The impacts of accessible child protection services on services, jobs, and families

This multi-faceted study assessed the differences between accessible and central child protection service delivery sites in Ontario on: (1) family functioning; (2) front-line child protection service providers' satisfaction with services; (3) parents' satisfaction with services; (4) the services and supports available to families; (5) front-line service job satisfaction; and (6) front-line helping relationships in child welfare. A quasi-experimental outcome design gathered data from parents at case-opening and approximately 10 months later. Semi-structured individual or group qualitative interviews were conducted with parents, front-line service providers, and supervisors/managers. Information also was gathered from agency files. Front-line service providers completed an employment questionnaire. Findings indicated that the accessible sites were able to foster a greater proportion of cooperative helping relationships with families and to create more service partnerships. Parents at the accessible sites were more positive about their service involvements and more willing to ask for help again in the future. Front-line child protection service providers at both service delivery models described positive aspects of their jobs as well as frustrations with the expectations of the formal child protection system.     

Contrasting perspectives of parents and service providers on respite care in Queensland,Australia

Abstract

Parent-carers need support to continue to care for their child with significant disability in their home. There has, however, been little evidence that respite interventions have consistent or enduring beneficial effects on carer well-being. This article reports the findings of a qualitative study which adopted an Appreciative Inquiry philosophy to interview parent-carers of children with significant intellectual and/or developmental disabilities on how formal support services have helped them maintain their health and well-being, and disability support staff on how they help such parent-carers foster their health and well-being. We conclude that better communication and collaboration between service providers and users, more targeted training of workers, and embracing a person-centred and family-centred approach to respite services are needed. In addition, clearer definition and communication of the scope of respite services are required to best support families of children with significant disability in their home.     

Spirituality in Latino families of children with autism spectrum disorder

Research on Latino parents of children with intellectual and developmental disabilities (IDD) suggests that these parents often use spirituality to conceptualize and to cope with their child’s diagnosis. However, there are no studies that examine religion among Latino parents of children with autism spectrum disorders (ASD). The current study explores how Latino parents of children with ASD incorporate spirituality into their conceptualizations of their child’s disability. In the current study, 34 Latina mothers of children with ASD were interviewed about autism-related services, family characteristics, and cultural beliefs including spiritual beliefs. Thematic analysis of the transcribed interview data relating to spiritual beliefs was conducted for the present study. Most mothers endorsed beliefs that their child with a disability was a message from God. Within this theme, mothers reported beliefs that their child was a blessing from God, a test from God, a sign from God or that the parent was special. Other parents believed that having a child with a disability was not an act of God, but related to biomedical factors, and another group of parents was unsure about the spiritual meaning of their child with a disability. Lastly, some mothers reported that their larger cultural group believed that having a child with a disability was a punishment or a negative sign from God but they markedly rejected that conception. These findings suggest that providers working with Latino families of children with ASD should acknowledge the importance of spirituality for these families.     

Parent-perceived Attitudes of Professionals: Implications for Service Providers

While parents' reactions to a diagnosis of disability in their child have been well documented, less is known of parents' reactions to the professionals who provide the diagnostic and support services used by parents. This study identified four major parameters within which the attitudes of professionals are perceived by parents of children/teenagers diagnosed as intellectually disabled. Comments of the 131 mothers and fathers interviewed helped to shed light on what they have expected of service providers, and suggest adjustments that may need to be made by professionals to the attitudes they convey in interaction with parents.     

Child care improvement on a shoestring: evaluating a low-cost approach to improving the availability of quality child care

The Philadelphia Early Childhood Collaborative (the Collaborative) was designed to improve the quality of child care by increasing coordination among organizations that locally deliver professional resources to child care providers. The evaluation examined the implementation of the Collaborative, utilization of its services, and the impact of service use on child care quality. Child care providers reported gains in their professional knowledge and behavior from using Collaborative resources and rated the resources highly. No long-term effects on provider behavior, knowledge, or attitudes were observed. Although the original organizations were able to function collaboratively and Collaborative services were widely used, more intensive interventions may be required to change the availability of quality child care.     

Transition without status: the experience of youth leaving care without Canadian citizenship

The origins of the project reviewed in this chapter lie in discussions with a Toronto agency that has a mandate to serve youth in transition from the care of the Children's Aid Society. This service system, also known in various jurisdictions as child welfare, child protection, or foster care, includes among its clients children and youth who are living in Canada without legal Canadian status. This could have occurred because the child arrived alone and was taken into care on arrival or because the child arrived with a family but was taken into care before status was obtained. While the child is in care, this lack of status is relatively inconsequential in that health, educational, and other services are provided through the Children's Aid Societies. Once the transition is made from care, the youth's vulnerability increases dramatically if legal status has not been obtained. Health services, educational opportunities, and legal employment are often beyond reach, and the youth is subject to deportation. The major objectives of the project were to explore the national and international literature to discover the dimensions of this issue, interview youth and service providers to gain insight into their experience, and discover ways to minimize the number of youth who leave care without having obtained status.     

Perceived Needs of Therapeutic Service Providers in Their Work with Families in the Child Welfare System

Each year approximately half a million children are identified as victims of abuse or neglect in the United States. Referrals to therapeutic service providers are a primary means to help alleviate risks leading to child maltreatment and promote child and family well-being, yet it is not clear how well therapeutic service providers are prepared to meet the specialized needs of a child welfare client population and/or navigate the contextual characteristics of child welfare practice. The purpose of this study was to assess the gaps in knowledge and skill among therapeutic service providers working in this specific service setting. Five focus groups were conducted with 40 current therapeutic service providers working with clients involved with state child protective services. Data were analyzed using conventional content analysis methods. Fifteen themes emerged and were organized into three primary categories of needed knowledge and skill development: (1) cross-system, (2) therapeutic, and (3) functional. Implications for training and practice are discussed, as well as directions for future research.     

Comparing Service Use of Early Head Start Families of Children With and Without Disabilities

The current study compared patterns of service utilization reported by Early Head Start (EHS) families of children with and without disabilities by secondary analysis of data from the longitudinal investigation of the effectiveness of EHS. Findings reveal comparable positive trends for both groups of families for receipt of services corresponding to EHS performance standards promoting child and family development, family support, and health care. Service challenges remain in the low use of dental services overall and the higher use of acute health care services for children with disabilities. Future research should examine causes and outcomes of service use.     

Family-centered child welfare services: new life for a historic idea

The recent emphasis on permanency planning in child welfare has strengthened the resolve of policy makers and service providers to serve the families of dependent children better. Permanency planning asks child welfare services either to reunite children in care with their families of origin or to find permanent substitute families for children, but the goal of a permanent family for every child has been much easier to articulate than it has been to achieve.     

Child Aware Practice in Adult Social Services: A Scoping Review

The development of “child aware” practice is about the capacity and capability of adult health and social service providers to identify and respond to the needs of children. A scoping review of the literature considered five adult adversities associated with family stress and reduced parenting capacity: mental illness, alcohol and substance abuse, homelessness, intellectual disability, and domestic violence. Although there are specific needs for children pertaining to particular adversities, there was substantial commonality of potential effects. These included emotional and psychological difficulties, physical and mental health problems, academic difficulties, language delays, peer difficulties, stigma, trauma reactions, loss and grief, instability, and social exclusion. How children react to difficulties in their family depends upon various protective factors, a child's frame of reference, and other dynamics within the family that can offset risks. The findings aim to inform policy, program development, and practice in adult social services, enhancing their responsiveness to children.     

Facilitating Mental Health Service Use for Caregivers: Referral Strategies among Child Welfare Caseworkers

Unmet needs for mental health care are common among caregivers involved in the child welfare system. Although child welfare caseworkers are well positioned to identify service needs and refer caregivers to treatment, little is known about the types of referral strategies used in practice, or their effectiveness for promoting mental health service use. The current study examined child welfare caseworkers' use of different referral strategies and the extent to which these strategies are associated with caregivers' receipt of mental health services within a national sample of child welfare cases. Analyses of the second cohort of families from the National Survey of Child and Adolescent Well-Being suggest that child welfare workers more often use informational strategies for referring caregivers, including suggesting treatment or providing information about treatment options. However, social referral strategies such as providing caregivers with direct assistance in completing applications and making and attending appointments were associated with a greater likelihood of caregivers receiving mental health services. Findings support evidence from other service contexts that service use is facilitated by caseworkers' direct support for arranging services. Implications for research and for child welfare managers and administrators are discussed.     

Characterizing the systems of support for families of children with disabilities: A review of the literature

ABSTRACT

During early childhood, children require major support that is tailored toward their specific needs. For children with disabilities, families play a crucial part in providing the needed services. However, families often lack the knowledge, resources, and skills that would help them in overcoming challenges that arise while raising a child with disability. Although much research has focused on defining the needs of families with children with disabilities and the impact of disability on the family system, many questions remain. A comprehensive perspective is needed to identify the types of support families provide to the child with a disability, the impact of providing that support on family members, the support systems that are available to families, and the impact of support on society. This review consolidates the empirical research to date on family support during early childhood and outlines areas of research that need further exploration.     

Restructuring Human Services in Canada: commodification of disability

The human service system in Canada has undergone significant changes as a result of the dismantling of provisions that were once in place to ensure access to services by society's more vulnerable citizens. This paper draws on a cross-Canada examination of services to adults with developmental disabilities to report on the response of service providers in this time of turbulence. Qualitative analysis provides insight into the ways in which services have responded to shrinking budgets. Without leadership and lacking a social policy framework from senior levels of governments, the changing face of human services has been accompanied by the arrival of a new market-orientated service provider group that has deepened the commodification of disability. The examination concludes with the introduction of an approach to support which resists the trend toward commodification and re-establishes the social good, allowing the individual with a disability the right to participate more fully in community life alongside other members of society.     

From symptom recognition to services: how South Asian Muslim immigrant families navigate autism

This study examined the experiences of three South Asian Muslim immigrant families who have a young child with autism. It describes the early period of their child’s disability as the families encountered four critical issues in their lives: a complex disability, the culturally diverse conceptualizations of the disability, family‐professional dynamics in cross‐cultural encounters and the search for appropriate services. Analyses were based on interviews with parents, supplemented by 17 months of participant‐observation in homes and community. Parents narrated their experiences beginning with symptom recognition through help seeking, diagnosis and subsequent service provision. Results suggest that for these families the challenging process of diagnosing and ameliorating autism is complicated by their unique positioning within and between diverse meaning systems. Challenges include American health and education professionals’ misunderstandings of their family organization and linguistic practices, and difficulties in cross‐cultural communication with professionals. Implications for professionals are discussed.     

Cultural and religious influences in maternal response to intrafamilial child sexual abuse:charting new territory for research and treatment

The role of culture when providing services for families in the wake of child sexual abuse disclosure is a charged issue although surprisingly little attention has been given in the research literature to this. This article reports the findings of a grounded theory study exploring facets of maternal response, and aspects of more and less supportive responses, to children who were sexually abused by the mother's intimate partner. Ten mothers, chosen on the basis of theoretical sampling, provided information through in-depth interviews to understand how they responded emotionally and behaviourally to their child's disclosure. As well, three service providers were interviewed as key informants. The research revealed cultural and religious influences as affecting how mothers made meaning of the sexual abuse and the actions they took. Mothers from cultural backgrounds that adhere to rigid patriarchal norms identified themes of intense value conflicts regarding family preservation, loyalty binds between the perpetrating partner and child victim, and anxieties around being alienated from their extended family and ethnic community. They also reported that their cultural belief systems were not well understood by service providers. In parallel, helping professionals identified cultural issues as presenting barriers for engaging with some clients. Practice implications and research directions are discussed.     

Pediatric Bipolar Disorder: The Child Psychiatrist Perspective

This study’s objectives were to gain insight into reasons for the considerable rise in pediatric bipolar disorder (PBD) and what impact the new diagnosis of disruptive mood dysregulation disorder (DMDD) may have on child psychiatric treatment. A purposive sample of 10 child psychiatrists was interviewed for this qualitative study. Interviews were transcribed and coded for themes. Participants believe that PBD is often misdiagnosed and overdiagnosed, though their understandings of the reasons behind this vary. The majority attribute it to providers trying to help children who need services but do not fit a diagnostic category, and undertrained professionals diagnosing children. Most see DMDD as positive, though opinions on how it might impact children and treatment vary. All see family as vital in the treatment process. Participants in this exploratory study support a team approach and social workers have a key role as part of this team.     

Policies supporting participation in leisure activities for children and youth with disabilities in Canada: from policy to play

Children with disabilities are at risk for lower participation in leisure. This study maps and analyzes disability-related leisure policies in Canada. Policy mapping and analysis were performed based on scope, social justice, disability models, and use of evidence. Few policies use scientific evidence, and their scope in supporting participation is often limited to organized sports, transportation, and financial incentives/exemptions. Few policies exist to support leisure promotion for children with disabilities. Action plans, benchmarking, and uptake measurement are rarely identified. Research-based evidence can be used to support socially-just policies to promote participation in leisure. Families should be able to identify mechanisms to guarantee access to their rights. Researchers, service providers, and families can use this framework of policy mapping and analysis to identify gaps where evidence can support policy development, to use these policies where services are needed, and to foster participation of children with disabilities in leisure.     

Responding to Adolescent Violence in the Home – A Community Mental Health Approach

Family violence perpetrated by adults is increasingly understood as a health issue, and we argue that this pertains even more strongly to violence by adolescents. The co-dependence of the parent–child bond, lack of maturity in the adolescent, and often related issues of disability or mental illness make these young people both complex and also vulnerable. This research paper reviews the current literature relating to adolescent violence in the home, identifies known best practice, and evaluates the importance of taking a family-focused, therapeutic approach to adolescent family violence, in place of a punitive one. It describes the use of a co-design workshop to unpack gaps in service provision and develop a potential family focused model of care to address the needs both of young people who use violence, and their families. The findings indicate that an inclusive family approach is a key element in addressing adolescent violence in the home across a spectrum of behaviours and mental health care needs. The use of a coordinated, family-inclusive response through mental health care services is recommended to address the complexity of this issue, as well as to provide support both to adolescents and to their families and carers.     

The child in family services: expanding child abuse prevention

Child welfare concerns have drifted to an inappropriate focus on crisis intervention and a punitive approach to child protection intervention at the expense of community-based preventive child welfare programs. Recent attempts to divert cases from the child protection system through differentiated response mechanisms have been criticised for failing to provide access to relevant services or preventing vulnerable families from re-entering the child protection process. A tension inherent in providing both child protection and family support within the one agency is also identified as a barrier to effective service delivery. This paper discusses the value of the UK Children in Need approach as a model for enhancing support to children and families outside the statutory child protection system. Information from an evaluation of a trial implementation of the UK Children in Need approach in Victoria is used to discuss the implications for policy and practice of placing responsibility for coordinating a response based on the needs of children and their families within family support services.     

Peer mentoring services,opportunities, and outcomes for child welfare families with substance use disorders

Peer recovery support services (PRSS) in child welfare are being provided by peer mentors in sustained recovery from substance use disorders (SUD) to parents with acute SUD. Previous retrospective interviews demonstrate that peer mentors engage parents in family-centered systems of care through relationships and empowerment. However, the specific profile of services provided is unknown. Personnel challenges and opportunities for persons in recovery serving as peer mentors are described in the literature without understanding the frequency of both. As enthusiasm for hiring peer mentors grows, it is important to understand the specific services provided, the risks and opportunities associated with hiring individuals in recovery, and the impact of mentor services on outcomes. This knowledge can assist in developing training, implementation guides, policies, job expectations, and program evaluation strategies. This is a prospective study of 28 family mentors providing PRSS services to 783 families with child maltreatment and parental SUD over 8 years in a family-centered integrated program with SUD treatment providers. We describe mentor services overall, during the early engagement period, in rural and urban settings, and test the association between services and child/parent unification status at case closure; we identify the proportion of peer mentors that experienced employment challenges and career advancement opportunities. Results demonstrate the complexity of service provision overall and in differing contexts. Face to face visits with children were associated with greater likelihood of parent/child unification at case closure and 64.3% of peer mentors experienced career advancement opportunities. The implications of these findings are discussed.