Changes in first entry to out-of-home care from 1992 to 2012 among children in England

Placement in out-of-home care (OHC) indicates serious childhood adversity and is associated with multiple adverse outcomes. Each year 0.5% of children in England live in OHC but evidence is lacking on the cumulative proportion who enter during childhood and how this varies over time. We measured the proportion of children born between 1992 and 2011 who entered OHC, including variation in rates of entry over time, and explored the determinants of these changes using decomposition methods. We also described changes in placement type, duration and stability. By age 18, 3.3% of children born 1992–94 entered OHC. This proportion varied by ethnicity (1.6% of White vs. 4.5% of Black children born 2001–03 entered OHC by age 9, 95% CI [1.5–1.7] and [4.4–4.6], p < 0.001) and increased over time (0.8% of children born 2009–11 entered OHC by age 1 vs. 0.5% born 1992–94, 95% CI [0.7–0.9] and [0.4–0.6], p < 0.001). This overall increase was driven primarily by the increased rate of entry among White children and not by concurrent changes in the population's ethnic composition. The proportion of children entering OHC in England is increasing and characteristics of the care they receive are changing with earlier intervention and longer, more stable placements. Further research is required to understand the reasons for these changes in practice and whether they are cost-effective, sustainable, and improve outcomes for children and society.     

Toward a further understanding of teachers’ reports of early teacher–child relationships: Examining the roles of behavior appraisals and attributions

This study examined teachers’ reports of early teacher–child relationships by focusing on their assessments of the severity and the causes of children's social behaviors. Eighty-one kindergarten teachers filled out questionnaires about socially inhibited, hyperactive, and average children (n = 237) selected from their own classes. Multilevel analyses indicated that teachers reported less close and more dependent relationships for the inhibited and hyperactive versus the average children, and more conflictual relationships for the hyperactive versus the average children. These differences were largely mediated by teachers’ perceptions of children's personal behavior problems. In addition, we found that the teachers’ control attributions for children's social behaviors increased the link between children's perceived (personal and social) problems and relationship closeness. Results further support the idea that teachers’ relationship reports are personal, evaluative accounts rather than objective measures of teacher–child interactions.     

Factors associated with re-entry to out-of-home care among children in England

Exiting and re-entering out-of-home care (OHC) is considered a disruption to permanence which may have long-lasting, negative consequences for children due to a lack of stability and continuity. Each year approximately one-third of children in OHC in England exit, but information is lacking on rates of re-entries and associated factors. Using national administrative data, we calculated rates of re-entry among children exiting OHC from 2007 to 2012, identified key child and care factors associated with re-entry using Cox proportional hazards modelling, and developed a simple probability calculator to estimate which groups of children are most likely to re-enter OHC within three months. Between 2007 and 2012 re-entries to OHC in England decreased (from 23.3% to 14.4% within one year of exit, p < 0.001), possibly due to concurrent changes in the way children exited OHC. Overall, more than one-third of children exiting OHC in 2008 re-entered within five years (35.3%, N = 4076), but rates of re-entry varied by child and care characteristics including age, ethnicity, mode of exit, and placement stability. Based on these associated factors, we developed a calculator that can estimate the likelihood of rapid re-entry to OHC for a group of children and could be used by social care practitioners or service planners. Our findings provide insight into which groups of children are most likely to re-enter OHC, who may benefit from additional support or ongoing monitoring.     

Rates of meaningful change in the mental health of children in long-term out-of-home care: A seven- to nine-year prospective study

Children residing in long-term out-of-home care have high rates of clinical-level mental health difficulties. However, the stability of these children’s difficulties throughout their time in care is uncertain. This paper reports estimates of the seven- to nine-year stability of carer-reported scores on the Child Behavior Checklist (CBCL) and Assessment Checklists for Children (ACC) and Adolescents (ACA) for 85 children in long-term foster or kinship care. Prospective score changes on the CBCL total problems and ACC-ACA shared-item scales were assigned to one of four change groups: ‘sustained mental health’; ‘meaningful improvement’; ‘no meaningful change’; and ‘meaningful deterioration’. On each of the two measures, more than 60% of children manifested either sustained mental health or meaningful improvement in their mental health, while less than a quarter showed meaningful deterioration. Mean mental health scores for the aggregate sample did not change over the 7–9 year period. Findings discount the presence of a uniform, population-wide effect—suggesting instead, that children’s mental health follows several distinct trajectories. Rather than asking whether long-term care is generally therapeutic or harmful for the development of previously maltreated children, future investigations should focus on the questions “…what are the systemic and interpersonal characteristics of care that promote and sustain children’s psychological development throughout childhood, and what characteristics are developmentally harmful?” and “…for which children is care therapeutic, and for which children is it not?”     

Reactive attachment disorder in looked‐after children

The great majority of children living in foster or residential care have been abused and neglected. Mental health problems are common and the nature of these problems may be rooted in early attachment relationships. The carers of 82 children in care in Scotland and 125 children from local schools completed questionnaires on mental health problems including Reactive Attachment Disorder. More than half (53%) of the children in care fulfilled criteria for mental health problems compared with 13% of the control group, and children living in care scored significantly higher for conduct problems, emotional problems (anxiety and depression), hyperactivity, problems with peer relations and Reactive Attachment Disorder. This has important implications for service development for this vulnerable group of children.     

The emotional and behavioural symptom trajectories of children in long-term out-of-home care in an English local authority

The significant mental health needs of young people in out-of-home care has been well-documented. However, there is little empirical evidence on the timing or development of these difficulties, once these young people have been removed from the maltreatment-environment. Such information may provide useful clinical insight in to how problems develop and persist and whether intervention timings may allow for the prevention of later mental health problems. The current service-data study explored the emotional and behavioural symptom trajectories of 207 young people under the long-term care of a local authority in the South West of England, over their first five years in the care system. Data were extracted from the yearly carer-completed strengths and difficulties questionnaire – providing an index of emotional problems, peer problems, conduct problems and hyperactivity. Trajectories were analysed using growth mixture modelling. For most domains the largest trajectories were chronic symptom profiles, where young people were rated in the abnormal range from their first year in care and remained in this range across the full five years. These young people had significantly more placement moves than their peers on resilient trajectories. There was some evidence that later age of removal was associated with more chronic internalising problems. Overall, findings demonstrate the significant mental health needs of young people in care and particularly highlight that, in many cases, the removal from the adverse environment is simply not enough to expect a young person in care to be resilient to their earlier experiences.     

Repeat reports among cases reported for child neglect: A scoping review

BackgroundIn the United States (US), child welfare policy prioritizes prevention of future harm (e.g., repeat reports) after a report of maltreatment. The majority of reports include some form of child neglect, but no prior review of the recurrence literature has focused on neglect.ObjectiveThis review sought to help guide future research, policy and practice by summarizing recurrence findings related to child neglect with attention to the broader ecological context in which maltreatment occurs.ParticipantsThe final review included 34 US studies of maltreatment recurrence. Twenty-eight studies compared child neglect with at least one other form of maltreatment and six studies examined recurrence among neglect cases.MethodsEleven online databases were searched to locate relevant empirical studies. This review attended specifically to contextualizing findings according to other modifiable factors as well as methodological variation. A scoping review approach was used to summarize findings.ResultsOf the 28 studies comparing neglect to other types of maltreatment, 14 found increased risk for neglect, 12 found no association, and two reported a lower risk. When significant, the effect size ranged from 10% to over three times higher risk for neglect. Poverty or material need was the most commonly included control (15 studies), with two thirds finding that lower resource families had higher risk.ConclusionMethodological variability across studies confounds current ability to guide practice or policy. More research is needed that can replicate and extend findings with comparable samples and model specifications that take into account the regional and policy context.     

“There are carers,and then there are carers who actually care”; Conceptualizations of care among looked after children and care leavers,social workers and carers

BackgroundLooked after children and care leavers (LACCL) are some of the most vulnerable and marginalized young people in our communities. Existing research demonstrates that this group often interprets care in terms of genuineness and tends to feel uncared for. Less work exists from the perspective of social workers and formal carers.ObjectiveThis study aims to explore how care is perceived and practiced among LACCL and those with a duty of care for them. We use a theoretical lens of care ethics to compare and contrast understandings in order to explore how they affect the delivery and receipt of care.Participants & settingThere were 44 participants from four local authorities in north-east England including nineteen LACCL aged 12–20, eight social workers, and nineteen formal carers.MethodTwenty-eight semi-structured 1:1 interviews, four dyad interviews and three focus group interviews.ResultsLACCL desired care that felt familial, went beyond minimum standards and involved understanding. Social workers had to manage LACCL expectations and build relationships by both rationing care according to role constraints whilst sometimes going ‘above and beyond’ statutory care. Carers conceptualized care in terms of dedication and discipline but felt limited in their ability to achieve care in this way.ConclusionBridging different conceptualizations of care is necessary to achieve integrated support for these vulnerable young people whilst also helping them to develop key skills for later adult life. A deeper understanding of frameworks of care has implications for social worker and formal carer training and practice.     

Inclusion of children with special needs in school-age child care programs

From an ecological perspective, the inclusion of children in school-age child care (SACC) requires collaboration among policy makers, educators, parents, and child care providers. Both typically and atypically developing children benefit from inclusive programs, yet they pose challenges for care-givers primarily due to lack of training, resources, and identification of successful inclusive program components. The process of successful SACC inclusion should be at the forefront of human service and research agendas.     

In the interests of the child: psychiatry,adoption, and the emancipation of the single mother and her child – the case of the Netherlands (1945–1970)

ABSTRACT

This paper discusses illegitimacy and single motherhood in the postwar period in the Netherlands from the perspective of what was considered to be in the interests of the child: being adopted by a married couple or being raised by the birthmother. It focuses particularly on the impact of psychiatry and the legalization of adoption in 1956 on the emancipation of the single mother and her child. The paper argues that the release of single motherhood and illegitimacy from the moral-religious stigmata of a “sinful fallen woman” and a “damned” or “degenerated” child has, in the Dutch case, not proceeded as a linear process. The process of emancipation toward proud and independent lone motherhood stagnated in the 1950s and 1960s because, when adoption was legalized, illegitimacy became an issue over which scientists, especially psychiatrists, gained the power of expert control. Guided by dynamic psychology and what they conceived of as the best interests of the child they declared single mothers to be victims of “sociopathology” and, consequently, unfit for motherhood. Adoption became the preferred option. This medicalised approach continued to dominate until the reawakening of feminism in the late 1960s made self-sufficient lone motherhood once more a respectable choice.     

Competence is in the Eye of the Beholder: Perceptions of intellectually disabled child witnesses

This study examines mock jurors’ perceptions of a young witness according to whether or not he was described as having an intellectual disability. Our study examined perceptions of a child witness younger (five or seven years) than previously studied. Mock jurors (n = 71) viewed a short video excerpt of a boy recalling a personally experienced event, and then rated him across nine domains of eyewitness ability. The boy was described as either having an intellectual disability or typically developing. Participants rated the child more negatively on dimensions relating to cognitive competence, but not trustworthiness, when he was presented as having an intellectual disability. Participants also watched the child answer a series of suggestive questions; when described as having an intellectual disability he was rated as less accurate in responding to these. The findings have implications for the involvement of children with intellectual disabilities within the legal system.     

Children's perceptions of national identity in Wales

The project forms part of a larger doctoral study which examines children's perceptions of national identity and its construction and importance in the world of the child in Wales. The research took place in a primary school class in the South Wales valleys, in a class of 27 children aged 7–8 years. Following an introductory activity, children drew a picture of a ‘Welsh person’. They were then interviewed with their artwork about their ideas of national identity in Wales. The initial findings revealed that the young children in this study, contrary to cognitive development theory (Piaget, J., and A.M. Weil. 1951. The development in children of the idea of the homeland and relations to other countries. International Social Science Journal 3: 561–578; Aboud, F., and M. Amato. 2001. Developmental and socialization influences on intergroup bias. In Blackwell handbook of social psychology: Intergroup processes, ed. R. Brown and A. Gaertner, 65–85. Oxford: Blackwell), had a complex and well-developed view of their own national identity. The children were able to consider in some depth, what characterises their concept of the national identity. Children categorised themselves using a range of parameters such as place of birth, parental nationality and current and previous residences. These findings contribute to previous studies in the Welsh context, which have been conducted with older children. The largest self-categorisation group was Welsh but a further interesting factor was that there were more children who categorised themselves as English rather than British.     

The consequences of being labelled ‘looked‐after’: Exploring the educational experiences of looked‐after children and young people in Wales

The educational experiences and attainment of looked‐after children and young people (LACYP) remains an issue of widespread international concern. Within the UK, children and young people in care achieve poorer educational outcomes compared to individuals not in care. Despite proliferation of research documenting the reasons for educational disadvantage amongst this population, there remains limited empirical consideration of the lived experiences of the educational system, as perceived by LACYP themselves. This paper draws upon qualitative research with 67 care‐experienced children and young people in Wales. The sample was aged 6–27 years, and comprised 27 females and 40 males. Participants had experienced a range of care placements. Findings focus on how educational policies and practices alienate LACYP from dominant discourses of educational achievement through assignment of the ‘supported’ subject position, where children and young people are permitted and even encouraged not to succeed academically due to their complex and disrupted home circumstances. However, such diminished expectations are rejected by LACYP, who want to be pushed and challenged in the realisation of their potential. The paper argues that more differentiated understandings of LACYP's aspirations and capabilities need to be embedded into everyday practices, to ensure that effective educational support systems are developed.     

How EPs record the voice of the child

Legislation, literature and research have recently advocated the importance of establishing and representing the views of children and young people. This study aimed to establish how Educational Psychologists (EPs) in one authority ascertain and present children's views in written reports. Content analysis was undertaken on the pupils' view section of 30 Year nine transition reports to determine the themes represented. Additionally focus group interviews helped identify EPs' methods for collecting, selecting and reporting pupils' views, indicating a wide variety of practice. EPs are challenged to explore report writing practices, in terms of representing the voice of the child, within their professional contexts.     

Institutional child abuse in Greece: some preliminary findings

A long-term study on child abuse and neglect in Greece is being carried out at the Institute of Child Health, Athens. A multidisciplinary team is investigating the nature of the problem in Greece, is trying a system of therapeutic intervention to families, is evaluating the adequacy of child protection as it is used in child abuse and neglect, and is examining the efficacy of the law. During a one year period, 5 children cared for in institutions were referred to the program. All were boys. All were children with minor or major handicaps. Two of died from the abusive incident. A study of the circumstances of the injury, and of the conditions in Greek institutions, supports the idea that institutional and family child abuse share many common characteristics. Special mention is made of the Greek circumstances pertaining to child protection and the law.     

Family abduction in a national sample of US children

This study examined the prevalence and characteristics of family abduction episodes occurring in a nationally representative sample of US children ages 0–17. It drew on the experiences of 13,052 children and youth from the aggregation of three cross-sectional waves (2008, 2011, and 2014) of the National Surveys of Children Exposed to Violence. The overall prevalence rate was 4.1% for a lifetime and 1.2% for a past year episode. Rates were higher for younger than older children. Parents constituted 90% of the abductors with females outnumbering males 60% to 40%, although men outnumbered women as perpetrators for certain types of abductions. A bit less than half of the episodes (43%) were reported to police. The experience of a lifetime family abduction had an independent association with traumatic stress symptoms independent of exposure to other kinds of victimization including child maltreatment and witnessing family violence.     

Predictors of quality and child outcomes in family child care settings

Few studies have examined correlates of quality ratings in family child care arrangements. This study analyzes data from a multi-state sample of family child care providers actively seeking professional development for two purposes. First, we examine predictors of observed quality ratings focusing on characteristics of child care providers, the most proximal influences of quality in family child care. Second, we explore associations between three targets of professional development (providers’ attitudes, beliefs, and practices) and the pre-academic and social–emotional skills of preschool-aged children. Provider characteristics indicative of personal and professional resources and stress, as well as providers’ professional attitudes and beliefs, are predictive of observed quality measures. Observed quality and providers’ child-centered beliefs and perceptions of job demands are related to children's developmental outcomes. Implications for future research, policies, and practices are discussed.     

Keeping your audience in mind: applying audience analysis to the design of interactive score reports

Score reports have one or more intended audiences: the people who use the reports to make decisions about test takers, including teachers, administrators, parents and test takers. Attention to audience when designing a score report supports assessment validity by increasing the likelihood that score users will interpret and use assessment results appropriately. Although most design guidelines focus on making score reports understandable to people who are not testing professionals, audiences should be defined by more than just their lack of statistical knowledge. This paper introduces an approach to identifying important audience characteristics for designing computer-based, interactive score reports. Through three examples, we demonstrate how an audience analysis suggests a design pattern, which guides the overall design of a report, as well as design details, such as data representations and scaffolding. We conclude with a research agenda for furthering the use of audience analysis in the design of interactive score reports.