Residential Child Care Research Articles

Emotion understanding in internationally adopted children and children in residential care: Developmental periods and mediation by language

Emotion understanding (EU) is a socio-cognitive skill that enables us to understand the expression of emotions in ourselves and others. Exposure to early adversity hinders its development, since quality social interactions are essential for its growth. Language is a critical component of EU, and therefore, it may be a mediator between early adversity exposure and EU. In this study, we analyzed EU development and the mediating role of language in the relation between early adversity and EU in internationally adopted children, maltreated children in residential care, and a community comparison group. Children ( N = 145) were between 4 and 8 years old at assessment. A total of 39 internationally adopted children, 48 maltreated children living in residential care, and a community comparison group of 58 children with no contact with child-protective services participated. We assessed EU using the Test of Emotional Comprehension and language using a receptive syntax language assessment. Both internationally adopted and maltreated children in residential care lagged behind community children in EU, with internationally adopted children showing a higher EU than children living in residential care in some areas. The effect of being in the adopted or residential care group on EU was mediated through receptive language, partially in the case of children in residential care. Results are discussed considering the potential for catch-up in socio-emotional development and the importance of adequate statistical modeling of mediator variables.

Validity of the Quality Standards Assessment for Children’s Residential Care

ABSTRACT Until recently, there were no validated measures of quality practice standards for youth residential programs, thus leaving a gap in the understanding of how residential programs are performing and ways to improve practice. The aim of this research was to test the validity of the Quality Standards Assessment (QSA) for youth residential programs and present evidence in a way that is accessible to practitioners and applicable to daily practice. Specifically, we present findings for the QSA using evidence from six approaches to evaluating validity:, face, content, factorial, construct, criterion, and ecological validity. The QSA was evaluated through a series of pilots and studies carried out from 2016–2022. Throughout this period of data collection, the research team tested the validity of the QSA. The results of this research lend preliminary support for the validity of the QSA as a measure of quality residential care for children and youth. Continued efforts to examine the QSA or related initiatives in other jurisdictions are needed to contribute to what we hope becomes a growing knowledgebase for quality measurement to support residential practice and policy.

Finding traces of everyday life in unusual places: looking beyond case files in German and Scottish residential child care

ABSTRACT Case records hold life-long significance for those who spent their childhoods in looked after care. Across Europe, public inquiries into the care and treatment of children in care have examined the content of records and have highlighted their limitations. This paper presents data from phase one of a wider study; ‘Archiving Residential Children’s Homes in Scotland and Germany (ARCH)’, which undertook content analysis of the archives of two residential settings, Aberlour and Freistatt. Findings highlight that records were kept and maintained not only by the institution but also for the institution. Despite this, children’s everyday lives were noticed and captured, albeit it often accidentally and incidentally. The ways in which these every day encounters were narrated and constructed suggest the power of the overarching ethos in place in the two settings and the adults’ orientations towards their role and purpose. Although different in tone and remit, both archives capture traces of daily life and tell us something about what a childhood in Freistatt or Aberlour might have been like. By examining the case recording practices in the past, we raise questions about what this means for contemporary social work and its responsibilities in relation to archiving children’s everyday childhoods.

Temperament Characteristics of Children in Residential Care and Perceived Acceptance/Rejection and Style of Discipline Used by Care Workers.

The ability to adapt interpersonal interactions to temperamental characteristics is essential for high-quality care. We analyzed how temperamental and self-regulation differences among children in residential care were related to the affective relationships and discipline styles of their caregivers. A total of 144 children aged 9-16 years (42.6% boys) and their caregivers from 22 residential care homes (Spain) participated. The Early Adolescent Temperament Questionnaire-Revised (EATQ-R) was used to assess temperament, the Affect Scale and Rules and Demands Scale was used to assess children's perceptions of affective relationships and discipline styles among their caregivers, and BRIEF-2 was used to assess children's self-regulation. Perceived warmth/communication was significantly higher than criticism/rejection and children perceived more inductive than rigid or permissive styles. Temperamental-scale fear was positively related to warmth/communication and an inductive style, and negatively related to criticism/rejection and a rigid style, whereas high-intensity pleasure showed the opposite pattern. In addition, some self-regulation and temperament scales explained 26% of the perception of warmth/communication, while others explained 15% of the variability of the rigid discipline style used by care workers. These results can help care workers to adjust their educational strategies according to the temperamental characteristics of this specific population.

Mental disorder diagnoses and symptoms and functional impairment in school-age children in the care of child protective services

Mental disorder diagnoses and symptoms and functional impairment in school-age children in the care of child protective services

Impact of clientelism on the rights of children in residential care: Cambodia and Myanmar

ABSTRACT Unregulated residential care facilities have continued to operate in Cambodia and Myanmar despite improvements to child protection laws, policies, and government commitments to care reforms. Children residing in these facilities have been admitted in contravention of legal gatekeeping mechanisms designed to prevent unnecessary separation and institutionalisation. Clientelism has been identified as a means used by directors of residential care facilities to circumvent child protection regulations and facilitate the recruitment and irregular admission of children. This article extends clientelism theory to examine the impact of clientelism on the rights of children residing in these unregulated residential care facilities in Cambodia and Myanmar. Reporting on findings from the qualitative analysis of interviews with social workers from Myanmar and Cambodian, the article describes the range of child rights infringements that stem from the use of clientelism in residential care facilities, including violations of the rights to family life, to preservation of identity and family ties, and to participation, and the best interests of the child principle. Drawing on norm diffusion theory and research, the article considers the implications of clientelism for child rights norm diffusion and care reform efforts.

The Issue of Extraordinary Talent in the Residential Childcare Institution: Giftedness or Dual Exceptionality?

The Issue of Extraordinary Talent in the Residential Childcare Institution: Giftedness or Dual Exceptionality?

Prevalence of Adverse Childhood Experiences in Child Population Samples

Exposure to adverse childhood experiences (ACEs) before the age of 18 years is a major contributor to the global burden of disease and disability. To meta-analyze data from samples with children 18 years or younger to estimate the average prevalence of ACEs, identify characteristics and contexts associated with higher or lower ACE exposure, and explore methodological factors that might influence these prevalence estimates. Studies that were published between January 1, 1998 and February 19, 2024, were sourced from MEDLINE, PsycINFO, CINHAL, and Embase. Inclusion criteria required studies to report the prevalence of 0, 1, 2, 3, or 4 or more ACEs using an 8- or 10-item ACEs questionnaire (plus or minus 2 items), include population samples of children 18 years or younger, and be published in English. Data from 65 studies, representing 490 423 children from 18 countries, were extracted and synthesized using a multicategory prevalence meta-analysis. These data were analyzed from February 20, 2024, through May 17, 2024. ACEs. The mean age of children across studies was 11.9 (SD, 4.3) years, the age range across samples was 0 to 18 years, and 50.5% were female. The estimated mean prevalences were 42.3% for 0 ACEs (95% CI, 25.3%-52.7%), 22.0% for 1 ACE (95% CI, 9.9%-32.7%), 12.7% for 2 ACEs (95% CI, 3.8%-22.3%), 8.1% for 3 ACEs (95% CI, 1.4%-16.8%), and 14.8% for 4 or more ACEs (95% CI, 5.1%-24.8%). The prevalence of 4 or more ACEs was higher among adolescents vs children (prevalence ratio, 1.16; 95% CI, 1.04-1.30), children in residential care (1.26; 95% CI, 1.10-1.43), with a history of juvenile offending (95% CI, 1.29; 1.24-1.34), and in Indigenous peoples (1.63; 95% CI, 1.28-2.08), as well as in studies where file review was the primary assessment method (1.29; 95% CI, 1.23-1.34). The prevalence of 0 ACEs was lower in questionnaire-based studies where children vs parents were informants (0.85; 95% CI, 0.80-0.90). In this study, ACEs were prevalent among children with notable disparities across participant demographic characteristics and contexts. As principal antecedent threats to child and adolescent well-being that can affect later life prospects, ACEs represent a pressing global social issue. Effective early identification and prevention strategies, including targeted codesigned community interventions, can reduce the prevalence of ACEs and mitigate their severe effects, thereby minimizing the harmful health consequences of childhood adversity in future generations.

Institutional escapes, breaks, and continuities: Reframing running away from residential child care institutions

Abstract This article offers a novel approach to understand the phenomenon of running away from residential care institutions, challenging prevailing views that pathologize these incidents as individual deviance. Drawing on insights from the sociology of escape and Deleuze and Guattari’s concepts of rhizome and lines of escape, we examine spatial, temporal, and relational dimensions of institutions, revealing the porous nature of institutional boundaries and non-linear characteristics of runaways. By reframing runaways as integral to institutional life rather than isolated events, we argue against reducing them to individual traits. Running away serves as pivotal moments that disrupt and shape institutional norms, highlighting inherent limitations in care. Conceptualizing running away as running-around within the institutional assemblage, we challenge binary inside/outside distinctions and argue that they oversimplify institutional complexity. Our analysis underscores how institutions exert totalizing control through surveillance, while being transformed through acts of running away. Examining the employees’ experiences though five focus group interviews, we critique the conventional perception of institutions as places of care, emphasizing their unbounded and multifaceted social configurations. We discuss how institutional powers shape semiotic systems that govern young people’s behaviour, advocating for a nuanced understanding of residential institutions as rhizomatic formations, where individual actions continually reshape institutional practices and perceptions.

An Innovative Intervention Model for Children and Young People in Residential Care: The D'ART-TE Project.

(1) Background: Residential care (RC) for children and youth should provide a holistic experience of growing up. Currently, RC homes face many challenges, highlighting the need for validated, innovative interventions. D'AR-TE is a pilot project aimed at creating an innovative intervention model for children and youth in RC, promoting protective factors through activities designed to enhance personal skills, socialization, and relationship building. The project spanned three years, focusing on two main areas: "Promoting the SELF" (including Sports, Art, and Virtual Reality) and "Promoting the US" (group activities with families and non-institutionalized peers). (2) Methods: To validate the D'AR-TE model, 46 children and youth in RC, aged between 6 and 20 years, were assessed. They were divided into an experimental group (26 participants) and a control group (20 participants). The evaluation, conducted at the beginning and end of the project, focused on cognitive and neuropsychological domains. (3) Results: By the end of D'AR-TE, the experimental group showed statistically significant improvements, including decreased aggression perception, increased social support, enhanced self-concept, and better cognitive and emotional performance. (4) Conclusions: These results suggest that D'AR-TE had a positive impact and could be a valid and replicable model for children and youth in RC.

The Impact of the War Conflicts on Residential Childcare: A Survey into Czech Children's Homes

The Impact of the War Conflicts on Residential Childcare: A Survey into Czech Children's Homes

The Sexual Exploitation of Children in the Care of the Irish State—Professionals' Perspectives

ABSTRACTDrawing on interviews with key stakeholders who have diverse experience of working with children in Ireland, this article highlights that children in residential care are being targeted for sexual exploitation in an organised manner, by networks or gangs of predatory men. The study found that current staffing challenges in the care environment are making it difficult for children to develop trusting relationships to feel sufficiently comfortable to disclose their experiences of sexual exploitation and seek help. It also found that some professionals saw children who were sexually exploited in residential care as ‘problematic’ or even at times inadvertently blamed them for their own exploitation. It further found that the risk of sexual exploitation for children is increased when care staff lack the skills and language to identify, speak about and respond to reports of sexual exploitation. Although there is some evidence of children in families being sexually exploited, a particular context for targeting children for sexual exploitation, that of being in state care, is clearly highlighted in this paper and aligns with evidence from other jurisdictions. The findings suggest a need for a national policy on the protection of children in care from sexual exploitation that would not only prioritise the issue but would trigger increased training and education of social carers, social workers and the Irish police force on the complexities underpinning sexual exploitation so that they are better equipped to protect children in care.

An Equine-Assisted Intervention Versus Non-Manualized Psychotherapy for Youth in a Residential Childcare Facility

AbstractCharacteristics of individuals with disruptive behavior disorders often include elevated externalizing behaviors such as impulsivity, defiance of authority and antagonism of social norms. Evidence shows that adolescents diagnosed with these types of disorders are particularly challenging to treat; however, therapies incorporating horses have shown some success. We examined the impact of an equine-assisted intervention compared to a non-manualized cognitive behavioral therapy in youth between 12- and 18-years old living in a residential childcare facility. Upon admittance, youth were administered three assessments: the Youth Self-Report, Adolescent Psychopathology Scale, and Basic Empathy Scale. Youth scoring in the clinical range for at least one externalizing subscale of the Youth Self-Report were assigned to equine-assisted intervention (EQI; N = 23) or non-manualized cognitive behavioral therapy (NM-CBT; N = 20) groups. Each group received a total of 7 h of treatment per week (three 2-hr group sessions and one 1-hr individual session) for 24 weeks. After 24 weeks of treatment, the same three assessments were administered a second time. There were no significant differences between the NM-CBT and EQI groups in the amount of change between assessments. A significant time effect was found for total externalizing behaviors in the Adolescent Psychopathology Scale and Youth Self-Report such that these measures were within the normal range after 24 weeks of treatment for participants in both groups.

Identifying the Challenges in the Detection and Protection of Child Victims of Human Trafficking in Spain: A Case Study of the Southern European Border

Despite the improvements in enhanced child protection, there is an increasing concern about the vulnerability and cases of child trafficking in Spain, the southern gateway to Europe from the African continent. Analyzing 23 interviews with professionals in the field, this article identifies the factors that contribute to high levels of child trafficking in Spain. This study identifies three primary results: (1) The dangers of residential childcare as places of recruitment; (2) The southern European and Spanish border as a place of elevated risk for the recruitment of children; (3) The stereotypes regarding child trafficking make invisible male victims, other types of trafficking for non-sexual purposes, domestic trafficking, and individual trafficking. Therefore, it remains imperative to advance a set of policies that: (i) invest in specific residential childcare resources for child victims either alone or with family members; (ii) invest in smaller residential childcare to prevent abuse; (iii) invest in mentoring programs for children previously under state guardianship; (iv) improve the working conditions and the training of residential childcare staff; (v) increase the visibility and diversity of child trafficking while avoiding stereotypes; (vi) improve the regional coordination; (vii) invest in campaigns to inform children about the dangers involved in running away, exploitation and abuse.

Working With Traumatised Children During Traumatic Times: Residential Child Care Educators' Compassion Fatigue and Work Engagement

ABSTRACTDrawing from an Italian study conducted in residential care for children and guided by the postulates of the Job Demands and Resources Model, our aims are to investigate residential childcare educators' levels of compassion fatigue and work engagement, and to focus on the individual, work and organisational conditions associated. The survey involved 215 educators who were on duty during the summer of 2023. Data analysis employed descriptive statistics, bivariate and non‐parametric analysis. Results concerning compassion fatigue indicate that while burnout globally registers low to medium scores, more than one‐third of the sample fell in the ‘high’ category for personal burnout, more than one quarter scored high in work burnout and another one quarter have high client burnout scores. One into two suffer from moderate to severe manifestations of secondary traumatic stress, together with relatively high levels of work engagement. Based on individual, work and organisational variables, substantial differences were identified. In the final sections, we discuss job resources and demands and contribute to the development of targeted strategies for preventing compassion fatigue in residential childcare, while addressing strategies for enhancing better well‐being levels for those working in alternative care, impacting children's well‐being as well. Please refer to the Supporting Information section to find this article's Community and Social Impact Statement.

Digital group archives in residential childcare: an investigation into memory responsibility

This article discusses phase two of the ARCH project (Archiving Residential Children’s Homes), and in particular, the development of a co-designed ‘digital archive’ that stores everyday, shared events and experiences for care experienced young people who live in residential children’s homes. We present research with young people living in residential care, care workers and care experienced adults about the types of everyday information or records they would like to be able to store, share and access in the future. There was a desire for the digital archive to have a different feel and purpose to content recorded in individual case files, with easy access to the archive deemed important. There were mixed views about the representation of events and experiences and whether these should contain mainly ‘light-hearted’ events and experiences. Our research gives an insight into memory-keeping practices within a residential children’s home and invites questions about whose responsibility it is for gathering, filtering and treasuring childhood experiences.

Impact of trauma and placement in residential or congregate care on the criminalisation of children in England/Wales and Australia

Children in residential care have the most complex needs of all children growing up in Out-of-Home care (OOHC), due to complex trauma from pre-care experiences of abuse and neglect, inadequate therapeutic supports while in care and significant placement instability. Some argue that residential care settings are intrinsically criminogenic, as evidenced by significant over-representation of this cohort in youth justice. However, little is known about how children’s experiences of trauma, including removal from family and placement in OOHC, is viewed by lawyers and decision-makers in criminal cases involving children in care. Criminal justice decisions can have long-term ramifications for children in care and custodial sentencing can often be a precursor to ongoing incarceration into adulthood. This qualitative, cross-national study explored the impacts of trauma and placement in residential or congregate care on the criminalisation of children in England/Wales and Australia. In-depth interviews were conducted with 28 legal, youth justice and judicial stakeholders in England, Wales (UK), New South Wales (NSW) and Victoria (Australia). While there are considerable differences in the operation of child protection and youth justice systems between these jurisdictions, thematic analysis using NVivo14 identified. confirmed ongoing systemic factors associated with criminalisation identified in previous literature persists despite attempts to address these through policy and practice reforms. These factors include an absence of therapeutic supports, unstable and unsafe residential care placements, over-reliance on police to respond to minor incidents, increasingly punitive police responses lacking awareness of the impacts of childhood trauma and inappropriate use of custody as an ‘alternative’ placement. These findings suggest the similar systemic processes across these jurisdictions are likely to reflect deeply entrenched ideologies about ‘care’ and ‘protection’ that function to criminalise trauma. The implications of these systemic factors when children are exposed to formal criminal justice decision-making are considered.

The nutritional and feeding status of children living in selected residential child care facilities in Zambia: implications for programs and policies.

This study aimed to estimate the prevalence of undernutrition and risk of feeding difficulties and describe common feeding practices for children from birth to 10 years of age living in residential care in Zambia. This was a secondary analysis of de-identified cross-sectional data on 397 children living in 22 residential care facilities in four provinces. Child demographics, anthropometrics, hemoglobin levels, risk for feeding difficulties, and facility-level feeding practices were collected by a trained study team using Count Me In, a digital health app. Interviews with staff were conducted at 15 residential care facilities. Around half of the study sample were boys (53.4%) and <5 years old (55.4%). Special healthcare needs were reported in 10.3% of the children, with cerebral palsy being the most common (3.5%). Underweight, stunting, wasting (using weight-for-length/height), and anemia were found in 22.4, 28.0, 7.1 and 54.7% of children, respectively, with higher rates in children with special healthcare needs and children <24 months old. Duration of residential care was positively associated with length/height-for-age but not weight-for-age or weight-for-length/height z-scores. A risk for feeding difficulties was found in 41.4 and 26.0% of children with and without special healthcare needs, respectively. Suboptimal bottle-feeding practices, including the use of altered nipples and poor caregiver-infant interactions, were observed for infants <12 months old. Residential care staff reported suboptimal diets in their facilities and gaps in knowledge and resources to meet children's nutritional needs. These results demonstrate that a large proportion of children living in residential care in Zambia are at high risk for undernutrition and feeding difficulties and contribute to the small body of literature on children living in residential care, both in Zambia and globally. In the context of Zambia's efforts to improve child nutrition and reform its alternative care, these findings can inform programming and policies for children living in residential care to fulfill their rights to health and family care.

Navigating the vulnerabilities and coping mechanisms of children in residential child care institutions: A qualitative exploration

Residential child care institutions around the globe play a significant role in protecting children in need of care and protection. While these facilities facilitate hope and rehabilitation, the displacement of children from their families introduces a variety of psychosocial stressors. This qualitative study aims to elucidate children’s vulnerabilities and coping mechanisms in residential child care institutions in Kerala, India. We conducted in-depth interviews with 21 children aged 8-16 living in institutional care within Ernakulam District, Kerala, India, registered under the Juvenile Justice (JJ) (Care and Protection of Children) Act 2015. Semi-structured interviews covered various domains, including demographics, emotional well-being, social interactions, behavioral issues, academics, and coping mechanisms. Attride-Stirling’s thematic network analysis was used in the data analysis to identify significant themes. The themes identified include (a) emotional well-being and self-perception, (b) behavioral problems, (c) social networking and interaction patterns, (d) educational and career aspirations, and (e) strengths and coping mechanisms. Our study presents the multifaceted challenges encountered by children in Kerala’s residential child care institutions, highlighting the need to create a nurturing environment that fosters child-centric practices that are essential to ensure their well-being and better prospects for their future.

In the Eye of the Beholder: Visualizing Strengths, Burdens and Desires Through the Lens of Neurodivergent Children, Their Parents, and Professionals Using the Yucel Method

Abstract Objectives In mental healthcare, there is a growing emphasis on one’s strengths and context instead of focusing primarily on individual deficiencies, pathologies, risks, and negative emotions. Using the visual and tactile Yucel method, this study gains insight into strengths, burdens, and desires of neurodivergent children in residential care and their parents from different perspectives. Methods In this qualitative study, a total of 45 interviews with the Yucel method were conducted with nine neurodivergent children, their parents, and involved professionals. All built a constellation of the child and family’s strengths, burdens, and desires using the Yucel method. To explore if by applying this visual and tactile method additional information is provided to that gathered in the standard diagnostic process, the information of the Yucel method was compared to the information found in the multidisciplinary reports of the children. Results Thematic analysis showed that besides common mentioned strengths (e.g., mother, sports and activities) and burdens (mental health problems), differences in the informants' perspectives were found. Parents mentioned strengths and burdens that were not addressed by other informants and a diversity in needs was found. The comparison of the results from the interviews with the Yucel method with the information in the multidisciplinary reports showed that the Yucel method provided additional information. Conclusions The Yucel method brought more strengths and perspectives into view than diagnostics as usual in the first three months of residential care. This study contributes to the knowledge regarding personal, strength-based, and family-oriented diagnostics in mental healthcare of neurodivergent children and their families.