When children cannot remain home: foster family care and kinship care

Despite the best efforts of child welfare agencies, community agencies, and individuals, some children are not safe in their homes and must be placed in substitute care settings by child welfare authorities. Increasingly, as this article points out, child welfare agencies are placing children in the homes of their relatives rather than in traditional foster family homes (31% of all children in out-of-home care in the early 1990s were living with kin). This article discusses how such factors as the availability of foster homes, the demand for foster care, attitudes toward the extended families of troubled parents, and policies regarding payment for the costs of care have contributed to the rapid growth in kinship foster care. It discusses differences in the personal characteristics of kin and traditional foster parents and in the supports provided to the caregivers by child welfare agencies. Research findings suggest that kinship homes can promote the child welfare goals of protecting children and supporting families, but they are less likely to facilitate the prompt achievement of legal permanence for children. To forge a coherent policy toward kinship caregivers, officials must balance the natural strengths of informal, private exchanges among family members with the power of government agencies to provide both resources and oversight.     

Understanding the mental health needs of children and adolescents in residential treatment.

With the penetration of managed care approaches in child welfare, residential treatment services have come under increased scrutiny. In these circumstances it is critical to understand the clinically indicated use of these expensive interventions. As part of a community-reinvestment strategy of reform within a state child welfare agency, a needs-based assessment of children and adolescents was undertaken. A review of cases revealed that although the level of mental health need for many was significant, a substantial proportion of children in residential placement were not at high levels of risk. On the basis of these data, a process of placement review was designed and implemented for more effective use of residential treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A multilevel analysis of whole family functioning using the McMaster Family Assessment Device.

This study demonstrates the use of multilevel modeling to examine influences on ratings of whole family functioning collected from multiple family members (N=26,614) living in 11,023 families with 1 or more dependent children aged 0 to 24 years. Results indicate that 45.7% of the variance in ratings of whole family functioning was shared among family members, whereas 54.3% was nonshared. Family-level characteristics, such as socioeconomic status (SES), family structure and composition, and family well-being, accounted for 30.6% of between-family variation (i.e., shared perceptions). Individual-level characteristics, such as sex, age, dependent child status, education, and well-being, accounted for 5.6% of within-family variance (i.e., unique perceptions). There was significant between-family variation in the relationship between dependent child status and ratings of family functioning, and increased rating discrepancies among members of the same family were linked with higher levels of family SES. The findings attest to the validity of measuring whole family functioning directly from self-report ratings provided from multiple family members. However, caution is warranted when assessments are available only from single respondents. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Family-centered services: approaches and effectiveness

Much of the emphasis in the nation's system of child protection focuses on investigations to determine whether child abuse or neglect has occurred, and procedures for arranging out-of-home care for children who are not safe at home. Less attention often goes to the capacity of public and private agencies to provide services that help stressed families prevent child maltreatment before it begins, or that enable families with serious child-rearing problems to stabilize the home and provide more appropriate care for their children. This article examines the current understanding of the most promising and effective means of serving families. It highlights the family-centered service approach, which encompasses family support services for families coping with normal parenting stresses, and family preservation services designed to help families facing serious problems and possible out-of-home placement. The article explains the characteristics of family support and family preservation services, and discusses how these services are accessed and financed. It reviews available evaluation findings regarding the effectiveness of the two types of family-centered services, and considers the challenges faced when evaluating such services. Finally, the article discusses issues related to planning and service delivery, such as coordination and system reform, financing, targeting, relationships between workers and families, and efforts to strengthen entire communities.     

In-home treatment of abusive families: Cost and placement at one year.

Evaluated a child-abuse prevention project designed to keep abused children safely at home. In-home prevention services were provided to 59 children in 26 families referred by county child protective services as an alternative to out-of-home placement. Therapists, carrying a caseload of 2 families each, provided intensive treatment in the families' homes for 4–6 wks. A comparison group of 24 child protective service referred families, with 49 children, received usual county services. A 1-yr follow-up evaluated the 2 groups on cost, on whether or not the children stayed at home, and on psychological measures of family functioning. Results indicate that the goals of reducing out-of-home placement and lowering placement costs were being met. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Economic and social vulnerability of Latino children and families by subgroup: implications for child welfare

Approximately 40% of all Latinos are under the age of 20, and close to one-third of all Latino children live in poverty. The Latino population varies considerably, however, a factor that is frequently obscured by data collection methods that either view Latinos collectively or fail to differentiate Latinos at all from within racial groups. This articles describes the social, economic, and family structure variables that place specific Latino subgroups at risk, synthesizes available data on Latino children in the child welfare system, and discusses a direction for research and practice in developing ethnic-specific child welfare policy for vulnerable Latino groups. The authors conclude that services to strengthen families have to promote economic as well as social integration within society and have to consider the unique characteristics of each Latino community.     

Korean children's concepts of adult and peer authority and moral reasoning.

This study examined Korean children's judgments about authority commands regarding moral events bearing on property rights (dealing with lost property), distributive justice (sharing candy), and public welfare (disposing of trash). Sixty children from the 1st, 3rd, and 5th grades were presented with story variations in which an individual intervened, giving a command to children, or in which 2 different persons gave opposing commands. At all ages, children judged that a principal, a teacher, a class president, and a child who held no position of authority have legitimacy and should be obeyed when giving directives considered morally right. Children also accorded greater legitimacy to persons giving commands consistent with moral demands (a teacher, a class president, or a child with no position of authority) over a principal's command contrary to the moral evaluation. Justifications for their choices were based on rights, sharing, and welfare. The findings showed that Korean children do not take a unilateral orientation to adult authorities or unquestioningly accept authority directives. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Permanency outcomes in kinship care: a study of children placed in kinship care in Erie County, New York

This article describes a longitudinal study of permanency planning for all of the 525 children placed in kinship foster care in Erie County, New York, in 1991. The study describes the length of time the children spent in care, the discharge destinations for the children discharged prior to October, 1995, and the discharge goal at the time of the study for the remaining children. The study showed that many children were adopted by their kin or were living with kin with the goal of adoption. This article also discusses a new approach, "Kinship Options," being developed by the Erie County Department of Social Services to assure permanent family connections for children who come into contact with the child welfare system.     

Placement shift, sibling relationship quality, and child outcomes in foster care: A controlled study.

Sibling unity during family transitions is considered a protective factor for child behavior problems, but there is little empirical support for the widespread child protection policy of placing siblings together in foster care. In a prospective study of 156 maltreated children, siblings were classified in 1 of 3 placement groups: continuously together (n = 110), continuously apart (n = 22), and disrupted placement (siblings placed together were separated; n = 24). Changes in child adjustment as a function of sibling relationship and placement group were examined. Sibling positivity predicted lower child problems at follow-up (about 14 months later), while sibling negativity predicted higher child problems. Placement group did not affect child behavior problems at follow-up; however, compared to siblings in continuous placement (either together or apart), siblings in disrupted placement with high initial behavior problems were rated as having fewer problems at follow-up, while siblings in disrupted placement with low initial behavior problems were rated as having more problems at follow-up. These findings highlight the importance of considering relationships between siblings and the risk that one poses to another before early placement decisions are made. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The forgotten parent: understanding the forces that influence incarcerated fathers' relationships with their children

Fathers who are in prisons and jails are not just convicts--they are parents as well. The family roles and responsibilities of incarcerated fathers, however, are seldom the focus of institutional policies, scholarly research, or child welfare services. This article examines the issues that must be addressed in designing policies and providing services that promote the maintenance of parent-child bonds and responsible parenting when fathers are incarcerated. It describes the family roles and structures of men in prison and looks at differences between public perceptions and the real-life experiences of prisoner parents. The ways in which correctional policies and child welfare practices influence and shape fathers' parenting abilities and father-child relationships are discussed, and strategies for creating a supportive environment for fathers and their children and families are proposed.     

Welfare policies and very young children: Experimental data on stage-environment fit.

The authors examined the effects of welfare programs that increased maternal employment and family income on the development of very young children using data from 5 random-assignment experiments. The children were 6 months to 3 years old when their mothers entered the programs; cognitive and behavioral outcomes were measured 2?5 years later. While there were no overall program impacts, positive or negative, on the development of children in this age group, there was a pair of domain- and age-specific effects: The programs decreased positive social behavior among 1-year-olds and increased school achievement among 2-year-olds. After exploring several explanations for these results, the authors suggest that the contextual changes engendered by the programs, including children's exposure to center-based child care, interacted differentially with specific developmental transitions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Child Well-Being in an Era of Welfare Reform: The Sensitivity of Transitions in Development to Policy Change.

This study examined the age-specific pattern of effects of welfare policies on child achievement. Drawing from 7 random-assignment welfare and antipoverty evaluations that provided more than 30,000 observations of children's achievement, this study found that times of developmental transition are the only periods sensitive to the changes in families brought about by these policies. More specifically, small positive effects of welfare and antipoverty policies were found for children making the transition into middle childhood, and small negative effects of these same policies were found for children making the transition out of middle childhood and into early adolescence. Effects were robust across various program groupings and could not be attributed to family characteristics that differ for children of different ages. This research informs the understanding of how changes in employment and income for low-income parents affect development across childhood. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Examination of preventive interventions for families with depression: evidence of change

Thirty-seven families who had a child between the ages of 8 and 15 (mean age = 12.0 years) and had at least one parent, who had experienced a recent episode of affective disorder were assigned randomly to one of two psychoeducational interventions. The interventions (clinician-facilitated or lecture-group discussion) were designed to prevent childhood depression and related problems through decreasing the impact of related risk factors and encouraging resiliency-promoting behaviors and attitudes. They were similar in content but differed in the level of the children's involvement and the degree to which the families' individual life experiences were linked to the educational material. Assessments included standard diagnostic and social functioning instruments and interviews designed specifically for this project to assess behavior and attitude change. Each parent and child was individually assessed by separate assessors who were blind to information about the other family members. Parent participants in both groups reported being satisfied with the intervention. Clinician group participants reported a significantly larger number of overall changes, as well as higher levels of change regarding communications about the illness with their children and increased understanding by the children of their illness. Significantly more children in the clinician group also reported they gained a better understanding of parental affective illness as a result of their participation in the project.     

Nonmaternal care in infancy and emotional/behavioral difficulties at 4 years old: Moderation by family risk characteristics.

The authors examined the role of familial risk and child characteristics in the association between the type of child care in infancy (maternal care [MC]) versus nonmaternal care [NMC]) and emotional/behavioral difficulties at 4 years old. Canadian families (N=1,358) with children between 1 and 12 months old were followed over 4 years. Family risks were found to moderate the association between type of child care and physical aggression. MC in infancy was associated with lower levels of physical aggression among children from a low-risk family background but not among those from a high-risk family background. The effect size was small (d=-0.16; confidence interval [CI]=-0.3, -0.01). Family risk and the sex of the child moderated the association between child care and emotional problems. MC in infancy was associated with a lower level of emotional difficulties among girls from low-risk families but not among boys or among children from high-risk families. The effect size was moderate (d=-0.44; CI=-0.65, -0.23). The study indicates that the effect of child care type in infancy varies by family and child characteristics. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

"Don''t know" responses in surveys: is what I know what you want to know and do I want you to know it?

The authors present finding from their study of a placement prevention program designed to facilitate addiction treatment for substance-abusing mothers and other primary caregivers reported for child maltreatment. Relationships between involvement in the program, the status of addiction treatment, and the variety of outcomes for caregivers and their children were tested. Findings indicate that nearly half of the participants were able to complete addiction treatment and achieve sobriety. Those who used the program's child day care component were three times more likely to complete treatment. Implications for confronting the problem of substance-abusing caregivers in the child welfare system are drawn.     

Racial distinctions in the psychosocial histories of incarcerated youth.

This study examined the psychosocial histories of 134 male, juvenile offenders, focusing on race and the probability of being diagnosed with internalizing and/or externalizing psychological disorders at the time of their sentencing to a correctional institution for committing serious and violent crimes as minors. In addition, based on case file information, the author investigated offenders' histories with child maltreatment, court-ordered probation, and counseling services received as part of the child welfare and/or juvenile justice system. Results from logistic regression analyses indicated the probability for White youth to be diagnosed with internalizing disorders was over 19 times that of Black youth; however, rates of externalizing disorders were similar across groups. Although maltreatment histories were comparable based on race, White youth received more counseling services, were significantly older at the time of diagnosis, and were more likely to be diagnosed with internalizing and comorbid disorders. Issues regarding multicultural assessment in the child welfare and juvenile justice system are discussed, specifically highlighting the potential for attributional bias in the diagnostic and treatment recommendation process. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Child abuse: why should I report it?

In Indiana, dental professionals are mandated by law to report suspected child abuse and neglect to Child Protective Services (CPS) or the law enforcement agency in their county. The penalty for non-reporting is fine and/or jail. This article will give dental professionals information on child abuse injuries that can be identified in the dental office, how to talk to the child and family members regarding suspicions, and how to report those suspicions to your local CPS or law enforcement agency. Dental professionals will receive reassurance and encouragement from this article to report suspected cases of child abuse to CPS or law enforcement. The report is not meant to be punitive, but is intended to get the family connected to services to assist them, the child, and any other children they have or may have in the future, to avoid further abuse, and to attempt to break the cycle of abuse. To report suspicions of child abuse in Indiana, dial: 1-800-800-5556.     

Therapeutic jurisprudence and preventive law in child welfare proceedings: A family systems approach.

The field of child welfare law exemplifies opportunities and challenges facing the proponents of therapeutic jurisprudence (TJ) and preventive law (PL). The field has held itself out as promoting a therapeutic standard and goal for children, and it explicitly embraces a psychological PL theory. Nevertheless, it has failed to embrace contemporary mental health thinking about children and families (family systems theory) and reflects an outmoded, psychoanalytic, medical model that has contributed to an antitherapeutic child welfare system inconsistent with PL principles. Adopting a family systems approach requires a paradigm shift toward respecting and empowering the family as a unit. This approach is consistent with TJ/PL principles and provides a better fit between the legal system and social reality. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

The experiences of Sudanese unaccompanied minors in foster care.

Sudanese unaccompanied minors were separated from their parents in childhood and lived apart from their families in refugee camps for close to a decade before being resettled in the United States. This phenomenological study examines the refugees’ experiences of living in American foster families after living in peer groups in the camps. Interviews with 18 young adults, 7 years after resettlement, revealed that nearly all of the youth struggled with parental authority initially, and nearly half of them changed placements because of relationship difficulties with their foster parents. Misunderstandings based on cultural differences often exacerbated conflicts. However, 15 of 18 youth currently had a positive relationship with at least 1 foster parent, sometimes with a parent from their second or third placement. Changing foster families is often considered a failure in the child welfare system, but several Sudanese youth reported that having supportive relationships helped them during the acculturation process whether those relationships developed during the first or last placement. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The moral challenge of children at risk: protective policies and pediatrics. A report of the Children's Services, Inc. Task Force of Greater Cleveland

Social workers and pediatricians are among the professionals who share a society-wide concern with current public policies regarding the placement of children at extreme risk. A healthcare professional may successfully treat a child, only to learn later that this same child was the victim of a tragic incident of domestic violence after returning home. Such events are not uncommon, create considerable frustration for pediatricians, and demand an integrated interprofessional and interdisciplinary response. This report emerged from 6 months of task force dialogue with leaders of children's services programs, healthcare professionals, clergy, ethicists, and other community leaders in one major urban environment. It indicates innovative directions in children's protective services with regard to family preservation, foster care, residential care, and adoption. The latter two options could be used much more creatively than is the case currently. The report also asserts that far too few resources are being directed to this problem area.