Children prenatally exposed to alcohol and other drugs: what the literature tells us about child welfare information sources, policies, and practices to identify and care for children
Many parents who interact with the child welfare system present with substance use issues, which means their children are at risk for prenatal exposure to alcohol and other drugs. Because child welfare agencies play an important role in identifying and providing services to mitigate negative impacts of prenatal exposures, we conducted a search for literature addressing child welfare information sources, policies, and practices related to this population. The search yielded 16 research/evaluation and 16 policy/practice papers, with most addressing exposures to both alcohol and other drugs. The literature most commonly reports that children identified as exposed are referred to child protection agencies during the newborn period. This practice may lead to underidentification, especially of children with prenatal exposure to alcohol. Research suggests that this population is at risk for poorer child welfare outcomes and that there are specific service needs for these children. This review indicates that there is an overall lack of research literature regarding identification of prenatally exposed children involved in the child welfare system that could best inform child welfare policies and practices. Studies investigating how the child welfare system identifies and cares for children with prenatal exposures are needed.
Implementation of Parent Child Interaction Therapy Within Foster Care: An Attempt to Translate an Evidence-Based Program Within a Local Child Welfare Agency
This paper describes an innovative adaptation of an evidence-based intervention - Parent Child Interaction Therapy or PCIT - to foster parent training services. The authors faced multiple problems that commonly plague translational child welfare research as they developed, implemented and tested their model. The paper discusses how the authors addressed these problems when: 1) specifying the child welfare context in which the intervention model was implemented and tested, choosing an intervention model that responded to child welfare service needs, and tailoring the model for a child welfare context; 2) securing external funding and initiating sustainability plans for model uptake; and 3) forging a university-community partnership to overcome logistical and ethical obstacles. Concluding with a summary of promising preliminary study results, a description of future plans to replicate and spread the model, and a distillation of project lessons, the paper suggests that child welfare translational research with PCIT is very promising.
Dual-System Families: Cash Assistance Sequences of Households Involved with Child Welfare
Dual-system families, those involved with the child welfare system and receiving public cash assistance, may be more vulnerable than families only connected to either of the two systems. This study advances our understanding of the heterogeneous and dynamic cash assistance histories of dual-system families in the post-welfare reform era. With merged administrative data from [state name removed] over the period 1998 to 2009, we use cluster analysis to group month-to-month sequences of cash assistance use among households over the 37-month period surrounding child removal. Close to two thirds of families who received any assistance either had a short spell of Temporary Assistance for Needy Families (TANF) or lost TANF. Smaller percentages had steady support. Families who lose assistance are less likely than average to reunify while those who connect to benefits are more likely, suggesting coordination between systems may serve dual-system families well.
Visualizing and Describing Foster Care Placement Pathways
This paper introduces a flowchart-based methodology for describing the movement of foster youth in and out of placements of differing types and durations. This longitudinal methodology is designed to be sufficiently simple to appeal to policymakers and administrators seeking to chart the movement of groups of youth over time and the sequencing of their placements, and sufficiently descriptive to be of use to researchers seeking to predict the placement trajectories of subgroups of foster youth. The paper provides an example of the use of the method drawing upon state administrative data from a large study of preadolescent and adolescent youth in foster care situated in Oregon. Implications for the application of the methodology to different issues of interest to researchers, policymakers, and administrators are discussed.
Infant Temperament and Behavioral Problems: Analysis of High-Risk Infants in Child Welfare
Researchers have demonstrated the association between difficult temperament in infancy and early childhood behavioral problems, but to date this has not been demonstrated in the child welfare population. This study utilized the National Survey of Child and Adolescent Well-Being (NSCAW), a nationally representative, longitudinal survey of children in the child-welfare system. The sample consisted of 1,084 infants 0-12 months old at baseline who were investigated for suspected child abuse. The researchers used longitudinal, multivariable logistic regression to examine the association between difficult temperament score in infants 0-12 months who had child welfare involvement and clinical-range Child Behavior Checklist (CBCL; Achenbach & Rescorla, 2000) score at 36-months-follow-up. Findings from this study suggest that among children with substantiated maltreatment, difficult temperament in infancy predicts early childhood behavioral problems. This relationship persists after adjusting for other risk factors, such as placement, caregiver depression, and family income. The study also discusses implications for child welfare practices.
Technology-Based Smoking Cessation for Youth Exiting Foster Care: A Pilot Randomized Trial
Despite high rates of cigarette use, little attention has been paid to screening and cessation services for youth in foster care. Study aims were to test the feasibility, acceptability, and preliminary efficacy of a technology-based smoking cessation intervention. Study enrollment, satisfaction, and engagement were high in the intervention arm, where readiness to change also significantly increased over time. Intervention and control participants significantly reduced cigarette use at 6-month follow up, though groups did not differ. Technology-based interventions appear to be attractive and offer a potentially scalable link to health care that this vulnerable population may not otherwise seek.
Enhancing Accessibility and Engagement in Evidence-Based Parenting Programs to Reduce Maltreatment: Conversations With Vulnerable Parents
11 focus groups (N = 160) of high-risk parents in Los Angeles County were asked to assess the value of social media to deliver an evidence-based parenting program, Triple P-Positive Parenting Program, to reduce child maltreatment. For feasibility, (N = 238) parents were surveyed regarding their internet use. Parents responded enthusiastically to the online program, and expressed the importance of a sense of community and learning through the experiences of others. 78% of the young, high-poverty, minority parents used the internet. An online evidence-based parenting program delivered in social media could enhance accessibility and engagement of high-risk parents - a powerful tool to reduce child maltreatment.
Evidence-Based Parenting Programs for Maltreating Parents: Views of Child Protective Services Caseworkers
Absorptive capacity in child welfare: A qualitative study with child welfare staff eliciting key factors for evidence-based practice adoption
Child Welfare (CW) provides an array of services to meet the needs of families, requiring agencies to be malleable in their ability to absorb new practices. Absorptive capacity (ACAP) refers to the routines and processes in which an organization acquires, assimilates, and applies new knowledge. ACAP has yet to be the focus of implementation research in CW settings. This exploratory study elicited feedback from CW staff in determining factors to consider when absorbing a new practice. Themes of logistic support, agency culture, and feedback from families emerged. Findings offer insights for CW agencies to consider when adopting a new practice.
Caregiver-relevant perspectives from a multi-stakeholder collaborative advisory board on adapting a child mental health intervention to be delivered in child-welfare settings
Adapting evidence based mental health interventions (EBI) to be provided in child welfare (CW) settings by CW workers could reduce barriers to families receiving mental health care. In order to promote implementation success, the adaptation of EBIs should include the perspectives of those who deliver and those who receive the EBI. The following study uses qualitative methods to elicit and analyze caregiver-relevant perspectives and adaption recommendations from CW stakeholders about the 4Rs and 2Ss Strengthening Families Program, an EBI for youth disruptive behavior disorders, to be implemented in CW settings. Recommendations included adjusting curriculum to better fit the culture of recipients and conveying the importance of openness and respect to providers.
Evaluation of a Brief Foster Parent/ Case Worker Training to Support Relationship Building Skills and Acceptance of LGBTQ+ Youth in Care
LGTBQ+ youth in foster care need unique support and acceptance; however, few case workers and caregivers receive specialized training. To address this, the eLearning was developed. This evaluation assesses whether attitudes and behavioral intentions regarding LGBTQ+ youth improved as a result of this training. Caregivers and child welfare professionals showed growth in many areas, including how important they felt it was to learn strategies and skills to support LGBTQ+ youth, as well as their confidence to care for LGBTQ+ youth. The eLearning is a promising tool for child welfare systems.
Differences in developmental problems between victims of different types of child maltreatment
This study examined differences in developmental problems between children who were victims of two child maltreatment dimensions: abuse versus neglect, and physical versus emotional maltreatment. Family demographics and developmental problems were examined in a clinical sample of 146 Dutch children from families involved in a Multisystemic Therapy - Child Abuse and Neglect treatment trajectory. No differences were found in child behavior problems within the dimension abuse versus neglect. However, more externalizing behavior problems (e.g., aggressive problems) were found in children who experienced physical maltreatment compared to children who experienced emotional maltreatment. Further, more behavior problems (e.g., social problems, attention problems, and trauma symptoms) were found in victims of multitype maltreatment compared to victims of any single-type maltreatment. The results of this study increase the understanding of the impact of child maltreatment poly-victimization, and highlight the value of classifying child maltreatment into physical and emotional maltreatment.
How do academic and career services affect employment, education, and disability benefit receipt in the transition to adulthood for youth with disabilities who have aged out of foster care?
The transition to adulthood is an important process with implications for inequality. Both those with disabilities and those who age of out of foster care are vulnerable during this transition. This project examines the intersection of these groups, exploring employment, education, and disability benefit receipt, the supports these youth receive, and how these supports may mitigate risk in this transition. Findings suggest that those with emotional or mental disabilities face employment risks in the transition to adulthood, and that services may mitigate some of this risk and present unique benefits for youth with disabilities. For example, the odds of employment are greater and the odds of receiving disability benefits are lower among those who receive academic supports (=1.3, ==0.7), post-secondary supports (=1.3, =0.8), education financial assistance (=1.3, =0.7), and career services (=1.3, =0.8). These services should be prioritized for funding, especially education financial assistance as a lower proportion of youth with disabilities receive than their non-disabled peers.
Child Welfare Caseworker Education and Caregiver Behavioral Service Use and Satisfaction with the Caseworker
Social work has long been identified with child welfare, and research has generally found that child welfare caseworkers with a social work degree are better prepared than aseworkers with other degrees. Little knowledge exists though about the relationship between caseworker professional background and caregiver behavioral health service use or their satisfaction with the caseworker. Using data from the National Survey of Child and Adolescent Well-Being, we found no significant relationships between having a social work degree and caregiver use of services or satisfaction with the caseworker. More research is needed to clarify how caseworker characteristics, including professional preparation, influence child welfare outcomes.
Predictors and correlates of unstable housing experiences among a child welfare-involved sample
The study examined whether youth demographics, family factors, and maltreatment type were related to unstable housing and whether unstable housing predicted delinquency and marijuana use. Participants included 216 child welfare-affiliated adolescents (mean age = 18.2 years). Youth with more lifetime residences were more likely to experience unstable housing although Latino youth (compared to White, Black, or multiethnic/biracial) were less likely to experience unstable housing. Unstable housing was associated with subsequent delinquency. Caregiver type (parent vs. relative/unrelated caregiver) was not related to unstable housing, thus homelessness prevention programs should include youth who remain with their parents and those with non-parent caregivers.
Building Analytic Capacity and Statistical Literacy Among Title IV-E MSW Students
Building and sustaining effective child welfare practice requires an infrastructure of social work professionals trained to use data to identify target populations, connect interventions to outcomes, adapt practice to varying contexts and dynamic populations, and assess their own effectiveness. Increasingly, public agencies are implementing models of self-assessment in which administrative data are used to guide and continuously evaluate the implementation of programs and policies. The research curriculum described in the article was developed to provide Title IV-E and other students interested in public child welfare systems with hands-on opportunities to become experienced and "statistically literate" users of aggregated public child welfare data from California's administrative child welfare system, attending to the often missing link between data/research and practice improvement.
Socioeconomic Characteristics of Neighborhoods where Youth in Out-of-Home Care Reside
In the U.S., little is known about the neighborhoods where youth in out-of-home care live prior to emancipation. This study describes the socioeconomic characteristics of such neighborhoods. Addresses for 229 youth aged 16-20 years and residing in out-of-home care in a single Midwest county were used. Addresses were geocoded and linked to U.S. Census' data at the census tract level. Neighborhoods, or tracts, with youth in out-of-home care were significantly more disadvantaged across five area-based socioeconomic indicators. Findings suggest that youth in out-of-home care live in neighborhoods with disproportionately high rates of socioeconomic disadvantage.
Assessing Restrictiveness: A Closer Look at the Foster Care Placements and Perceptions of Youth With and Without Disabilities Aging Out of Care
The aim of the study was to examine the experience of restrictiveness among transition-aged youth with disabilities in foster care. Utilizing a sample of 207 youth, placement types were explored for differences in disability status, race and sex. Further, youth perceptions of restriction around communication, movement around one's home, and access to the community were examined for youth receiving special education services (SPED), youth receiving developmental disability services (DD), and youth without disabilities. Youth with disabilities were more likely to be placed in more restrictive placement types and had significantly higher levels of perceived restriction around communication, movement, and community when compared to youth without disabilities. Additionally, males with disabilities experienced higher levels of restrictiveness, particularly those who received DD services, while White youth with disabilities also experienced greater community restrictiveness.
Supporting disabled parents and their families: perspectives and recommendations from parents, attorneys, and child welfare professionals
While it is well-established that parents with disabilities and their families are over-represented in the child welfare system, no known research has described the parents,' child welfare professionals,' and attorneys' perspectives on the system's capacity to support them or their recommendations for improvement. This qualitative phenomenological study involved semi-structured interviews with 15 disabled parents, 15 child welfare professionals, and 15 parent attorneys. Respondents agreed that the child welfare system lacks expertise on disability and adequate services for disabled parents, and holds negative attitudes about them. Respondents recommended robust training for professionals on parents with disabilities, and individually-tailored services for disabled parents.
Practices Changes in the Child Protection System to Address the Needs of Parents With Cognitive Disabilities
Parents with cognitive disabilities (PCD) are over-represented in the child protection system. However, the current state of the child protection system is not well prepared for working with them. Biases that exist against their parenting, the need for accommodations in assessment and intervention practices, and specific training in staff and cross systems barriers need to be addressed. This paper argues for changes that will ensure such parents are more effectively served and that child protection staff and contract providers are better equipped to work with them. Specific changes are discussed in assessment and intervention practices. These changes will require human capacity building and organizational restructuring. Although empirically based behavioral approaches with PCD will be emphasized, recent empirical work suggests that social information processing and neurocognitive problems occur in PCD. Approaches to working with such problems are emerging and must also be considered and integrated into a blueprint for change.
Analyzing decision-maker's justifications of care orders for newborn children: equal and individualized treatment
Seeking insights into how decision-makers uphold obligations to equal and individualized treatment in decisions about state intervention, this study examines justifications by decision-makers in care orders for newborn children. Eighty-five care order judgments from eight European countries concerning children of mothers who misuse substances are analyzed to determine how decision-makers justify removing a newborn child from their mother's care. I find that the results display similarities in what risk factors they find relevant to these cases, but it differs which are deemed decisive. Protective factors are rarely important. Implications for the US context are commented on.