This month's CBX spotlight features an article on the dental and oral aspects of child maltreatment, recommendations for maintaining a strong and professional child protective services workforce, maltreatment estimates within U.S. military families, and Tribal prevention programs, as well as other resources to help professionals prevent child abuse and neglect.
- Oral and Dental Aspects of Child Maltreatment
The oral and dental aspects of child maltreatment are the focus of a 2016 report from the American Academy of Pediatrics Committee on Child Abuse and Neglect and the American Academy of Pediatric Dentistry. The report reviews the oral and dental characteristics of physical abuse, sexual abuse, and dental neglect and how physicians and dentists can evaluate bite marks, oral injuries, infections, or diseases that might suggest child abuse or neglect. The report notes that physicians receive limited training in oral health and dental injury and, therefore, might not be as likely to detect the oral and dental symptoms of child maltreatment as readily as other physical symptoms. Pediatric dentists and maxillofacial surgeons are required to go through oral and dental-specific child maltreatment training and, as a result, can assist doctors in assessing related symptoms of potential child maltreatment. For example, pediatric and forensically trained dentists can assist physicians in identifying bite marks indicative of abuse and neglect. Physicians and dentists are encouraged to collaborate to increase prevention and detection of possible child abuse and neglect.
More than half of child maltreatment cases involve some injury to the head, face, or neck, according to the report, which recommends a thorough oral examination in all suspected cases of child maltreatment. Eating utensils, bottles, hands, fingers, scalding liquids, and caustic substances can all be used forcefully and maliciously to inflict oral damage. Providers should look for contusions, burns, or lacerations on the lips, cheek, tongue, palate, and gums and for discolored or infected teeth or gums.
The report calls upon pediatricians to be aware of oral and dental injuries as signs of potential maltreatment and the need for follow-up testing. Pediatricians are also encouraged to be aware of bite marks, document them carefully, and consult a pediatric or forensic dentist for appropriate testing, diagnosis, and treatment when questions arise. The report notes that children suspected to have been sexually abused may require specialized forensic testing and that forensic odontologists or pathologists may need to be consulted to evaluate bite marks or infection.
The report points to the Prevent Abuse and Neglect Through Dental Awareness (PANDA) coalition as an important resource for physicians, encouraging physicians with child maltreatment experience to make themselves available to dentists and dental organizations as educators and consultants.
Guideline on Oral and Dental Aspects of Child Abuse and Neglect is available at http://www.aapd.org/media/Policies_Guidelines/G_Childabuse1.pdf (95 KB).
- Community-Based Child Abuse Prevention Programs Support Tribal Prevention Efforts
The Community-Based Child Abuse Prevention (CBCAP) program, which was established by the Child Abuse Prevention and Treatment Act Amendments of 1996, is a key piece of Federal legislation that provides funding and support to community-based efforts and initiatives to prevent child abuse and neglect. The CBCAP program distributes Federal funds to States and territories under a formula grant, with 1 percent of these funds reserved for Tribes, Tribal organizations, and migrant programs.
Partnering With CBCAP Programs to Support Tribal Prevention Efforts, a brief produced by the FRIENDS National Center for Community-Based Child Abuse Prevention, provides important information on what the CBCAP program entails, including who manages the program at the Federal and State levels, what activities are authorized by the program, and the program's target populations. The brief also describes how Tribal governments and organizations can access CBCAP funds to develop, operate, expand, enhance, and coordinate initiatives, programs, and activities aimed at supporting families and preventing child abuse and neglect.
Tribal governments and organization can access CBCAP funds in the following two ways:
- CBCAP Grants to Tribes, Tribal Organizations, and Migrant Programs—To be awarded the grant, applicants and their proposed programs must meet key expectations, such as meeting the criteria for evidence-based and evidence-informed programs that reflect the unique cultural needs of their community, supporting an evaluation of the programs and services funded by the grant, and developing stronger relationships with their CBCAP State Lead Agency. In September 2016, the Kickapoo Tribe in Kansas was awarded a grant as part of this program. More information on these grants can be found at https://friendsnrc.org/tribal-and-migrant-grantees.
- CBCAP Community-Based Grants Program—Tribal governments are encouraged to contact their State Lead Agencies to learn more about the criteria for accessing CBCAP community grants in their States. To determine who to contact, Tribal governments can visit http://friendsnrc.org/state, which features a map of the United States from which they can obtain contact information for each State's Lead Agency representative(s).
Although Tribes, Tribal organizations, and migrant programs are encouraged to take advantage of the funds available through the CBCAP program, only a few have accessed State CBCAP funding. Infrequent participation by Tribes may be attributed to the inexperience of the State Lead Agencies in working with Tribal governments and a lack of awareness of culturally appropriate outreach and programming. Collaborating with State Lead Agencies is highly recommended to bring awareness to Tribes' unmet needs and to help Tribes receive CBCAP funding for culturally specific support of Tribal children and families.
The full article, Partnering With Community-Based Child Abuse Prevention (CBCAP) Programs to Support Tribal Governments and Tribal Organization's Prevention Efforts, is available at https://friendsnrc.org/component/jdownloads/download/72-attachments/1877-partnering-with-cbcap-programs-to-support-tribal-governments-and-tribal-organizations-prevention-efforts (PDF - 647 KB).
- April Is National Child Abuse Prevention Month
Every April, the Children's Bureau observes National Child Abuse Prevention Month to raise public awareness of child abuse and neglect, recommit efforts and resources aimed at protecting children and strengthening families, and promote community involvement through activities that support the cause. The theme of this year's Child Abuse Prevention Month initiative continues to mirror the theme of the 20th National Conference on Child Abuse and Neglect, "Building Community, Building Hope."
This year's initiative also highlights the 2016/2017 Prevention Resource Guide: Building Community, Building Hope, which is intended to support child welfare service providers in their work with parents, caregivers, and their children to strengthen families and prevent child maltreatment. It was developed through a partnership between the Office on Child Abuse and Neglect within the Children's Bureau, Child Welfare Information Gateway, and the FRIENDS National Center for Community-Based Child Abuse Prevention. This year, the Prevention Resource Guide was updated with new child maltreatment statistics for Federal fiscal year 2015, which can be found in Chapter 4, "Protecting Children."
Also in 2017, two new web-only tip sheets were made available on the Child Abuse Prevention Month website. "Find Affordable Housing for Your Family" directs families to valuable resources to understand affordable housing and other available resources. "Preparing Your Family for an Emergency" outlines the components of a family emergency preparedness plan for various types of disasters.
The information and resources available in the Prevention Resource Guide can be used all year to help professionals and families prevent maltreatment and work toward child and family well-being. For more information on National Child Abuse Prevention Month, or to view or order a copy of the 2016/2017 Prevention Resource Guide, visit the National Child Abuse Prevention Month website at https://www.childwelfare.gov/topics/preventing/preventionmonth/.
The 2016/2017 Prevention Resource Guide and activity calendars are also available on the Preventing Child Abuse & Neglect section of the Child Welfare Information Gateway website at https://www.childwelfare.gov/topics/preventing/.
- Estimation of Maltreatment in Army Families
According to a recent study of the U.S. Army Family Advocacy Program (FAP), which is the agency responsible for providing services to soldiers' families and ensuring child safety, current reporting requirements may contribute to underestimating the actual number of maltreatment cases in U.S. Army families and need revision.
The U.S. Army-sponsored study analyzed medical claims of child maltreatment from both military and civilian doctors that were made between 2004 and 2007 and resulted in a substantiated report to FAP. The study assessed 5,945 medical claims for dependent children of soldiers—ages 0 through 17—who had received a diagnosis of maltreatment from either a military or civilian medical doctor. The study was designed to link the claims with corresponding substantiated reports to FAP and determine how the child, the specific maltreatment episode, and the soldier's characteristics influenced the extent of FAP involvement.
The study found that 20 percent of claims had substantiated FAP reports, and the authors suggest that this likely underestimates the true number of maltreatment victims as many maltreatment cases are either never reported to a child protection agency or are never investigated or substantiated. The authors also emphasize the complexity of reporting requirements for U.S. Army families due to multiple possible routes to communicate reports of suspected maltreatment to the U.S. Army FAP, the likelihood that medical providers are not uniformly reporting maltreatment diagnoses to FAP, and a failure by civilian child protection agencies to consistently share information with FAP on maltreatment reports they receive involving military children. The study authors conclude that this results in an undercounting of military child maltreatment cases and many vulnerable children and families going without needed FAP services.
The authors suggest further study to identify and understand the barriers to more comprehensive child maltreatment reporting and communication across agencies so that programs and policies can be developed to improve FAP reporting and support the children and families of U.S. Army soldiers.
Under-Ascertainment From Healthcare Settings of Child Abuse Events Among Children of Soldiers by the U.S. Army Family Advocacy Program is available at http://www.sciencedirect.com/science/article/pii/S0145213416302587.
- Texas CPS Workforce Analysis and Recommendations
Between 2001 and 2015, a total of 3,078 children died as a result of abuse and/or neglect in the State of Texas, and approximately half of those fatalities involved families that had current or previous involvement with child protective services (CPS). These statistics stress the need for dedicated and experienced CPS workers to respond to reports of maltreatment in a timely manner and to conduct trauma-informed investigations, assessments, and removal or placement decisions.
Because of the rising number of child abuse and neglect cases in Texas, hiring and retaining dedicated CPS caseworkers can be a challenge. There are a number of hindrances to job satisfaction in this field, which can lead to a high turnover rate and heavy caseloads for those who stay in their jobs. The report, Child Protective Services Workforce Analysis and Recommendations, produced by the Texas Association for the Protection of Children, addresses the challenges causing CPS workers to voluntarily leave their jobs and provides recommendations to ensure CPS maintains a strong and professional workforce to ensure better outcomes for children in Texas.
The report focuses on the following obstacles that may cause CPS caseworkers to resign from their positions and the recommendations for reform:
- Insufficient compensation—About three-quarters (76 percent) of former caseworkers revealed during their exit interviews that their pay was insufficient in relation to the amount and nature of the work they do. Recommendations to address compensation include implementing a market-driven, cost-of-living adjusted compensation package, which would increase annual baseline salaries to be on par with other professions.
- Heavy caseloads—Survey results indicated that turnover increases when caseworkers have an unmanageable caseload. This also results in poor outcomes for the children and families involved in these cases as well as even more work for existing caseworkers. Recommendations to address heavy caseloads include implementing a "just-in-time" hiring process using turnover data to help forecast when turnover is more likely to occur. This strategy would allow the Department of Family and Protective Services to hire based on projected and current vacancies, which will result in timelier replacement of caseworkers and fewer abandoned cases.
- Education—Social workers with either a bachelor's or a master's degree in social work are better trained and better suited to be caseworkers and are less likely to leave their jobs than those who do not have social work degrees. In 2016, the Department of Family and Protective Services, however, relaxed a requirement for hiring to focus on applicants with at least a bachelor's degree in a human services field and is now allowing applicants with a combination of 60 college credits and 2 years relevant work experience to substitute for a bachelor or master's degree in social work. Recommendations to address these relaxed education requirements include developing a workforce consisting of a minimum of 65 percent bachelor's-level and 25 percent master's-level social workers, with only 10 percent exceptional applicants from other human services fields.
- Secondary traumatic stress (STS) and burnout—The symptoms of STS often mirror the symptoms of stress exhibited by direct victims of trauma. Child welfare caseworkers are more likely to experience these symptoms than any other behavior health professional. Recommendations to address STS and burnout include additional onsite wellness supports that are integrated into day-to-day program work, such as decompression rooms and onsite counselors.
- Supportive supervision—As a result of the high turnover rate among CPS caseworkers, CPS is often left with no other option than to promote employees with as little as 2 years of experience into the role of supervisor. This can lead to increased stress among both workers and supervisors. Recommendations to address promoting inexperienced workers to a supervisory role include addressing and finding solutions to the previously described four challenges, which would reduce employee turnover and allow CPS to retain employees long enough to form a solid and experienced management pool.
The complete report, Child Protective Services Workforce Analysis and Recommendations, is available at http://texprotects.org/media/uploads/improving_the_protection_of_texas_children_workforce_analysis._january_2017_final_release.pdf (1,630 KB).
Spotlight on Child Welfare Data and Technology
Spotlight on Tribal Child Welfare
News From the Children's Bureau
We highlight a webinar produced by the Office of Planning, Research and Evaluation that discusses findings from a survey of American Indian/Alaska Native Head Start programs as well as a new resource guide that provides information on the recent advances in trauma and what these advances mean for program design and service delivery.
- Resource Guide to Trauma-Informed Human Services
Trauma can have a profound effect on how a person learns; interacts with others; and develops mentally, physically, or emotionally. Human services agencies that use a trauma-informed approach develop programs and services that take into account the effects of trauma on individuals, children, and families. A new resource guide produced by several Federal agencies provides human services leaders and other stakeholders at the local, State, Tribal, and territorial levels with information and resources on recent advances in trauma and what these advances mean for program design and service delivery. It also teaches professionals about trauma-informed care and helps those currently engaged in trauma-informed work to improve their practice.
The guide is divided into the following four sections:
- Concept Papers—Focuses on six key concepts (trauma, toxic stress, resilience, historical trauma, executive functioning, and compassion fatigue) associated with trauma-informed care that are particularly important for human services providers interested in expanding their understanding of trauma and its implications for service delivery.
- Guidance Questions and Answers—Answers questions about trauma and trauma-informed care and provides a foundational background that may help human services professionals develop their trauma-informed approach. One subsection, Q&A: Trauma, defines trauma and discusses how trauma may affect brain development. Another section, Q&A: Adverse Childhood Experiences (ACEs), defines ACEs and provides links to the ACEs Study, which is conducted by the Centers for Disease Control and Prevention in collaboration with Kaiser Permanente.
- Trauma Resources for Specific Human Services Programs or Populations—Provides links to information about aging populations, American Indian/Alaska Native populations, early childhood programs, emergency/crisis services, and more.
- Community Spotlights—Highlights lessons learned and promising practices from Kansas City, KS; Kansas City, MO; San Francisco, CA; and Walla Walla, WA.
The complete Resource Guide to Trauma-Informed Human Services was produced by the collaborative efforts of the Administration for Children and Families, the Substance Abuse and Mental Health Services Administration, the Administration for Community Living, and the Offices of the Assistant Secretary for Health and the Assistant Secretary for Planning and Evaluation. It is available at https://www.acf.hhs.gov/trauma-toolkit.
- Findings From the First National Study of Tribal Head Start Programs
The webinar, "Study Progress & Selected Findings From the First National Study of Tribal Head Start Programs," produced by the Office of Planning, Research and Evaluation, discusses the methods, findings, and implications gleaned from the first time Region 11 was included in the Family and Child Experiences Survey (FACES). Region 11 primarily comprises American Indian and Alaska Natives (AI/AN) on or near reservations and serves federally recognized programs in 26 States.
Historically, Region 11 Head Start programs operating in Tribal communities were not included in FACES, mainly attributed to Tribal concerns about research in general as well as the unique protocols for research involving sovereign Tribal nations. To close this gap in Head Start data, AI/AN FACES set out to provide Federal, Tribal, and program stakeholders with data they can use to inform policies and practices that address the needs of children and families in Region 11. The data collected from AI/AN FACES can also be used to describe the school readiness skills of children in Region 11 and how they compare to children of similar ages in the general population as well as to other Head Start children in Regions 1 through 10.
The following are the key features of AI/AN FACES:
- The survey was a source for national data on Region 11 Head Start programs and not a study of any one program or one Tribal community.
- The purpose of the survey was primarily descriptive and not meant as a study of the effectiveness of Region 11 programs.
- Data were collected from children, parents, teachers, program and center directors, and classroom observations.
- Children participated in a 45-minute, one-on-one direct assessment of their skills in several areas: language, literacy, math, and executive functioning.
- Parents' data were used to collect information on family, home, community, and Head Start experiences.
- Data about Head Start staff (i.e., teachers and directors) were used to assess staff background and experience, classroom or program characteristics, and cultural and native-language resources and opportunities.
- Classroom observations data were used to assess the quality of Head Start classroom and teacher-student interactions as well as children's exposure to Tribal language and culture.
The data garnered from AI/AN FACES found that a majority of families in Region 11 have access to financial resources and are food secure, but many still have needs related to their economic well-being. With regard to psychological well-being, a majority (58 percent) of parents in Region 11 reported that they were not depressed, but a sizeable number reported symptoms of being mildly (24 percent) or moderately (10 percent) depressed. Additionally, a small percentage indicated they are severely depressed. In addition, data show that culture and language—as well as participation in cultural community activities, such as dancing, drumming, and interacting with elders—are important to Head Start families in Region 11.
To learn more about AI/AN FACES and to view the complete webinar, visit https://www.acf.hhs.gov/opre/resource/study-progress-selected-findings-from-the-first-national-study-of-tribal-head-start-programs.
Children's Bureau Express has covered previous rounds of FACES in the following articles:
- Fifth Wave of Data in Head Start Survey (May 2012, Vol. 13, No. 4): https://cbexpress.acf.hhs.gov/index.cfm?event=website.viewArticles&issueid=135&articleID=3494&keywords=Family%20and%20Child%20Experiences%20Survey
- Spotlight on Child Well-Being (February 2013, Vol. 14, No. 1): https://cbexpress.acf.hhs.gov/index.cfm?event=website.viewArticles&issueid=143&articleID=3758&keywords=Family%20and%20Child%20Experiences%20Survey%20%28FACES%29
- CB Website Updates
The Children's Bureau website hosts information on child welfare programs, funding, monitoring, training and technical assistance, laws, statistics, research, Federal reporting, and much more.
Recent additions to the site include the following:
- National Youth in Transition Database (NYTD) Reviews: https://www.acf.hhs.gov/cb/monitoring/nytd-reviews
- How to Send a Formal Submission: https://www.acf.hhs.gov/cb/research-data-technology/state-tribal-info-systems/managers/submit
- Regulatory Actions: https://www.acf.hhs.gov/cb/laws-policies/federal-laws/regulatory-actions
- IM-17-02: High-Quality Legal Representation for All Parties in Child Welfare Proceedings: https://www.acf.hhs.gov/cb/resource/im1702
- IM-17-03: Efforts by Child Welfare Agencies, Local Communities, and Federal Agencies to End Family and Youth Homelessness: https://www.acf.hhs.gov/cb/resource/im1703
- Engaging Fathers Part 3: https://www.acf.hhs.gov/cb/resource/child-welfare-podcast-engaging-fathers-part3
- CB Fact Sheet: https://www.acf.hhs.gov/sites/default/files/cb/2016factsheets_cb.pdf
- Title IV-E Foster Care Eligibility Reviews 2017 Schedule: https://www.acf.hhs.gov/cb/resource/title-iv-e-2017-review-schedule
- Tribal Federal Medical Assistance Percentage (FMAP): https://www.acf.hhs.gov/cb/resource/tribal-fmap
- PI-17-03: Availability of Fiscal Year 2017 Children's Justice Act Grants to States Under the Child Abuse Prevention and Treatment Act (CAPTA): https://www.acf.hhs.gov/cb/resource/pi1703
Visit the Children's Bureau website often to see what's new.
Read about how the San Francisco Human Services Agency is partnering with the University of California to develop an evidence-driven child welfare workforce; an Office of Planning, Research and Evaluation brief that explains the implications of existing State standards for incorporating relationship-based care into early care programs; and a Department of Justice study evaluating technology-based harassment within the context of other types of youth victimization and risk factors.
- Role of Technology in Youth Harassment Victimization
Youth who are harassed and victimized by their peers suffer most from technology-based bullying when it is reinforced by in-person harassment, according to a recent U.S. Department of Justice (DOJ) study. The study was conducted by the Office of Juvenile Justice and Delinquency Prevention within the DOJ National Institute of Justice to evaluate technology-based harassment within the context of other types of youth victimization and risk factors.
The Technology Harassment Victimization study was conducted between December 2013 and March 2014 using a telephone survey designed for the following purposes:
- To define technology-involved harassment incidents and their associated adverse consequences
- To explore the role that harassment characteristics have on the impact of technology-involved harassment
- To assess the frequency and nature of bystander involvement in technology-based harassment
- To determine whether youth who have experienced multiple types of victimization are at particular risk for technology-based harassment
The study targeted youth aged 8–17 and asked questions about technology use, perpetration, bystander experiences, psychosocial characteristics, victimization history, and degree of emotional distress. Caregivers provided demographic information about the respondents—the child's gender, age, race/ethnicity, family structure, and socioeconomic status. Of the 2,127 youth in the original sample, 791 responded to the survey.
The study evaluated technology-based-only harassment, in-person-only harassment, and mixed forms of harassment and asked youth if they had experienced the following in the last year:
- Name calling or hurtful teasing
- Being excluded, ignored, or ganged-up on
- Having false rumors spread or something private or confidential disclosed
- Physical harm
If so, the youth were invited to share specific details about the incidents. Of the 791 respondents, 34 percent reported 311 unique harassment incidents in the last year. In 70 percent of incidents, respondents reported that there was a bystander who tried to make them feel better. While negative bystander behaviors were less common, bystanders joined in or helped to make the harassment worse in 24 percent of the reported incidents.
The study made the following conclusions:
- Technology-only harassment is the least distressing to its young victims.
- Mixed-peer harassment, involving both in-person and technology-based bullying, is the most distressing, especially for those who have faced multiple types of victimization in the past.
- Future research should be aimed at finding ways to prevent and successfully intervene in mixed and in-person peer harassment.
The Role of Technology in Youth Harassment Victimization is available at https://www.ncjrs.gov/pdffiles1/nij/250079.pdf?ed2f26df2d9c416fbddddd2330a778c6=nrphxbhrdu-nrunhhnzh (PDF- 509 KB).
- Developing Infant-Toddler Relationship-Based Care
According to a recent research brief from the Office of Planning, Research and Evaluation (OPRE) within the Administration for Children and Families within the U.S. Department of Health and Human Services, early childhood practitioners and policymakers should encourage the establishment of relationship-based care for infants and toddlers to promote more responsive caregiving. The OPRE brief notes that infants and toddlers learn best in the context of relationships with caregivers who know them well, and responsive caregiving provides the foundation infants and toddlers need to be engaged learners in preschool and beyond. The OPRE brief explains the relationship-based care approach, related practice considerations, and the implications of existing State standards for incorporating relationship-based care into early care programs.
It also points out that approximately half of all children under age 3 in the United States have some sort of regular child care arrangement and that developmental research supports relationship-based early care and education to optimize learning in infants and toddlers and improve long-term outcomes.
According to the brief, "policies, procedures, and practices (or specific components) that support families, teachers, and children as they build relationships with and among each other" are at the heart of relationship-based care. This interaction forms a partnership that allows families, teachers, and children to better understand each other's needs and promotes trust, security, and comfort.
The brief recommends two relationship-based care supports: primary caregiving and continuity of care. Primary caregiving involves assigning infants or toddlers to one teacher who has the primary responsibility of caring for a small group of children within a larger group setting. The primary caregiver takes the lead in building relationships with the children and families in their care "by providing intentional and individual care for the child's routine needs such as feeding, sleeping, and diapering times." This person also keeps track of a child's developmental progress and communicates regularly with the parents. Continuity of care refers to the practice of keeping infants and young children and their caregivers together for an extended period of time—preferably until the child turns 3—rather than switching to a new caregiver or new group based on age or developmental milestones.
OPRE points to several options that existing child care centers can explore for promoting relationship-based care, including organizational, staff, and space/facility adjustments to enhance the teacher-child relationship. The brief also notes that States can incentivize this approach by rewarding child care centers that use primary caregiving and continuity of care with additional supports or higher subsidy payments.
The May 2016 OPRE Research-to-Practice Brief, Including Relationship-Based Care Practices in Infant-Toddler Care: Implications for Practice and Policy (OPRE Report #2016-46) is available at https://www.acf.hhs.gov/sites/default/files/opre/nitr_inquire_may_2016_070616_b508compliant.pdf (1,320 KB).
- University-Child Welfare Agency Partnership Helps Build Evidence-Driven Workforce
The San Francisco Human Services Agency (HSA) is partnering with the School of Social Welfare at the University of California, Berkeley in a public-private partnership aimed at developing an evidence-driven child welfare workforce.
The Cal-Child Welfare Leadership Training (Cal-CWLT) is a 5-year student and staff training and leadership partnership funded through a National Child Welfare Workforce Institute grant that includes HSA, Berkeley, and the Seneca Family of Agencies. The partnership was launched to help child welfare agencies make better decisions for the children in their care by relying more on evidence-based practice (EBP) and by sharing this knowledge with the incoming workforce and current child welfare administrators.
At the heart of this initiative is increasing Federal and State reliance on continuous quality improvement (CQI) as a tool to ensure greater use of EBP to guide the strategic use of limited resources. CQI is designed to provide a framework for making practice and policy decisions using the best information available. Round 3 of the Child and Family Services Reviews includes a provision for States to evaluate specific policy and practice changes by measuring their child welfare outcomes. The interest in building CQI capacity offers an opportunity to train existing and incoming child welfare staff on how to best use data and EBP for better decision-making in child welfare practice.
Cal-CWLT provides for collaboration between public and private agencies, a local university, students in the Master of Social Work program, and child welfare agency supervisors and middle managers that focuses on which child welfare practices are most successful in the field. Cal-CWLT uses the principles of CQI—observation, question and hypothesis development, testing, hypothesis revision, and theory development—to bridge the gap between research and practice.
A recent article in the Journal of Social Work Education describes this effort to build and support the components of a successful CQI infrastructure and points to several barriers to an EBP-based child welfare system, including the difficulty interpreting and choosing from the large amount of available research, time constraints, skepticism about the validity of data, and dilemmas in applying research to specific situations. To combat this, the article suggests that training can help familiarize workers with data and help them connect their practice with outcomes. The authors explain that the Cal-CWLT project aims to develop the type of "change agents" that will promote greater use of data by public child welfare agencies. They conclude by explaining that, if successful, Cal-CWLT will have prepared 25 new child welfare professionals to obtain and understand high-quality data, effectively rely on them as evidence, and provide leadership in an environment that values data.
Building an Evidence-Driven Child Welfare Workforce: A University-Agency Partnership is available at http://www.tandfonline.com/doi/pdf/10.1080/10437797.2015.1073080?needAccess=true (PDF - 454 KB).
This section of CBX offers publications, articles, reports, toolkits, and other instruments that provide either evidence-based strategies or other concrete help to child welfare and related professionals.
- Structured Decision-Making Model
The National Council on Crime and Delinquency's Structured Decision Making (SDM) model is a suite of assessment tools that promote safety and well-being for vulnerable populations, such as youth in foster care and youth involved with the juvenile justice system, as well as vulnerable adults. The five-part SDM model combines evidence-based research with best practices to offer workers a framework for consistent decision-making and agencies a way to target resources toward those who can benefit most.
The SDM models focus on the following areas of child welfare:
- SDM Model in Child Protection—The child protection model uses intake, safety, risk, family strength and needs, and reunification assessments to help reduce harm to children and ensure permanency. In addition, the model includes clearly defined service standards, mechanisms for timely reassessments, methods for measuring workload, and mechanisms for ensuring accountability and quality controls.
- SDM Model in Foster Care and Placement Support—Focused on placement stability, this model helps agencies and workers in making better decisions for and with foster and kinship families. The foster care and placement support model uses support, placement, provision-of-care, and placement safety assessments to assist in the decision-making involved in placing a child in foster care.
- SDM Model in Juvenile Justice—This model uses detention screening and actuarial risk assessments, a disposition matrix, and postdisposition decisions and case management tools to improve outcomes for youth who are or at risk of becoming involved with the juvenile justice system.
Other SDM models include the SDM Model in Adult Protection, which helps agencies promote the safety of older adults and adults with disabilities, and the SDM Model in Welfare-to-Work, which helps employment counselors identify those most likely to have difficulty finding and maintaining sustainable employment.
For more information on the National Council on Crime and Delinquency's SDM models, visit http://www.nccdglobal.org/assessment/structured-decision-making-sdm-model.
- Introduction to Child Welfare Funding
Child welfare funding can come from a variety of places, such as Federal, State, and local sources. The research brief, An Introduction to Child Welfare Funding, and How States Use It, published by ChildTrends, provides an overview of child welfare funding. It also describes how States use and access funds to achieve their goals, including where funds come from, how States make decisions about funding sources, challenges they face in accessing funds, and title IV-E funding and waivers, which allows for more flexibility in how the funds are spent.
The brief also provides advice and examples of best practices based on interviews with child welfare agency officials in 10 States (Colorado, Florida, Illinois, Indiana, Massachusetts, Michigan, Ohio, Texas, Utah, and Wisconsin) that represent a significant proportion of the total national child welfare expenditures and have a current or previously approved title IV-E waiver.
The interviews supported several key findings:
- The limit on the amount of Federal funding and the restrictions on how they are used pose challenges to policymakers and child welfare agency decision makers as they decide how best to allocate funds to meet the needs of children and families at risk of abuse and/or neglect.
- Factors such as the State economy, media attention, and leadership strength contribute to shifts in State child welfare funding.
- State policymakers and decisionmakers are invested in new and innovative methods to support children and families, such as strategies that help children remain at home with their families and increasing support for youth transitioning out of foster care.
- State child welfare agencies and State decision makers reported that the flexibility of title IV-E waivers helps reduce the obstacles they face accessing Federal money for vulnerable children in their States.
The strategies and concerns addressed in the brief can help inform agencies as they make decisions to ensure the health and safety of the children, youth, and families they serve.
The research brief, An Introduction to Child Welfare Funding, and How States Use It, is available at https://www.childtrends.org/wp-content/uploads/2016/01/2016-01IntroStateChildWelfareFunding.pdf (960 KB).
This CBX section provides a quick list of interesting resources, such as websites, videos, journals, funding or scholarship opportunities, or other materials that can be used in the field or with families.
- Is It ADHD or Trauma Symptoms?
When children exhibit aggression or frustration, are easily distracted, or are having difficulty in school, there is a tendency to diagnose these behaviors as signs of attention deficit/hyperactivity disorder (ADHD). However, ADHD is not the only viable diagnosis. Children exposed to traumatic events can present with symptoms that mimic those associated with ADHD, which can lead to a misdiagnosis.
In the podcast "Is It ADHD or Trauma Symptoms?" produced by the National Child Traumatic Stress Network, Beth Barto, L.M.H.C., interviews Heather C. Forkey, M.D., about how children exposed to traumatic events can exhibit symptoms that overlap with ADHD. Dr. Forkey explains that exposure to trauma affects the prefrontal cortex of the brain, which is the part of the brain that is important for executive function. Executive function is related to learning, impulse control, memory, and cognitive flexibility. In cases of trauma, the brain, in a sense, shuts down these executive functions in an effort to respond to the threat the child has been exposed to.
Dr. Forkey suggests disclosing any potentially traumatic experiences the child has had to pediatricians and other health-care staff. She also suggests that school staff observe the child in the classroom to determine whether the child is being triggered by anything in the school setting that would put him or her into a state of fear, which may be misinterpreted as ADHD.
To listen to the full podcast, "Is It ADHD or Trauma Symptoms?," go to http://learn.nctsn.org/mod/pcast/showepisode.php?eid=37.
- Tips for Caring for a Child With Special Health-Care Needs
For parents of children with special health-care needs, forming partnerships with the child's doctors and other health-care providers is essential to making sure all of the child's needs are met. The tip sheet, TIPS: Caring for a Child With Special Health Care Needs: Partnering With Your Child's Provider, which was produced by the National Center for Family/Professional Partnerships, is divided into four sections, each of which can help parents and caregivers better communicate with health-care providers and understand their child's diagnosis:
- Preparing for a doctor's office visit—Lists suggestions on how to prepare for an office visit, such as searching for providers that meet the child's needs, being prepared to ask for special consideration, letting the provider know about the child's specific needs, and getting other family members to participate in key appointments
- Talking with the child's provider—Lists ways to facilitate and improve communication between parents and providers, such as communicating openly, preparing to ask questions, helping the child build a relationship with his or her providers, asking questions without feeling intimidated, asking for reading material about the child's diagnosis, and more
- Learning more after the visit—Lists ways to keep abreast of the child's health-care diagnosis and needs, such as reaching out to other parents; keeping copies of the child's records to refer to during future visits; seeking a second opinion, if needed; changing providers, if needed; and being persistent in finding the answers to the child's health-care concerns
- Helping the provider help other families—Lists ways to help providers help other families and improve their practices, such as providing feedback; sharing information with the provider about meetings, parent groups, or community resources that may be of value to other patients; and getting involved in family advisory groups, where available
The tip sheet also lists the qualities of a family-professional relationship, including mutual respect, communication, commitment, equality, skills, and trust.
The tip sheet, TIPS: Caring for a Child With Special Health Care Needs: Partnering With Your Child's Provider, is available at http://www.fv-ncfpp.org/files/4414/2149/5755/ParentsPartnering_01-16-2015r.pdf (474 KB).
Find trainings, workshops, webinars, and other opportunities for professionals and families to learn about how to improve the lives of children and youth as well as a listing of upcoming events and conferences.
Upcoming national conferences on child welfare and adoption from April through June 2017 include the following:
- 2017 LEAD (Leadership. Evidence. Analysis. Debate.) Conference
"Moving From Research to Policy and Practice to Improve the Lives of Youth"
Center for Juvenile Justice Reform
April 6–7, Washington, DC
- Coming Together: 2017 National Meeting
Association of Administrators of the Interstate Compact on Adoption and Medical Assistance
April 10–12, Washington, DC
- 25th Annual Children’s Justice Conference
Children's Justice Task Force
April 11–12, Bellevue, WA
- 2017 Conference: Building Bridges
Indiana Adoptee Network
April 21–22, Bloomington, IN
- 17th ABA National Conference on Children and the Law and the 5th National Parent Attorney Conference
ABA Center on Children and the Law
April 24–28, Tyson's Corner, VA
- 16th Annual National Citizen Review Panel Conference
Alaska Citizen Review Panel
May 10–12, Anchorage, AK
- Center for Fostering Success Conference
Western Michigan University
May 15–20, Kalamazoo, MI
- 2017 Ties That Bind: Parents & Children Strengthening the Bond Adoptive Family & Youth Training Seminar
Family Matters Consulting, Inc.
May 19–21, Atlanta, GA
- 2017 National Title IV-E Roundtable
Arizona State University’s Center for Child Well-Being
May 23–25, Phoenix, AZ
- 20th Annual National Human Services Training Evaluation Symposium
California Social Work Education Center (CalSWEC),
Kent School of Social Work, University of Louisville
May 23–25, Louisville, KY
- One Child, Many Hands: A Multidisciplinary Conference on Child Welfare
Field Center for Children's Policy, Practice & Research
June 7–9, Philadelphia, PA
- Violence Intervention and Prevention (VIP) Summit
Gundersen National Child Protection Training Center
June 20–22, Rogers, AR
- 2017 LEAD (Leadership. Evidence. Analysis. Debate.) Conference
- A Primer for Youth Justice Advocates
Established in 1984, the Crime Victims Fund is financed annually by the fines and penalties paid by those convicted of Federal offenses and offers an opportunity to fund services that could help youth and families who have been victims of crime. The parameters for how these funds could be used were expanded in 2016, opening up new ways to support youth who are at risk of or already involved in court engagement. The updated factsheet The Crime Victims Fund: A Primer for Youth Justice Advocates, which was produced by the National Juvenile Justice Network, is intended as a basic primer for youth advocates on how the Crime Victims Fund operates and how it might be possible to move some of these increased resources to the communities that lack these services.
The factsheet highlights the updated guidelines that are relevant to youth advocates, including the following:
- Expanding the definition of child abuse by adding exposure to violence, sexual exploitation, and bullying, which allows for more youth to be served by these funds
- Prioritizing underserved victims of violent crime because of the nature of the crime (e.g., child victims of sex trafficking), the characteristics of the victim (e.g., Native Americans in jurisdictions with insufficient resources), or both
- Allowing for a greater variety of assistance, including traditional, cultural, and/or alternative therapy and healing; substance abuse counseling; peer support; and more
- Allowing services to incarcerated victims by removing the prohibition on rehabilitation and counseling for people who have committed crimes
- Requiring States to prioritize children and other underserved victims by emphasizing programs serving victims of sexual assault, spousal abuse, and child abuse as well as making sure that funds are available to programs serving underserved victims
Youth justice advocates can use this factsheet to educate themselves about the Crime Victims Fund, changes to the guidelines about using funds, and how they can leverage the fund to better serve youth and communities. The factsheet also includes a Q&A and links to additional information.
The factsheet, The Crime Victims Fund: A Primer for Youth Justice Advocates, is available at http://www.njjn.org/uploads/njjn-publications/VOCA_Fact_Sheet_Update_Nov2016.pdf?ed2f26df2d9c416fbddddd2330a778c6=tulhlzlejc-tuczhhzkh (PDF - 726 KB).