Children's Appraisals of their Experiences in Out-of-Home Care

Foster Care, Kinship Care, and the Transition to Adulthood: Do Child Welfare System Processes Explain Differences in Outcomes?

Despite longstanding policy preferences favoring kinship care placements over non-relative family foster care placements, research findings on the benefits of kinship care vary by measurement, assessed outcome, follow-up period, and other study design elements. We examined early adulthood outcomes-incarceration and teen parenthood-among WI youth who entered foster care in early-to-middle childhood (ages 5-10). Results suggest that initial placement in kin or nonrelative kinship care was not significantly related to imprisonment or teenage parenthood directly; however, first placement in kinship care is associated with fewer moves, longer duration in care, and a higher probability of a new maltreatment investigation, which in turn is related to long-term outcomes. Further, a new maltreatment investigation was an important mediator and was significantly associated with a higher probability of incarceration and teenage parenthood. This study provides mechanisms on the ways in which first placement setting influences incarceration and teenage parenthood. Findings provide important policy and practice implications on how children's experiences in foster care, based on their initial placement type, can lead to maladaptive outcomes.

Foster youth's placement preferences: The roles of kin, siblings, and age

BACKGROUND

Debates exist regarding whether foster youth should be asked about their placement preferences following removal, with only youth aged 12 years and older at times assumed legally competent to provide input.

OBJECTIVES

The present study evaluated whether placement-related factors known to predict youth's well-being also shape their placement preferences and whether preferences differ between youth below and above the age at which they are considered legally competent to provide input.

METHOD

Data (N = 1033, ages 6-17 years, 54 % female) were obtained from NSCAW-I. Youth were asked open- and closed-ended questions about their placement preferences.

RESULTS

Among youth removed for shorter periods, placement with kin was related to a greater preference for their current placement (RRR = 0.31, p < .001) and desire for permanency in that placement (OR = 1.95, p = .005) relative to youth placed with non-kin. However, youth removed for longer periods (e.g., a year) were similar in their desires for their current placement to be permanent regardless of whether they were living with kin or non-kin caregivers. Among younger youth, placement with siblings (RRR = 0.42, p = .015) was linked to a preference for their current placement. Racial match between youth and their non-kin caregiver was unrelated to their placement preferences.

CONCLUSIONS

Findings revealed that both younger and older youth's placement preferences were shaped by factors objectively linked to youth's well-being and thus align with best practices in placement decisions. The paper discusses the importance of asking youth as young as 6 years about their placement preferences and offers suggestions for social service and legal professionals regarding questioning strategies.

Validation of a Measure of Foster Home Integration for Foster Youth

OBJECTIVES

This article introduces a youth-reported measure (Essential Youth Experiences [EYE]) developed to assess the experiences of foster youth in their home environment and their critical relationships across a number of service systems. Empirically, the article reports on the psychometric properties of a 9-item scale within the EYE that measures the construct of positive home integration (PHI).

METHODS

The EYE was administered to 328 preadolescent and adolescent youth (164 sibling dyads) enrolled in a larger randomized clinical trial.

RESULTS

Correlational analysis suggests that the PHI Scale shows good psychometric properties and strong current and predictive validity.

CONCLUSION

The PHI is a reliable and valid scale that measures youth perspectives of inclusion in the foster home and relationships with their foster care provider. This scale quickly gathers youth perspectives and differentiates between youth who have more versus less significant needs. Implications for research and social work practice are discussed.

Foster home integration as a temporal indicator of relational well-being

This study sought to identify factors that contribute to the relational well-being of youth in substitute care. Using data from the [BLIND] study, youth responded to a 9-item measure of positive home integration, a scale designed to assess the relational experiences of youth to their caregivers and their integration into the foster home. Data were collected from youth in six month intervals, for an 18-month period of time. Latent growth curve modeling procedures were employed to determine if child, family, and case characteristics influenced youth's home integration trajectories. Results suggest stability in youth reports of home integration over time; however, children who were older at the time of study enrollment and youth who experienced placement changes during the period of observation experienced decreased home integration during the 18-month period. Results suggest youth's perspectives of home integration may in part be a function of the child's developmental stage and their experiences with foster care placement instability. Implications for practice and future research are discussed.

Practice parameter for the assessment and management of youth involved with the child welfare system

This Practice Parameter presents principles for the mental health assessment and management of youth involved with the child welfare system. Important definitions, background, history, epidemiology, mental health care use, and functional outcomes are described. Practical guidance regarding child welfare-related considerations for evaluation and management are discussed.

Direct confirmation of quiescence of CD34+CD38- leukemia stem cell populations using single cell culture, their molecular signature and clinicopathological implications

Background

The proliferating activity of a single leukemia stem cell and the molecular mechanisms for their quiescent property remain unknown, and also their prognostic value remains a matter of debate. Therefore, this study aimed to demonstrate the quiescence property and molecular signature of leukemia stem cell and their clinicopathological implications.

Methods

Single cell sorting and culture were performed in the various sets of hematopoietic stem cells including CD34+CD38- acute myeloid leukemia (AML) cell population (ASCs) from a total of 60 patients with AML, and 11 healthy controls. Their quiescence related-molecular signatures and clinicopathological parameters were evaluated in AML patients.

Results

Single cell plating efficiency of ASCs was significantly lower (8.6%) than those of normal hematopoietic stem cells i.e.: cord blood, 79.0%; peripheral blood, 45.3%; and bone marrow stem cell, 31.1%. Members of the TGFβ super-family signaling pathway were most significantly decreased; as well as members of the Wnt, Notch, pluripotency maintenance and hedgehog pathways, compared with non ASC populations. mtDNA copy number of ASCs was significantly lower than that of corresponding other cell populations. However, our data couldn’t support the prognostic value of the ASCs in AML.

Conclusions

ASCs showed remarkable lower plating efficiency and slower dividing properties at the single cell level. This quiescence is represented as a marked decrease in the mtDNA copy number and also linked with down-regulation of genes in various molecular pathways.

Electronic supplementary material

The online version of this article (doi:10.1186/s12885-015-1233-x) contains supplementary material, which is available to authorized users.

Kinship care for the safety, permanency, and well-being of children removed from the home for maltreatment

BACKGROUND

Every year a large number of children around the world are removed from their homes because they are maltreated. Child welfare agencies are responsible for placing these children in out-of-home settings that will facilitate their safety, permanency, and well-being.However, children in out-of-home placements typically display more educational, behavioural, and psychological problems than do their peers, although it is unclear whether this results from the placement itself, the maltreatment that precipitated it, or inadequacies in the child welfare system.

OBJECTIVES

To evaluate the effect of kinship care placement compared to foster care placement on the safety, permanency, and well-being of children removed from the home for maltreatment.

SEARCH METHODS

We searched the following databases for this updated review on 14 March 2011: the Cochrane Central Register of Controlled Trials(CENTRAL),MEDLINE, PsycINFO, CINAHL, Sociological Abstracts, Social Science Citation Index, ERIC, Conference Proceedings Citation Index-Social Science and Humanities, ASSIA, and Dissertation Express. We handsearched relevant social work journals and reference lists of published literature reviews, and contacted authors.

SELECTION CRITERIA

Controlled experimental and quasi-experimental studies, in which children removed from the home for maltreatment and subsequently placed in kinship foster care were compared with children placed in non-kinship foster care for child welfare outcomes in the domains of well-being, permanency, or safety.

DATA COLLECTION AND ANALYSIS

Two review authors independently read the titles and abstracts identified in the searches, and selected appropriate studies. Two review authors assessed the eligibility of each study for the evidence base and then evaluated the methodological quality of the included studies.Lastly, we extracted outcome data and entered them into Review Manager 5 software (RevMan) for meta-analysis with the results presented in written and graphical forms.

MAIN RESULTS

One-hundred-and-two quasi-experimental studies,with 666,615 children are included in this review.The 'Risk of bias' analysis indicates that the evidence base contains studies with unclear risk for selection bias, performance bias, detection bias, reporting bias, and attritionbias, with the highest risk associated with selection bias and the lowest associated with reporting bias. The outcome data suggest that children in kinship foster care experience fewer behavioural problems (standardised mean difference effect size -0.33, 95% confidence interval (CI) -0.49 to -0.17), fewer mental health disorders (odds ratio (OR) 0.51, 95% CI 0.42 to 0.62), better well-being (OR 0.50,95% CI 0.38 to 0.64), and less placement disruption (OR 0.52, 95% CI 0.40 to 0.69) than do children in non-kinship foster care. For permanency, there was no difference on re unification rates, although children in non-kinship foster care were more likely to be adopted(OR 2.52, 95% CI 1.42 to 4.49), while children in kinship foster care were more likely to be in guardianship (OR 0.26, 95% CI 0.17 to 0.40). Lastly, children in non-kinship foster care were more likely to utilise mental health services (OR 1.79, 95% CI 1.35 to 2.37).

AUTHORS' CONCLUSIONS

This review supports the practice of treating kinship care as a viable out-of-home placement option for children removed from the home for maltreatment. However, this conclusion is tempered by the pronounced methodological and design weaknesses of the included studies.

Time well spent: the duration of foster care and early adult labor market, educational, and health outcomes

Individuals who spent time in foster care as children fare on average worse than non-placed peers in early adult life. Recent research on the effect of foster care placement on early adult life outcomes provides mixed evidence. Some studies suggest negative effects of foster care placement on early adult outcomes, others find null effects. This study shows that differences in the average duration of foster care stays explain parts of these discordant findings and then test how foster care duration shapes later life outcomes using administrative data on 7220 children. The children experienced different average durations of foster care because of differences in exposure to a reform. Later born cohorts spent on average 3 months longer in foster care than earlier born cohorts. Isolating exogenous variation in duration of foster care, the study finds positive effects of increased duration of foster care on income and labor market participation.

12-month follow-up outcomes for youth departing and integrated residential continuum of care

This study examined the 12-month post-departure outcomes for youth who exited a residential treatment program at differing levels of restrictiveness. Study participants were 120 youth who entered an integrated residential continuum of care at its most restrictive level and then either departed the program at the same level or stepped down and departed at a lower level of restrictiveness. Results indicate that youth who stepped down and exited at the lowest level of restrictiveness were the most likely to be living at home or in a homelike setting and experienced fewer formal post-departure out-of-home placements. However, there were no differences in post-departure rates of substance use, arrests, or being in school or having graduated. These results suggest that youth who were served in the integrated continuum and departed at the lowest level of restrictiveness had more positive outcomes at 12-month post-discharge.