Peer Relations at School Entry: Sex Differences in the Outcomes of Foster Care

The Association Between Child Maltreatment and Loneliness Across the Lifespan: A Systematic Review and Multilevel Meta-Analysis

While there is evidence that child maltreatment is positively associated with loneliness, the strength of this association is not yet clear. It is also unclear whether the magnitude and statistical significance of this association varies across groups of individuals. Therefore, this meta-analysis examines whether there are differences in loneliness between individuals with and without maltreatment histories, and which factors may influence the association between child maltreatment and loneliness. A three-level meta-analysis was conducted on 52 studies reporting 116 effect sizes (N = 1,705,493; Mage = 30.93; 49.6% females). Results showed a medium overall effect (g = 0.45, p < .001, 95% CI [0.36, 0.53]), indicating that individuals with maltreatment histories, on average, feel lonelier than individuals without maltreatment histories. Moderator analyses showed that effect sizes were larger for emotional abuse and emotional neglect as compared to other types of child maltreatment and decreased when participants were older at the time of loneliness assessment. These findings suggest that individuals with maltreatment histories, especially those who have been emotionally abused and/or emotionally neglected, are vulnerable to experiencing loneliness across the lifespan. The results also suggest that feelings of loneliness warrant attention in prevention and intervention programs for individuals with maltreatment histories.

Effects of formal center-based care and positive parenting practices on children in foster care

BACKGROUND

The current study examined whether children in foster care have better cognitive and social-emotional outcomes at kindergarten age when they enroll in formal center-based care and when they receive positive parenting practices at home.

OBJECTIVE

Two primary questions were addressed: (1) Do children in foster care who attended formal center-based care (including Head Start) have higher cognitive and socio-emotional outcomes than children in foster care who did not attend formal center-based care? (2) Does positive parenting practice promote better cognitive and socio-emotional outcomes?

PARTICIPANTS AND SETTING

Based on the Early Childhood Longitudinal Study-K: 2011 data, 299 children in foster care were selected.

METHODS

Regression analyses were conducted on children's cognitive and social-emotional scores by types of children's childcare arrangements (formal vs informal care) and positive parenting practices. Active parental involvement was measured based on how frequently parents read books with their children, and authoritarian parenting discipline was measured based on whether parents spanked their children.

RESULTS

Children in foster care who enrolled in formal center-based childcare at pre-school age have higher cognitive and socio-emotional scores at kindergarten age. Positive parenting practice also promotes children's outcomes. Children in foster care who are both enrolled in formal center-based care and experience positive parenting practice had the most positive outcomes.

CONCLUSIONS

Parents raising children in foster care should be informed about the positive impacts of certain parenting practices on their children. Foster parents should be connected to available community resources, including formal-center-based preschool programs and required to continuously attend parenting classes to sustain positive impact of parenting practice on foster children.

Peer Status as a Potential Risk or Protective Factor: A Latent Profile Analysis on Peer Status and Its Association with Internalizing Symptoms in Adolescents with and without Parental Physical Abuse Experience

Research has well established that parental physical abuse experiences can lead to devastating consequences for adolescents, with peer relationships acting as both protective and risk factors. With the person-centered latent profile analysis (LPA), we analyzed questionnaire data from a cross-sectional study in 2020 composed of a sample of 1959 seventh-grade high school students from Switzerland. This study investigated and compared peer-status profiles combining peer acceptance and peer popularity for adolescents with and without parental physical abuse experiences. We conducted a multinomial logistic regression analysis to investigate further depression, anxiety, and dissociation as predictors of profile membership. With LPA, we identified three distinct profiles for adolescents within the subgroup with experiences of parental physical abuse (n = 344), namely liked, liked-popular, and rejected-unpopular. Within the subgroup of adolescents without parental physical abuse experiences (n = 1565), LPA revealed four profiles, namely liked, liked-popular, rejected-unpopular, and average. For adolescents with parental physical abuse experiences, higher levels of dissociation significantly indicated they were more likely to belong to the rejected-unpopular group than belong to the liked group. Anxious students without experiences of parental physical abuse were more likely to belong to the rejected-unpopular and liked profiles than belong to the liked-popular and average profiles. These findings clearly argue for a deeper understanding of the role of parental physical abuse when analyzing the relationship between dissociation and anxiety and peer status. Operationalizing peer status with the four individual dimensions of likeability, rejection, popularity, and unpopularity was valuable in that the role of peer rejection with respect to different internalizing symptoms became apparent.

Childhood psychopathology mediates associations between childhood adversities and multiple health risk behaviours in adolescence: analysis using the ALSPAC birth cohort

BACKGROUND

Childhood adversity strongly predicts adolescent multiple health risk behaviours (MRBs) such as alcohol/tobacco use, self-harm and physical inactivity, and both adversities and MRBs are associated with premature mortality and several chronic health conditions that are among the leading causes of death in adults. It is therefore important to understand the relationship between adversities and MRBs and what could mediate any association. The aim of this study was to explore whether childhood psychopathology mediates associations between adversities and MRBs.

METHODS

Participants were young people in the Avon Longitudinal Study of Parents and Children (ALSPAC) (N = 5,799). Using structural equation modelling, we explored the associations between adversities before 9 years and MRBs at age 16 years. We also explored potential mediating pathways through dimensional psychopathology measured by the Strength and Difficulties Questionnaire subscales at age 12 years.

RESULTS

There were strong positive associations between adversities and MRBs (β .25, 95% CI 0.20, 0.31, p < .001) suggesting that each additional adversity is associated with a 0.25 increase in number of MRBs out of 13 total risk behaviours. We found robust evidence of mediating pathways from adversities through conduct problems (β .05, 95% CI 0.03, 0.06, p < .001), hyperactivity/inattention (β .02, 95% CI 0.01, 0.03, p < .001) and peer relationship problems (β -.02, 95% CI -0.03, -0.02, p < .001) to MRBs.

CONCLUSIONS

Increased conduct problems and hyperactivity/inattention appear to partially explain the relationship between adversities and MRBs. Peer relationship problems also appear to reduce the association between adversities and MRBs, and further research is needed to understand how to encourage peer connectivity without increasing risk of MRBs. These results suggest that interventions aimed at reducing MRBs among those exposed to childhood adversities could focus on prevention of behavioural problems.

Peer Relations and Delinquency Among Girls in Foster Care Following a Skill-Building Preventive Intervention

There is evidence that risk for delinquency is elevated among girls with foster care histories, and one correlate of delinquency is affiliating with peers who engage in delinquent behavior. Although intervention studies have shown positive effects of interventions that target delinquent peer affiliation on reductions in delinquency among adolescents with juvenile justice histories, the success of such interventions for younger girls in foster care, without prior involvement with juvenile justice, is unknown. We analyzed data from a randomized clinical trial of the middle school version of the Keep Safe intervention in a sample of girls in foster care (n = 100). The intervention was delivered to girls and foster parents during the transition to middle school. Path analysis suggested a significant intervention effect on reduction in affiliation with delinquent peers at 12 months (B = -.21). No significant mediation effects were identified. The middle school Keep Safe intervention shows promise as a preventative intervention for reducing affiliation with delinquent peers, which importantly is associated with adolescent delinquent behavior. Implications for researchers and professionals who tailor and deliver evidence-based programs for girls in foster care are discussed.

The Peer Relationships of Those Who Have Experienced Adoption or Foster Care: A Meta-Analysis

This meta-analytic review examines the presence and quality of close peer relationships for adoptees and individuals with foster care experience. Results indicate that adoptees show difficulty forming close peer relationships compared with biologically reared individuals, but they do not differ in the quality of these relationships. In contrast, those with foster care experience report lower quality peer relationships than biologically reared individuals. Additionally, this meta-analysis includes prevalence rates of close peer relationships that illustrate most adoptees and foster youth report having high-quality peer relationships. These findings have important implications for intervention and prevention efforts and offer directions for future research on peer relationships among adoptees and foster youth, but should be considered in light of the presence of some publication bias.

Decreasing Risk Factors for Later Alcohol Use and Antisocial Behaviors in Children in Foster Care by Increasing Early Promotive Factors

Children in foster care are at high risk for poor psychosocial outcomes, including school failure, alcohol and other substance abuse, and criminal behaviors. Promoting healthy development by increasing broad-impact positive skills may help reduce some of the risk factors for longer-term negative outcomes. School readiness has been linked to a number of positive outcomes across childhood, adolescence, and adulthood, and may also boost intermediary positive skills such as self-competence. This paper presents findings from a longitudinal study involving 192 children in foster care who were 5 years old at the start of the study. They participated in a randomized controlled trial of a school readiness program to prepare them for kindergarten. Outcomes were assessed at third grade (9 years old) on variables associated with risk for later involvement in substance use and delinquency. These included positive attitudes towards alcohol use, positive attitudes towards antisocial behaviors, and involvement with deviant peers. Results showed that the intervention decreased positive attitudes towards alcohol use and antisocial behaviors. Further, the mediating role of children's self-competence was tested. The intervention positively influenced children's third-grade self-competence, which in turn, decreased their involvement with deviant peers. Findings suggest that promoting school readiness in children in foster care can have far-reaching, positive effects and that increased self-competence may be a mechanism for reducing risk.

Plasticity of risky decision making among maltreated adolescents: Evidence from a randomized controlled trial

Childhood maltreatment has lasting negative effects throughout the life span. Early intervention research has demonstrated that these effects can be remediated through skill-based, family-centered interventions. However, less is known about plasticity during adolescence, and whether interventions are effective many years after children experience maltreatment. This study investigated this question by examining adolescent girls' ability to make advantageous decisions in the face of risk using a validated decision-making task; performance on this task has been associated with key neural regions involved in affective processing and executive functioning. Maltreated foster girls (n = 92), randomly assigned at age 11 to either an intervention designed to prevent risk-taking behaviors or services as usual (SAU), and nonmaltreated age and socioeconomic status matched girls living with their biological parent(s) (n = 80) completed a decision-making task (at age 15-17) that assessed risk taking and sensitivity to expected value, an index of advantageous decision making. Girls in the SAU condition demonstrated the greatest decision-making difficulties, primarily for risks to avoid losses. In the SAU group, frequency of neglect was related to greater difficulties in this area. Girls in the intervention condition with less neglect performed similarly to nonmaltreated peers. This research suggests that early maltreatment may impact decision-making abilities into adolescence and that enriched environments during early adolescence provide a window of plasticity that may ameliorate these negative effects.

Multilevel correlates of behavioral resilience among children in child welfare

Resilience, defined as positive adaptation and functioning following exposure to significant adversity, is an important topic of investigation in child welfare. The current study used data from the Ontario Looking After Children (OnLAC) project to estimate the prevalence of behavioral resilience (i.e., lower frequency of conduct and emotional problems, higher frequency of prosocial behavior) in 531 5-9 year olds living in out-of-home care, and to determine how behaviorally-resilient children are functioning in other domains (i.e., peer relationships and academic performance). Furthermore, hierarchical linear modeling was used to examine the contribution of four levels of analysis (i.e., child, family, child welfare worker, and child welfare agency) on behaviors and to identify the contribution of predictor variables within each of these levels. Findings indicated that 50-70% of children exhibited resilience on one behavioral outcome while approximately 30% showed resilience on at least two of the outcomes. Also, 8.4-9.6% exhibited resilience on one of the behavioral outcomes in addition to peer relationships and academic performance. The child level accounted for the highest proportion of total explained variance in behavioral outcomes, followed by the family-, child welfare worker-, and child welfare agency-levels. A number of child and foster family variables predicted behavioral functioning. Findings indicate that it is important to inquire about children's functioning across multiple domains to obtain a comprehensive developmental assessment. Also, child and foster family characteristics appear to play considerable roles in the promotion of behavioral resilience.

Preventing Child Behavior Problems and Substance Use: The Pathways Home Foster Care Reunification Intervention

This paper evaluated the Pathways Home manualized selective preventive intervention designed to prevent reunification failures once children are returned home to their biological parent(s) after first time stays in foster care (n = 101). The theoretically based intervention focused on support and parent management practices designed to prevent the development of child behavior problems including internalizing and externalizing problems, and substance use. Intent to treat analyses employed probability growth curve approaches for repeated telephone assessments over 16 weeks of intervention. Findings showed that relative to services as usual reunification families, the Pathways Home families demonstrated better parenting strategies that were in turn associated with reductions in problem behaviors over time. Growth in problem behaviors in turn predicted foster care re-entry. Maternal substance use cravings were a risk factor for growth in problem behaviors that were buffered by participation in the Pathways Home intervention.

Practitioner review: Children in foster care--vulnerabilities and evidence-based interventions that promote resilience processes

BACKGROUND

An increasing number of children are placed in foster care (i.e., a kin or nonkin family home other than the biological parent) due to experiences of physical, sexual, emotional, or psychological abuse, and/or neglect. Children in foster care are at increased risk for a host of negative outcomes encompassing emotional, behavioral, neurobiological, and social realms.

METHODS

Areas of risk and vulnerability among foster children are described, including emotional and behavioral deficits, impaired neurobiological development, and social relationship deficits. Evidence suggesting the significance of family placement changes and prenatal exposure to substances as contributing mechanisms is presented. Based on a systematic search of the PsycINFO database (to March 2012), eight efficacious evidence-based interventions for foster families are summarized.

FINDINGS

Although the development of evidence-based interventions that improve outcomes for foster children has lagged behind the delivery of interventions in other service sectors (e.g., mental health and educational sectors), several interventions across childhood and adolescence offer promise. Service system constraints offer both challenges and opportunities for more routine implementation of evidence-based interventions.

CONCLUSIONS

Given the increased likelihood of poor outcomes for foster children, increased efforts to understand the pathways to vulnerability and to implement interventions shown to be effective in remediating risks and improving outcomes for this population are indicated. Evaluation of efficacious interventions in countries outside of the United States is also needed.

Cognitive flexibility and theory of mind outcomes among foster children: preschool follow-up results of a randomized clinical trial

Young children who experience early adversity are at risk for problems regulating emotions, behavior, and physiology, which in turn place them at risk for later psychopathology, school problems, and peer relation difficulties. Therefore, early parenting interventions are critical in helping this vulnerable population develop adequate self-regulatory capabilities. Attachment and Biobehavioral Catch-up (ABC) is an intervention developed to help parents learn to behave in ways that enhance young children's self-regulatory capabilities. In the present study, we found that preschool-aged foster children who had received the ABC intervention showed stronger cognitive flexibility and theory of mind skills, relative to foster children who had received a control intervention. Foster children who had received the ABC intervention showed capabilities in these areas that were not significantly different from a comparison group of children who were never in foster care. These findings are promising in suggesting that the ABC intervention enhances the development of foster children's self-regulatory capabilities.

Girls in Foster Care: Risk and Promotive Factors for School Adjustment Across the Transition to Middle School

Girls in foster care may face difficulties across the transition to middle school. Latent growth curve modeling was employed to examine trajectories and predictors of academic competence and aggression from and against peers for 75 girls in foster care from the end of elementary school to the 2(nd) year of middle school. Across the transition to middle school, academic competence increased. Poor self-regulation was associated with decreased academic competence, and higher caregiver support was associated with increased academic competence. Frequency of aggression from peers decreased across the transition, with perceived school competence predicting smaller decreases. Aggression against peers dropped initially and then increased to pretransition levels by the end of the 2(nd) year of middle school. Lower caregiver support was associated with higher rates of aggression against peers at the end of the 1(st) year of middle school. The results are discussed in terms of implications for interventions for girls in foster care.

Preventing internalizing and externalizing problems in girls in foster care as they enter middle school: impact of an intervention

Girls in foster care have been shown to be at risk for emotional and behavioral problems, especially during the preadolescent and adolescent years. Based on these findings and on the lack of research-based preventive interventions for such youths, the current study examined the impact of an intervention targeting the prevention of internalizing and externalizing problems for girls in foster care prior to middle school entry. Study participants included 100 girls in state-supported foster homes who were randomly assigned to an intervention condition or to a control condition (foster care services as usual). The intervention girls were hypothesized to have fewer internalizing problems, fewer externalizing problems, and more prosocial behavior at 6-months post-baseline compared to the control girls. The results confirmed the hypotheses for internalizing and externalizing problems, but not for prosocial behavior. Limitations and future directions are discussed.

Early elementary school adjustment of maltreated children in foster care: the roles of inhibitory control and caregiver involvement

In this study, 85 maltreated foster children and 56 non-maltreated community children (M age=3-6 years) were assessed across kindergarten and first grade to examine the hypothesis that inhibitory control and caregiver involvement mediate associations between a history of maltreatment and foster placement and early school adjustment. Specifically, academic and social-emotional competence were evaluated. The maltreated foster children performed more poorly in academic and social-emotional competence. Inhibitory control fully mediated the association of maltreatment and foster placement with academic competence, whereas inhibitory control and caregiver involvement mediated their association with social-emotional competence. The results suggest that inhibitory control and caregiver involvement might be promising targets for school readiness interventions for foster preschoolers.

Clinical implications of traumatic stress from birth to age five

Children aged birth to five years are exposed to a disproportionately increased amount of potentially traumatic events compared to older children. This review examines the prevalence of traumatic exposure in the birth-to-five age range, the indicators and diagnostic criteria of early traumatic stress, and the contextual issues associated with the experience of early trauma. The article also selectively reviews the impact of trauma on the biological, emotional, social, and cognitive functioning of young children's development along with some promising clinical treatment and service interventions that target the parent-child relationship as a vehicle of trauma recovery. Despite extensive documentation of the negative impact of trauma on the normal development of young children, research, clinical, and policy efforts to address the psychological repercussions of early victimization remain remarkably limited. Future directions in research and clinical practice as well as implications for policy are discussed.

Multidimensional treatment foster care as a preventive intervention to promote resiliency among youth in the child welfare system

Demographic trends indicate that a growing segment of families is exposed to adversity such as poverty, drug use problems, caregiver transitions, and domestic violence. Although these risk processes and the accompanying poor outcomes for children have been well studied, little is known about why some children develop resilience in the face of such adversity, particularly when it is severe enough to invoke child welfare involvement. This paper describes a program of research involving families in the child welfare system. Using a resiliency framework, evidence from 4 randomized clinical trials that included components of the Multidimensional Treatment Foster Care program is presented. Future directions and next steps are proposed.

Foster Parent Intervention Engagement Moderating Child Behavior Problems and Placement Disruption

OBJECTIVE: The authors conduct a within intervention group analysis to test whether caregiver engagement (e.g., participation, homework completion, openness to ideas, apparent satisfaction) in a group-based intervention moderates risk factors for foster child outcomes in a state-supported randomized trial of caregiver parent training. METHODS: The intervention is delivered in 16 weekly sessions by trained leaders. Outcomes are pre-post change in problem behaviors and negative placements. RESULTS: Analysis of 337 caregivers nested within 59 parent groups show caregiver engagement moderates number of prior placements on increases in child problem behaviors, and moderates risk of negative placement disruption for Hispanics. CONCLUSIONS: Variance in parent group process affects program effectiveness. Implications for practice and increasing effective engagement are discussed.

Dimensions of health in young people in foster care

To describe the dimensions of health and illness from the perspective of adolescents in foster care.

METHODS

Descriptive analyses of dimensions of health were conducted on N = 105 adolescents in foster care. Differences among demographic (age, gender, race/ethnicity) and foster care placement (age at first placement, reason(s) for foster care placement, length of time in care, number, and types of placement) variables and the dimensions and subdimensions of health (Child Health and Illness Profile- Adolescent Edition) were determined using T-tests and ANOVA.

RESULTS

Most were placed in long-term foster care (x = 6.46 years; SD = 4.86) during adolescence (38%), with multiple placements (x = 3.99; SD = 3.8). All domains of health were self-reported to be average to low average, with poorer findings in specific risk and resilience subdomains. There were no significant differences by age or race/ethnicity. Girls had lower satisfaction with health and self esteem and more physical and emotional discomfort. Pre-placement adverse experiences were associated with increased risks.

CONCLUSIONS

Adolescent self-report of the domains of health for those in foster care was better than expected, based on literature review and qualitative data for the larger study. Potential explanations for this inflation of status and functioning include the need for self-protection in foster care, the familiarity of testing regimes by children in foster care with some social desirability effect, and their paradoxical responses to pre-placement problems. Data including qualitative and significant other-reported data may be necessary to gain an accurate portrayal of the health status of adolescents in foster care.