Foster Care Research Articles

Examining Prevalence and Predictors of Economic Hardships for Transition-Age Foster Youth

Previous articleNext article No AccessExamining Prevalence and Predictors of Economic Hardships for Transition-age Foster YouthMelanie L Nadon, Sunggeun Park, Huiling Feng, and Mark CourtneyMelanie L Nadon Search for more articles by this author , Sunggeun Park Search for more articles by this author , Huiling Feng Search for more articles by this author , and Mark Courtney Search for more articles by this author PDFPDF PLUS Add to favoritesDownload CitationTrack CitationsPermissionsReprints Share onFacebookTwitterLinkedInRedditEmail SectionsMoreDetailsFiguresReferencesCited by Journal of the Society for Social Work and Research Just Accepted Published for the Society for Social Work and Research Article DOIhttps://doi.org/10.1086/721667 Views: 111Total views on this site Citations: 2Citations are reported from Crossref HistoryAccepted June 28, 2022 PDF download Crossref reports the following articles citing this article:Angela B. Pharris, Ricky T. Muñoz, Chan M. Hellman Caseworkers as a source of hope leading to perceptions of academic success for transitional age foster youth, Child & Family Social Work 96 (Jan 2023).https://doi.org/10.1111/cfs.12996Kizzy M. Lopez, Jennifer M. Geiger, Nathanael J. Okpych, Sara I. Gamez, Danielle Larregui The impact of COVID-19 on campus-based support programs serving students with foster care experience: Focus groups with administrators and students, Children and Youth Services Review 143 (Dec 2022): 106696.https://doi.org/10.1016/j.childyouth.2022.106696

Identifying the essential competencies for court professionals to promote youth engagement in permanency planning in court hearings

ABSTRACT Many youth age out of foster care without achieving permanency. This article describes a process undertaken to determine priorities for creating curricular content to train court personnel on how to authentically engage youth in permanency planning. Utilizing the Delphi method with adults with foster care lived expertise, a list of competencies was prioritized for inclusion through a comprehensive literature review and a series of individual interviews conducted with a broad range of stakeholders (youth with lived experience, state and tribal direct service workers, supervisors, administrators, judges, and child attorneys). Highly rated competencies were included in the subsequent training developed after completion of the Delphi process.

Child Protection Responses to Domestic Violence Exposure: Co-Occurring Safety Concerns and Investigation Outcomes.

Childhood exposure to domestic violence (CEDV) poses significant risks to children's safety and wellbeing, yet its prevalence and impact on child protection outcomes remains understudied. This study examined administrative data for child protection investigations in Los Angeles County, California between January 2018 and March 2021 to determine the prevalence of CEDV safety concerns, associated case characteristics, and child protection outcomes (case openings and foster care placements). Results indicated that 5.9% of investigations had CEDV concerns and CEDV investigations represented 17.9% of placements. Investigations with CEDV concerns had higher co-occurring indicated safety concerns than investigations without, including substance abuse (31.1%) and mental health (14.2%). Investigation outcomes for those with CEDV concerns included the substantiation of more than one individual (36.6%), while 28.4% resulted in case openings (without placement) and 30.2% resulted in placements. The study underscores the importance of moving beyond punitive frameworks and exploring the use evidence-based service planning to address the complex needs of families affected by CEDV.

Abstract 4136509: Children in Foster Care with Heart Disease Have Greater Resource Utilization and Mortality

Background: While children and youth in foster care (CYFC) have greater healthcare needs generally, data are lacking in heart disease. We characterize CYFC with heart disease, assess the impacts of being in foster care on outcomes, and examine validity of ICD-10 code Z62.21 for identification of CYFC in administrative data. Methods: In this single-center, retrospective cohort study of all cardiac surgical patients (<18yo) admitted 2017-2022, CYFC were identified using institutional Electronic Medical Records via natural language processing or ICD codes, with confirmation by chart review. Demographics, medical characteristics and outcomes of CYFC were compared to children not in foster care. Generalized linear models assessed associations with primary outcomes of mortality at current follow-up (logit link) and total hospital days (log link), controlling for clinical factors and length of follow-up. We separately added Child Opportunity Index (COI) and payer to models. This cohort was then studied in the administrative pediatric health information system (PHIS) dataset to calculate ICD code sensitivity and specificity. Results: Of 4,431 cardiac surgical patients, 67 (1.5%) were in foster care. CYFC did not have significantly higher mortality (9% vs 5.8%), 30-day readmission or cardiac reoperation, number of complex chronic conditions (CCC), RACHS-2, or distance from center compared to non-CYFC. CYFC had lower COI (median 61 vs 72, p=0.016) and more Medicaid coverage (87% vs 40%, p<0.001). Length of stay after index surgery was similar; however, cumulative hospital days during the study were significantly higher for CYFC (median 22 [IQR 10,45] vs 12 [6,27], p<0.001). Adjusting for RACHS-2, CCC, age, readmission, reoperation, and follow-up duration, CYFC had higher odds of mortality (2.7 [95%CI 1.0,6.9] p=0.046) and more total hospital days (p=0.008). With COI or payer in the model, CYFC was not associated with mortality but remained an independent risk factor for more total hospital days. Only 16/67 (23.9%) of CYFC were coded with the Z62.21 in PHIS, yielding sensitivity of 21.9% (95%CI 13.1,33.1), and specificity of 100% (99.9,100). Conclusion: CYFC with heart disease have a relative social disadvantage, greater hospital resource utilization, and long-term mortality despite similar illness severity. Improved capture of foster care status in administrative data is needed to guide future studies and reduce health disparities for the vulnerable population of CYFC.

Impact Findings From a Randomized Controlled Trial of a Supportive Housing Demonstration Programme for Homeless, Child Welfare–Involved Families

ABSTRACTA “Housing First” approach to homelessness, showing promise for single adults, might also be effective for families whose homelessness combined with other challenges bring them to the attention of the child welfare system. This paper reports impact findings from the evaluation of a randomized, controlled trial in San Francisco that tested the effectiveness of an intervention designed to provide permanent housing and supportive services to such families, with the goal of safely reducing the use of foster care. Compared with families in the control group (33 families with 60 children), we found no significant impact on the likelihood of out‐of‐home placement up to 2 years after randomization. For families whose children were already in foster care, children in the treatment group (43 families with 63 children) reunified faster than those in the control group (42 families with 68 children), although nearly always before being housed. There was no difference between groups in time to case closure or likelihood of subsequent child welfare involvement. We discuss these findings in the context of important implementation challenges that have implications for further testing this intervention in tight housing markets.

Academic Performance, Health and Support Needs: Comparing Foster Care Alumni and Peers in Higher Education in Norway

The completion rates of higher education are low among young adults with a history of foster care. Understanding how students from foster care alumni fare is imperative for facilitating attainment and preventing drop-out. The aim of this study was to compare students from foster care alumni and the general student population by examining (1) sociodemographic characteristics, academic functioning and need for special assistance; (2) contextual factors important for student life; and (3) mental and somatic health, loneliness, life satisfaction and use of cannabis and alcohol. Data comprised self-reports from the Norwegian national survey Students’ Health and Well-being Study 2022. Reports from foster care alumni students (n = 508) were compared to those of the general student sample (n = 59,036). Compared to the general sample, twice as many foster care alumni students reported receiving or needing special assistance in their studies. Moreover, they reported substantially higher economic burden than their student peers, by higher frequency of work income, more financial worries, and less parental financial support. Foster care alumni students also reported a higher load of informal care responsibilities, poorer mental and somatic health, more loneliness and lower life satisfaction. Foster care alumni students fare comparably well in terms of grades and study progression despite the reported economic burden and impaired health and well-being. As these are factors shown to impact study completion, policies need to be put in place to ensure that care-experienced students receive adequate support through their young adulthood and specifically in higher education.

Latent class analysis of adverse outcomes for youth transitioning out of foster care and early risk factors

Youth transitioning out of foster care are at high risk for adverse outcomes compared to their peers, but the factors that influence those outcomes are complex. Early intervention is key for this population but developing priorities can be a challenge. Researchers and programs serving these youth must be able to effectively target interventions to disproportionately affected youth to receive the best results. Previous studies have not considered the complexity and heterogeneity of assessing multiple youth outcomes in a sound methodological way. For this study, Latent Class Analysis (LCA) was used to identify youth with similar patterns and outcome experiences, using a practical demonstration with the public National Youth in Transition (NYTD) and Adoption and Foster Care Analysis and Reporting System (AFCARS) databases. This study aims: 1) to apply latent class analysis to determine latent classes of youth who transition out of foster care according to the adverse outcomes they experience; 2) to estimate whether youth sociodemographic characteristics and adverse youth’s experiences before and during foster care is associated with identified latent classes of youth adverse outcomes. Three latent classes were identified: 1) mostly homelessness outcome, 2) little or no adverse outcomes, 3) complex adverse outcomes. Our results further highlight that multiple youth’s experiences before and during foster care, youth sociodemographic characteristics, and events while in foster care are associated with youth’s outcomes once they transition out of foster care. Stakeholders and program administrators at welfare agencies may use these findings to enhance policy and procedures to ameliorate youth outcomes.

Supporting the educational success of children in foster care: the educational advocacy program

ABSTRACT Children in foster care face a heightened risk of poor educational outcomes, yet published research on programs designed to improve outcomes remains scant. Findings from an evaluation of the Educational Advocacy Program (EAP) that works with foster and adoptive caregivers and educators to address unmet educational needs are presented to help fill this gap. Youth, services data, and contact information for caregivers and educators were drawn from EAP files for cases closed during 2018–2019 (n = 234). Surveys of identified educators and caregivers as well as district foster care liaisons were conducted. Youth information was linked to state administrative data on foster care placements. Descriptive and bivariate analyses of program outcomes, program satisfaction, and placement stability were completed. Caregivers and educators perceived benefits for themselves and youth served. EAP staff ratings of post-service youth function were congruent with caregiver ratings of youth school outcomes. Statistically significant decreases in youth placement moves were found during and after services compared to before EAP onset. While not a causal design, results indicate that EAP holds promise for supporting caregiver and educator collaboration and improving youth school and placement outcomes. Implications for future research and practice are discussed.

Legal protections for sexual and gender minority youth in foster care: A review of Preventing Sex Trafficking and Strengthening Families Act (Normalcy Standards)

The aim of this study was to investigate legal protections for sexual and gender minority (SGM) youth population who identify as lesbian, gay, bisexual, transgender, queer, intersex (LGBTQ+), or any nonheterosexual orientation, gender identity, or expression (SOGIE) within the context of the United States (US) publicly administered state child welfare foster care system through federal Public Law 113–183 (Preventing Sex Trafficking and Strengthening Families Act – Prudent Parenting for short). SGM youth are identified in foster care 2.5 times higher than their heterosexual peers and often report worse outcomes. There are some federal recommendations for SGM youth, but it does not include normalcy or other activities that are federally supported. A state-by-state analysis of legislation, policy, implementation policy and youth bill of rights was conducted. While there was significant variance across the USA, many states provided levels of support in their legislation, policy implementation and youth bill of rights that could assist SGM youth impact normalcy efforts. More research is needed to investigate if SGM youth in foster care experience protections in the states that have legal protections.

The Context of Poverty and Cancer: Denying Human Potential.

Poverty is a carcinogen and a leading cause of cancer disparities and overall mortality in the United States. Poverty is often viewed as an individual failure for "being poor," but in fact, poverty is structurally driven, intergenerational, and place-based that socially deprives and denies human potential. Disparities in timely cancer prevention, diagnosis, treatment, survivorship, and survival disproportionally impact people living in poverty and especially in persistent poverty areas, an extreme form of place-based poverty that affects communities over multiple generations. There has been some progress made to address place-based conditions that exacerbate poverty, such as the NCI's initiative on persistent poverty. However, gross inequality and cancer disparities continue to exist and persist. The time is now to accelerate the development of research-informed strategies and solutions with communities along with multisectoral collaborations with education, housing, occupation/workforce, foster care, criminal justice, transportation, and data collection systems. This commentary discusses the structural, place-based, and generational context of poverty, illustrates how entrenched inequities shape poor cancer outcomes, and describes opportunities for future research.

Risk Factors of Post-Traumatic Stress in Pediatric Solid Organ Transplant Recipients.

Life with end-stage organ failure is accompanied by an accumulation of traumatic medical or surgical experiences. Despite recovery after solid organ transplantation (SOT), many children and adolescents develop post-traumatic stress symptoms (PTSS). PTSS remain underappreciated as a major comorbidity in SOT programs, despite their association with decreased quality of life. We conducted a retrospective, cross-sectional study of 86 pediatric SOT recipients (17 heart, 44 kidney, and 25 liver) to evaluate potential determinants of PTSS. Trauma symptoms were measured by the Child Trauma Screening Questionnaire (CTSQ). Demographic, baseline, and contemporaneous factors were tested for independent association with CTSQ scores. The median post-transplant CTSQ score was 2 (IQR 1-4), and 22% were identified as high risk (score ≥5) for PTSD. Higher CTSQ scores were independently associated with the number of ICU days within the previous 12 months, the number of medications (complexity), and involvement with foster care in the primary model (R2 [adj.] = 0.26). The addition of the Family Impact Module improved the overall model (R2 [adj.] = 0.33), wherein higher family functioning was independently associated with lower CTSQ scores. An exploratory analysis of pre-transplant patients (n = 34) found a median pre-transplant CTSQ of 2 (IQR 1-6), suggesting that PTSS are onset before transplant and persist afterward. PTSS are highly prevalent in the SOT population. Risk factors include recent adverse medical experiences and complexity, whereas family stability may be protective. Additional research is needed to improve early ascertainment and support for patients at high risk of developing PTSS throughout their transplant journey.

Does money motivate prospective foster parents? Are responses from high vs. low‐income towns different? Evidence from Google advertising

AbstractRecruiting foster parents is a worldwide challenge. In the US, foster parents are supposed to volunteer but receive stipends to cover the cost of foster children. Thus, Foster Care agencies hesitate to highlight the Stipend in their recruitment messaging to prospective foster parents. This hesitation is to weed out extrinsically (stipend) motivated prospective parents early in the application, training and licensing process.The first step in foster parent recruitment is to start the conversation between prospective foster care parents and foster parent recruiters.Extant research has relied on current or former foster parents to find their motivations for fostering and continuing to foster. We believe ours is the first study to empirically examine whether mentioning money (stipend) early in the recruitment process makes a difference in the response of prospective foster parents.The research reports Google ads data from two foster parent recruitment campaigns. These Google search ads showed when “foster parenting” related words were Googled. One ad had the word “stipend,” and the other did not. We then examine differences in response between high and low‐income towns. Next, we analysed differences in click behaviour over 207 days between the two versions of the ads. We then examined differences in click behaviour between residents of high and low‐income towns. We used the t‐test to test for differences in our data analysis approach.We find no statistical difference in response between the ads that mention ‘stipend’ and those that do not (t = 0.64, p = 0.26). However, residents of low‐income towns are five times more likely to click on a foster parent ad than residents from high‐income towns, irrespective of whether the stipend is mentioned in the ad (without mentioning stipend: t = 3.21, p = 0.0008; mentioning Stipend: t = 3.77, p = 0.0001).

Exploring the Dimensions and Correlates of Teen Economic Abuse Through a Cross-Sectional Survey

PurposeTeen economic abuse (TEA) is an understudied form of adolescent relationship abuse with limited measures available to assess prevalence. The purpose of this article is to assess the underlying dimensions of survey items (developed with youth) to refine measurement of and validate the structures comprising TEA and examine differences in prevalence of TEA perpetration (Prp) and victimization (Vct) by demographic characteristics. MethodsThis cross-sectional, online survey was conducted between July and September 2021. Youth ages 13–19 who read English and reside in the United States were eligible to complete this study. Recruitment occurred through a national violence prevention listserv with an emphasis on reaching organizations serving youth who are unhoused, juvenile justice and child welfare-system involved, identifying as sexual or gender minorities, or from communities of color. Based on exploratory and confirmatory factor analysis, negative binomial regression models were run to assess associations of demographic characteristics, with levels of TEA Vct and Prp. ResultsAdolescents who identify as White reported significantly more types of TEA exposures than their American Indian or Alaskan Native (adjusted incident rate ratios = 1.3; 95% CI = [1.1, 1.4]), Hispanic Latino (1.2 [1.1, 1.4]), and Multiracial peers (2.4 [1.8, 3.1]). Gender diverse adolescents (1.14 [1, 1.3]) and cisgender females (1.08 [1, 1.2]) had significantly more types of TEA exposures than cisgender males. Those with past-year physical or sexual violence in dating relationships reported more types of TEA exposures (4.1 [3.8, 4.4]) than those who had not experienced such violence. Adolescents with exposure to foster care or homelessness had more types of TEA (1.3 [1.2, 1.4]) than those without such experiences. DiscussionHealthcare providers serving youth should be aware of how economic abuse manifests in adolescent relationships when providing support and resources for youth, especially those who are system-involved or experiencing housing instability. Findings also highlight the need for education about TEA and economic justice in violence prevention programs.

Experiences in the relationship between foster children and foster parents in specialized foster care—Thematic analysis conducted on five minute speech sample-data

Experiences in the relationship between foster children and foster parents in specialized foster care—Thematic analysis conducted on five minute speech sample-data

Gambaran Praktik Pengasuhan Anak Kembar di Kabupaten Gayo Lues

The purpose of this study is to know the image of the practice of child care in gayo lues district. This study uses qualitative methods with a descriptive approach. Number of participants in the study are three subjects. The data is analyzed using thematic analysis techniques. The findings suggest that there are 7 themes illustrating the practice of foster care in gayo lues district, of which 7 include the following sub themes. Parenting stress that covers the subtheme of financial demands, the lack of time for yourself. Support system that includes sub themes of extended family help, husband support, local government assistance. Coping strategies that include the subtheme manage time through other work, not managing emotions in a healthy way. Teaching that includes sub themes that enhance understanding, direction and example. The culture that includes the sub theme educating children firmly, the high tone of voice and educating children independently. The vaforitism consists of the sub theme divide and contrast.

The Impact of Foster Care on Child Development: The Role of Sibling Separation

This paper explores the impact of sibling relationships on children’s development within the foster care system, focusing particularly on how sibling separation affects children of different ages emotionally, cognitively, and socially. To address this, the study synthesizes existing literature and theoretical models by combining the developmental stages of children with the role of siblings in child development. Findings reveal that sibling separation at different ages leads to distinct developmental challenges: infants experience severe disruptions in attachment and emotional regulation, middle childhood separations hinder cognitive and social skills development, and adolescent separations result in long-term relational and identity challenges. Previous research underscores the importance of maintaining sibling bonds in foster care, highlighting that these relationships can provide crucial emotional support and stability, mitigating the adverse effects of family disruptions. This study emphasizes the necessity for age-appropriate actions and support services in foster care to minimize the detrimental impacts of sibling separation and promote healthy development. Additionally, it calls for further longitudinal studies to track the developmental trajectories of children separated from their siblings and consider variables such as age differences between siblings and the dynamics of step-sibling relationships. This comprehensive understanding is essential for informing policies and practices that enhance the well-being of children in foster care.

Educational and employment for adults with a history of migration and foster care in Finland

Abstract Several studies document the adverse educational prospects for both immigrant-origin as well as out of home placed children and youth. Few studies have examined the educational and employment outcomes of migrant-origin young adults with a history of out-of-home care (OHC), which is the aim of our study. Methods. We studied all subjects born in 1976 to 1995 abroad and immigrated to Finland as underage persons prior to 2010 (N = 20 037), comparing them to children born in Finland to foreign born parents (N = 3198) and a matched random sample of host population (N = 23 187) according to register data 1991 to 2015. We formed OHC alumni and non-OHC alumni groups among refugee-origin born abroad and in Finland, non-refugee-origin born abroad and in Finland as well as native Finns group. Logistic regression analysis was used in which age of the child in the first placement, number of placements and the type of the first place were adjusted. Results.Minors both with refugee and non-refugee background born in Finland were more likely than native Finns to be placed in OHC. A history of OHC predicted less chance of degrees completed and being employed compared to non-OHC peers in all study groups. Refugee background born abroad having history in OHC had lower educational and employment outcomes as young adults compared to other OHC groups. Education made difference since immigrant background having OHC history and post-compulsory degree had two times higher likelihood of being employed. The first OHC during teenage years decreased odds for post-compulsory education but increased odds for employment. Multiple placements in OHC decreased a youth’s chances of completing degrees and employment Key messages • Education made difference since persons with OHC history and degrees done had two times higher likelihood of being employed. • Refugee origin OHC alumni were in the most vulnerable position with less degrees and less employment, and thus they need any support in their studies.

Matching in practice: how to find the right family foster home for the right child

The concept of matching refers to the process of selecting a family foster home to fit an individual child in placement. Matching is important for the quality of care, as the carers need the necessary resources to meet the child’s needs. Failure in matching can have negative consequences, such as a ‘breakdown’. The aim of this article is to explore the social workers’ practice when matching children and foster carers to ensure the children will receive good care and avoid a placement change. The article uses a qualitative approach and is based on interviews with 31 participants. Social workers and managers at municipal social services, as well as consultants, were interviewed about their work. The professionals reflected on what aspects they perceive as most important in matching and what challenges they encounter that complicate the process. Narratives of successful matches often focused on the characteristics, competence and experience of the foster carers to meet the needs of the children. Some of the challenges highlighted were time pressure and a lack of family foster homes to choose from. This means that professionals have to compromise and prioritise what is most important in relation to the needs of the child.

What challenges exist within the child welfare system in meeting the health needs of children in care?

Abstract From society’s perspective, the goal of societal care is to protect disadvantaged children and provide them with improved opportunities. In the realm of social care, the child welfare system takes the place of parental responsibilities to safeguard children’s well-being and developmental needs, including their health. However, while holding child welfare agencies responsible, national legislation often lacks specific methods for fulfilling this mandate. Over the years, evidence has shown that limited health care access and unmet health needs often endure in care. In Sweden, efforts to address the issue include mandatory health assessments upon entry into care and collaborative agreements between social services and health care sectors. However, recent studies reveal that only one-third of children undergo these assessment, and collaborative agreements remain lacking in many local authorities. This suggests that additional legal requirements do not offer a straightforward solution. Dr Forsman, with a background in social work, will discuss the child welfare system’s responsibilities and the traditional reliance on social workers and foster carers to address health needs and coordinate care. What are the underlying barriers to successful advocacy and comprehensive health care coordination within the child welfare system? How can the system better respond to the health needs of children in care?

Abstract Strengths and difficulties Lithuania

Abstract Background Most mental health disorders begin before the age of 18, peaking at 14.5 years (Solmi, 2022) and manifest as emotional and behavioural difficulties that are more frequent in institutional social care (ISC): former foster care recipients have higher rates of depression and PTSD than the general population (Pecora, 2009). The rate of children living in residential care facilities in Europe and Central Asia is double the global average (UNICEF, 2024). This study aims to assess and compare the mental health of children in ISC centers and regular high schools. Methods A cross-sectional study was conducted in ISC centres and high schools in 2022-2023. The sample size consisted of children aged 11-17 living in ISC (n = 49) or in families (n = 193). Online anonymous survey was applied to assess the prevalence of endured violence, substance use and measure mental health outcomes using the Strengths and Difficulties Questionnaire (SDQ-25). Results A total of 242 respondents (age mean 14.6, SD = 2.12) in ISC and families showed similar poor mental health rates (42% and 44%, respectively). Prosocial behaviour problems were exhibited more by boys (p < 0.05), whereas emotional symptoms were more common in families (p < 0.001): 90% normal SDQ-25 scores in ISC vs 60% in families. Enduring psychological (38% vs 60.2%) violence was more prevalent among children in families (p < 0.05); smoking - in ISC, alcohol use - in families (p < 0.05). In both groups enduring physical violence was associated with smoking and alcohol use (p < 0.05), and overall poor SDQ-25 results strongly correlated (p < 0.001, r = 0.815, r = 0.610, respectively) with hyperactivity. Conclusions A significant part of study participants reported poor mental health outcomes with most problems in relationships with peers. Mental health risk factors such as violence or substance abuse are associated with poor emotional wellbeing while being more common among children living with families. Key messages • Children living in ISC and in families demonstrate similar level of mental health problems. • Varying prevalence of substance abuse among children living in different settings highlights the importance of environmental factors when addressing the issue.