Children In Foster Care Research Articles

Navigating the complex behavioral landscape of children in foster care and adopted families

Navigating the complex behavioral landscape of children in foster care and adopted families

Infant mental health services for birth and foster families of maltreated pre-school children in foster care (BeST?): a cluster-randomized phase 3 clinical effectiveness trial.

Children entering foster care are at high risk of poor mental health. In this single-blind, cluster-randomized phase 3 trial, 382 families with 488 0-5-year-old children, entering foster care, were randomized to the New Orleans Intervention Model (NIM) or social work services as usual (SAU). NIM offers infant mental health assessment (~3 months) and treatment (6-9 months) to children and to their birth and foster families, aiming to improve child mental health and recommend return home or adoption. The principal outcome was child mental health, as measured by the Strengths and Difficulties Questionnaire Total Difficulties (SDQ-TD) scale at 2.5 years after study entry. In total, 286 families (149 NIM and 137 SAU, 367 children) were followed-up (79.4%). Intention-to-treat analysis found no intervention effect of NIM: mean (s.d.) SDQ-TD NIM, 11.5 (7.6); SAU, 11.1 (7.2); adjusted mean difference (NIM - SAU), 1.4; 95% confidence interval (-0.63, 3.53); P = 0.17. No within-trial effects for primary or secondary outcomes were observed. Despite its components being delivered to a high standard, the UK legal context surrounding NIM led to it being impossible to deliver to all eligible families, and less than 70% of families received the intervention to which they were randomized. Future research will be required to evaluate NIM in more favorable social and legal contexts. ClinicalTrials.gov registration: NCT02653716 .

Prevalence and Factors Affecting Delayed Development of Early Childhood in the Rangsit Children’s Home

Background: The period from birth to five years is crucial for brain growth, more than at any other time in life. Proper development during this time can significantly impact the child’s foundational quality of life. This is especially true for children in foster care, who often come from backgrounds that put them at risk of developmental delays. Objective: To investigate the prevalence of suspected developmental delays and identify factors associated with these delays in early childhood at Rangsit Children’s Home. Materials and Methods: A cross-sectional descriptive study was conducted, focusing on 88 children aged one to five years at Rangsit Children’s Home, along with eight caregivers. The data were collected between July 1, 2022 and June 30, 2023, using the Early Childhood Development Surveillance and Promotion Manual (DSPM) for developmental evaluation and questionnaires for gathering general information and developmental factors, completed by caregivers. Data analysis was done using SPSS Statistics, version 25. Results: Among 88 children, most were male and aged three to five years. A significant number of these children came from broken families, with the majority entering the welfare center at zero to one year of age. The developmental assessment revealed that 56 children (63.6%) were suspected of having developmental delays, predominantly in language understanding and usage. Factors significantly associated with these delays include staying less than a year in the care home between the age of one to three years, weight, and being under the care of caregivers with at least a grade six or vocational certificate education. Conclusion: A notable 63.6% of children in the Rangsit Children’s Home showed suspected developmental delays, with language skills being the most affected area. Key factors associated with these delays include the child’s age, being one to three years, weight, duration of stay of less than one year, and caregiver’s education level. These findings suggest the need to enhance developmental support, particularly in language development during early institutional care.

From foster care to incarceration: A prospective analysis of the National Youth in Transition Database.

From foster care to incarceration: A prospective analysis of the National Youth in Transition Database.

Economic evaluation of a complex intervention to improve the mental health of maltreated children in foster care (BeST? Services trial)

Abstract Background Children in foster care who have experienced abuse and neglect are at risk of poor long-term health and societal outcomes. Evidence on the costs, benefits and cost-effectiveness of early interventions aimed at improving the mental health of abused and neglected children is limited. Methods This study reports the within-trial economic evaluation alongside BEST?, a randomized controlled trial comparing the New Orleans Intervention Model (NIM) with services as usual (SAU), targeting children aged 0–60 months entering UK foster care. In line with guidance for conducting economic evaluations of complex and social care interventions, a cost-utility analysis (CUA) estimated incremental cost of NIM per quality-adjusted life year (QALY); a cost-effectiveness analysis estimated incremental cost per unit improvement in child mental health; and a cost-consequence analysis combined costs with broad-ranging outcomes. Results NIM is significantly more costly than SAU (NIM: £10 002; SAU: £4336), with wide cost variations according to context. There are no significant differences between NIM and SAU in QALYs or child mental health. Conclusions Within the current UK care systems, NIM is not a cost-effective alternative to SAU. However, these results need to be interpreted with caution and within the prevailing service provision context.

Navigating Foster Care: A Practical Guide for Advanced Practice Registered Nurses.

Navigating Foster Care: A Practical Guide for Advanced Practice Registered Nurses.

Separation and psychosocial challenges of parents with children in foster care

Separation and psychosocial challenges of parents with children in foster care

Addressing Kinship Caregivers' Ambivalence and Internalized Stigma to Improve Acceptance of Financial Assistance for Children in Foster Care.

Financial assistance programs, such as the Kinship Guardianship Assistance Program, provide essential ongoing support for the care of children when reunification with their biological parents or adoption by other families is not feasible. However, these programs are underutilized by relatives who step in to provide stable, permanent homes for these children, partly due to unresolved internal conflicts about accepting financial support for caring for family members. Formative data (N = 178) and Bayesian inferential methods were used to examine whether a tailored training and support program for kinship caregivers could influence the internal conflict and attitudes of these caregivers concerning their acceptance of financial assistance. The study also assessed whether reductions in internal conflicts differed by program delivery mode: in-person versus virtual. Findings indicate that internal conflicts and stigma (a) reduced after participation in the program, (b) reduced with both delivery modes, with greater reductions among the virtual participants, but (c) did not reduce for participants of the standard foster parent training program. Results trending in the desired direction indicate that kin-specific training and programs may have crossover effects on internalized financial stigma, thus highlighting the need for future evaluations to affirm these results and inform intervention planning.

THE CONTRIBUTION OF COMMUNITY VOLUNTEERS IN FOSTER CARE PLACEMENTS OF CHILDREN LIVING WITH HIV: TOWARDS COMPREHENSIVE AND SUSTAINABLE SERVICES

This article discusses the importance of involving community volunteers to contribute towards meeting the needs of children in foster care living with HIV. This discussion is anchored in Abraham Maslow’s theory of the hierarchy of human needs. The findings presented in this article emanated from a broader study that was conducted in the City of Johannesburg with social workers and community volunteers. This article discusses qualitative results which were derived from the semi-structured interviews conducted with community volunteers consisting of eight social auxiliary workers and twelve community caregivers. The participants were selected from drop-in centres using a purposive sampling strategy. The data collected were analysed thematically. The findings revealed that community volunteers offered services such as food/nutrition services, home visits, psychosocial support, homework assistance, HIV support groups, HIV adherence programmes and linking children living with HIV to care. However, very few children who were in foster care placements benefited from these services. It is concluded that the programmes rendered by community volunteers were unable to attract children in foster care, despite the children needing these services. Therefore, the study recommends a collaboration between foster care social workers and community volunteers for children in foster care to benefit from these services.

293 The case for investigating the palliative needs of children in foster care: A call to action

Objectives/Goals: The purpose of this study was to document the publicly available literature, measurement tools, secondary data, and expert perspective on the intersectional care gaps and disparities of children with palliative needs in foster care. Methods/Study Population: Four data collection methods determined the frontier of available information on the palliative needs of children in foster care. A literature review assessed the quality and content of published evidence. A catalogue of relevant measures tools and validation results determined what psychometric tools exist for the population, how well they performed in validation studies, and if any incorporated community members in their development. The National Data Archive for Child Abuse and Neglect was consulted to assess whether existing secondary data was fit for purpose. Informal interviews will be conducted with subject matter experts (pediatrics, palliative care, foster care) to determine the legitimacy and urgency of the problem. Results/Anticipated Results: Health inequities among children in foster care and children with medical complexity (CMC) suggest a strong likelihood of unmet palliative care needs for CMC in foster care; however, no literature or data describe the scope and severity, and few insights support development of safe and supportive interventions to meet these needs. No national publicly available datasets include both foster-related case or placement information and diagnosis or service-specific data, including Medicaid data and the Adoption and Foster Care Analysis and Reporting System (AFCARS). No work has been published integrating foster parents or former foster youth input on palliative needs. Participatory action research methodologies with critically ill patients have led to improvements in patient experience and clinical care. Discussion/Significance of Impact: The lack of data, community engagement, and validated measures to identify palliative needs of children in foster care stymie efforts to identify and correct health inequities. Participatory action research is needed to meaningfully engage foster and health care partners to determine what palliative care needs should be prioritized and measured.

Benefits and Challenges of Providing Telemental Health Services for Children in Foster Care in a Southeastern State: Perspectives from Telemental Health Providers

Benefits and Challenges of Providing Telemental Health Services for Children in Foster Care in a Southeastern State: Perspectives from Telemental Health Providers

“It Is Possible to Call More People Mum”—Contact Between Children in Foster Care and Their Birth Parents

Contact arrangements in child protection can often create conflicts and distress. This is an area the Norwegian Child Welfare Services (CWSs) have paid greater attention to in recent years, to a large degree due to several recent decisions made by the European Court of Human Rights (ECHR) in the early 2020s and Norway’s Supreme Court in March 2020, as well as subsequent case law, all highlighting the importance of post-care contact. In the article, we focus on conditions that contribute to successful contact arrangements. We also discuss how CWSs can organise such arrangements in ways that lead to cooperative relationships around the children. The article analyses data from two cases where all those participating in the contact arrangements agreed that they worked well. In addition, we draw on supplementary data from a survey of caseworkers in the CWS about their experiences and assessment of contact arrangements in 525 cases. The analyses show that flexibility, openness, recognition, dialogue, and participation are particularly significant. It is essential to look at contact arrangements as ongoing processes, incorporating changes occurring in the child’s situation, the parents or the foster parents.

Examining the reliability of the administrative case review process of a state child welfare system.

Examining the reliability of the administrative case review process of a state child welfare system.

Agency in the developmental paths of young adults with a foster care background

Foster care children are at a higher risk of experiencing social or health problems in their lives ( Sariaslan et al., 2022 ). Nevertheless, some youth show high adaptiveness when engaged in work, schooling and forming family relationships ( Jones, 2011 ). The present study focuses on agency in the developmental paths of 18 young adults (14 females, four males, aged 18–32 years old) with family foster care backgrounds. Four main narratives emerged from analyses of individual interviews with these participants: (1) Relational agency; (2) Restricted agency; (3) Accommodated agency; and (4) Independent agency. The young people’s narratives involved affordances and constraints with respect to the manifestation and development of agency at different phases of their lives. This study is part of a larger project that examines factors contributing to the resilience of these young people; family foster care is the most common form of care in Finland, but there is scant literature highlighting the experiences of the young people affected. The findings can help both those working within care to understand the factors that facilitate resilience and the young people themselves to reflect on the potential to influence their lives. The findings can deepen our understanding of the support that fostered youth need to cope with their early experiences and to develop their own agency.

Caring for youth in foster care: A trauma-informed practice guide.

Providing comprehensive healthcare to children in foster care can be challenging. Youth placed in foster care are a vulnerable population of patients who often have complex trauma histories and chronic healthcare needs that are further compounded by fragmented and transient healthcare. With an estimated 368,000 children in foster care in the US in 2022 based on the most recently available national data, it is critical for providers to understand the challenges associated with providing care to this population and to know how to address them. This discussion provides healthcare providers with a practical, trauma-informed guide to caring for youth in foster care rooted in evidence-based practice and current guidelines.

Improving the quality of contacts during foster care: Learnings from foster families

Abstract Contact visit with the family of origin during foster care is a recognized right in Spain, although these contacts are often not of quality. The current study examines the changes achieved by foster families who have completed the parental education programme Visits: a context for family development to improve the quality of the visits that children in non-kinship foster care have with their birth parents. Qualitative research was conducted using semi-structured interviews before and after the intervention with six foster carers from four foster families. This study demonstrates the short-term effectiveness of the potential of this programme to improve the quality of contact visits and collaboration relationships between birth and foster families. It highlights the importance of adequately preparing foster carers to enhance contact visits quality, by promoting parenting skills, encouraging communication between the foster carers and the child, and providing resources to manage the preparation of children for visits. My Visits Book is a resource that helps foster carers to feel more engaged in collaboration with birth families. These findings are relevant for child welfare practitioners to promote positive parenting during foster care and contact, creating rewarding experiences for parties involved.

Occupational Therapists Enhance Comprehensive Health Assessments for Children in Foster Care

Aims Children in foster care (CFC) have prevalent developmental health needs. Comprehensive health assessments (CHA) that include development evaluation are recommended for CFC. The impact of adding occupational therapy (OT) to multidisciplinary CHA teams is unknown. We aimed to describe findings from OT evaluations performed as part of CHA for CFC and determine if OT evaluation influences developmental health recommendations. Methods Retrospective study at a clinic for CFC that included 335 children with OT evaluation during their CHA and 217 without OT evaluation due to limited availability. OTs performed developmental components of CHA using observation and standardized testing. We used descriptive statistics, and chi-square and Fisher’s exact tests to compare developmental health recommendations between patients with and without OT assessment. Results Median age was 8.3 years (range 0, 19). At least one aspect of development was delayed in 230/335 (69%) children evaluated by OT. OTs provided strategies to strengthen development to 74% of evaluated youth. Children seen by OT received significantly more developmental referrals compared to controls (38% versus 58%, p<.001). Conclusions Our findings suggest rehabilitation specialists such as OTs can enhance detection of developmental needs and provide strategies to strengthen development when included in CHA for CFC.

Psychosocial aspect and medical co-morbidity in Foster Care Children in Assiut Governorate

Background and aim Childhood is a developmental stage in which the importance of reciprocal emotional bonding between a child and his/her caregivers for healthy physical, psychological, and social development has been known for centuries. The Ministry of Social Solidarity regulates Foster care in Egypt according to detailed procedures of the child law No. 126 for 1996 and its amendments of 2008. We aimed to assess psychosocial aspects and medical co-morbidities in foster care children in the Assiut governorate and compare psychosocial problems and medical co-morbidities between foster care children and school children in the Assiut governorate. Patients and methods We compared a cross–sectional observational study psychosocial problems and medical co-morbidity in 50 children aged from 5 to 18 years old from September 1, 2018 to September 30, 2022 selected from Assiut governorate foster care centres to 50 healthy children from Assiut governorate schools matched for age and sex. Results There is a significant increase in attention problems, aggressive behavior, conduct disorder, bullying behavior, and attention-deficit hyperactivity disorder, depression, in foster care children. No difference in the prevalence of medical conditions between the two groups. Conclusion Children living in foster care are more prone to suffer from various mental health problems which are more prevalent in foster care children than other populations.

An Investigation of Developmental Disabilities and the Experience of Abuse Among Children in Foster Care

An Investigation of Developmental Disabilities and the Experience of Abuse Among Children in Foster Care

Evaluating the Feasibility of Utilizing Telehealth With Youth in Foster Care

Evaluating the Feasibility of Utilizing Telehealth With Youth in Foster Care