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1.
    

Objectives

To describe health-related problems across placement types (unrelated foster, kin foster, in-home with birth parent); to examine the association of placement and demographic/child welfare variables (child gender, age, race/ethnicity; caregiver language; type of maltreatment, and length of time receiving services from child welfare) with health-related problems.

Methods

This study utilized a retrospective medical chart review of children less than 6 years old (n = 449) seen at an outpatient child welfare pediatric clinic. Logistic regression modeling was used to estimate odds of having a weight, medical, or provisional developmental delay problem by placement and demographic/child welfare characteristics.

Results

Almost 13% of children in the sample were obese (≥95% age-gender specific percentile) and more than a quarter were overweight/obese (≥85%) while only 7% were underweight (≤5%). Most children (78%) had a physical health diagnosis and 25% were provisionally identified with a developmental delay. No differences between weight diagnoses, type of medical diagnoses, and provisional developmental delay by placement type were found, although children with 3 or more medical diagnoses were more likely to be with kin (p < .05). Children 2 years old or older were more likely to be overweight/obese than children under 2 years old (p < .05) and Hispanic children were more likely to be overweight/obese than non-Hispanic children (p < .01). Length of stay in child welfare was positively related with a medical diagnosis or provisional developmental delay (p < .01).

Conclusions

Results argue for careful assessment of weight, medical, and developmental problems in children active to child welfare, whether residing in their home of origin, with kin, or with unrelated foster parents. The increasing problem of obesity among young children in child welfare warrants further investigation and intervention.

Practice implications

The comprehensive health examination and enhanced health maintenance schedule for children in foster care should be extended to children who remain at home with child welfare services as child welfare involvement rather than placement is related to health-related problems.  相似文献   

2.
    
Decision-making in the child protection system is influenced by multiple factors; agency and geographic contexts, caseworker attributes, and families’ unique circumstances all likely play a role. In this study, we use the second cohort of the National Survey of Child and Adolescent Well-Being to explore how these factors are associated with two key case decisions—substantiation and removal to out-of-home care. Analyses are conducted using weighted hierarchical linear models. We find that substantiation is strongly influenced by agency factors, particularly constraints on service accessibility. Substantiation is less likely when agencies can provide services to unsubstantiated cases and when collaboration with other social institutions is high. This supports the concept that substantiation may be a gateway to services in some communities. Agency factors contributed less to the probability of removal among substantiated cases, though time resources and constraints on decision-making had some influence. For both substantiation and removal risks, county, caseworker, and child characteristics were less influential than agency characteristics and family risk factors.  相似文献   

3.
    
Child maltreatment (CM) in foster care settings (i.e., institutional abuse, IA) is known to have negative effects on adult survivor’s mental health. This study examines and compares the extent of CM (physical, emotional, and sexual abuse; physical and emotional neglect) and lifetime traumatization with regard to current adult mental health in a group of survivors of IA and a comparison group from the community. Participants in the foster care group (n = 220) were adult survivors of IA in Viennese foster care institutions, the comparison group (n = 234) consisted of persons from the Viennese population. The comparison group included persons who were exposed to CM within their families. Participants completed the Childhood Trauma Questionnaire, the Life Events Checklist for DSM-5, the PTSD Checklist for DSM-5, the International Trauma Questionnaire for ICD-11, and the Brief Symptom Inventory-18 and completed a structured clinical interview. Participants in the foster care group showed higher scores in all types of CM than the comparison group and 57.7% reported exposure to all types of CM. The foster care group had significantly higher prevalence rates in almost all mental disorders including personality disorders and suffered from higher symptom distress in all dimensional measures of psychopathology including depression, anxiety, somatization, dissociation, and the symptom dimensions of PTSD. In both groups, adult life events and some but not all forms of CM predicted PTSD and adult life events partly mediated the association of PTSD and CM. Explanations for the severe consequences of CM and IA are discussed.  相似文献   

4.
Foster care, created to overcome some of the disadvantages and abuses of institutional care of children, can present its own problems. One problem is overt abuse, but there are other, more subtle, deficiencies and concerns about foster care. In response, the concept of permanency planning has been introduced as a philosophy, a policy, and a technique. It is designed to return every child who enters care to the stability of a family as quickly as possible. This paper presents findings of a longitudinal study of the outcomes of permanency planning. Results show that over half the children returned to their biological parents, that adoptions were more common for Caucasian than black children, that 78% of the children were still in their permanent placements 12-16 months later, that most children were functioning well, and that there was a marked need for services for the families. In addition to the results of the study, the discussion focuses on implications for foster care practice and child welfare policy, including the importance of relatives, the impact of foster care placements, the needs of biological families, and the provision of services and supports for reunified families.  相似文献   

5.
    
This study explored friendships in a sample of 51 high-risk preschool-aged children. Thirty-eight children were placed in foster care (25 placed with their siblings and 13 separated from their siblings). Thirteen children, receiving preventive services, were living at home with their biological parents and siblings. Chi-square, ANOVA, and paired t-tests were used to test for between-group and within-subject differences in the target children's friendships. The results demonstrated that the majority of the high-risk children had a “best friend.” However, the foster children all had friends who could be described as quasi-siblings. The results suggest that foster care placement and the presence of siblings may influence the nature of a child's interactions with nonrelated peers.  相似文献   

6.
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.  相似文献   

7.
    
Foster parents need access to supports and resources in order to be satisfied with their caregiving role and continue providing foster care services. However, they often experience multiple demands in their role as a substitute caregiver that could lead to stress. Child behaviors especially may be a significant factor when considering sources of strain and may be a potential risk factor for negative outcomes such as dissatisfaction or the decision to discontinue providing foster care. The purpose of this study was to examine whether child disruptive behaviors moderated or influenced the nature or strength of the relationship between foster parent supports and satisfaction as a caregiver as well as intent to continue fostering. The sample consisted of 155 licensed foster caregivers from across the United States. Child behaviors served as a significant moderator between some types of supports and satisfaction. Implications for future research, practice, and policy are discussed.  相似文献   

8.
约翰·贝拉米·福斯特是西方生态学马克思主义理论的代表人物之一,他以对马克思生态学思想的历史性研究,以及对马克思“物质变换断裂”理论所进行的生态学内涵的深刻剖析而为国内外学界所关注。近年来,对其思想的研究呈上升趋势,其理论所包含的“资本主义生态批判”、“生态学马克思主义的理论建构”,以及“生态危机的政治解放路径”等维度受到了较广泛的研究。文章对这些研究成果进行了梳理,并对一些不足与遗缺进行了说明与评介。  相似文献   

9.
    
Childhood adversity negatively impacts the biological development of children and has been linked to poor health outcomes across the life course. The purpose of this literature review is to explore and evaluate the effectiveness of interventions that have addressed an array of biological markers and physical health outcomes in children and adolescents affected by adversity. PubMed, CINAHL, PsychInfo, Sociological Abstracts databases and additional sources (Cochrane, WHO, NIH trial registries) were searched for English language studies published between January 2007 and September 2017. Articles with a childhood adversity exposure, biological health outcome, and evaluation of intervention using a randomized controlled trial study design were selected. The resulting 40 intervention studies addressed cortisol outcomes (n = 20) and a range of neurological, epigenetic, immune, and other outcomes (n = 22). Across institutional, foster care, and community settings, intervention programs demonstrated success overall for improving or normalizing morning and diurnal cortisol levels, and ameliorating the impacts of adversity on brain development, epigenetic regulation, and additional outcomes in children. Factors such as earlier timing of intervention, high quality and nurturant parenting traits, and greater intervention engagement played a role in intervention success. This study underlines progress and promise in addressing the health impacts of adversity in children. Ongoing research efforts should collect baseline data, improve retention, replicate studies in additional samples and settings, and evaluate additional variables, resilience factors, mediators, and long-term implications of results. Clinicians should integrate lessons from the intervention sciences for preventing and treating the health effects of adversity in children and adolescents.  相似文献   

10.
    
Objective: Infants comprise nearly one fourth of all entries to foster care. Linkage of administrative birth and placement data can provide information about these infants that may otherwise be unavailable or difficult to obtain.Method: Statewide birth records and foster care placement histories were linked via probability matching. Logit regression was used to compare 26,460 maltreated infants who entered foster care between 1989 and 1994 with a random sample of 68,401 other infants born during that time frame.Results: Infants in care were more than twice as likely to have single parents and be born with low birthweight, and twice as likely to have been born with a birth abnormality as other infants, controlling for other factors. The largest difference was in the eightfold increased likelihood for mothers of infants in care to have had no prenatal care. Infants in care were nearly three times as likely to be born into larger families (third or greater live births to the mother). Mothers of infants in care were more than twice as likely to be African American compared to White than mothers of other infants, while Hispanic and Other ethnic groups were underrepresented in the group of infants in care. Foreign born mothers, especially Hispanic women, were much less likely to have infants in care than they were to have children in the other group.Conclusions: Administrative datasets, while often limited in the number of variables they include and scope of their information, can be a valuable tool when used to understand demographics and frame questions for future research. Infants who enter foster care differ in substantial ways from other children. These findings have important implications for future research aimed toward targeting of child welfare services and supports.  相似文献   

11.
12.
In the United States public concern about foster care drift is widespread. "Drift" means lengthy placement away from the natural family, without a clear goal to return the child or find some other permanent home. Concern is focused on the negative effect of lengthy foster care on the psychological health of the child, and also on the increasing cost of such placement. Recently, the federal government, in response to extensive testimony about these issues, passed landmark legislation designed to reduce foster care drift, the Adoption Assistance and Child Welfare Funding Act of 1980. Thus the government has now become a leader in child welfare planning. The law requires a reporting and tracking system so that no child already in placement becomes "lost in the system." In addition, all proposed foster placements are now hedged with requirements that there be clear purposes and goals to be achieved by such placements. In effect placements must be defended, tracked, and reviewed periodically. The new requirements pose a rebuke to the professions serving children which have failed to stem the increase in foster care, and to control and place a time limit on such interventions in the family. Federal leadership has created a political climate in child welfare planning. The regulations issued to implement the law in the Carter presidency differ from those of the current administration. The current policy of the government of the United States is to provide protection of the family from excessive foster care placements by child welfare agencies. This is support for greater autonomy for the family, a more conservative approach.(ABSTRACT TRUNCATED AT 250 WORDS)  相似文献   

13.
Prior research has repeatedly documented higher placement stability for children who enter kinship care rather than non-relative foster care. However, little is known about why, and under what circumstances, kinship care is more stable. This study uses longitudinal state administrative data to explore possible explanations. Results suggest that, while children in non-relative foster care are indeed at higher risk of any placement move than their peers in kinship care, this appears to be partly driven by child selection factors and policy preferences for kinship care. That is, the gap is not explained primarily by different rates of caregiver-requested moves. However, the gap was sizably smaller among select high-risk subgroups of foster children, suggesting that higher stability in kinship care may be partly explained by differences in the characteristics of children entering kinship care (versus non-relative foster care). Moreover, a large portion of the gap is explained by children in non-relative care being moved into kinship care; a move that is likely the result of policy preferences for kinship care rather than a defect in the initial placement. In sum, these results suggest that kinship care provides only a limited stability advantage, and the reasons for that advantage are not well understood.  相似文献   

14.
    
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.  相似文献   

15.
Given the relatively large body of literature documenting the adverse impacts of institutionalization on children’s developmental outcomes and well-being, it is essential that countries work towards reducing the number of children in alternative care (particularly institutional care), and, when possible, reunite children with their families. In order to do so, reliable estimates of the numbers of children living in such settings are essential. However, many countries still lack functional administrative systems for enumerating children living outside of family care.The purpose of this paper is to provide a snapshot of the availability and coverage of data on children living in residential and foster care from some 142 countries covering more than 80 per cent of the world’s children. Utilizing these country-level figures, it is estimated that approximately 2.7 million children between the ages of 0 and 17 years could be living in institutional care worldwide. Where possible, the article also presents regional estimates of the number of children living in residential and foster care.This work represents an important step to systematically identify and compile sources of data on children in alternative care and provides updated global and regional estimates on the magnitude of the issue. Its findings contribute to raising awareness of the urgent need to strengthen the capacity of countries to improve national systems for counting, monitoring and reporting on these vulnerable children.  相似文献   

16.
    
The distribution of attachment styles has been shown to differ between groups of children living with their parents and children placed in alternative care (AC), defined as residential or foster. However, this is the first study in Latin America to explore possible factors affecting the quality of attachment in children living in both residential and foster care. Two groups of children (N = 57) were compared: one group living in Residential Homes (RC) and the other in Foster Care (FC) in Chile. Children’s, caregivers’ and structural factors (e.g., child: caregiver ratios) and their links with attachment styles were investigated. The micro caregiving environment (i.e., the specific individual child caregiver relationship), especially the caregivers’ engagement, sensitivity, disciplinary control and affection, as well as some structural factors (i.e., child: caregiver ratios), were linked to attachment security in children. Specifically, better emotional caregiving and lower child-caregiver ratios were associated with higher rates of secure attachment. The association between quality of care (as measured by the HOME inventory) and attachment styles seems to be influenced by caregiver relationships (as measured by CCSERSS). Caregiver relationship factors (i.e., affection, engagement and sensitivity) directly impact the quality of the attachment children establish with them while living in AC. However, the relationships that caregivers establish with children under their care can be facilitated by good quality structural factors, particularly child-caregiver ratios.  相似文献   

17.
    
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.  相似文献   

18.
    
Attachment has been assessed in children living in alternative care (AC) settings, such as Residential Homes (RC) and Foster Care (FC). However, no study has been conducted to compare attachment styles in residential, foster and parental care conducted as usual in the same country at the same point in time. There is also a lack of studies conducted in less developed countries. Therefore, the aim of this study was to compare outcomes for children living in three different types of care in Chile. Three groups of children (N = 77), living in (RC), (FC) and with biological parents (PC) were compared. Attachment styles, Indiscriminate Friendliness (IF) and socio-emotional/behavioral difficulties were assessed.Higher rates of secure attachment were observed in the RC group (36.1%) when compared to studies in RC in other countries (mean 18%). However, children in both types of AC were significantly more likely to have insecure and/or disorganized attachment styles than PC children. Higher rates of socio-emotional and behavioral problems were observed in RC (55.6%) and FC (50%) compared to PC (10%). Within type of AC, no significant differences were found, for attachment styles or for socio-emotional/behavioral difficulties, the only difference were the levels of IF, with children in RC having higher levels. As a conclusion, impact of placement in AC can vary between different countries, other factors, rather than only type of AC could better explain differences in attachment security for children. Implications for research and practices are discussed.  相似文献   

19.
    
《Child abuse & neglect》2014,38(10):1618-1627
Multiple studies of homeless persons report an increased prevalence of a history in-care, but there is a dearth of information on associated outcomes or relevant demographic profiles. This information is critical to understanding if certain individuals are at elevated risk or might benefit from specific intervention. Here, we investigate how a history in-care relates to demographics and multiple outcome measures in a homeless population with mental illness. Using the Mini International Neuropsychiatric Interview (MINI), the Short-Form 12, and a trauma questionnaire, we investigated baseline differences in demographics and length of homelessness in the At Home/Chez Soi Trial (N = 504) Winnipeg homeless population with and without a history in-care. Approximately 50% of the homeless sample reported a history in-care. This group was significantly more likely to be young, female, married or cohabitating, of Aboriginal heritage, have less education, and have longer lifetime homelessness. Individuals of Aboriginal heritage with a history in-care were significantly more likely to report a familial history of residential school. Individuals with a history in-care experienced different prevalence rates of Axis 1 mental disorders. Those with a history in-care also reported significantly more traumatic events (particularly interpersonal). A distinctive high-risk profile emerged for individuals with a history in-care. Sociocultural factors of colonization and intergenerational transmission of trauma appear to be particularly relevant in the trajectories for individuals of Aboriginal heritage. Given the high prevalence of a history in-care, interventions and policy should reflect the specific vulnerability of this population, particularly in regards to trauma-informed services.  相似文献   

20.
    
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, Mage = 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.  相似文献   

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