Children In Foster Care Research Articles

Psychotropic Medication Prescribing: Youth in Foster Care Compared with Other Medicaid Enrollees.

Objective: To compare the prevalence of psychotropic medication prescriptions among youth in foster care with those among nonfoster youth on Medicaid. Methods: Children ages 1-18 years in a region of a large southern state who were enrolled in their respective Medicaid plan for at least 30 days between 2014 and 2016 and had at least one health care claim were included. Medicaid prescription claims were categorized by class: alpha agonists, anxiolytics, antidepressants, antipsychotics, mood stabilizers, and stimulants. Primary mental health (MH) or developmental disorder (DD) diagnostic groups were identified for each class. Analyses included chi-square tests, t-tests, Wilcoxon sign rank tests, and logistic regression. Results: A total of 388,914 nonfoster and 8426 children in foster care were included. Overall, 8% of nonfoster and 35% of foster youth were dispensed at least one prescription for a psychotropic medication. Prevalence was higher for youth in care within each drug class and, with one exception, across all age groups. Among children prescribed a psychotropic medication, the mean number of drug classes prescribed was 1.4 (SD 0.8) and 2.9 (SD 1.4) for nonfoster and foster youth, respectively (p < 0.000). Except for anxiolytics and mood stabilizers, more children in foster care were prescribed psychotropic medications without an MH or DD diagnosis. Finally, children in foster care experienced 6.8 (95% CI: 6.5-7.2) times higher odds of being prescribed a psychotropic medication than their nonfoster peers, after controlling for age group, gender, and number of mental and developmental diagnoses. Conclusions: Across all age groups, children in foster care on Medicaid were prescribed psychotropic medications disproportionately more than their nonfoster peers on Medicaid. In addition, children in foster care were significantly more likely to be prescribed psychotropic medication absent an MH or DD diagnosis.

Addressing the Surge in Unaccompanied Migrant Children

Unaccompanied migrant children (UMC) account for a growing share of apprehensions along the US-Mexico border. Contrary to past UMC flows, which were primarily comprised of older youth fleeing violence in Mexico, recent UMC flows include children of all ages escaping life-threatening conditions in Central America's Northern Triangle. To manage the growing influx of UMC, the Biden Administration established surge facilities, which rely on emergency standards to house and care for the children. We show that surge facilities created capacity in traditional shelters, enabling them to accommodate tender-age children and reducing the number of children in foster care.

Caregiver perceptions of the pediatric medical home model to address the health services needs of youth in foster care

BackgroundChildren in foster care demonstrate higher rates of physical health difficulties and lower rates of engagement in preventative health services than the general population. This pattern places foster youth at heightened risk for long-term health complications in adolescence and adulthood. Interventions for children in foster care are needed to decrease barriers to health services, increase continuity of care, and ameliorate negative long-term outcomes. Pediatric Medical Home (PMH) models may be a viable solution, but little guidance exists on the adaptation of these models for vulnerable youth. ObjectiveThe current project utilized a qualitative approach to evaluate the perceived utility of PMHs as a health care delivery system for youth in foster care. Method: Face-to-face semi-structured interviews were conducted with 40 parents of children in foster care who had received PMH services within the past year. ResultsQualitative themes demonstrated overall positive perceptions of the PMH model, with numerous advantages related to foster-care specialization that sustained caregiver engagement. Participant themes aligned with several of the major characteristics of PMHs, most specifically with continuity of care, and highlighted additional needs specific to families with child welfare involvement. ConclusionsFindings address the utility of medical homes for parents and youth with child welfare involvement and can inform future efforts on enhancing interprofessional health interventions for children with histories of maltreatment.

Points of foster parent stress in the system: A qualitative interpretive meta-synthesis

Foster parents provide invaluable care for just under half of the almost 400,000 U.S. children in foster care due to experiences of child maltreatment. Indeed, while many of these children present with various physical or mental health needs because of the complex, often interpersonal traumas they have experienced, some scholars say healthy relationships are a key pillar in healing. The breadth and depth of foster parents’ roles make their wellbeing a key consideration in the wellbeing of the child welfare apparatus itself. Existing literature details a variety of sources of foster parent stress, noting in particular the impact of foster child behavior. However, it seems much more could be gleaned about the nuances of foster parent stress with a more holistic inquiry. The present study aimed to answer the question, “What do foster parents tell us about their greatest points of stress in the foster care system?” Utilizing a Qualitative Interpretive meta-Synthesis (QIMS) research design, the authors synthesized 21 previously published qualitative research articles conducted across the U.S. with a broad sample of 572 foster parent responses. Four primary themes emerged from the analysis, including (1) fighting for respect and inclusion; (2) feeling unsupported; (3) missing information; and (4) parenting stress. Additional subthemes yielded even greater insight into the experience of foster parent stress. Notably, foster parent stress appears to be impacted by interpersonal dynamics with caseworkers, lack of supportive resources, and tension between the respective needs of their children. Implications for child welfare policy, practice, and training are provided.

Mental Health Diagnoses, Health Care Utilization, and Placement Stability on Antipsychotic Prescribing Among Foster Care Youth.

This study sought to examine how mental health diagnoses, health care utilization and foster care placement instability affect antipsychotic prescribing and how these factors may contribute to disproportionate antipsychotic prescribing among youth in foster care. This retrospective cohort study utilized EHR data that were linked to administrative child welfare data. Two outcome variables were analyzed: 1) any antipsychotic prescription documented and 2) number of antipsychotic prescriptions documented. Predictor variables included foster care status, number of unique mental health diagnoses, counts of health care encounters over the study period, and counts of foster care placements. Covariates included gender, persons of color, and age in years. Models were estimated using logistic regression for the dichotomous outcome and Poisson regression for the count outcome. Increased antipsychotic prescribing among children in foster care persists even after accounting for mental health diagnoses and health care utilization. However, the number of placements modified the effect of foster care involvement on antipsychotic prescribing such that after 2 placement changes, the odds of being prescribed an antipsychotic surpassed the effect of foster care involvement. More mental health diagnoses, more inpatient and emergency health care encounters, and more foster care placements were associated with an increased odds of being prescribed an antipsychotic and an increased count of antipsychotic prescriptions. Decreased primary care encounters were associated with increased odds of antipsychotic prescriptions, and decreased specialty encounters were associated with higher counts of antipsychotic prescriptions. Placement instability is associated with disproportionate antipsychotic prescribing among youth in foster care.

The Association Between Permanency and Length of Time in Foster Care for Children with Older Adult Foster Caregivers: Children Removed Due to Substance Use Behavior

The Association Between Permanency and Length of Time in Foster Care for Children with Older Adult Foster Caregivers: Children Removed Due to Substance Use Behavior

Self-Regulated Learning as Related to Academic Performance of Foster Care and Home Reared Children

The current study aims to investigate the association between self-regulated learning and academic achievement in foster care and home-reared children in order to expand on the findings of prior research on the same sample. In the current study, a correlation design tailed by a t-test was used, and the overall self-regulated learning is found significantly and positively associated with the academic performance of foster care and home-reared children, as well as found the significant difference between foster care and home reared children on their academic performance at three levels of overall self-regulated learning and its sub-factors.

Use of Telemedicine for Children in Foster Care.

Introduction: Telemedicine studies specific to children in foster care are needed, given unique health care needs and barriers. It is important to utilize lessons learned from telemedicine programs deployed by necessity during the COVID-19 emergency. Objectives: Describe telemedicine health assessments for children in foster care performed during the COVID-19 pandemic. Compare medical recommendations resulting from telemedicine and in-person assessments. Methods: After navigating barriers specific to children in foster care including consent issues, we implemented a telemedicine program at our specialty clinic for children in foster care when in-person visits were restricted. Outcomes of telemedicine referrals were tracked. After each visit, physicians were asked to rate ability to express themselves, hear and see patients from 1 (strongly disagree) to 5 (strongly agree) using items from the validated Telehealth Usability Questionnaire. Recommendations for laboratory work, medication, and health services referrals were recorded and compared with 205 patients seen in-person the year prior. Results: From 91 referrals, 83 (91%) children with a mean age of 9 years completed telemedicine visits. Physicians rated receptive and expressive communications more favorably than visual quality. Most telemedicine patients (77%) received a referral for health care services but had significantly lower rates of laboratory work completion, vision referrals, and prescriptions for new medications compared with 205 patients seen in-person. Conclusions: Results suggest that telemedicine was accessible to most patients and highlighted essential in-person components of comprehensive health assessments. Findings could inform ongoing telemedicine applications and advocacy for underserved populations.

Policy and Legal Implications for Working with Unaccompanied Immigrant Children in Foster Care in the United States

Unaccompanied immigrant children arrive in the US having fled deteriorating conditions and human rights violations in their home countries. Despite the large numbers of unaccompanied children, there is a lack of research on outcomes for unaccompanied children in the US and particularly for those in the Office of Refugee Resettlement’s (ORR) Long Term Foster Care (LTFC) program. This manuscript begins with a review of the existing laws that influence unaccompanied children (UC) served through the ORR’s LTFC program and a review of the current research on UC in foster care in the US. Notably, this manuscript also visualizes the numbers of UC that have arrived in the US since the early 2000s. These are used to provide a synthesis of recommendations for policy and practice with unaccompanied children.

Asperger's Children: The Origins of Autism in Nazi Vienna by Edith Sheffer

Reviewed by: Asperger's Children: The Origins of Autism in Nazi Vienna by Edith Sheffer Katherine Arens Edith Sheffer, Asperger's Children: The Origins of Autism in Nazi Vienna. New York: W.W. Norton, 2018. 320 pp. Edith Sheffer, a historian of Germany and Central Europe at UC Berkeley, has provided an important book: Asperger's Children, a case study in the ideologization of institutions and institutional discourses. Its focus is physician Hans Asperger (1906–1980), who evolved the standard diagnosis of autism, and how a public welfare debate in Vienna fell under the influence of Nazi ideologies through a combination of opportunism and willful malfeasance. Eugen Bleuler had introduced the term autism in 1911, but child psychiatrist Leo Kanner, a 1940s Austrian refugee working in the United States, specified in 1943 its most compelling cause: poor parenting, especially "refrigerator mothers." His essay cited Asperger's 1944 postdoctoral thesis, "The 'Autistic Psychopaths' in Childhood," which had drawn on Asperger's work at the Am Spiegelgrund pediatric psychiatric clinic in Vienna (a part of the Steinhof complex). There, German and Austrian social politics intertwined with the Nazi T4 euthanasia programs from 1940 until war's end. Sheffer, however, is less focused on Asperger's possible individual guilt than on how Vienna's extended medical and social welfare establishment assimilated to Nazi psychiatric standards under the Nuremberg Laws, when [End Page 90] "two-thirds of all Vienna's 4,900 doctors and 70 percent of its 110 pediatricians lost their positions" (74), and many more emigrated, leaving a vacuum soon filled by Nazi ideologues. The Steinhof Psychiatric Institute had opened in 1907 as a progressive institution (it still exists on the Baumgartnerhöhe, topped by Otto Wagner's church). Yet under pro-Nazi leadership after 1940 and the start of the T4 programs, Steinhof was implicated in at least 7,500 deaths, starting in that year with the deportation of over 3,000 patients to the gas chamber (probably Hartheim). That made room for the "Vienna Municipal Youth Welfare Institution" at Spiegelgrund. The 640 beds of Steinhof's youth ward retained a pediatric euthanasia unit even after T4 was abolished in 1941, ultimately responsible for almost 800 deaths. Red Vienna's 1920s positive response to the lingering effects of World War I and the depression had turned deadly. Between 1923 and 1934, Vienna had innovated in social welfare, including building 380 apartment buildings housing 220,000 persons (a tenth of the city's population). Some measures were educational: Erwin Lazar's "Curative Education Clinic" (founded in 1911) had introduced innovations in the state school structure for social workers, teachers, and doctors; from 1918 to 1925, he consulted for the new Ministry of Public Health. Yet "social welfare" became in the 1940s a way to manage populations in increasingly normative ways. "Problem children" and school surveillance became boom industries, part of what Sheffer calls a "diagnosis regime" that "sort[ed] the population into categories, cataloguing people by race, politics, religion, sexuality, criminality, heredity, and biological defects" (15) that converged with Nazi eugenics. Asperger, who had been a member of the Nazi youth movement, helped Red Vienna's "curative education" turn into "positive eugenics"—triaging individuals for desirable traits (25–27) while also facilitating eventual turns toward the negative eugenics of extermination. Lazar had distinguished physiological causes from social causes for a lack of "community competence" (Gemeinschaftsfähigkeit), but, as "community competence" turned into an ideology of "national community" (Volksgemeinschaft, 16) in Steinhof, poverty and child neglect came to be defined as a threat to the community. "By 1936, an average of twenty-one children a day were removed from families into Vienna's Child Foster Care Service" (33), and from there to Spiegelgrund and its regimented "therapeutic" regimen, and not infrequently to medical "research" (including twin research). [End Page 91] By spring 1944, the city's Public Health Office had compiled a medical index that included 767,000 people (a quarter of the city's population). A staff of seventy went through "birth records, Youth Office records, medical records, police records, Steinhof records, Nazi Party records, and city registries of prostitutes and alcoholics" and identified 12,000 disabled children and 40,000 "difficult...

Effects of social support on career maturity of children in foster care : Mediating effect of self-efficacy and stigma

연구목적: 본 연구는 가정위탁아동의 사회적 지지가 자기효능감과 낙인감을 통해 진로성숙도에 영향을 미치는지 확인하는 것을 목적으로 하였다. 방법: 가정위탁아동패널 3차년도 조사에 참여한 265명의 데이터를 사용하여 분석하였다. 가정위탁아동의 사회적 지지가 진로성숙도에 미치는 영향에서 자기효능감과 낙인감의매개효과 분석을 위해 구조모형분석, 부트스트래핑, 팬텀모형 분석을 실시하였다. 결과: 첫째, 가정위탁아동이 사회적 지지는 진로성숙도에 직접적으로 영향을 미치지 않았다. 둘째, 가정위탁아동의 사회적 지지는 자기효능감을 매개로 진로성숙도에 영향을 미쳤다. 셋째, 가정위탁아동의 사회적 지지는 낙인감을 매개로 진로성숙도에 영향을 미쳤다. 결론: 본 연구결과를 바탕으로 가정위탁아동의 진로성숙도를 높이기 위한 방안을 논의하였다.Objectives: The purpose of this study was to confirm whether the social support for foster care children affects career maturity through self-efficacy and stigma. Methods: The analysis was conducted using data from 265 children who participated in the ‘Korea Foster Care Children Panel Study(third wave)’. As Statistical methods, Structural Equating Modeling, bootstrapping, and a phantom model analysis were utilized to analyze the mediating effect of self-efficacy and stigma on the effect of social support on the career maturity of foster children. Results: The study results are as follows. First, social support for foster care children did not directly affect career maturity. Second, social support for foster care children affected career maturity through self-efficacy. Third, social support for foster care children affected career maturity through a sense of stigma. Conclusions: Based on the results of this study, measures to increase the career maturity of foster children are discussed.

The Effect of Parental Conflict, Domestic Violence and Other Factors on Children Which Leads to Voluntary Placement in Foster Care: A Study on Cathy Glass’s “A Terrible Secret”

This paper explores the impact of parental conflicts and other factors on children which pave the way for the children to voluntarily place themselves in foster care. Children may be more likely to experience behavioral, social, and academic problems as well as mental health issues when there is frequent, intense, and poorly resolved conflict between the parents. Also, it may have a major impact on a child's long-term outcomes. Conflict between parents hurts teens. Children show sorrow when their parents are fighting. Their reactions include fear, anxiety, irritability, melancholy, and depression, and they are at a greater risk of having negative personality development. Investigating parental conflict and its detrimental effects on teenage personality development was the main goal. This research will be done through the study of Cathy Glass’s “A Terrible secret”. Cathy Glass work is strongly identifying with true life stories and inspirational memoirs genres. In chronological sequence, the prolific novelist Cathy Glass has produced 34 books in all. She frequently examines the difficulties these helpless infants confront and how their foster carers, like Cathy, assist them in overcoming these difficulties in her novels, which are centered on the lives of children in foster care.

A qualitative study about changes that parents experience through a pilot parenting support program to improve the quality of contact visits in non-kinship foster care

Despite the important impact that contact with birth parents during non-kinship foster care can have on a child's well-being, there are few psychoeducational programs aimed at improving the quality of visits. The purpose of this study was to analyze the perceptions of changes in birth parents who have completed the first program of this kind to be developed in Spain, here in its pilot application. The aim of the program Visits: a context for family development is to improve parents' emotional, communication, and parenting competences, and it comprises a total of seven sessions: six individual sessions that take place in the hour prior to consecutive scheduled visits with the child, and one group session involving all participating birth parents. A total of five families began the program, and three mothers completed all seven sessions. We conducted semi-structured interviews with mothers before and after the intervention so as to explore their perceptions regarding changes in their parenting competences and the quality of visits with their child. These data were complemented by participant-observer notes taken by one of the researchers during program sessions. Through content and semantic network analysis of interviews, we were able to identify changes in relation to five aspects of contact visits following participation in the parenting program. The results suggest that the program has the potential to enhance the parenting competences of birth mothers, to improve parent–child interaction during contact visits, and to encourage collaboration between the birth and foster families. These preliminary findings support the utility of the program for improving the quality of contact visits between birth parents and their children in non-kinship foster care.

Fostering educational prosperity: A randomized controlled trial of home tutoring in foster care

AbstractThe educational gap between children in out‐of‐home care and their non‐placed peers is well‐documented. However, tutoring stands out as a promising intervention to raise children's educational attainment in out‐of‐home care. This study randomized 105 children in foster care (62% girls, aged 7–15 years [M = 10.3, SD = 2.0]) to the home tutoring program Foster Caregivers as Tutors (FCT) or regular public school services (treatment as usual [TAU]). In the FCT group, the foster caregivers tutored the children for 2.5 h/week for 40 weeks. The program effect is measured in learning and developmental outcomes, including reading and math ability, learning skills, IQ, executive function, and psychosocial function. Follow‐up was 17.5 months after baseline. The results show a significant effect over time in both groups on IQ (effect size [ES] = 0.40, P &lt; 0.001), verbal comprehension (ES = 0.29 P = 0.02) and perceptual reasoning (ES = 0.60, P &lt; 0.001) measured by WISC IV. Neither the FCT nor TAU provided any significant academic recovery in reading and math nor progression in executive function, learning skills or psychosocial function. These findings, implications for practice and future efforts to support the schooling of children in out‐of‐home care are discussed.

Forced Displacement and Violence Against Children in Bidibidi Refugee Settlement

This study sought to examine the impact of forced displacement on violence against children. Forced displacement relates to the coerced movement of persons because of either natural or manmade disaster, while violence against children refers to the deliberate usage of physical force or power, either threatened or actual, on oneself, another child or a group of children with resultant impact on the child’s physical, emotional, and psychological wellbeing. The study was guided by three objectives which included examining the causes of violence against children in the Bidibidi refugee settlement, examining the forms of violence against children in the Bidibidi Refugee settlement, and examining the effectiveness of existing mechanisms to prevent and respond to violence against children in Bidibidi Refugee settlement. In this study, the researcher adopted mixed-method research where both qualitative and quantitative data was collected. The researcher also applied descriptive research to carry out the study. The population of the study was 283,000 from which a sample of 399 was arrived at using the Slovene formula for sample size determination. Respondents were sampled through stratified sampling technique for the survey respondents and purposive sampling for the Key informants. Data was collected using questionnaires, interview guides and focused group discussion guides and was analysed using mean and standard deviation. The study found out that VAC is happening in Bidibidi and is being influenced by several factors including separation of children from parents, lack of livelihood opportunities for caregivers, and lack of awareness raising on child rights. The study further found that unaccompanied children (UACs) in foster care, child-headed households, and adolescent girls are the main categories of children at heightened risk of sexual, physical, and emotional violence.

Socio-psychological analysis of foster families’ safety

The relevance of this work lies in the fact that success is one of the main criteria of life in modern society. With regard to children who are in foster care or under custody, the phenomenon of success acquires increased importance because it is an indicator of how well a child has adapted to society and revealed his/her individual characteristics and talents.The main purpose of our work is to study the factors influencing the successful self-fulfillment of children in foster care or under custody.

Success stories of children taken into care or custody (in history and modern times)

The relevance of this work lies in the fact that success is one of the main criteria of life in modern society. With regard to children who are in foster care or under custody, the phenomenon of success acquires increased importance because it is an indicator of how well a child has adapted to society and revealed his/her individual characteristics and talents.The main purpose of our work is to study the factors influencing the successful self-fulfillment of children in foster care or under custody.

Exploring early termination patterns and effectiveness of trauma-focused cognitive behavioral therapy for children in foster care

Children in foster care experience trauma at a high rate, resulting in their need for effective and accessible mental health treatments. Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) has the potential to significantly improve the functional impairment and post-traumatic stress symptoms (PTSS) of children in foster care who fully complete treatment without terminating early. The purpose of this study was to explore child- and setting-level predictors (age, sex assigned at birth, race and ethnicity, treatment setting, and pre-treatment level of post-traumatic stress symptoms) of early termination and multifaceted TF-CBT effectiveness outcomes within a statewide practice initiative (N = 399). Accessibility and completion of TF-CBT within this sample of children in foster care were measured by early termination rates. Older children (7.8% more likely) and those receiving home-based TF-CBT (57.1% more likely) terminated TF-CBT early at significantly higher rates. No differences in treatment completion were found for race and ethnicity, sex assigned at birth, or pre-treatment PTSS. Results support that TF-CBT can improve PTSS and associated functional impairment at a degree that is statistically and clinically significant for children in foster care. Implications of study findings for TF-CBT treatment of foster care youth who are older and receiving home-based care are provided.

Developmental research for social foster care and parental support

Developmental research for social foster care and parental support Japanese child welfare services serve over 42,000 children in social foster care. Almost 80% of these children receive these services at care facilities, and foster parent placement rates are comparatively lower than in other countries. The international community viewed this as a problem after Japan ratified the Convention on the Rights of the Child in 1994. The Convention establishes residential care as a less readily utilized option. Here Professor Keiji Noguhci at Fukuyama City University, in the Faculty of Education, presents a practical model for social foster care in Japan.

FOSTER CARE: YES OR NO? THE DECISION-MAKING PROCESSES OF SOCIAL WORKERS RENDERING FOSTER CARE SERVICES

Decisions made by social workers play a crucial role in foster care. Despite the challenging conditions under which social workers work in South Africa, they continue to make decisions to place children in foster care. There is a lack of research on the decision-making processes of social workers rendering foster care services. A need to understand what decisions are made and how these decisions are made prompted this study. A qualitative approach was applied using the multiple case study design, with explorative, descriptive and contextual designs. Most social workers make decisions using a mix of intuition and empirical evidence, justifying the child's best interest as the basis for their decisions. This study contributes to the knowledge of the decision-making processes of social workers rendering foster care services. This knowledge can enable social workers to be consciously aware of their own decision-making processes during all the phases of rendering foster care services, facilitating transparent decision-making, with the best outcome for the foster child and his/her biological and foster family.