Dimensions of maltreatment and academic outcomes for youth in foster care

Childhood maltreatment is often associated with youth’s ability to successfully function in school. Youth with a history of maltreatment often receive lower grades and scores on tests of academic achievement, as well as demonstrate more negative behaviors in school, as compared to non-maltreated youth. However, there are many inconsistencies in previous studies examining the association between maltreatment and academic outcomes in youth. One potential reason for mixed findings within the literature could be a result of how maltreatment is measured and operationalized. The current study examined if the methods used to define and describe maltreatment contribute to the association between maltreatment and academic functioning in youth. Youth in foster care (N = 490, M_age = 13.13[3.09]) were recruited and information on their maltreatment history and academic functioning was obtained from official agencies, school records, and self-reported measures. Using a SEM framework when examining each dimension separately in the same model, results suggested that frequency maltreatment was more predictive of academic behavior, as compared to type and severity. No dimensions were associated with grades and significant findings were only observed for models using self-report data. However, when examined using a measurement model approach, maltreatment as a whole was associated with school behavior, which was found for both self-report and case file measurement models. The findings suggest a need for research on academic functioning to take a comprehensive approach when measuring and defining maltreatment as this may be a more robust and accurate predictor of academic functioning.     

Temperamental sensitivity to early maltreatment and later family cohesion for externalizing behaviors in youth adopted from foster care

Children in foster care frequently have histories of physical/sexual abuse and neglect, increasing their risk for externalizing behaviors (EB; e.g., aggression). According to the differential susceptibility theory, children with reactive temperaments (e.g., negative emotionality) may be particularly vulnerable to early maltreatment, but may also benefit the most from environmental enrichment such as family cohesion. In a high-risk longitudinal sample of 82 children adopted from foster care in Los Angeles County from 1996 and 2001, we examined predictions of EB from childhood to adolescence/young adulthood from temperament, preadoption maltreatment, and adoptive family cohesion. Overall, results from generalized linear models and generalized estimating equations (GEE) did not support differential susceptibility theory – specifically, youth with early reactive temperament did not exhibit heightened sensitivity to maltreatment nor to later adoptive family cohesion. Instead, reactive temperament was associated with higher EB at initial adoptive placement and escalating EB across childhood, controlling for age, gender, race-ethnicity, preadoption maltreatment, and adoptive family cohesion. Preadoption maltreatment history was unrelated to baseline EB, although sexual abuse history predicted escalating childhood EB post-adoption, whereas exposure to family violence (e.g., domestic violence) inversely predicted EB over time. By late adolescence/young adulthood 11–15 years post-adoption, rates of arrest and substance use in this sample were relatively comparable to normative populations of youth, although older age of adoption predicted more substance use in late adolescence/young adulthood. Findings highlight early reactive temperament and preadoption maltreatment as important risk factors to target for ameliorating patterns of EB growth in the first few years of adoption.     

The relation between dimensions of maltreatment,placement instability,and mental health among youth in foster care

Youth in foster care with maltreatment experiences often demonstrate higher rates of mental and behavioral health problems compared to youth in the general population as well as maltreated youth who remain at home. Previous research has demonstrated that dimensions of maltreatment (type, frequency, and severity) and placement instability are two prominent factors that account for high rates of psychopathology (e.g., depression, anxiety, and disruptive behavior disorders). The present study sought to clarify the relation between maltreatment and mental health among youth in foster care by studying both the isolated dimensions of maltreatment and cumulative maltreatment, and to determine whether the effects of maltreatment on mental health operated indirectly through placement instability. Information on youth in foster care’s (N = 496, M_age = 13.14) mental and behavioral health, maltreatment history, and placement changes were obtained from state records and primary caregivers. Using a SEM framework, the results suggest that maltreatment and placement instability each independently relate to mental and behavioral health problems. Further, none of the maltreatment types predicted greater placement instability in the current models. These findings suggest that placement stability is critical for mental health for youth in foster care, regardless of the type, severity, or frequency of their maltreatment experiences. Results also indicated that, although cumulative maltreatment predicted both internalizing and externalizing symptoms, maltreatment frequency and severity had direct relations to externalizing symptoms only. These findings underscore the utility of comprehensive maltreatment assessment, encouraging researchers and clinicians to assess and carefully consider the relation between maltreatment dimensions and outcomes.     

Coping styles in youth exposed to maltreatment: Longitudinal patterns reported by youth in foster care

Coping styles in youth living in foster care with a history of maltreatment were examined to determine the nature and stability of self-reported coping behavior over time. Participants included 542 (time 1), 377 (time 2), and 299 (time 3) youth ages 8–22 years (M = 13.28 years, SD = 3.04). Using the Behavioral Inventory of Strategic Control, a dimensional, continuous measure of coping, across four possible coping styles endorsed in reference to specific potentially stressful situations, the results indicated that direct action coping was the most frequently endorsed or preferred style for more than 50% of the sample at each time point. A number of youth endorsed using more than one coping style, indicating some flexibility in the approach to coping when problems occur. Although most youth endorsed a preferred style, coping style endorsed did vary somewhat over time. The coping style endorsed also varied depending on the type of problem referenced, but no statistically significant differences were noted across situations, including social, academic, general, and foster-specific situations. Effects for age were also examined and the results indicated no significant differences across the age range for type of coping most commonly endorsed. The present study is the first large-scale, longitudinal assessment of coping styles in youth in foster care and the results suggest that coping is not a simple, categorical-only construct and the implications for the endorsement of the direct approach for youth in foster care along with the other findings are discussed.     

Maltreatment histories of aging out foster youth: A comparison of official investigated reports and self-reports of maltreatment prior to and during out-of-home care

This study compared official investigated reports of child maltreatment with retrospective self-reports prior to and during out-of-home care for a sample of foster youth who reached the age of majority in out-of-home care in Illinois. Using matched administrative and self-reported data for 474 youth who completed a baseline interview in the Midwest Evaluation of Adult Functioning of Former Foster Youth (i.e. the Midwest study) at ages 17–18, and 386 youth who completed a follow up interview at age 19, this study finds that official reports and self-reports of maltreatment prior to and during out-of-home care differ significantly. Findings from this study add insight into measurement discrepancies, and help to inform understanding of the extent of maltreatment experienced by this sub-sample of young people exiting out-of-home care in adulthood. Study findings have implications for independent living policy and practice in child welfare.     

Educational attainment for youth who were maltreated in adolescence: Investigating the influence of maltreatment type and foster care placement

Decades of research have consistently shown a link between foster care and low rates of high school completion. Despite the overwhelming knowledge surrounding this association, it remains unclear whether the low rates of high school completion are due to placement in foster care or the maltreatment and other contextual factors that foster care youth have experienced. This study examined the extent to which (a) maltreatment type and (b) foster care placement were associated with the educational attainment of 337 maltreated adolescents. Logistic regression analyses were conducted using two waves of data and the ACR dataset of the National Survey of Child and Adolescent Well-Being (NSCAW). After controlling for academic risk factors related to the adolescents (age, race, and gender), their family (household poverty and parental education), and their environment (community environment), neither maltreatment type nor foster care placement status were associated with subsequent high school completion.Overall, only 58% of the maltreated adolescents reported completing their education. That is about 15% less than the national average at the time data were collected for this study. Results, overall, suggest a need for educational supports and interventions for youth who experience maltreatment during their adolescent years, regardless of maltreatment type and foster care placement.     

Developing a tailored substance use intervention for youth exiting foster care

Youth who are aging out of the foster care system face significant barriers to accessing substance use treatment. Mobile interventions have shown efficacy for several mental and physical health issues and may be helpful in overcoming barriers facing foster youth with substance use problems. A program (iHeLP) for substance use reduction was developed that used a computerized screening and brief intervention (SBI) followed by six months of dynamically-tailored text messages. The program was shown to focus groups of youth (N = 24) ages 18–19 who recently left foster care and had moderate to severe substance use risk. Focus group feedback was used to modify iHeLP prior to delivery in an open trial (N = 16). Both study phases included assessments of feasibility and acceptability; the open trial also included assessments of substance use outcomes at 3 and 6 months. Focus groups indicated a high level of acceptability for the proposed intervention components. Of those screened for the open trial, 43% were eligible and 74% of those eligible enrolled, indicating good feasibility. Retention through the final follow-up was 59%, and drop out was associated with involvement in the criminal justice system. Participant ratings for liking, ease of working with, interest in and respectfulness of the SBI were high. Satisfaction ratings for the texting component were also high. A computerized brief screening intervention for substance use risk reduction together with tailored text messaging is both feasible and highly acceptable among youth who have recently aged-out of foster care.     

Trajectories of post-traumatic stress and externalizing psychopathology among maltreated foster care youth: A parallel process latent growth curve model

Few longitudinal studies have analyzed how violence exposure (e.g. child maltreatment, witnessing community violence) influence both externalizing and Post-Traumatic Stress (PTS) symptoms among children in foster care. Data from three waves of the National Survey of Child and Adolescent Well-Being (1999–2007) (NSCAW; National Data Archive on Child Abuse and Neglect, 2002) were analyzed to investigate the change trajectories of both externalizing and PTS symptomatology among children with a substantiated report of child maltreatment by Child Protective Services (CPS) between October 1999 and December 2000. This study uses data collected at three time points: baseline and approximately 18 (Wave 3) and 36 (Wave 4) months post-baseline. The Child Behavior Checklist (CBCL) scale measured externalizing symptoms and the Post Traumatic Stress Disorder section of a version of the Trauma Symptom Checklist for Children (TSCC) provided the measure of current trauma-related symptoms or distress. Analyses were conducted using a parallel process growth curve model with a sample of n = 280 maltreated youth between the ages of 8 and 15 following home removal. Findings revealed that initial levels of externalizing and PTS symptomatology were both significantly and positively related and co-develop over time. Externalizing symptom severity remained in the borderline range during the first two years in out-of-home care. Both direct and indirect forms of interpersonal violence exposure were associated with initial level of externalizing symptom and PTS symptom severity, respectively. Taken together, our results suggest an underlying process that links early violence exposure to the co-development and cumulative impact of PTS on externalizing behavior above and beyond experiences of maltreatment. We conclude by discussing the key points of intervention that result from a more nuanced understanding of the longitudinal relationship between PTS and externalizing symptoms and the effect of complex trauma on growth in these symptoms over time.     

The predictors of perceived social support among former foster youth

Based on a 5-wave panel survey of 732 foster youth, the current study examined the respective relationships between foster youths' individual characteristics, youths' social connections with individuals and formal institutions, and the development of perceived social support across the transition to adulthood. Several youth characteristics – including self-reported delinquency and attachment insecurity – were found to be statistically significantly associated with perceived social support. Attachment insecurity also appeared to mediate the relationships between social support and several other youth-level characteristics, including prior placement disruptions and placement with relatives. Social connections with different types of individuals – including caregivers, relatives, natural mentors, and romantic partners – were found to be associated with additive increases in perceived social support. However, some types of connections (e.g., romantic partners, natural mentors) appeared to be associated with much larger increases in social support than other connections (e.g., school or employment). Collectively, the findings help inform agencies' efforts to bolster foster youths' social connections as they transition to adulthood.     

An intervention to improve sibling relationship quality among youth in foster care: Results of a randomized clinical trial

Sibling programming is an important part of a prevention framework, particularly for youth in foster care. After children are removed from their families and placed into foster care in the aftermath of maltreatment, the sibling relationship is often the most viable ongoing relationship available to the child, and may be critical to a youth’s sense of connection, emotional support, and continuity. The promise of dyadic sibling programming in particular rests on the ability of interventions to enhance the quality of sibling relationships; yet little research exists that suggests that sibling interventions can improve relationship quality among foster youth. The primary aim of the current study was to examine the effects of a specific dyadic sibling-focused intervention for older and younger siblings on sibling relationship quality. One hundred sixty four dyads (328 youth) participated in the study, with each dyad consisting of an older sibling between 11 and 15 years of age at baseline and a younger sibling separated in age by less than 4 years. Hierarchical linear models were applied to self-reported, observer-reported and observational data over the 18-month study period. Findings suggest that the sibling intervention holds promise for improving sibling relationship quality among youth in foster care. Implications and future directions for research are discussed.     

The grip of trauma: How trauma disrupts the academic aspirations of foster youth

The academic challenges foster youth encounter during their P-12 education have been widely reported. Yet, despite these challenges, the majority of foster youth desire postsecondary education. What is less known is the reason why so few foster youth alumni who desire a four-year college degree, achieve this goal. For the participants in this four-year longitudinal study, maltreatment, resulting in foster care placement, and the ensuing exposure to the foster care system, resulted in trauma histories and mental health diagnoses. Anxiety, depression, and posttraumatic stress disorder (PTSD), were the most common diagnosis. The participants shared the ways in which these mental health challenges manifested throughout their college education. Of those in the study, almost half successfully graduated from college, a third dropped out, and only two remain enrolled. This study provides a unique and critical insight into the experiences of foster youth, enrolled in a four-year university, by sharing their stories     

The profile and progress of neglected and abused children in long-term foster care

ObjectivesThis study compared the profile of neglected and abused children in the Australian foster care system as well as differences between maltreatment types in relation to parental contact, reunification and psychosocial progress in care.MethodThe case files of 235 children entering foster care were examined and their social workers were administered standardised questionnaires at the point of intake. All measures were repeated for those remaining in care 1 year and then again 2 years later.ResultsNeglected children were younger than non-neglected children, more likely to have a physical or mental disability, more likely to experience multiple forms of maltreatment and less likely to pose conduct problems for carers. Neglected children were more likely than non-neglected children to experience a decline in parental contact over time, and were less likely to be reunified with their families of origin. There was minimal difference between neglected and non-neglected in their psychosocial progress while in care. Aboriginal children were more likely to be reunified than non-Aboriginal children when neglect was attributable to transient factors (parental incapacity) but the reverse was true for non-neglected children.ConclusionsThe fact that neglected children more often require a second form of maltreatment before being removed from home suggests that children's services workers are less inclined to remove children for neglect than for other forms of maltreatment. As a consequence, those neglected children who are in care tend to come from more dysfunctional families than non-neglected children do, as evidenced by the relatively poorer parental contact and reunification results of neglected children.Practice implicationsNeglected children differ systematically from non-neglected children and suffer relative disadvantage in relation to multiple forms of maltreatment, parental contact, and reunification. The fact that declines in parental contact among neglected children in care occurred only when indirect contact was provided suggests that, wherever possible, care plans should include face-to-face visits and overnight stays rather than being restricted to less direct forms of contact. The difference in the success of reunification according to type of neglect (chronic or transient) also suggests that parental intervention programs need to focus their efforts on chronic factors rather than transient parental factors.     

Patterns of maltreatment and diagnosis across levels of care in group homes

Patterns of Axis I psychiatric diagnosis and maltreatment history were explored among youth in group homes, including match of clinical need to level or restrictiveness of care. Data on demographics, diagnoses, maltreatment, and group home level of care (Level I, II, or III homes, representing lower to higher intensity of supervision and treatment) were obtained from 523 youth who participated in a quasi-experimental study of group homes. Three quarters of youth had a diagnosis and two-thirds of youth had a maltreatment history. Youth in higher level homes had more diagnoses and higher rates of all disorders except adjustment disorders. Youth in Level I homes had a history of more maltreatment types, particularly high rates of neglect. Sexual abuse, physical abuse, and emotional abuse were most common among youth in higher level homes. Regardless of diagnosis history, comparable proportions of youth had a maltreatment history, and similar patterns were found across levels of care. Together, findings indicate that group homes with varying degrees of restrictiveness serve youth with different psychiatric diagnosis and maltreatment histories. Youth triaged to higher level homes had more diagnoses, while youth placed in the least restrictive homes had a history of more maltreatment subtypes. Further, distinct patterns of diagnosis types and maltreatment subtypes were seen across homes. Implications include the importance of assessing unique clinical needs of youth to promote an appropriate match to level of care and treatment plan.     

Abuse of children in foster and residential care

OBJECTIVE: There have recently been many debates in the UK about how to provide good care for children placed away from home. Professionals have realized that the level of child abuse in foster care and children's homes is high. This research examines the characteristics of physical and sexual abuse of children in foster and residential care in a city in England. The number of cases of abuse reported by pediatricians in this group was compared to the number reported by the same pediatricians for the population of Leeds as a whole. METHOD: This is a retrospective study of 158 children, fostered or in residential care who were involved in 191 episodes of alleged physical and/or sexual abuse assessed and reported by pediatricians over a 6 year period from 1990 to 1995 in Leeds, England. Details of the child including the reason for placement in care, their physical and mental health, abuse characteristics, including perpetrator and case management were studied. RESULTS (see Table 1): 158 incidents of abuse in 133 children in foster/residential care are described. In foster care, 42 children were physically abused, 76 were sexually abused, and 15 experienced both forms of abuse. In residential care, 12 children were physically abused, 6 were sexually abused, and 6 experienced both forms of abuse. In foster care 60% of sexual abuse involved girls and 60% of physical abuse involved boys. In residential care almost twice as many boys as girls were reported to be abused. Foster carers perpetrated the abuse for 41%, natural parents on contact for 23%, and children 20% of incidents. A significant proportion of abuse was severe with 1 death, 8 children with burns, 18 with genital, and 34 with anal penetration. Long-standing emotional, behavioral and learning difficulties were common. Most children (80%) had been abused prior to entry into care. Foster children were 7-8 times and children in residential care 6 times more likely to be assessed by a pediatrician for abuse than a child in the general population. CONCLUSIONS: Children in foster or residential care form an at risk group for maltreatment. Their special needs include additional measures to protect them from abuse.     

‘Upturned participation’ and youth work: using a Critical Utopian Action Research approach to foster engagement

ABSTRACT

This article reflects on how participatory processes inspired by action research hold a genuine potential for developing social educational work in a more democratic way. We present our concept of ‘Upturned Participation’, which is built upon the methodological framework of Critical Utopian Action Research. First Critical Utopian Action Research is introduced briefly, including a presentation of the core method of the action research approach. We then present an extract from an action research project aimed at creating space for participation for marginalized young people in the area of Copenhagen. On this basis, we reflect on how the ideas of the young people could influence the field of social work. The article addresses contemporary challenges and opportunities for creating development in the field of youth work or social work through participatory processes with marginalized young people.     

The socioemotional development of orphans in orphanages and traditional foster care in Iraqi Kurdistan

In order to investigate orphans' situation and development in Iraqi Kurdistan, samples from the two available orphan care systems, the traditional foster care and the modern orphanages, are examined at an index test and at 1-year follow-up regarding competency scores and behavioral problems at both test occasions, and post-traumatic stress reactions at a 1-year follow-up. Achenbach Child Behavior Check List (CBCL) and two instruments regarding post-traumatic stress disorder (PTSD) were used. While competency scores showed an improvement in both samples at the follow-up test, the problem scores increased in the orphanage sample and decreased among the foster care subjects. Moreover, the orphanage sample reported higher frequency of post-traumatic stress disorder (PTSD) than the foster care children. The results are discussed with regard to the value of the Kurdish society's own traditions in taking care of orphans.     

Heuristic decision-making in foster care matching: Evidence from a think-aloud study

Complex decisions are often based on heuristics, which are shortcuts or simple ‘rules of thumb’. Since the matching decision in family foster care is often made in a less-than-ideal setting and riddled with uncertainty, heuristics are expected to be applied in that field of child and youth care on a daily basis. However, the use of heuristics in the matching decision has not been studied empirically until now. This research explores how decision-making heuristics are used by practitioners to determine which foster family is the best fit for a child. A number of 20 matching practitioners from the Netherlands were interviewed using vignettes and a ‘think-aloud’ methodology to generate an understanding of their reasoning. Two types of vignettes were created: hypothetical children and hypothetical foster families. The interviews were analyzed using a qualitative deductive content analysis focusing on key indicators of three classes of heuristics: recognition heuristics, one-reason heuristics, and trade-off heuristics. The results show that recognition heuristics did not play a decisive role in the matching process; practitioners considered more than one family before making a final decision. The findings for the one-reason heuristics reveal conjunctive decision-making rules; families were rejected based on one negative premise. The analysis of the trade-off heuristics demonstrates that the number of positive premises and the ratio between positive and negative premises predicted the matching decision. However, the total number of premises also predicted the matching decision, which might indicate confirmation bias.     

Child welfare outcomes for youth in care as a result of parental death or parental incarceration

Every day, in the United States, children are removed from their homes and placed into state supervised out-of-home care because of concerns around their safety. These children enter care as a result of child abuse, child neglect, abandonment or some other reasons. Lost in most discussions of out-of-home care is the role that parental incarceration and parental death have on the trajectory of children through the child welfare system. In order to address this gap in the literature, the present study aims to compare youth in foster care as a result of parental death or youth in foster care as a result of parental incarceration with youth in care because of child maltreatment in terms of the length of time to achieve permanency. Holding all other variables constant, entering care as a result of parental death more than doubled the average time to exit (HR = 2.32, SE = 0.22), and these youth were significantly less likely to exit to permanency when compared to children entering care for other maltreatment reasons (OR = 0.35, SE = 0.24). Entering care as a result of parental incarceration led to a 24% longer time to exit (HR = 1.24, SE = 0.09) compared to children entering care for other maltreatment reasons. Findings suggest that a one-size-fits-all approach to policy and practice may not be useful to identifying permanent placements for children entering care as a result of parental death or incarceration.     

Academic achievement among a sample of youth in foster care: The role of school connectedness

Research shows that youth in foster care experience poor academic performance and disciplinary actions in school more frequently than do non-foster care youth. The purpose of this cross-sectional study was to further examine youth in foster care and the relationship between individual/intrapersonal factors (future orientation and school connectedness) and exosystem factors (number of placement and school moves) and academic performance (grades) and disciplinary referrals among 363 youth (9–11 years of age; males = 52.9%). Controlling for key variables, hierarchical linear regression analysis was utilized to understand how well students' school connectedness, future outlook, number of placement changes, and number of school moves predicted academic and disciplinary outcomes. Beyond the variance explained by control variables, school connectedness made a significant contribution to this model. Results are discussed in the context of implementing interventions that foster school connectedness among this vulnerable population.