Children Return Home Research Articles

Boomerang children and parental retirement outcomes

AbstractAs the share of U.S. adult children living with their parents increases, it is important to understand how children who “boomerang” back home impact their parents in their pre-retirement and post-retirement years. We use data from the Health and Retirement Study (HRS) to examine the effects of boomerang children on their parents’ labor market expectations and choices, as well as on their wealth, health, and life satisfaction. Event study analysis suggests that boomerang children return home due to short-term instabilities, such as negative shocks to marriage, income, and employment. We find that boomerang children are associated with a small increase in their parents’ subjective probability of working after age 65, and with a temporary increase in their parents’ non-housing debt. However, in the aggregate, we find no clear evidence that boomerang children impact parents’ current or future labor market choices, overall wealth, health, or life satisfaction. (We do find some evidence of an increase in hours worked among parents in the bottom wealth decile). One possible explanation for the lack of aggregate impact is that boomerang children contribute to household expenses. We find that boomerang events are associated with an increase in financial transfers from children to parents, particularly among parents in the bottom half of the wealth distribution.

Inkendaal Paediatric Partial Day Hospitalisation

Inkendaal Rehabilitation Hospital is a neurorehabilitation hospital in Flanders (Belgium) with 178 in-patient beds subserving 15 defined rehabilitation trajectories for adults and children. The rehabilitation trajectories are also organised within an outpatient department for adults and children. The children's outpatient department offers an integrated programme that includes education, interdisciplinary therapy and care. The target groups of the outpatient paediatric operation are children with acquired brain injury, cerebral palsy, neuromuscular disorders, spinal cord disorders, autism spectrum disorder, other developmental disabilities and deconditioning following a period of intensive care or long-term hospitalisation. 
 Within the paediatric partial day hospitalisation, intensive, transdisciplinary rehabilitation is offered in combination with care and education, for children and adolescents with complex rehabilitation needs, whose development as well as school and societal participation is at risk. Management and care are designed and delivered within the ICF-framework.
 The partial day hospitalisation for children and adolescents accommodates 80 children aged, every year, 1 to 12 and 16 adolescents aged 13 to 18. An average of 80 children attends daily.
 The children attend the partial day hospitalisation and hospital school daily for a full school year or two school years. Funding is from the rehabilitation hospital budget (BRZ) by the federal government of Belgium, supplemented by federal hospital nomenclature for monodisciplinary services. However, the BRZ only provides funding for 60.
 Through intensive collaboration between the Ministries of Care, Health and Education, financial resources can be pooled (infrastructure), staff deployment can be handled flexibly and a transdisciplinary rehabilitation offer can be pursued throughout the school day. 
 The children spend the entire school day in a rehabilitation class with their regular class instructor. The different disciplines (nursing, teaching, rehabilitation: speech and language, physical, occupational therapy) pursue the shared objectives with a child (as determined in discussion with the child and family) during individual therapy, group therapy or in the classroom with the teacher, based on the needs of the child and the parents, and taking the environment in to account. In this way, efforts are made to increase the child's opportunities for participation in order to achieve social integration, optimal educational opportunities and increased self-reliance. In the evening, the children return home, so that the home context can also be mobilised and involved in the pursuit of the child's rehabilitation goals. Every 3 months, there is a team meeting and a meeting with the parents to monitor progress with respect to the goals and requests for help, and eventual update of the goals. Medical follow-up can be provided on the service by the presence of a paediatric neurologist and nursing staff. 
 
 Within the partial day hospitalisation, 16 teachers are present daily, together with 11 care staff (first level and specialist nurses) and 1 paediatric neurologist. There are 6 FTE physiotherapists, 5 FTE speech therapists, 3 FTE psychologists, 5 FTE occupational therapists and 1 conductor (conductive education) working weekly.
 The department is managed by the doctors, the head therapist, the head nurse and the director of the hospital school.

Implementation of 21st Century Learning Oriented to the Independent Curriculum in Islamic Religious Education Learning at SMA Negeri 1 Tarik Sidoarjo

Learning in the 21st century era faces various complex challenges. In the midst of this situation, the world of education has a crucial role and responsibility in facing and responding to these challenges. The government has taken innovative steps by introducing an independent curriculum as an effort to overcome these challenges. This research is qualitative research with a descriptive character. The data collection techniques used were in-depth interviews, observation and documentation. Data analysis is carried out through data reduction, data presentation and then drawing conclusions. The results showed that: 1. Learning at SMA Negeri 1 Tarik Sidoarjo applies the 4C principles (Critical thinking, creativity, collaboration, and communication), 2. The supporting factors for the 21st century learning process are adequate facilities and infrastructure, 80% of learning uses digital media, supported by teachers' IT mastery. Meanwhile, the inhibiting factor regarding the material which according to students and parents is a bit burdensome is because there are a few projects, a little work. As well as parents or guardians complaining about their children's return home being sometimes late or often having a lot of extra work.

A Horse Is a Horse

A Horse Is a Horse

The lived experience of parents whose children discharged to home after cardiac surgery for congenital heart disease.

Background: Congenital Heart Diseases (CHDs) afflicting children are estimated in 8 per 1000 live births. Recent advances in surgery and medical treatments allowed an improvement in survival rates leading to changes in diseases management as chronic conditions. Parents involvement during clinical pathways is considered an essential component of care, but frequently they experience stress and anxiety conditions during the care path. These feelings are typical of the pre and peri-operative period, however they don’t disappear easily and sometimes they can increase after hospital discharge, affecting the family environment and its behaviors. Aim of the work: The purpose of this qualitative study is to examine the lived experience of parents during the time just after their children return home from hospital after undergoing surgery for CHD. Methods: Parents were enrolled and interviewed as a prepositive sampling until concept saturation using Cohen’s phenomenology approach. A quantitative approach was also applied using SF-12 questionnaire. The study was conducted in two Italian hospitals: the Pediatric Heart Surgery Center of the Fondazione Toscana G. Monasterio Institute in Massa and the Pediatric Cardiac Surgery Center of the Federico II University Hospital in Naples. Results: The main themes emerged after the analysis were “happiness and uncertainty”; “chronic psychophysical fatigue”; “the rediscovery of a strong link with health care professionals”. Conclusions: Fully understand the life experience of these families will allow the implementation of targeted health interventions through the implementation of shared strategies and tools to reduce families and children discomfort after hospital discharge.

E.G.O.: The Passions of Eugene Gladstone O'Neill: A play in two acts (excerpted)

<i>E.G.O.: The Passions of Eugene Gladstone O'Neill</i>: A play in two acts (excerpted)

Medical Service Utilization Among Youth with School-Identified Disabilities in Residential Care

Background Behavioral, social, emotional, and educational risks among children and youth with school identified disabilities served in residential care have been well documented. However, the health care needs and medical service utilization of this high-risk population are less well known. Given the risks associated with children with disabilities, one might expect that medical care usage is elevated and will continue to be a need when children return home or age out of the system. The purpose of this study was to evaluate if medical service utilization differed between youth with and without school-identified disabilities in care, and whether certain correlates (e.g., demographic characteristics and mental health functioning) would be associated with medical service use among youth with disabilities.

Exploring the needs of parents for achieving reunification: The views of foster children, birth family and social workers in Spain

BackgroundFamily reunification refers to the process through which children and adolescents under a measure of temporary separation (foster care or residential) return to live with their biological families. The research has begun to reflect a paradigm change in intervention and support for these families that affects the consolidation of reunification and the prevention of new processes of separation and reentry into the protection system. ObjectivesThis article examines the needs of parents who are susceptible to an educational intervention from a positive focus that contributes to the consolidation of family reunification. MethodEighteen semi-structured interviews were conducted and 22 discussion groups were convened with 135 participants (63 protection-system professionals, 42 parents and 30 children and adolescents). The data were analyzed through content analysis and were subject to peer revision. ResultsA series of parents' specific educational needs when their children return home was recognized. These needs can be the objects of family intervention based on a positive focus directed toward highlighting parents' strengths and are related to awareness of family progress, emotional management, giving and receiving help from other families and social support. The participants' comments show that feelings of self-sufficiency and positive reinforcement are fundamental for consolidation of the process. ConclusionsSocial support through formal and informal networks may be a path to explore for providing more and better support after returning home. Empowering families so that they can be agents of support for other families can be a way to consolidate reunification, allowing families to be active agents in the reunification process. In addition, listening to children's voices can be a good strategy for family consolidation.

Person-to-person transmission of norovirus resulting in an outbreak of acute gastroenteritis at a summer camp.

A significant proportion of norovirus (NV) gastroenteritis outbreaks described in the Spanish literature have been because of contaminated food or water. This study describes an outbreak of acute gastroenteritis because of NV in which there was person-to-person transmission. A retrospective cohort study was carried out; we established the case definition for primary and secondary cases. An epidemiological survey was designed, including possible food exposures, and clinical and laboratory data. Water and stool samples were taken from affected individuals and food handlers. The presence of NV was detected using a reverse transcription-PCR assay. We analyzed the risk of gastroenteritis using relative risk and its 95% confidence interval as the measure of association, and estimated the basic reproductive number (R0). The primary attack rate was 45.0%, with no significant differences between sexes. The secondary attack rate during the camp stay was 22.7%. The basic reproductive number for 5 days was R0=2.62. The most frequent symptoms were abdominal pain (85.7%) and vomiting (81.9%). Epidemiological analysis showed no association with food or drinking water. A total of 66.6% (8/12) of stool samples tested positive for NV (genogroup II). Control measures in general, and hand hygiene in particular, should be extended to the families once the children return home, to prevent secondary cases in NV outbreaks.

Maltreatment following reunification: Predictors of subsequent Child Protective Services contact after children return home

Objectives This study examined risk of maltreatment among children exiting foster care using a statewide sample of children reunified between 2001 and 2004 in Rhode Island. The objectives were: (1) to compare rates of maltreatment following parental reunification for youth in care as a result of maltreatment with those in care for other reasons; and (2) to assess the effects of child, family, and case characteristics on rates of re-maltreatment among children placed in foster care due to maltreatment. Method A longitudinal dataset of all reunified cases was matched with state records of substantiated Child Protective Service (CPS) investigations. Two Cox proportional hazards models were tested. The first model compared rates of subsequent maltreatment for two groups: children in foster care as a result of maltreatment, and those in care for other reasons. The second model investigated the effects of child, family, and case characteristics on re-maltreatment rates for those in care as a result of maltreatment. Results Children in foster care due to maltreatment were significantly more likely to be maltreated following reunification. Among children in foster care due to maltreatment, factors that raised risk for re-maltreatment included a previous foster care placement, exiting care from a non-relative foster home, and removal due to neglect. Older adolescents had lower rates of re-maltreatment than infants. Child neglect was the primary type of recurrent maltreatment that occurred following reunification. Conclusions Supports are needed for families about to be reunified, particularly when the removal was prompted by incidents of abuse or neglect. Incidents of neglect are particularly likely and appropriate services should specifically target factors contributing to neglect. Cases involving youth with a history of repeated foster care placement or in which non-relative placements are utilized may need additional supports. Practice implications This study suggests that services should be developed to minimize the risk for recurrent maltreatment following reunification. Services would be most useful for high-risk cases prior to reunification and during the first year following reunification. Understanding the risks associated with maltreatment will help guide development of appropriate interventions.

Reunification with Children in the Context of Maternal Recovery from Drug Abuse

Little is known about mothers' experiences of reunification with children in the context of recovery from drug abuse. Using a stress and coping framework, this qualitative study interviewed 6 mothers and 11 service providers from substance abuse and child welfare agencies regarding reunification experiences. Analysis of themes indicated that multiple parenting stressors and lack of resources and supports complicate women's abilities to manage parenting pressures upon reunification. Maternal readiness for reunification was an important theme; returning children prematurely heightens risk for poor outcomes, especially if insufficient services are in place to support children's return home. The stress of dealing with child protective services and multiple service systems was another theme. Implications for service provision to mothers and families are discussed.

Health and Well-Being of Children in Foster Care Placement

1. Sandra H. Jee, MD, MPH 1. Department of Pediatrics University of Rochester Rochester, NY 1. Mark D. Simms, MD, MPH 1. Department of Pediatrics Medical College of Wisconsin Milwaukee, Wisc Improving the Odds for the Healthy Development of Young Children in Foster Care . Dicker S, Gordon E, Knitzer J. National Center for Children in Poverty: Columbia University Mailman School of Public Health. Promoting the Emotional Well-Being of Children and Families (Policy Paper No. 2). January 2002;1–28 Children and Family Services Reviews, Part V: Most States Fail to Meet the Mental Health Needs for Foster Children . Huber J, Grimm B. Youth Law News . 2004;Oct-Dec:1–36 CWLA Standards for Health Care Services for Children in Out-of-Home Care . Washington, DC: Child Welfare League of America; 1988. Educational Experiences of Children in Out-of-Home Care . Smithgall C, Gladden RM, Howard E, Goerge R, Courtney M. Chicago, Ill: Chapin Hall Center for Children at the University of Chicago; 2004:1–77 Fostering Health: Health Care for Children and Adolescents in Foster Care . 2nd ed. Task Force on Health Care for Children in Foster Care, American Academy of Pediatrics, District II, New York State. Elk Grove Village, Ill: American Academy of Pediatrics: 2005 Healthy Foster Care America . www.aap.org/advocacy/HFCA/ On any given day, more than 500,000 children are living in state-supported foster home care. In the course of a year, more than 800,000 children experience placement in a foster home. Many of these children return home quickly, but for some, placement may extend for years and may involve care in multiple foster homes. Most of the children have experienced serious family dysfunction prior to placement, including exposure to domestic violence and to their parents’ mental health disorders, addiction, or criminal activity. Serious neglect and abuse are the most frequently stated reasons for removing children from their parents’ care. Children entering foster homes have extremely high rates of physical and mental health problems, developmental delays, and educational underachievement. As a group, children in foster care …

Bill Seeks to Reverse Trend Of Parents Ceding Custody

Bill Seeks to Reverse Trend Of Parents Ceding Custody

Using the resiliency model to deliver culturally sensitive care to Chinese families

In 1998, 4% of U.S. children were Asian/Pacific Islander; of these, 23% were Chinese. The incidence of infants with congenital heart defects (CHD) in Chinese children approximates that of Caucasian children in the United States. Parents of children with CHD are faced with caring for the children at home after surgery. Parents' roles and responsibilities expand significantly as their children return home with complex care needs. In pediatric nursing, we not only take care of the individual child but also the family as a whole. The family is the primary institution in society that preserves and transmits culture. Understanding Chinese culture and its association with health care practice helps nurses to establish culturally sensitive nursing interventions; develop appropriate discharge plans; decrease family stress; reduce future medical hospitalization costs; increase positive coping, adaptation, and family function; and improve health outcomes of the child and the family. The Resiliency Model was used to examine its applicability in caring for Chinese families in this paper. Copyright 2002, Elsevier Science (USA). All rights reserved.

Empty nest or revolving door? A prospective study of women's quality of life in midlife during the phase of children leaving and re-entering the home.

This study documents changes in household composition and effects on women's quality of life of children leaving and returning home. A 9-year annual prospective study of a population-based sample of mid-aged Australian-born women who were premenopausal at baseline (N = 438) was conducted. Documentation was made of household composition and change, well-being, bothersome symptoms, daily hassles, feelings for partner and frequency of sexual activities. There was an increase in the number of women living alone, and a reduction in number of households in which there were children or parents. Each year > 25% of women reported a change in household composition. In the first year after the last child departed (N = 155), there was an improvement in women's positive mood and total well-being and a reduction in negative mood and the number of daily hassles. This improvement in mood was confined to those women who at baseline were not worried about children leaving home. In the first year after children return home there was a trend towards reduced frequency of sexual activities but no mood changes. For the majority of women, the departure of the last child from the household leads to positive changes in women's mood state and a reduced number of daily hassles. Return of offspring may have an adverse effect on sexual relating of the parents.

Growth, morbidity, and mortality of children in Dhaka after treatment for severe malnutrition: a prospective study

Over 1300 severely malnourished children (< 60% of US National Center for Health Statistics weight-for-height, with edema, or both) are admitted each year to the Children's Nutrition Unit in Dhaka. Fatality during treatment is low and recovery is rapid. Our aim was to determine whether this initial success is sustained when children return home. A previous attempt to address this question was frustrated by the difficulty in tracing children after discharge because most are from slum settlements and families move frequently. This prospective study with fortnightly monitoring was therefore undertaken. The main outcomes of interest were anthropometric status, relapse, morbidity, and mortality. Children (n = 437) who had been treated for severe malnutrition when aged 12-59 mo and had reached the discharge criterion of 80% of weight-for-height, were followed for the next 12 mo. During follow-up, 7.5% were lost without trace, 0.6% relapsed, and 2.3% died. Morbidity was high, with a mean of seven episodes of diarrhea during the year. Outpatient visits for diarrhea occurred for 67% of children, and 58% had pneumonia (10% had pneumonia three times). After 12 mo, mean weight-for-height was 91% (-0.92 z score) but mean height-for-age remained at 84% (-4.14 z score). Weight gain, but not height gain, tended to be lower in children who experienced more diarrhea. Fever and cough were not associated with either weight or height gain. The high prevalence of illness highlights the need for continued accessible health care and for interventions to reduce disease acquisition.

Shared Parenting: Assessing the Success of a Foster Parent Program Aimed at Family Reunification

Objective: There were two main objectives of the study: (1) To assess the effectiveness of a model of family reunification which united the role of parent aide and foster parent; and (2) to determine which characteristics of the families with children in care were associated with reunification. Method: A multisite project known as the Shared Parenting Project recruited families from five child protection agencies to participate in a program in which foster parents became extended rather than substitute families. Families were tested before the program began on a number of sociodemographic, psychological, and family measures. The success of the program was determined by whether the child was able to return home or if the program facilitated permanency planning. The success of the project was also examined by considering the relationship between returning home and a number of risk factors measured in the families with children in care. Results: Very few families who met the criteria for the project could be recruited and only 31% of the participants completed the program and returned home. The process of permanency planning was facilitated in another 50% of the cases. The more stable families with less risk factors were more likely to complete the program successfully and to have their children return home. Conclusions: The results indicate that although the treatment model has excellent potential with less at-risk families it could not meet the treatment needs of the majority of families with children in foster care in the five child protection agencies. It is recommended that this model could be most helpful offered through parent aides attached to community support agencies that could provide respite care, support, and resources to families as needed thus avoiding the child having to be placed in care.

"Boomerang Kids" and Midlife Parental Marital Satisfaction

BOOMERANG KIDS AND MIDLIFE PARENTAL MARITAL SATISFACTION* Barbara A. Mitchell and Ellen M. Gee** This study examines determinants of midlife marital satisfaction in 172 families with kids. The principal factors being considered include characteristics of leaving home and returning home that may influence parental marital satisfaction. Key findings suggest that child variables--particularly number of returns home and reason for initial homeleaving--are important determinants. The results are discussed in terms of professional interventions with small proportion of couples that are negatively affected by coresidence. Over past few decades, considerable changes have occurred in family life course, changes involving likelihood, timing, and sequencing of family transitions. We have, for example, witnessed significant increases in age at (first) marriage, a growing incidence of cohabitation, declines in number of births, and increases in likelihood of divorce. These changes, which have been welldocumented, point to a trend of nonfamilial living arrangements for larger portions of life course, a pattern first identified 20 years ago by Kobrin (1976) in a seminal article documenting the rise of primary individual. However, a countertrend has been observed in recent research on that part of transition to adulthood involving establishment of residence away from parental home. Adult children are remaining at home until older ages, in concert with recent increases in age at (first) marriage and a propensity for homeleaving just prior to marriage (e.g., Boyd & Pryor, 1989; DaVanzo & Goldscheider, 1990; Gee, Mitchell, & Wister, in press; Goldscheider & Goldscheider, 1994; Ravanera, Rajulton, & Burch, 1995). Also, children are more likely to return after first (and subsequent) departure from parental home (Weinick, 1995). Although this pattern is relatively common, it is not normative (Treas & Bengston, 1987), and it has affected family life course of both children and parents. Children have been characterized as a generation on hold (Cote & Allahar, 1994), and middle-generation adults face an empty that is less predictable and may be of shorter duration than they expected. Research on adult child-parent coresidence has examined its determinants (e.g., DaVanzo & Goldscheider, 1990; Gee et al., in press; Lewis, Volk, & Duncan, 1989; Mitchell & Gee, 1996; Speare & Avery, 1993), tending to focus on characteristics of children, such as age, sex, marital status, personal in come, and ambivalence about capacity to take on adult roles (e.g., DaVanzo & Goldscheider, 1990; Grigsby & McGowan, 1986, Schnaiberg & Goldenberg, 1989). Other research has investigated parent-child relationship(s) and flow of assistance during coresidence (e.g., Boss, Pearce-McCall, & Greenberg, 1987; Kuiack, Norris, & Tindale, 1994; Mancini & Blieszner, 1989; Shehan & Dwyer, 1984; Speare & Avery, 1993). However, with exception of two small studies conducted by Clemens and Axelson (1985), no research to date has focused upon midlife parental marital relationship in families with coresident boomerang adult children. Nevertheless, idea that coresident adult children have a negative impact on family well-being as a whole is rapidly becoming accepted as a social fact by media, general public, and some social scientists (Umberson & Gove, 1989). How-to books on coping with adult children at home (e.g., Okimoto & Stegall, 1987) are available, community support groups dealing with family problems associated with extended coresidence have sprung up, and media regularly highlight family difficulties experienced when adult children return home. Although implication is that cluttered nest children create major problems in family functioning, research is in its infancy and results are often contradictory. …

Why adult children return home

This article examines the question of why more young adults are living with their parents. The expectation of the 1960s and 1970s that grown children establish separate residence, even before marriage, began to erode in the 1980s. We asked a small, convenience sample of parents and coresident adult children to respond to two possible interpretations of the trend: (1) that children return home due to economic hardship, or (2) that children return home because they feel entitled to a particular standard of living. Parents and children concluded that economic factors drive adult children home again, but few of the adult children in this study had come home because of genuine economic hardship.

The management of post-circumcision penile contractures performed outside the medical profession

Circumcision is a religious tradition in many countries, especially for Muslims, Jews and others. It is fundamental for Muslims in the Middle East area, and it is rare to find an uncircumcised male after the age of puberty. Unfortunately, most village people bring their children to religious feasts and other ceremonies to be circumcised by non-medical people who claim to be experienced. The procedure is performed with a complete lack of hygenic conditions and the use of primitive instruments. Naturally, the children return home to their villages without either follow-up arrangements or dressing instructions. They are, therefore, susceptible to infection and serious adhesions which can lead to penile contracture. Such a case is presented in this paper. We have analyzed 20 cases presented to our hospital with penile contracture over a period of 1 1/2 years. The surgical technique for the repair of these deformities is presented.