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September 2012Vol. 13, No. 8Spotlight on Evaluation

As a follow up to our August Spotlight on Practice Models, this month we are focusing on Evaluation. CBX looks at Utah's evaluation of social work practice, Washington State's ICW case review tool, and performance-based contracting in Illinois. Anita Barbee, M.S.S.W., Ph.D., Kent School of Social Work, University of Louisville, also contributed a guest article outlining different evaluation designs.

Issue Spotlight

  • Performance-Based Contracting in Illinois

    Performance-Based Contracting in Illinois

    Performance-based contracting in child welfare allows public agencies to contract with private agencies to provide services in an environment that focuses on child and family outcomes (e.g., residing in a permanent home) rather than on outputs (e.g., number of children served). The Illinois Department of Children and Family Services (DCFS) began using performance-based contracting in 1997 for its foster care case management. This initiative proved to be successful, but no formal evaluation was ever completed. In 2007, the National Quality Improvement Center on the Privatization of Child Welfare Services awarded an evaluation grant to DCFS, the Child Care Association of Illinois (a private child welfare agency), and the Children and Family Research Center of the University of Illinois (the project evaluator) to develop, implement, and evaluate a performance-based contracting initiative. The initiative would evaluate performance-based contracting for DCFS's residential treatment program and independent living opportunities/transitional living program (ILO/TLP). In 2012, 39 agencies participated in the project. This article provides information about the residential treatment component of the project.

    A key factor to any performance-based contracting initiative is the development of the performance measures. Working with the existing Illinois Child Welfare Advisory Committee, as well as an array of experts in social work, statistics, and other fields from local universities, DCFS developed the performance measures, fiscal structure, and other components. Residential treatment providers are assessed based on the percentage of children in residential treatment who remain in a favorable postdischarge placement (i.e., less restrictive or neutral discharge) for 90 days or more and on the percentage of time in residential treatment that a child is not on the run, in detention, or in a psychiatric hospital. A "no decline" policy was established to prevent providers from only accepting children who are more likely to boost their performance ratings. Additionally, providers can outline the characteristics of the children they can best serve, and the Centralized Matching Team refers children to the providers that are best prepared to care for them.

    The project instituted a risk adjustment model to account for the differences in the characteristics of the population served by each agency (e.g., child history, gender, age). Brice Bloom-Ellis, the Statewide Residential Quality Assurance Manager at DCFS, highlighted the importance of "striking a balance between simplicity and complexity." The initiative needs to be straightforward enough that providers can fully understand their role and that neither the providers nor DCFS are overly burdened by its administration, but the initiative also needs a degree of intricacy that allows it to capture the realities and desired outcomes of the child welfare system.

    The first year of the project included financial incentives and penalties for providers based on how they fared on their performance measures. Staff from DCFS and Lawrence Hall Youth Services, one of the service providers, noted that the financial incentives and penalties were critical to grabbing providers' attention at the beginning of the project. Upon hearing about the move to performance-based contracting for residential treatment and ILO/TLP, providers' initial response was that "this too shall pass," but the financial incentives and penalties forced them to evaluate their current business and service practices.

    The incentives and penalties were discontinued in the second year, however, due to a fiscal crisis in Illinois. Staff hoped the project would be cost-neutral, but it ended up paying out more in incentives than it took back with penalties. Even without the financial incentives and penalties, though, DCFS still regularly collects and assesses data on provider performance. DCFS uses the data to make decisions about contract renewals, with three agencies (five contracts) having been terminated since the beginning of the initiative. Additionally, 18 agencies have implemented quality improvement plans based on their performance data. Providers also want to improve their performance to serve children and families better and because of a sense of organizational pride. DCFS distributes annual provider rankings on the measures, and the providers want to compare well against similar contracts. Mary Hollie, CEO of Lawrence Hall Youth Services, said that many of the providers have built the performance measures into their organizational quality improvement processes and use the data to assess and adapt their services.

    The evaluation of this project uses mixed methods, including onsite facility visits, an implementation survey of provider staff, focus groups, and a document review. The evaluation is ongoing, but the following are preliminary findings:

    • In-placement stability has remained relatively constant over the course of the project.
    • The percentage of all youth served who were negatively discharged has decreased from 16.5 percent in fiscal year 2009 to 14.1 percent in fiscal year 2011. A negative discharge is when a youth disrupts from care due to running away, a detention placement, psychiatric hospitalization, or a shelter placement and subsequently does not return to the same residential agency contract. Additionally, a negative discharge includes being transferred to another contract agency at the same or a more restrictive placement level. Approximately half of all negative discharges throughout the project are due to youth running away.
    • The percentage of all youth served who were favorably discharged has increased from 22.1 percent in fiscal year 2009 to 29.4 percent in fiscal year 2011.
    • These improvements may be caused by several factors, including the initiation of the project, implementation of quality improvement plans with struggling contracts, and the termination of poorly performing contracts.
    • Agencies that did not perform well did not tend to have a well-defined treatment model or had staff that could not articulate the treatment model.
    • Staff in agencies that performed lower than average tended to blame the youth for their poor performance.
    • Urban group homes did not perform as well as other provider groups. The project established a workgroup to analyze these findings and make recommendations for improvement.

    Many thanks to Brice Bloom-Ellis, Statewide Residential Quality Assurance Manager, Illinois DCFS and Mary Hollie, CEO, Lawrence Hall Youth Services for providing information for this article.
     

  • Washington State's ICW Case Review

    Washington State's ICW Case Review

    After its 2003 Federal Child and Family Services Review (CFSR), staff from the Washington State Department of Social and Health Services (DSHS) Children’s Administration conducted a special evaluation of the State’s Indian Child Welfare cases. Concerned with what they saw, the agency met with Tribal representatives and agreed to further evaluate and improve Indian Child Welfare (ICW) practice in Washington.

    "This is not a State ICW review," said Lyn Craik, Supervisor of the Central Case Review Team. "This is a partnership and collaboration; a Tribal-State case review. We have had that value since the beginning."

    That collaboration began in 2004 in the form of a workgroup composed of staff from the DSHS Children's Administration and representatives from Tribes, Recognized American Indian Organizations, and the Indian Policy Advisory Committee. Together, the workgroup developed the ICW Case Review Tool. Modeled after the CFSR process, the ICW Case Review Tool aimed to increase collaboration and partnership between the State and Tribes, increase staff knowledge of ICW, improve ICW practice to meet the best interests of American Indian children and families, and identify systemic barriers to improving outcomes.

    "We had concerns about disproportionality and recognized that there were areas that needed improvement in our ICW work," said Sharon Gilbert, DSHS Deputy Director for Field Operations. "There was a strong commitment by the State and the Tribes to develop a quality assurance protocol that could address the disproportionate number of Indian children in the child welfare system through training and ongoing evaluation of our work." 

    Each 4-day review is conducted at the regional level, one review that examines a sample of cases from each of the State's six regional hubs. "We're always trying to review more cases," said Deborah Purce, Executive Staff Director for DSHS' Children's Administration's Division of Quality Management and Accountability. "In the first review, we looked at 176 cases for an average of 25–35 per site. In 2008, we looked at 217 cases or 30–35 cases per site. We look at child protective service cases, voluntary service cases, and out-of-home care cases." 

    Review teams are composed of approximately 12 people: 6 Tribal-State volunteers, including social workers, supervisors, and program managers, and 6 members of the State's Central Case Review Team. In order to be a member of a review team, one must have a minimum of 2 years' Indian child welfare experience and complete a 1-day training.

    A Tribal and a State reviewer evaluate each case together, building consensus on ratings across a number of indicators, including inquiry of Indian status, family and Tribal engagement, cultural connections, court notification, placement preference, safety, well-being, and permanency. On each case reviewed, feedback identifying strengths and areas needing improvement is provided to the supervisor, social workers, and management. Regional and statewide reports are written and disseminated outlining strengths and areas needing improvement. Regional staff collaborate with Tribal representatives to develop an implementation plan for practice improvement.

    "Staff at the Tribal and State levels were not always familiar with the ICW laws and agreements and how they should be followed," said Liz Meuller, Tribal Council Vice Chair/Government Liaison for the Jamestown S'Klallam Tribe, who, along with Craik, conducts all review participant trainings. "That is what we wanted in this review—criteria that would set forth clear practice guidelines."

    Craik added: "That's what social workers want to know: What are the steps? We wanted to demystify ICW cases and we're doing that. We've had workers—many with several years' ICWA experience—say this case review tool taught them more about ICW practice than anything else."

    Thus far, two statewide reviews have been conducted, in 2007 and again in 2009. Washington State passed its own Indian Child Welfare Act in 2011, requiring some modifications to the DSHS ICW Case Review Tool. The third round of reviews began in  August 2012.

    Since the first review, improvements have been made in identification of Indian status and assessing and adequately addressing safety threats. The most substantial change in practice has been the inquiry of Indian heritage. "Now, we are sending out inquiry letters and contacting Tribes within 1 working day," said Craik. "We are making improvements in maintaining cultural connections when a child is removed from the home and working with the Tribes regarding placement preference. It has a big impact on outcomes."

    The case review tool also has played a critical role in professional development. "This is an ongoing training for social workers. The case review tool is not just for gathering data. It's developmental. Staff across the State, whether they're social workers, managers, or supervisors, learn from applying the tool to their own cases," said Craik.

    She added that implementing a Tribal-State case review model takes patience and a commitment to relationship building and collaboration. "Something like this isn't built over night. It took from 2004—when we started holding meetings—to 2007 when we had the first review. It continues today. We train together. We review the cases together. The unique aspect of this review is collaboration."

    Special thanks to Debora Purce, Executive Staff  Director for the Division of Quality Management and Accountability, DSHS Children's Administration, Sharon Gilbert, Deputy Director for Children’s Administration Field Operations, Betsy Tulee, ICW Manager, Lyn Craik, Supervisor for the Central Review Team, Liz Meuller, Tribal Council Vice Chair/Government Liaison for the Jamestown S'Klallam Tribe, for providing information for this article.

  • Evaluation Designs for Assessing Practice Models

    Evaluation Designs for Assessing Practice Models

    By Anita P. Barbee, M.S.S.W., Ph.D., Kent School of Social Work, University of Louisville

    When nonprofit agencies, counties, and States embark on implementation of a practice model, it is important to plan the evaluation of its effectiveness right from the beginning. Indeed, one of the first objectives for the team should be a decision about the evaluation design. It is imperative that the organization choose the most rigorous evaluation design that it can accommodate. This brief article describes a few rigorous evaluation designs that could be or have been utilized in assessing child welfare practice models.

    1. Randomized Controlled Trial or Experimental Design. This evaluation design randomly assigns individual workers within nonprofit agencies, counties, or Tribes to one of two conditions. These conditions include an experimental condition in which a new practice model is adopted by a randomly chosen subset of individuals, and a control condition in which another subset of individuals practice as usual. These two groups are then compared on safety, permanency, and well-being outcomes related to the model

      Very seldom can an experimental test of a practice model be carried out, even though that is the gold standard for assessing the efficacy of any intervention. Few organizations are structured in a way that allows individuals to be randomly assigned to conditions, kept from talking to people in the other condition, or kept from feeling resentful about having to learn new skills or being excluded from learning new skills.
       
    2. Non-Equivalent Group Design. In this design, a set of similar agencies, counties, or Tribes that choose to participate in learning and executing a new practice model are assigned to the treatment group or a comparison group. The outcomes of the treatment group are compared to the outcomes of the comparison group both before practice model implementation and after. In addition, measures of characteristics of both groups can help control for confounds (variables that account for the difference in outcomes between groups besides the intervention) to the design.

      This design was used in the evaluation of Alternative Response in Ohio (Loman, Filonow, & Siegel, 2010). Counties that adopted Alternative Response had more improvement from before to after implementation and better outcomes than counties that had not yet adopted Alternative Response. This design is even better if the alternate group is a wait-list control group that receives the intervention after the treatment group. This design is almost as strong as an experiment if measures are taken before and after each treatment condition for both groups. This design is being carried out in the New Hampshire practice model evaluation supported by the Northeast and Caribbean Child Welfare Implementation Center and the National Resource Center for Organizational Improvement.
       
    3. Comparison of High Versus Low Adherence Groups. In this evaluation design, researchers measure worker adherence to the practice model. This usually occurs through observation or case reviews. In both methods, the researcher develops a measurement tool that assesses the degree to which a worker's practice behaviors align with the practice model. This design compares workers who practice with high fidelity based on a cutoff score or percentage of adherence (high adherence group) to workers who practice with low fidelity (low adherence group). Differences in outcomes between the two groups are attributed to the new practice, although poorer ability or motivation of the low adherence group must be assessed and ruled out.

      The high vs. low adherence design is not ideal, but it addresses the reality that it is difficult to engage in a randomized controlled trial or nonequivalent group design in many State-administered systems. Also, if administrators are not fully committed to the importance of measuring and ensuring high fidelity, then outcome comparisons become meaningless because the adherence to the model by staff is either unknown or low. 

    In both Kentucky and Washington State, evaluators were able to utilize the high vs. low adherence design. In both States, it was found that when workers adhered to the Solution-Based Casework practice model, outcomes for families and children were more positive than when workers did not adhere to the model (Antle, Sullivan, Barbee, & Christensen, 2010; Courtney, 2011). A follow-up study assessing 4,550 case reviews conducted during the State's Continuous Quality Improvement process showed that those workers who practiced with high fidelity to the practice model achieved all the Federal Child and Family Services Reviews outcomes in those cases. This provides some support for the intervention but also raises questions about employee selection (Antle, Christensen, van Zyl & Barbee, 2012).

    One innovation, which we have developed, that is utilized either during or after installation of a practice model, is to link the evaluation of training, coaching, and supervision to measurement of casework quality through quality assurance case reviews and organizational and client outcomes. That way, as new workers are added to the system and as the practice model is embedded in the organization over time, a continuous and connected evaluation is occurring to ensure fidelity and achievement of positive outcomes (Antle, Barbee, & van Zyl, 2008; Antle, Barbee, Sullivan, & Christensen, 2010; Antle, Christensen, Barbee, & Martin, 2008; Antle, et al., 2010; van Zyl, Antle, & Barbee, 2010). 

  • Utah's Qualitative Case Review

    Utah's Qualitative Case Review

    In 1999, Utah's Division of Child and Family Services (DCFS) was embroiled in a lawsuit, resulting in a settlement agreement that required a new evaluation of child welfare practice. That new evaluation became the State's Qualitative Case Review model that evaluates outcomes for children and families and practice model fidelity. For the past 12 years, Utah's rigorous evaluation of child welfare practice has created a culture change benefiting children, families, and child welfare staff statewide.

    An independent evaluator, the State's Office of Services Review (OSR), conducts the Qualitative Case Reviews (QCRs). Each year, OSR administers a total of six reviews, ranging from 20 cases for the smallest region to 50 cases for the largest metropolitan area, totaling 150 cases. "One hiccup with the evaluation tool prior to the QCR," said Kristin Lambert, Services Review Manager at OSR, "was that it was compliance based. In the first years of the settlement agreement, the Division was not doing better on the compliance review. Improvement was happening, but the measurement tool wasn't showing it." OSR then shifted to an interview-style evaluation involving service recipients, moving from a compliance-driven to an outcome-based evaluation. "It mattered less if the case plan was signed on time. What mattered was whether the services provided resulted in better outcomes for children and families."

    QCRs are conducted similarly to the Federal Child and Family Services Reviews (CFSRs). A team of two review the case and interview key stakeholders—including birth and fosters parents, teachers, therapists, caseworkers, lawyers, mentors, and more. Reviewers are drawn from OSR, DCFS, and community partners. Child and family status is assessed across eight indicators, including safety, stability, permanency, behavioral and emotional well-being, family connections, and satisfaction. Child welfare practice is evaluated across seven indicators, including engagement, teaming, assessment, intervention adequacy, and tracking and adaption. If QCR indicators decline below standards, DCFS must create an action plan to improve practice. All annual QCR reports are posted on the OSR website.

    The first full QCR was conducted in 2000. Between 2000 and 2010, DCFS scores on child and family status increased from 78 percent to 89 percent, with a decline from 96 percent in 2007. System performance scores increased from 42 percent in 2000 to 89 percent in 2010, with a slight decline from 93 percent in 2009. Linda Wininger, Director of Programs and Practice Improvement, said the QCR can be used for more than performance evaluation. "It is a way to measure the broader child welfare system. When we look at outcomes for children and families, and we see a track record of improvement for 10 years and then 2 years of decreased scores, we can't ignore that. We were able to use QCR results as a part of a presentation to ask for more caseworkers so that we could once again provide the level of service that we had in the past. That's a compelling way to use this information."

    Utah's QCR and its Practice Model are closely aligned. In fact, the QCR was used as a foundation for building the practice model. Jeff Harrop, Practice Improvement Coordinator at DCFS, said, "Our practice model was designed based on what we thought a great child welfare system should look like. We built a system that supports great practice, and the QCR informed that process."

    The QCR has become part of the DCFS culture. While there have been several new directors over the past 12 years, most have been certified reviewers and all have been dedicated to the QCR process. DCFS has taken foolproof measures to ensure sustainability. The QCR is now required under State law. "With budget cuts, something like this could be axed. We see the value in this type of review, and we know we need to keep sharpening our tools," said Aude Bermond Hamlet, Practice Improvement Coordinator.

    When asked for advice to States or counties interested in implementing a QCR, Lambert noted the importance of the balance between costs and benefits. "You can have the most helpful and beneficial review system, but if it's too demanding on resources, if it's too burdensome or complex, or if it tries to measure everything, it won't survive." DCFS welcomes administrators from other States to take part in the QCR process as shadow reviewers.

    The QCR process was the subject of a December 2011 webinar for the National Resource Center for Organizational Improvement's (NRCOI's) Practice Model Peer Network. A recording of that webinar and multiple materials pertaining to the State's QCR, OSR, and more, are available:

    Special thanks to Linda Wininger, Director of Programs and Practice Improvement, Aude Bermond Hamlet, Practice Improvement Coordinator, Jeff Harrop, Practice Improvement Coordinator, and Brad McGarry, Director of Office of Services Review, and Kristin Lambert, Services Review Manager with the Offices of Service Review, for providing information for this article. 

    Related Items

    Children's Bureau Express featured the Practice Model Peer Network in the article "NRCOI Practice Model Peer Network" (August 2012).

    Children's Bureau Express also highlighted Utah child welfare practice in the articles "Practice Models in Child Welfare" (March 2008) and "Child and Family Team Meetings Improve Utah Outcomes" (September 2010).

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News From the Children's Bureau

The fifth article in our second Centennial Series highlights the Children's Bureau's 50th anniversary. We also draw attention to a new webinar on key findings from Round 2 of the CFSRs, a report on States' use of Chafee funds to provide housing assistance to transitioning youth, and an initiative to prevent child heatstroke fatalities.

  • Round 2 CFSR Webinar Recording Available

    Round 2 CFSR Webinar Recording Available

    A webinar hosted by the National Conference of State Legislatures highlighted key findings from the second round of Federal Child and Family Services Reviews (CFSRs). The webinar, held on June 18, points to a national portrait of strengths and areas needing improvement across the seven outcome areas and seven systemic factors assessed in Round 2 of the CFSRs. Areas of particular interest to State policymakers were also discussed.

    During the second round—conducted between fiscal years 2007 and 2010—52 States were evaluated, more than 3,300 cases were reviewed, over 2,700 foster care cases were examined, and nearly 1,300 in-home services were assessed. Each State's CFSR includes a Statewide Assessment and an onsite evaluation of 65 foster care and in-home services cases. In Round 2, States were assessed on 45 items grouped into seven outcomes that measured safety, permanency, and well-being and seven systemic factors.

    Listen to the webinar recording here:

    www.ncsl.org/podcasts2/webinar_archives/061812ncsl_reviews.wmv

    The full report, is available on the Children's Bureau's website:

    http://www.acf.hhs.gov/programs/cb/cwmonitoring/results/cfsr_findings.pdf   (332 KB)

    Related Item

    Children's Bureau Express wrote about the second round of CFSRs in the article "Findings From Round 2 of the CFSRs" (February 2012).
     

  • Centennial Series: The Children's Bureau's Golden Anniversary

    Centennial Series: The Children's Bureau's Golden Anniversary

    This is the fifth article in our second Centennial Series, CB Decade-by-Decade. These articles will examine highlights from each decade of the Children's Bureau's first 100 years. The first Centennial Series addressed some of the social issues, practices, and policies that laid the groundwork for the creation of the Children's Bureau.

    On April 9, 1962, the Children's Bureau celebrated 50 years of service to the nation's children and families. The occasion was marked by special publications, events, and recognition—by some of the nation's most prominent leaders—of the great work done on behalf of American children and families since 1912.

    It's Your Children's Bureau, a commemorative publication written by then-Chief Katherine Oettinger, describes the long and often obstructed road toward the Bureau's creation in 1912. Oettinger predicted, "The Bureau's past has truly been a prologue, and what the future will bring for children is not clearly outlined today. One certainty is clear—children will be a major concern of our democratic society and government. Citizens, Federal, State, and local public and voluntary organizations will continue to join forces to advance the one sure resource of the future, the Nation's children."

    It's Your Children's Bureau also highlighted the Bureau's partnerships with State health and child welfare agencies, explained how its grant-in-aid programs served children and families, and presented case studies of children involved with child welfare who had become child welfare success stories. The publication's title was derived from the citizen action that demanded the creation of the Bureau and the citizen concern that propelled the Bureau's mission. Thus, the publication ends with a statement to the citizens of the United States:

    It's Your Children's Bureau
    You must keep your Children's Bureau alert and sensitive to the circumstances surrounding boys and girls in your own community and State. Only if you demonstrate your concern and support in this way can the Bureau continue to fulfill its historical mission as spokesman for children and to carry its responsibilities to this Nation's children and their parents.

    Other notable anniversary publications include Dorothy Bradbury's Five Decades of Action for Children: A History of the Children's Bureau. The 130-plus-page publication presents a detailed account of the Bureau's history and accomplishments, as well as a vision for its future. Oettinger wrote in the Afterword: "As we look back through 50 years of action for children, one thing stands out beyond all others. It seems of great significance and particularly fitting that the first Federal grant-in-aid provision for the health and welfare of the individual was concerned with children. Perhaps herein lies the perspective of the past and the forecast for the future: Society moves forward in terms of what its care, hopes, and aspirations are for its children. With pride and dedication, the Children's Bureau begins a new half century."

    A special issue of the Bureau's much-lauded publication, Children, featured articles by several leaders in the field of child welfare. Oettinger, along with the Deputy Director of UNICEF, the Director of the Child Welfare League of America, and the Director of the National Committee on the Employment of Youth of the National Child Labor Committee were a few of the many contributors.

    The Children’s Bureau also produced the scrapbook 50th Anniversary of the Children’s Bureau: Memory Book. The memory book is filled with newspaper clippings highlighting the anniversary, photographs, articles from Children's Bureau chiefs recognizing the Bureau's efforts over 50 years, and correspondence from renowned national leaders. Also preserved in the scrapbook are telegrams from such notables as President Harry Truman; Lister Hill, Chairman of the U.S. Senate Committee on Labor and Public Welfare; Arthur Flemming, former Secretary of the Department of Health, Education, and Welfare; and Norman S. Marshall, Commissioner of the Salvation Army.

    The actual anniversary celebration was a daylong event followed by an evening reception that honored the three living former and current Bureau Chiefs: Katharine Lenroot, Martha Eliot, and Katherine Oettinger. To organize the golden anniversary, a citizens committee was formed with First Lady Jacqueline Kennedy as the honorary chairperson. President Kennedy kicked off the celebration with a speech, detailing significant improvements in child health and well-being over the Bureau's 50 years.

    A recording of President Kennedy's speech, “Remarks on the 50th Anniversary of the Children's Bureau," is available on the JFK Library website:

    http://www.jfklibrary.org/Asset-Viewer/Archives/JFKWHA-085-001.aspx

    The written speech is also available:

    http://www.jfklibrary.org/Asset-Viewer/Archives/JFKPOF-037-038.aspx

    This year marks the Bureau's 100th anniversary. While the format for celebration has changed—newspaper articles gave way to websites, conferences to webinars, and printed publications to PDFs—the cause for remembrance remains the same. Just as it did 50 and 100 years ago, the Children's Bureau continues to work with States, Tribes, and territories to improve the health and well-being of the nation's children and families.

  • Child Heatstroke Fatality Prevention

    Child Heatstroke Fatality Prevention

    The National Highway Traffic and Safety Administration (NHTSA) and Safe Kids Worldwide announced a joint national initiative to prevent child deaths from heatstroke. Since 1998, at least 532 children have died from heatstroke due to being left in hot cars. In 2011 alone, there were 33 child deaths. The "Where's Baby? Look Before You Lock" campaign raises awareness of the dangers of leaving a child unattended in a hot vehicle.

    Through educational materials, public events, and public service announcements, the campaign provides information to parents and caregivers on the warning signs of heatstroke, what happens when a child becomes overheated, and precautions to keep children safe. Suggested precautions include:

    • Never leave a child in a parked car, even if the windows are partially open.
    • Make it a habit to look in your vehicle, both in the front and back seats, before leaving it.
    • Partners should call each other after a child has been dropped off at child care to ensure the drop went smoothly, especially if there has been a change in routine.

    For more information on the campaign, visit the NHTSA website:

    http://www.nhtsa.gov/About+NHTSA/Press+Releases/2012/NHTSA+and+Safe+Kids+Worldwide+Announce+New+Partnership+to+Prevent+Child+Heatstroke+Deaths+in+Hot+Cars

    For access to downloadable educational materials, see NHTSA's Parents Central website:

    http://www.safercar.gov/parents/heatstroke.htm

  • Chafee Housing Funds for Youth

    Chafee Housing Funds for Youth

    A new report prepared by the Urban Institute and funded by the Office of the Assistant Secretary for Planning and Evaluation (ASPE) explores States' use of Chafee Foster Care Independence Program funds for housing for transitioning youth. Chafee provides $140 million annually for Independent Living services for youth exiting foster care. States are permitted to use up to 30 percent of their respective Chafee allocations to meet the housing needs of youth after they leave care. The report examines how States use these funds, in addition to other State and Federal funding sources, to provide housing to this population.

    The authors, during the spring and summer 2011, examined various State documents and websites and contacted State Independent Living Coordinators to gather information. The report's findings represent only one-third of States, those that use the maximum 30 percent of their Chafee funds to provide housing to transitioning youth.

    A majority of the States in the report use Chafee housing funds to help youth with beginning rental costs, ongoing support, and emergency funds. Other States have developed their own housing assistance services, many of which are time limited and available only to youth who meet certain criteria.

    The report, Housing Assistance for Youth Who Have Aged Out of Foster Care: The Role of the Chafee Foster Care Independence Program, is available on the ASPE website, part of the U.S. Department of Health and Human Services:
     
    http://aspe.hhs.gov/hsp/12/chafeefostercare/rpt.pdf (468 KB)

    Related Item

    See "Housing for Newly Independent Youth" in this issue.
     

  • Youth in Foster Care and Psychotropic Medications

    Youth in Foster Care and Psychotropic Medications

    Making Healthy Choices: A Guide on Psychotropic Medications for Youth in Foster Care looks like a graphic novel, but its photo-heavy format and cartoon speech balloons carry a serious message. Designed to appeal to youth, the booklet walks the reader through the decisions that have to be made when mental health problems—short- or long-term—need to be addressed.

    Often, the quick solution to dealing with behavior issues of youth in foster care has been to prescribe psychotropic medications. Recent publicity about the high numbers of medicated children and youth in foster care has caused policymakers and agencies to revisit this issue and to consider alternative ways of helping children and youth—many of whom have experienced trauma because of abuse or neglect and removal from their parents.

    Making Healthy Choices was developed by a collaborative committee of individuals from the Children's Bureau and other Federal and State agencies and private organizations. Youth in foster care were part of the committee and contributed to the content and review of the final publication.

    The booklet discusses medication, but it also discusses alternatives to medication, and it includes vignettes that describe teens' mental health dilemmas. It includes worksheets and lists of questions that youth or their caregivers can ask doctors or other health-care professionals.

    The booklet is posted on the website of the National Resource Center on Youth Development, which offers a number of resources for youth in foster care:

    http://www.nrcyd.ou.edu/psych-med-youth-guide

    The booklet is currently available in English, and a Spanish version is in development.

    Related Item:

    The Administration for Children and Families, the Centers for Medicare and Medicaid Services, and the Substance Abuse and Mental Health Services Administration recently hosted a conference on psychotropic medication use by children in foster care. Materials and presentations from the meeting, "Because Minds Matter: Collaborating to Strengthen Management of Psychotropic Medications for Children and Youth Foster Care," are available here:

    http://www.pal-tech.com/web/psychotropic/

  • New! From CB

    New! From CB

    The Children's Bureau website carries information on child welfare programs, funding, monitoring, training and technical assistance, laws, statistics, research, Federal reporting, and much more. The "New on Site" section includes grant announcements, policy announcements, agency information, and recently released publications.
    Recent additions to the site include:

    Visit the Children's Bureau website often to see what's new!

    http://www.acf.hhs.gov/programs/cb

Training and Technical Assistance Update

Learn about barriers to reuniting incarcerated mothers with their children, resources for children of parents with co-occurring mental illness and substance abuse disorders, and other updates from CB's T&TA Network.

Children's Bureau Grantee Updates

This month, we highlight the Next Steps program in Rockland County, NY.

  • Site Visit: Next Steps Program

    Site Visit: Next Steps Program

    A number of mothers, heading low-income households at risk for or involved with child welfare services in Rockland County, NY, have benefited from a program designed to integrate services from Temporary Assistance for Needy Families (TANF) and child welfare. Using funding from a Federal Children's Bureau (CB) grant awarded in 2006, the county's Department of Social Services (DSS) expanded its welfare-to-work program, Next Steps. Drawing from best practices in both TANF and child welfare programs, Next Steps is a 6-month weekday program that helps participants develop and work toward accomplishing goals in academics, employment readiness, computer skills, behavioral therapy, and parenting. The CB grant expanded Next Steps to include child welfare services and improve child safety, father involvement and family stability and self-sufficiency. Mothers who participate often have learning disabilities that have impacted their employment, and a significant number have not earned a high school diploma. They often lack support from their family and from their children's father, who may be incarcerated or have a history of incarceration. The program's focus on academic, employment, parenting, and relationship goals seeks to address these barriers to family stability and self-sufficiency. Participants document weekly progress toward accomplishing their goals and discuss their progress with Next Steps staff.

    Next Steps consists of four components that help participants reach their goals:

    1. Dialectical Behavior Therapy (DBT) helps mothers learn to examine and manage their behaviors and feelings, problem-solve, and manage stress in order to improve relationships and develop conflict resolutions skills.
    2. Parenting education is modeled on the Every Person Influences Children (EPIC) Families in Transition model and includes lecture, discussion, observation, and coaching to improve parenting skills. Mothers complete daily activities with their children and track their children's development with videos and journals.
    3. Father involvement is encouraged and facilitated by the Next Steps Male Coordinator, who helps mothers understand the importance of father involvement and helps fathers feel welcomed by the program.
    4. Mentoring is provided by volunteers, many of whom are DSS workers who serve as information resources for their mentees.

    While the program has experienced some challenges, including enrollment barriers and resistance to father involvement, Next Steps staff have developed strategies for addressing these challenges. Their keys to success have included engaging participants in planning, co-locating the Next Steps program with the county's health services program, providing onsite child care, and modeling recreational activities, among others.

    At the time of the site visit, the Next Steps program had served 35 mothers and their children. While formal evaluation of the program outcomes is currently underway, anecdotal evidence from staff points to positive findings. Staff note that they receive three or four phone calls each week from former participants who want to connect or ask for advice or support. In informal discussions, participants have listed the benefits that Next Steps has provided, including increased support and confidence, knowledge of child development and parenting, and a collaborative culture with the opportunity to make their voice heard.

    For more information about this project, contact Elizabeth Kohlmeier: elizabeth.kohlmeier@dfa.state.ny.us

    The full site visit report will soon be posted on the Child Welfare Information Gateway website:

    http://www.childwelfare.gov/management/funding/funding_sources/tanfcw.cfm

    The Next Steps Program is funded by the Children's Bureau (Award 90CW1137). This article is part of a series highlighting successful Children's Bureau grant-funded projects around the country, emerging from Children's Bureau site visits.

Child Welfare Research

CBX points to research comparing child abuse and neglect in rural versus urban areas, the effect of therapeutic mentoring on youth behavioral and educational outcomes, and a literature review on housing needs and outcomes common among youth who age out of foster care.

  • Mentoring Improves Outcomes for Children in Foster Care

    Mentoring Improves Outcomes for Children in Foster Care

    Children and youth in foster care who form positive relationships through therapeutic mentoring experience significantly better behavioral and educational outcomes than their peers, according to a new study published in the journal Child Welfare. Children improved the most when they received frequent and consistent mentoring and when relationships lasted 1 year or more. The study suggests that therapeutic mentoring shows promise in protecting children in foster care from additional trauma and helping them recover more quickly from previous traumatic experiences.

    Therapeutic mentoring is more intensive than traditional mentoring and generally involves:

    • Screening of mentors' ability to work with traumatized children and compensation for mentors
    • At least 12 hours of mentor training on relationship building and tailoring shared activities to children's needs
    • Monthly mentor supervision by agency staff and careful planning to end the mentoring relationship

    In the study, researchers examined the experiences of 262 children and youth in foster care in a Midwestern metropolitan area who were receiving systems of care services due to risk of experiencing a placement disruption. Researchers compared outcomes of children who did and did not receive therapeutic mentoring, and they looked at the impact of the quality and length of the mentor relationship. Children spent 3 to 5 hours with their mentor the same time and day each week for 9 months on average. Among the study's significant findings:

    • Children receiving substantial mentoring improved in family and social functioning and school behavior and achievement, and trauma symptoms decreased after receiving mentoring for 1 year or more.
    • Children receiving limited mentoring showed no improvement and experienced worse outcomes during the first 6 months of mentoring than children who were not mentored.
    • Children who were not mentored showed no differences or experienced worse outcomes in all areas than children who received substantial mentoring.

    The authors suggest that limited mentoring relationships may lead to more disappointment and worsen children's outcomes. The study indicates a need to explore how mentoring may improve coping skills and reduce trauma for children and youth in foster care.

    "The Role of Therapeutic Mentoring in Enhancing Outcomes for Youth in Foster Care," by Sara Johnson, Julia Pryce, and Zoran Martinovich, Child Welfare, 90(5), 2011, is available by subscription on the Child Welfare League of America website:

    http://www.cwla.org/articles/cwjabstracts.htm

    Related Item

    Public/Private Ventures has published an issue brief entitled Making the Most of Youth Mentoring: A Guide for Funders. While not specific to child welfare, the resource may prove useful to professionals when choosing mentoring program partners.

    The brief, written by Carla Herrera, is available here:

    http://www.issuelab.org/research/making_the_most_of_youth_mentoring_a_guide_for_funders

  • Preventing Domestic and Sexual Violence in Indian Country

    Preventing Domestic and Sexual Violence in Indian Country

    A bulletin prepared by the Alaska Native Tribal Health Consortium and the Alaska Native Epidemiology Center presents data about domestic and sexual violence among Native Americans. The brief is the first publication to present, in one place, data on rates of violence against American Indians of all ages. Information about violence prevention resources and research, screening resources, and services is also included. 

    In the United States, domestic violence against Native American and Alaska Native women is roughly three times higher than rates of violence against White women. There are several barriers to providing violence prevention services to the American Indian population, including geographical isolation, lack of law enforcement and child advocacy centers, lack of prosecution resources, and more. Beginning with pregnancy and ending with the elder years, the issue brief provides information on the rate of domestic and sexual violence against each Native age group, the effects of violence at the respective life stage, and prevention strategies. Examples of prevention programs targeting specific age groups are also highlighted.

    Recommendations for enhancing domestic and sexual violence prevention among American Indians include the following:

    • Health-care facilities, including Tribal Health Organizations, should screen individuals for violence exposure. Best practice screening protocols should be implemented and applied to every age group to help identify victims, offer assistance, and make referrals.
    • Tribes, States, and other organizations should increase collaboration to investigate both domestic and sexual violence, their effects, and risk factors. Risk factors for substance abuse and suicide also should be investigated.
    • Tribes and States should evaluate services and initiatives to assess their efficacy in meeting the needs of the Native American population.

    Healthy Native Families: Preventing Violence at All Ages is available on the Alaska Native Epidemiology Center website:

    http://www.anthctoday.org/epicenter/assets/healthyFamilies/DVSAbulletinFinalLarge.pdf (9 MB)

    A list of Tribal programs focused on domestic and sexual violence, child abuse, and healthy relationships—including contact information for programs in each region of Alaska—is also available on the Alaska Native Epidemiology Center website:

    http://www.anthctoday.org/epicenter/alaskanativefamilies.html

  • Comparing CAN in Rural and Urban Areas

    Comparing CAN in Rural and Urban Areas

    Certain child and family characteristics make cases of abuse and neglect more likely to be substantiated—or confirmed—by child protective services (CPS) in rural versus urban settings, according to a new issue brief by the Carsey Institute at the University of New Hampshire. Using data collected in 2008 and 2009 for the second National Survey of Child and Adolescent Well-Being (NSCAW II), researchers found many similarities in confirmed cases across settings. However, cases of abuse and neglect with the following three characteristics were more likely to be confirmed in rural than in urban areas:

    • Children age 11 or older (35 percent of rural cases confirmed versus 23 percent of urban cases)
    • Parents experiencing cognitive impairments or domestic violence (72 percent of rural versus 54 percent of urban cases)
    • Families with income greater than 200 percent of the Federal poverty level (36 percent of rural versus 26 percent of urban cases)

    The authors explain that abuse and neglect confirmation often affects whether families will receive support services, but that most children with reported cases experience the same outcomes regardless of confirmation. Therefore, professionals should strive to provide similar services to families with unconfirmed cases in order to improve child outcomes and reduce risks for another report. Because CPS agencies in rural settings often are challenged by finding and keeping skilled workers and providing services across long distances, the issue brief concludes with recommendations for service providers in those areas.

    Understanding Child Abuse in Rural and Urban America: Risk Factors and Maltreatment Substantiation, by Wendy Walsh and Marybeth Mattingly, is available on the Carsey Institute website:

    http://www.carseyinstitute.unh.edu/publications/IB-Walsh-Child-Abuse-Substantiation.pdf (605 KB)

  • Housing for Newly Independent Youth

    Housing for Newly Independent Youth

    The U.S. Department of Housing and Urban Development, Office of Policy Development and Research, recently published a literature review on housing needs and outcomes common among youth who age out of foster care. These youth face unique housing challenges; they often quickly transition from being dependents of the State to being independent young adults. Because of these fast transitions, many have difficulties finding and maintaining suitable housing, and they often have little to no support from family members or the State. The review gives a detailed summary of the issue and focuses on programmatic initiatives geared toward tackling the problem.

    The literature review examines various characteristics of young adults aging out of foster care. It also examines the rate of homelessness among these youth, which the reviewed studies estimated to be between 11 and 36 percent. The review also discusses obstacles that youth must overcome in securing housing, including personal (e.g., inadequate income), systemic (e.g., lack of preparation for independent living), and housing market (e.g., lack of affordable housing) challenges. Additionally, the document examines Federal and State policies related to youth homelessness but notes that these policies appear to fall short of meeting the needs of this population. 

    A substantial portion of the review is devoted to describing the range of existing housing programs developed for youth aging out of care. An environmental scan yielded 58 unique programs, and the authors synthesized the components of these programs in order to create a picture of the existing landscape in the field. Findings from the scan and synthesis show that housing programs for this population vary along several key dimensions, including the housing model on which they are based, the level of supervision provided, and the availability of onsite supports. Finally, the review identifies a small number of innovative programs that may warrant closer examination in terms of their effectiveness.

    The full report, Housing for Youth Aging Out of Foster Care: A Review of the Literature and Program Typology, is available through the Department of Housing and Urban Development's website:

    http://www.huduser.org/publications/pdf/HousingFosterCare_LiteratureReview_0412_v2.pdf (1,016 KB)

    Related Item

    See "Chafee Housing Funds for Youth" in this issue.

Strategies and Tools for Practice

  • Achieving Safety for Runaway Youth

    Achieving Safety for Runaway Youth

    A four-part series in the National Clearinghouse on Families and Youth (NCFY) newsletter, The Exchange, focuses on improving outcomes for homeless and runaway youth. The issues feature a variety of programs that help achieve and enhance well-being, permanent connections, safety, and self-sufficiency for this vulnerable population.

    The latest issue in the series, "Focusing on Outcomes for Youth: Safety," examines ways to increase safety for homeless and runaway youth, providing examples of what some organizations are currently doing to achieve safety for their community's youth. The article highlights practices designed to promote runaway prevention and reaching youth before they become homeless by teaching communication skills and coping mechanisms to at-risk youth.

    The Let's Talk Runaway Prevention Curriculum program, developed by the National Runaway Switchboard, is also featured. The program helps to build life skills and provides youth with alternatives to running away from home. The curriculum consists of 14 components, including anger management, body language, and the reality of running away, among others.

    Finally, best practices for keeping youth safe after they leave these programs are examined.   

    Previous issues focused on well-being and permanent connections, and the final part of the series will focus on self-sufficiency. Read "Focusing on Outcomes for Youth: Safety" and the other issues on youth outcomes on the NCFY website:

    http://ncfy.acf.hhs.gov/tools/exchange

  • Home Visiting Toolkit for Children in Child Care

    Home Visiting Toolkit for Children in Child Care

    As home visiting programs have gained popularity over the past few years, attention is now moving to the children who spend substantial time being cared for by adults other than their parents. In response to the growing interest, the Center for Law and Social Policy (CLASP) created a toolkit for State policymakers and advocates, offering tips and strategies for expanding access to State and federally funded home visiting models via coordination with family, friend, and neighbor (FFN) child care providers. Information is organized in the following sections and appendix:

    • Part I: What are Family, Friend, and Neighbor and Home Visiting Partnerships, and How Can They Help You Reach Families?
    • Part II: A Home Visiting and Family, Friend, and Neighbor Partnership Planning Tool
    • Part III: Case Studies of Existing Home Visiting-FFN Partnerships
    • Appendix A: An Overview of Home Visiting Models


    Home Away From Home: A Toolkit for Planning Home Visiting Partnerships With Family, Friend, and Neighbor Caregivers was funded by the Annie E. Casey Foundation, the Birth to Five Policy Alliance, the George Gund Foundation, and an anonymous donor. The paper was written by Christine Johnson-Staub and Stephanie Schmit and is available on the CLASP website:

    http://www.clasp.org/admin/site/publications/files/Home-Away-from-Home.pdf (368 KB)

  • Wisconsin Postadoption Services Booklet

    Wisconsin Postadoption Services Booklet

    Adoptive families in Wisconsin can find information on an array of resources designed to meet the needs of their adopted children in the new booklet Home to Stay: A Post-Adoption Resource Guide for Wisconsin Families. The resources and services described include the following:

    • Postadoption resource centers
    • Adoption-related websites
    • Adoption assistance
    • Support groups
    • Early childhood interventions
    • Educational supports
    • Diagnostic evaluations
    • Developmental and physical disabilities services and mental health supports
    • Respite care
    • College tuition

    Descriptions and contact information for each type of service are provided. Home Stay is a program of Adoption Resources of Wisconsin, with support from Jockey International, Inc. The booklet is available on the Adoption Resources of Wisconsin website:

    http://wiadopt.org/Portals/WIAdopt/Brochures/HTS.pdf (2,488 KB)

  • Icebreaker Meetings Toolkit

    Icebreaker Meetings Toolkit

    A toolkit from The Annie E. Casey Foundation aims to strengthen and build the relationships between caseworkers, foster parents, and birth parents. Icebreaker Meetings Toolkit: A Tool for Building Relationships Between Birth and Foster Parents gives agencies an overview of icebreaker meetings, describes the roles and responsibilities of attendees, and provides a self-assessment tool to help with implementation. Users will also find samples of various forms, handouts for the foster and birth parents, and tips for supporting youth during icebreaker meetings.

    To view an icebreaker training video and download the toolkit, visit The Annie E. Casey Foundation website:

    http://www.aecf.org/OurWork/ChildWelfarePermanence/IcebreakerMeetings.aspx

  • Parenting Traumatized Children

    Parenting Traumatized Children

    New York State Citizens' Coalition for Children (NYSCCC) features several 2012 workshop materials adapted from National Child Traumatic Stress Network (NCTSN) resources. NYSCCC is a State membership organization that provides support, information, and advocacy for foster and adoptive parents and professionals.

    Specific workshop materials include Becoming a Trauma Competent Parent: Part II, a PowerPoint presentation and handout highlighting the three skills and nine tasks families should know to successfully parent traumatized children.

    The handout Essential Elements of Trauma Informed Care and "How-To," also featured as part of the NYSCCC 2012 workshop, was adapted from the NCTSN toolkit. Both are available on the NYSCCC website:

    http://nysccc.org/wp-content/uploads/SchoolerPPointPart2TraumaCompPart.pdf (425 KB)

    http://nysccc.org/wp-content/uploads/SchoolerPart2Essentials.pdf (302 KB)

Resources

  • Eligibility and Access to Public Assistance Guide

    Eligibility and Access to Public Assistance Guide

    The Center for Economic and Policy Research has created a guide to help child welfare and human services professionals assist children in foster care and transitioning youth access important public benefits. The guide provides professionals with eligibility and access tips and recommendations for the Supplemental Nutrition Assistance Program (SNAP), the School Lunch Program, Supplemental Security Income (SSI), Medicaid, and the Children's Health Insurance Program (CHIP). The guide also includes a brief background on foster care, including 2010 statistics on the number of children in care, those who exited care, and information on their well-being.

    Improving the Economic Security of Children in Foster Care and Young People Who are Transitioning From Foster Care: A Guide to Eligibility and Access to Food Assistance, Supplemental Security Income, and Medicaid was written by Shawn Fremstad, Consultant and Senior Research Associate at the Center for Economic and Policy Research. The guide is available on the First Focus website:

    http://www.firstfocus.net/sites/default/files/Improving%20the%20Economic%20Security.._0.pdf (168 KB)

  • Benefits of Extended DYFS Assistance for Youth

    Benefits of Extended DYFS Assistance for Youth

    The New Jersey Department of Children and Families' Office of Adolescent Services produced a video highlighting the benefits of extending a youth's case with the Division of Youth and Family Services (DYFS). At the age of 18, youth can choose to have their cases closed. However, if they exercise their right to keep their case open until age 21, they can continue receiving benefits to help them transition to independent living. In addition, youth who have already closed their cases and are still under the age of 21 can request to have them reopened to receive these benefits.
    In the video, several young people who elected to keep their cases open after they turned 18 relate their experiences and describe the assistance they received. Some of the benefits available to those who extend their cases include:

    • Assistance in finding housing and employment
    • Stipends for food and transportation
    • Access to transitional living programs and mentoring services
    • Continued access to Medicaid coverage

    "Keeping Your DYFS Case Open Until 21 in New Jersey: The Experiences of Young People Like You" is available on the New Jersey DYFS YouTube channel:

    http://www.youtube.com/watch?v=bnX6olTnPck&feature=youtu.be

  • Suicide Prevention Toolkit

    Suicide Prevention Toolkit

    The Substance Abuse and Mental Health Services Administration (SAMHSA) has prepared a toolkit for school administrators to help prevent student suicides and promote positive behavioral health. The toolkit provides a variety of prevention strategies to help schools do the following:

    • Assess their current suicide prevention programs
    • Better understand ways to help at-risk students
    • Learn how to respond to student suicide
    • Identify existing, effective suicide prevention programs
    • Combine current suicide prevention methods with other prevention programs, such as alcohol and drug abuse prevention programs

    The toolkit suggests developing a multifaceted approach to suicide prevention, including the following steps in sequential order:

    • Protocols for helping students at risk of suicide
    • Protocols for responding to suicide death
    • Staff education and training
    • Parent education
    • Student education
    • Screening

    The toolkit provides implementation strategies for each step. Preventing Suicide: A Toolkit for High Schools is available on the SAMHSA website:

    http://store.samhsa.gov/shin/content//SMA12-4669/SMA12-4669.pdf (3.82 MB)

  • Drug Court Programs Factsheet

    Drug Court Programs Factsheet

    A new factsheet from the U.S. Department of Justice (DOJ) Office of Justice Programs describes drug courts, in which court-directed programs aim to reduce drug use relapse. The factsheet highlights an array of multidisciplinary services, including risk and needs assessment, judicial monitoring and supervision, and treatment and rehabilitation services. Drug courts are tailored to address the specific needs of different populations. For example, family drug courts apply the drug court model to child welfare cases in which substance abuse is identified as a contributing factor to child abuse or neglect. These programs emphasize treatment to aid in the reunification and stabilization of families.

    The factsheet goes on to describe available DOJ programs that provide financial grants and other assistance to help States build drug court capacity and increase participation among the targeted populations.

    Drug Courts is available on the National Criminal Justice Reference Service website:

    https://www.ncjrs.gov/pdffiles1/nij/238527.pdf (346 KB)

  • Signs of Sexual Abuse Tip Sheet for Media

    Signs of Sexual Abuse Tip Sheet for Media

    A new pamphlet developed by the National Sexual Violence Resource Center (NSVRC), What Is Child Sexual Abuse?, highlights various forms of sexual victimization and their distinctive signs and symptoms. Targeted to media professionals, the pamphlet summarizes common behavioral red flags displayed by sexually abused children. A checklist of warning signs to help with the detection and identification are also provided, including:

    • Bodily signs (i.e., bedwetting, stomachaches)
    • Emotional signs (i.e., fear, sadness, acting out)
    • Sexual signs (i.e., inappropriate sexual behavior)
    • Verbal signs (i.e., narrative accounts of non-age-appropriate sexual activities)

    The brochure illustrates characteristic behaviors exhibited by child sexual abuse perpetrators and cites common factors influencing children's ability to disclose sexual abuse. Finally, data on the prevalence of this problem is presented and briefly discussed.

    What Is Child Sexual Abuse? is available online on the National Sexual Violence Resource Center website:  

    http://nsvrc.org/sites/default/files/Publications_NSVRC_Factsheet_Media-Packet_What-is-CSA.pdf (364 KB)

Training and Conferences

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.

  • Tough Starts Matter Package

    Tough Starts Matter Package

    The Adoption Learning Center is offering a four-course package for parents that focuses on how their adopted child's tough start in life may lead to difficult behaviors in the future. The "Tough Starts Matter Package" is specifically centered on providing parents with educational, practical, easy-to-use, and encouraging material to help their child heal.

    The package contains the following products:

    • Tough Starts: Brain Development Matters: Explains the impact that initial trauma has on a child's brain chemistry, brain development, and sensory processing
    • Tough Starts: Treatment Matters: Provides parents with strategies for seeking professional help once they recognize significant challenges in their child, discusses the importance of understanding a diagnosis, and addresses when to consider medication and how to choose a therapist
    • Tough Starts: Parenting Matters: Includes a strengths-based, therapeutic approach of exercises, family stories, and expert advice for parents in order to parent and heal a child who exhibits challenging behaviors due to a tough start in life
    • Tough Starts: Family Matters: Explores techniques parents can use to support each member of the family, and themselves, through the challenges of raising a tough start child and the toll it can take on them, their relationships, and their other children

    The "Tough Starts Matter Package" contains four courses, totaling to 5 credit hours, and is available on the Adoption Learning Center website:

    http://www.adoptionlearningpartners.org/catalog/courses/tough-starts-matters-package.cfm

  • Conferences

    Conferences

    Upcoming national conferences on child welfare and adoption through December 2012/January 2013 include:

    October 2012

    • National Staff Development and Training Association's 2012 Annual Professional Development Institute
      American Public Human Services Association
      October 14–17, Portland, OR
      http://nsdta.aphsa.org/pro_dev_inst.htm
    • 7th Biennial Adoption Conference "Best Interests of the Child?"
      Race, Religion, and Rescue in Adoption
      The Adoption Initiative/St. John's University
      October 18–20, New York, NY
      http://adoptioninitiative.org
    • 10th Annual Together We Can Conference
      Together We Can C/O Team Dynamics
      October 23–25, Lafayette, LA
      http://www.latwc.com

    November 2012

    December 2012/January 2013

    Further details about national and regional child welfare and adoption conferences can be found through the Conference Calendar Search feature on the Child Welfare Information Gateway website:

    http://www.childwelfare.gov/calendar/index.cfm

  • Mandatory Reporters Online Training

    Mandatory Reporters Online Training

    The Middlesex Children's Advocacy Center is offering an online training course for mandatory reporters who work with children in Middlesex County, MA. This training has been updated to address recent changes in mandatory reporter's obligations under the State's human trafficking law. Some of the topics discussed include:

    • A mandated reporter's obligations under the law
    • How to recognize signs of possible child abuse and neglect
    • How to respond to a child's disclosure of abuse
    • How to report signs of abuse and neglect
    • What happens when a report is filed

    For further information on this online training, or to register for and complete the course, visit the Middlesex Children's Advocacy Center website:

    http://middlesexcac.org/51A-reporter-training/

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