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June 2017Vol. 18, No. 4In-Home Support Promotes Birth Parents' Relationships With Their Toddlers Upon Reunification

When birth parents are reunified with their child after foster care placement, they often need in-home support services to help prevent any recurrence of maltreatment leading to the child's reentry into foster care. This study in the journal Children and Youth Services Review reports on the findings from a randomized control trial of the 10-week home visiting program, Promoting First Relationships (PFR). The present study focuses on young children from birth to three years of age, as this population of children comprise one-third of first entries into foster care, which is a higher than any other age group.

This study included a subsample of 43 reunified birth parents and children who were originally part of a larger sample of participants in the Fostering Families Project, which was a study that assessed the effectiveness of the PFR program from April 2007 to March 2010. For the purposes of the current study, the subsample of parents and children were randomly assigned to with the PFR protocol (18 parent-child dyads) or a psychoeducational program developed for this study called early education support (EES) (25 parent-child dyads).

The PFR group participated in 10 weekly 60- to 75-minute in-home visits by trained providers from community mental health agencies. The PFR protocol comprised a manualized but flexible curriculum combined with video feedback, worksheets and handouts, and a strengths-based orientation to promote more sensitive parenting. The parents in the EES group participated in a 90-minute in-home session once a month for three months delivered by an early education specialist. These sessions included guidance on early childhood developmental issues as well as referral to service programs such as child care, housing, and mental health.  

The authors hypothesized that the parent-child dyads in the PFR group would show improvements in understanding their toddler's behavior and parental sensitivity and support; reductions in perceiving the child as difficult, having behavioral problems, and reporting a dysfunctional parent-child relationship; and increases in observed child self-regulation and engagement with parents. The results show that although there were no significant differences between parents and children in the PFR group and the EES group immediately after the study posttest, after six months the PFR group showed positive results, indicating that a longer time was required for the intervention to effect change.

When children are placed in out-of-home care, eventual reunification is the goal, when appropriate. However, successfully reunifying parents with their children can be challenging. Parents and their children must transition from spending limited time together, often with supervised visitation, to becoming a full-time family again. Parents have reported this as a time of joy mixed with anxiety as well as feeling disappointment at the perceived lack of support from the child welfare system. The implications of this study are that participating in the PFR program before reunification, during visitation times, and then continuing with PFR as a support postreunification is a model that could be effective in alleviating the stress involved with reunification as well as help to prevent reentry in to the foster care system. The authors suggest that PFR would be a good addition to the services that should be offered by state agencies to strengthen the parent-child relationship.

"Promoting birth parents' relationships with their toddlers upon reunification: Results from Promoting First Relationships home visiting program," by Monica L. Oxford, Maureen Marcenko, Charles B. Fleming, Mary Jane Lohr & Susan J. Spieker, Children and Youth Services Review, 61, 2016, is available through ScienceDirect at