using routines and structure while also offering children a variety of experiences), understand the effects of trauma and teach socio-emotional health, provide culturally competent care, recognize, express and process grief, take care of oneself, valuing and participating in life -long learning, training and education, and valuing a connection to the child's birth family.     

Kinship foster parenting; gender,class and labour-force participation

Objective: Knowledge about gender, class and labour-force participation of kinship foster parents in European countries is scarce. This study examines the gendered structure and generational pattern of kinship foster parenting in Norway and compares class components and labour-force participation of kinship foster mothers to the larger female population and to non-kinship foster mothers.

Method: The analysis is based on survey data on relationships between foster parents and child, social demographics and placement characteristics from 123 kinship and 88 non-kinship foster mothers of children in state custody. Labour Force Survey and Education Statistics from Statistics Norway were used to compare the kinship sample to the average female population.

Findings: Kinship foster care in Norway is gendered, in that it is women who assume the responsibility for relatives' children. Kinship foster care reflects class differences in that the educational level of kinship foster mothers and their household income are lower than the average female population and of non-kinship foster mothers in Norway. The labour-force participation of kinship foster mothers in Norway is comparable to that of the country's female population in general, except for women aged 35–55 with children under seven, among whom labour-force participation is lower than for the female population.     

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.     

Issues of shared parenting of LGBTQ children and youth in foster care: preparing foster parents for new roles

Foster parents have increasingly assumed new and challenging roles during the past decade. Meeting the developmental, attachment, and grieving needs of children and youth in out of home care is challenging by itself, but can become even more difficult with the issues that arise when the child is lesbian, gay, bisexual, transgender, or questioning (LGBTQ). Preservice and in-service foster parent training programs can strengthen shared parenting skills by focusing on the universal critical issues of safety, well being, and permanence for children and youth in foster care. This article will focus on these skill areas: (1) sharing parenting to promote healthy growth and development of LGBTQ youth in foster care, (2) threats to safety of LGBTQ youth in foster care, and (3) general challenges and strategies for preparing foster parents of LGBTQ youth to build support systems.     

An exploratory study of self-esteem and quality of care of 100 children in foster care

This small-scale research study examined children's perceptions of themselves, their situation, career aspirations and hopes for the future. One hundred San Francisco children in foster care were interviewed and filled out a questionnaire. 50 of the children lived in foster family care; 50 in group homes. The Department of Social Services in San Francisco cooperated in executing this study. Children ranged in ages from 8–18. Both male and female children participated. The questionnaire contained two standarized tests, Coopersmith Self-Esteem Inventory and Parks Career Role Inventory. A section was written by the authors to examine how children in care spend their time, and how they feel about where they live and their foster care status. The last part, an open-ended section asks them which foster care setting they liked best, why, and what they would suggest to improve the foster care system. An additional question “Why do you think you are in foster care?” was designed to elicit the children's understanding of why they lived in foster care rather than their biological home.     

Interjurisdictional placement of children in foster care

As the population of children in foster care has increased and more children are freed for adoption, foster and adoptive families are needed in ever increasing numbers. One avenue for expanding the pool of families is through placement of children with families in other counties and states. This article considers the policy and practice implications of interjurisdictional placement in the context of foster care, adoption, and kinship care and suggests directions for interjurisdictional adoption practice and policy.     

Comparing the health status of low-income children in and out of foster care

Children in foster care face poverty, family dysfunction, neglect, and abuse, with high rates of chronic health, emotional, and developmental problems. This study compared the overall health status of a group of children entering foster care with a group of Medicaid-eligible children living with their parents, matched for age and gender. It identified significantly more health and developmental problems in children in foster care than in the comparison group. Possible contributors to the higher percentage of problems among foster care children may be that the foster children have more problems related to the underlying risk factors resulting in placement, or that the foster care physicians conducted a more comprehensive assessment or had lower clinical thresholds. Further research is necessary to identify and treat the problems of this high-risk group.