A study published recently in the Journal of Social Service Research found a significant relationship between post-adoption service utilization and positive adoption outcomes. Outcomes examined included parental satisfaction, quality of parent-child relationships, perceived impact of the child's adoption on the family, and perceived impact of the child's adoption on the marriage (if applicable).

Study participants included 249 of the 609 families in Nevada who were receiving adoption subsidies or who had an adoption subsidy agreement. Each family completed a "Needs and Satisfaction With Services Inventory," addressing whether they needed and/or received particular services.

The most needed services reported by adoptive parents on behalf of their children included:

• Other financial benefits (health benefits)--78 percent
• Financial subsidies--73 percent
• Dental care--65 percent
• Routine medical care--63 percent
• Individual counseling--52 percent

Financial and needed medical supports were the most frequently reported services received; the majority of caregivers were able to obtain these services. There were, however, significant reports of unmet needs. For example, only 28 percent of respondents indicated they had received needed respite care services. Counseling and in-home supports were the most frequently reported unmet needs.

Researchers found a significant correlation between parents' receipt of services and their satisfaction with parenting. In particular, parents who received informal support services (support groups, time with other adoptive parents), financial services (subsidies, health insurance), or other support services (social work coordination, legal services) reported higher satisfaction with parenting.

Conversely, unmet needs in the following areas were associated with lower quality of parent-child relationships and more negative impact on the family and married life:

• Counseling
• Informal supports
• Out-of-home placement
• Financial services
• In-home supports
• Other service needs (as defined above)

Contrary to findings from other studies, no differences were found between adoption outcomes reported by former foster parents and those reported by parents new to the adoptive child.

Based on their findings, the authors offer the following recommendations for child welfare agencies:

• Develop a list of in-home and out-of-home respite services available to adoptive families.
• Develop and nurture informal supports for adoptive families.
• Provide adoption-specific training for community mental health providers.
• Promote policies that support enhanced subsidies, ensure subsidy agreements are in place for all families adopting special needs children, and attempt to make the application process for subsidies less bureaucratic.
• Have specific post-adoption staff available to work with families who adopt special needs children.
• Link families who have adopted with each other and assist in the formation of support systems for parents and children.
• Develop adoption recruitment efforts that target the larger community, not just existing foster parents.

"Post-Adoption Service Needs of Families With Special Needs Children: Use, Helpfulness, and Unmet Needs" was published in the Journal of Social Service Research (Vol. 30, No. 4). Find more information about the journal or order a copy of this article online at http://www.tandfonline.com/toc/wssr20/30/4

Study findings indicating that the Hawaii Healthy Start home visiting program had little impact on the incidence of child abuse and neglect have prompted changes both to the program and to the evaluation of home visiting program outcomes. As a result of a 3-year study, researchers from the Johns Hopkins Children's Center have endorsed the value of testing different models, training programs, and implementation systems in home visiting programs, as well as utilizing experimental tests to determine the impact of home visiting on the incidence of child abuse and neglect.

The Hawaii Healthy Start Program was the focus of a large-scale study involving 643 families with infants who were identified as being at risk for child abuse and neglect. In this randomized evaluation, families were assigned to home visiting or control groups. Families in the home visiting groups received regular visits from paraprofessionals who were trained to establish a trusting relationship with parents, model parenting and problem-solving skills, and help families access needed services.

Annual assessments, including mothers' self-reports, home observations, child hospitalization and child protective services reports, and home visitors' records, showed little difference in the incidence of child abuse and neglect between families enrolled in the home visiting program and control families. In fact, high rates of abusive and neglectful parenting behaviors were found in both groups. Abusive and neglectful behavior was correlated with such maternal factors as depression, illegal substance abuse, and having no partner or having an abusive partner. These maternal risk factors for child abuse and neglect often went unrecognized by home visitors, so appropriate referrals to community services that might have prevented abuse and neglect were not made.

Researchers who studied the Healthy Start Program also noted a shift in the home visitation model that affected the content and focus of the home visits. This shift marked a change from the home visiting model of the late 1980s, in which the home visitor and supervisor developed a case plan based on family risk for abuse, to a more recent model in which parents designed their own goals within a strengths-based perspective. The latter model relied on families to propose their own risk-reduction goals, but staff were not trained to help families recognize and address their risk for abuse and neglect.

The results of this study have prompted Hawaii's Healthy Start Program to consider a number of changes, which will be tested for their effectiveness in preventing abuse and neglect. These include:

• Collaboration between home visitors and families in developing family support plans
• Partnering with families to help them address risks for abuse while building on their strengths
• Addressing factors that discourage or block families' use of community resources

Information about this study can be found in three journal articles in the June issue of Child Abuse & Neglect, The International Journal 28(6):

• "Randomized Trial of a Statewide Home Visiting Program: Impact in Preventing Child Abuse and Neglect"
• "Randomized Trial of a Statewide Home Visiting Program to Prevent Child Abuse: Impact in Reducing Parental Risk Factors"
• "Risk of Mother-Reported Child Abuse in the First 3 Years of Life"

Article abstracts and information about subscriptions to Child Abuse & Neglect, The International Journal can be found at http://www.journals.elsevier.com/child-abuse-and-neglect/.

Related Items

Studies of other home visiting programs have yielded more positive results. Read more about evaluations of home visiting programs in previous issues of Children's Bureau Express:

• "Time Spent in Home Visits Related to Personality Traits of Mothers and Staff" (December 2003/January 2004)
• "Home Visiting Programs Help Reduce Child Maltreatment" (April 2003)
• "Home Visitation Measured as a Way to Prevent Child Abuse" (November 2000)

The Nurse-Family Partnership Program is a home visiting program that has shown positive results for first-time, low-income parents who are visited by nurses. For information on that program, including scientific results tracked over 20 years, visit their website at http://www.nursefamilypartnership.org

The Harvard Family Research Project sponsors the Home Visit Forum, comprised of representatives from national home visitation programs committed to improving outcomes, developing research that leads to better practice and training, and sharing lessons throughout the field. Information about the Home Visit Forum can be accessed at http://www.hfrp.org/other-research-areas/home-visit-forum-completed-project.

Program-intensive therapeutic foster care can prevent violent behavior among chronically delinquent youth, ages 12 to 18, who are at risk of committing violent acts, according to a recent report by The Task Force on Community Preventive Services.

The Task Force examined experimental studies published prior to December 2001 on two types of therapeutic foster care:

• Cluster therapeutic foster care--Clusters of foster parent families cooperate in the care of children ages 5 to 13 with severe emotional disturbance.
• Program-intensive therapeutic foster care--Program staff collaborate closely and daily with foster families caring for chronically delinquent adolescents, ages 12 to 18.

The Task Force found that program-intensive therapeutic foster care reduces the number of arrests, the rates of incarceration, and days of incarceration. On the other hand, they concluded that current research regarding the effectiveness of cluster therapeutic foster care is inconclusive and that more studies are needed.

The report recommends that communities that are considering implementing or expanding program-intensive therapeutic foster care services consider these results in the context of local data, such as the number of chronically delinquent juveniles exhibiting violent behavior in the community and the availability of resources to implement these services.

This report is part of a series of topics included in the Guide to Community Preventive Services, a product of the Task Force on Community Preventive Services, with the support of the U.S. Department of Health and Human Services in collaboration with public and private partners. The Centers for Disease Control and Prevention (CDC) provide staff support to the Task Force.

The report is available on the CDC's website at http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5310a1.htm. Information about the Guide to Community Preventive Services is available at http://www.thecommunityguide.org/index.html

Related item

For more information on outcomes for youth in therapeutic foster care, see the 1999 Surgeon General's Report on Mental Health at http://www.surgeongeneral.gov/library/mentalhealth/chapter3/sec7_1.html

Federal and State adoption subsidy programs, commonly referred to as "adoption assistance," were established to provide cash assistance and supportive services to adoptive families of children with special needs. To reduce barriers to adoption for waiting children, Federal law encourages States to facilitate the provision of adoption assistance even when a family who wishes to adopt lives outside the child's State of residence or when an adoptive family moves out of State after the adoption. A December 2003 report by the Association of Administrators of the Interstate Compact on Adoption and Medical Assistance (AAICAMA), Report on the Interstate Movement of Children Receiving Adoption Assistance, finds that increasing mobility and use of national adoption exchanges such as the AdoptUSKids website have resulted in increased numbers of children with special needs living in a State other than the State providing the adoption assistance ("the adoption assistance State").

The study, based on a survey of all States conducted in 2002, shows the majority of adopted children receiving State and Federal adoption subsidies (more than 75 percent) still reside in the State providing the adoption assistance. A relatively small percentage (9.8 percent) live in other States, while the child's State of residence could not be provided by approximately 16 percent of reporting States. Just 5 years earlier, however, the percentage of children living outside their adoption assistance State was 6.1 percent. Among the 30 States for which a comparison was possible, the numbers of children residing in a State other than the adoption assistance State grew by 70 percent during the 5-year period, from 9,878 children in 1997 to 17,098 children in 2002. Study authors suggest this increase indicates States are making progress toward breaking down geographic barriers to adoption.

Other findings include:

• The number of children with special needs receiving State or Federal subsidies increased 71 percent (from 155,468 to 266,931) between 1997 and 2002 in the 39 States that completed surveys in both years.
• During that time, there was an 80 percent increase in the number of children receiving Federal (Title IV-E) adoption assistance, and a 29 percent increase in the number of children receiving State-funded adoption assistance.
• The proportion of children with special needs receiving Federal (vs. State-funded) subsidies is increasing--from 73 percent of children receiving subsidies in 1997 to 82.5 percent in 2002.
• The majority of children living outside their adoption assistance State (59.4 percent) were initially adopted across State lines. A smaller percentage (41.1 percent) moved across State lines with their adoptive families after the adoption was finalized.

Research has shown that children with special needs and their adoptive families need support throughout the life of the adoption. As a result, this study highlights the need for States to have resources to provide adequate medical and post-adoption services for the growing numbers of children with special needs who will be crossing State lines during or subsequent to their adoptions.

The Interstate Compact on Adoption and Medical Assistance (ICAMA) provides a formal mechanism to ensure that adoptive parents and their children receive medical benefits and other services in interstate situations. For more information about ICAMA, visit the AAICAMA website at http://aaicama.aphsa.org

This study was supported by a Children's Bureau Adoption Opportunities Grant (#90-CO-0866). The report is available at http://aaicama.org/cms/resources-docs/Interstate_Movement_Survey_2003.pdf

Related Item

Adoption Assistance for Children Adopted From Foster Care: A Factsheet for Families, available from Child Welfare Information Gateway (http://www.childwelfare.gov/pubs/f_subsid.cfm), has more information about adoption assistance.

Acting on the knowledge that infants are the largest group of children to enter the child welfare system, the New York State Permanent Judicial Commission on Justice for Children spearheaded a unique collaboration among the courts, the child welfare system, and service providers. These groups worked together to radically redirect the focus of the court process onto the health and well-being of infants in foster care. The result of this collaboration was the Babies Can't Wait Initiative, created in February 2001 and funded by the Robert Wood Johnson Foundation.

Babies Can't Wait was initially implemented in the Bronx Family Court. Early activities around this initiative involved identifying the needs of infants in foster care and linking them to services, as well as supporting caregivers' needs and enhancing potential for permanency. There were five components of the Babies Can't Wait Initiative:

• Bringing together stakeholders, including judges, experts in the field of infant development and health, the Bronx Court-Appointed Special Advocate (CASA) project, and the New York City Administration for Children's Services.
• Capitalizing on judicial leadership to promote a problem-solving model of judging and to bring attention to the health and welfare needs of infants.
• Building a knowledge base about the needs of infants through a training series for court and child welfare professionals.
• Creating opportunities for collaboration, including the formation of an advisory group that included court representatives, child welfare professionals, and child development experts.
• Accumulating data to identify and refine project emphases and training needs.

A key product of the initiative was the development of an Infant Checklist to help track risk factors in infants who entered the child welfare system. In the Bronx Family Court, the checklist was used to review immunization status and make court referrals to early intervention programs.

The implementation of the Babies Can't Wait Initiative in the Bronx had a number of positive results, the most prominent of which was the increased communication among the court, child welfare professionals, and child development experts. The increased communication was accompanied by increased morale among court professionals, a stronger focus for the Bronx CASA program, and new guidelines to be used in placing infants with no siblings into foster care. In addition, as judges, lawyers, and child welfare staff became more aware of the developmental needs of infants, they began to consider caregiver capacity issues when making placement recommendations and to revise concurrent planning to emphasize appropriate first placements for infants.

The impact of the Babies Can't Wait Initiative also spread beyond the Bronx. Several other New York counties have begun to use the Infant Checklist, the training curriculum, and the collaboration model. The initiative also has been presented at several national conferences.

The full story of the Babies Can't Wait Initiative can be found in "Building Bridges for Babies in Foster Care: The Babies Can't Wait Initiative" in the spring 2004 issue of the Juvenile and Family Court Journal at http://www.isc.idaho.gov/cp/docs/Building%20Bridges%20for%20Babies%20in%20Foster%20Care.pdf (PDF - 170 KB).

Related Item

Read more about the issue of infants in foster care in "Researchers Study Infants Who Reenter Child Welfare System" in the November 2000 issue of Children's Bureau Express.

Treating families as partners in child welfare practice is the theme of Volume 19(2) of American Humane's journal, Protecting Children. In partnership-based practice, families are involved with child welfare agencies in goal setting, assessment, and intervention. Their participation is seen as necessary to the success of the solution and, ultimately, to building stronger networks and communities.

In addition to the introduction, "Advancing Partnership-Based Practice with Families," six articles address various facets of this topic:

• "Building Solution-Focused Partnerships in Children's Protective and Family Services"
• "Relationship-Grounded, Safety-Organized Child Protection Practice: Dreamtime or Real-Time Option for Child Welfare?"
• "Creating a Constructive Practice: Family and Professional Partnership in High-Risk Child Protection Case Conferences"
• "Partnership with Families and Risk Assessment in Child Protection Practice"
• "Partnership Practice and Responsive Regulation"
• "Partnership Working: Changing Understandings in Child Welfare Services in England"

Information about obtaining this issue of Protecting Children can be found on the American Humane website www.americanhumane.org

The Federal Helping Outreach Programs to Expand (HOPE) program offers up to $5,000 for grassroots community- and faith-based victim service organizations to improve outreach and services to crime victims. Funds may be used to develop program literature, train advocates, produce a newsletter, support victim outreach efforts, and recruit volunteers. Funds are available on a continuous basis, contingent on availability.

Organizations and coalitions interested in applying must meet the following criteria:

• Applicants cannot also receive Federal Victims of Crime Act (VOCA) victim assistance grant funding.
• Applicants must have an annual operating budget of $50,000 or less.
• Applicants must be operating for at least 1 year.

Initiated in 2002, HOPE is a program of the U.S. Department of Justice, Office of Justice Programs, Office for Victims of Crime (OVC). Information on applying for HOPE funds is available on the OVC website at http://www.ojp.usdoj.gov/ProgramPlan/section5.htm#hopeIII.

Organizations looking to build their capacity to provide services can use the Philanthropic Capacity-Building Resources (PCBR) database to identify foundations that support such efforts. A free resource developed by the Human Interaction Research Institute, the PCBR database contains information on 318 capacity-building programs being operated by U.S. foundations. The database includes a description of each program, the types of activities supported (e.g., governance, staff development, fund development), contact information, and more. Users can run twelve different types of reports to obtain the information they need (e.g., by type of grant available, by type of foundation), or users can scan all 318 programs.

The database can be accessed at http://www.humaninteract.org/reports/pcbrdatabase.asp.

A collaboration between professionals in the fields of child welfare and aging has resulted in the development of public policy recommendations and a call to action regarding kinship care by elderly caregivers for children who might otherwise be in foster care. The New York Council on Adoptable Children, Inc., formed the Forging Connections Policy Group in 2002, bringing together professionals from the two fields; the culmination of their work, with support from the New York Community Trust, was published in the June 2004 report, Forging Connections: Challenges and Opportunities for Older Caregivers Raising Children.

This report identifies key areas where elderly caregivers face challenges, including economic hardship, the bureaucracy surrounding access to resources, health care challenges, and a cumbersome legal system. The report then makes recommendations for addressing these challenges. While 19 recommendations are offered, 5 are seen as paramount:

• Educate elderly caregivers about resources, services, and supports.
• Involve elderly caregivers in planning for a child's future.
• Create subsidized guardianship programs.
• Inform judges, attorneys, and others working with elderly caregivers of the unique needs facing these families.
• Train caseworkers about the financial needs of and the entitlements available to elderly caregivers.

The report also includes a list of national resources for elderly caregivers and those who provide services, as well as an extensive bibliography. Access it at http://www.coac.org/Espanol/pdf/Forging_Connections.pdf.

Related Items

The National Abandoned Infants Assistance Resource Center recently published a factsheet, Kinship Care, that discusses the definition and incidence of such care, State and Federal policies, the relationship between substance abuse and kinship care, characteristics of caregivers and the children for whom they provide care, and available services. The factsheet can be downloaded from http://aia.berkeley.edu/media/pdf/kinship_care_factsheet_2004.pdf.

The Federal Government maintains a web page that serves as link to other government resources on grandparents raising grandchildren. This can be found at www.firstgov.gov/Topics/Grandparents.shtml.

More than merely fulfilling administrative requirements, data collection and analysis can help child welfare professionals fine-tune their interventions to better serve children and families. The July 2004 issue of the North Carolina Division of Social Services' newsletter, Practice Notes, focuses on various aspects of data and child welfare services. Topics include:

• Using data for agency self-evaluation
• Using data-based newsletters to engage frontline staff
• The influence of organizational culture on the use of data in decision-making
• The link between individual case documentation and the results of the Federal Child and Family Services Reviews

This newsletter is available online at www.practicenotes.org/vol9_no4.htm

Federal child welfare laws and national reform initiatives require courts to work more quickly and efficiently with child welfare agencies to meet the needs of children and families at risk. Two recent publications acknowledge the barriers faced by courts in helping vulnerable children and explore the court's role in improving outcomes for families.

• View from the Bench: Obstacles to Safety and Permanency for Children in Foster Care summarizes key findings from a national survey of dependency court judges. The survey was sponsored by Fostering Results, a national, nonpartisan public education project to raise awareness of issues facing children in foster care, in partnership with the National Center for State Courts and the National Council of Juvenile and Family Court Judges. Read the survey results at http://www.pewtrusts.org/uploadedFiles/wwwpewtrustsorg/Reports/Foster_care_reform/fostering_results_070104.pdf.
• Building a Better Collaboration: Facilitating Change in the Court and Child Welfare System identifies systems change as imperative for juvenile and family courts, child welfare agencies, and community stakeholders to meaningfully improve the lives of vulnerable children. This National Council of Juvenile and Family Court Judges Technical Assistance Bulletin (Vol. VII, April 2004) identifies elements and strategies that support effective and sustainable systems change and offers examples from across the country that demonstrate how theoretical concepts can be implemented in the real world of child welfare reform. For more information about the bulletin, go to http://www.ncjfcj.org/resource-library/publications/building-better-collaboration-facilitating-change-court-and-child or contact the Permanency Planning for Children Department, National Council of Juvenile and Family Court Judges at 775.327.5300 or ppcd@ncjfcj.org.

Therapists working with victims of maltreatment and other forms of trauma may find a new publication from Haworth Press of interest. Rebuilding Attachments with Traumatized Children, by Richard Kagan (2004), uses attachment theory and research to frame a discussion of how to work with traumatized children to rebuild their self-esteem and hope for the future. Along with a discussion of how trauma impacts the development of positive attachments, the author includes case examples, strategies, and tips for therapists to use in their work.

A workbook, Real Life Heroes, complements the text by providing a tool for professionals and other caring adults to use with traumatized children. Designed for children ages 6 to 12, the workbook, or lifebook, helps children develop confidence and self-respect by honoring their past and preparing for their future.

The book and workbook are available from Haworth Press at http://www.amazon.com/.

Upcoming national conferences on adoption and child welfare through December 2004 include:

October

• 16th Annual ATTACh Conference on Attachment and Bonding (The Association for Treatment and Training in the Attachment of Children; October 3 through 6, Richmond, VA)
• Indian Child Welfare Training Institute (National Indian Child Welfare Association; October 4 through 8, Reno, NV)
• Adoption Exchange Association 2004 Biennial Conference (October 7 through 9, Santa Fe, NM)
• 2nd Annual "It's My Life" Conference (Casey Family Programs; October 12 through 14, Sacramento, CA)
• 6th National Structured Decision Making Conference "Strengthening SDM Implementation for Improved Outcomes" (Children's Research Center; October 13 through 14, Long Beach, WI)
• NCALP and Fostering Results 2004 National Symposium "Permanency by the Numbers: Improving Dependency Caseflow Management Through Data-Driven Strategies" (National Center for Adoption Law and Policy; October 18 through 19, Columbus, OH)
• 2004 Child Welfare League of America Biennial Leadership Summit: "Is the System Broken? Creating the Will, Wisdom and Ways to Meet the Needs of America's Children" (October 20 through 22, Hilton Head, SC)
• 2004 National Youth Services Summit: Transitioning At-Risk Youth to Employment and Self-Sufficiency (The Performance Institute; October 25 through 27, San Diego, CA)

November

• Adolescence and The Transition To Adulthood: Rethinking Public Policy For A New Century (Chapin Hall Center for Children at the University of Chicago; November 8 through 9, Chicago, IL)
• 2004 National Adoption Training Conference "All in the Family: Achieving Excellence in Adoption" (Child Welfare League of America; November 8 through 10, Los Angeles, CA)
• Children's Rights Council 15th Annual National Conference "The Best Parent is Both Parents" (November 11 through 13, Toledo, OH)
• 66th Annual National Council on Family Relations Conference (November 17 through 20, Orlando, FL)
• APSAC's Second Annual Trauma Treatment Clinic (American Professional Society on the Abuse of Children; November 29 through December 3, Maui, HI)

December

• 19th National Training Institute "A Changing World for Babies" (Zero to Three; December 3 through 5, Sacramento, CA)
• Federation of Families for Children's Mental Health 16th Annual Conference (December 9 through 12, Washington, DC)

Further details about national and regional adoption and child welfare conferences can be found in the Conference Calendar on Child Welfare Information Gateway: www.childwelfare.gov/calendar

Through a grant from the Office for Victims of Crime, Office of Justice Programs, U.S. Department of Justice, ARC Riverside California is offering an online conference of 22 1-hour "webinars" on the abuse of children and adults with disabilities. The online seminars will be offered September 9 through 29 and will be available in archive form until August 2005.

Topics of the seminars include prevention, identification, investigation, prosecution, and treatment of abuse. Seminars will concern casework and caregiving where people with disabilities are victims of child abuse, domestic violence, dependent adult abuse, and elder abuse.

The cost for the entire conference is $150. To register, visit [Editor's note: This link is no longer available].

The State of New Hampshire uses Federal Title IV-E funds to support training for prospective foster parents through a partnership between the State Department of Children, Youth and Families (DCYF) and the College for Lifelong Learning (CLL). In 2002, the partnership conducted an evaluation to determine the effectiveness of its 21-hour training program, Foundations for Fostering (FFF). The evaluation found this curriculum contributes to the knowledge base of prospective foster parents, enhances feelings of preparedness and confidence, and serves as a useful resource that participants can draw upon during initial foster placements.

Prospective foster parents (41) were surveyed at the beginning and end of training, and face-to-face interviews were conducted with participants (13) who went on to become licensed foster parents and had a child placed within 3 months of completing training.

Results included:

• Participants felt significantly more prepared for foster parenting after training.
• Participants gained a better understanding of children in placement and the child welfare system in general.
• Participants appeared to apply the knowledge they gained when children were placed in their homes.

From the interviews, evaluators concluded that the sharing of fostering stories and real-life situations made a significant impression on the participants. Participants also indicated the need for further training in a number of areas, including the needs of older children, behavior management strategies, emotional disabilities, and services available to children in placement.

From these findings, evaluators concluded that preservice foster parent training offered through a Title IV-E university-agency partnership can provide numerous benefits. These findings support previous research indicating the importance of foster parent training. The partnership is repeating this study in State FY 2004 with an eye toward increasing the sample size.

More information about the Education and Training Partnership and the FFF curriculum is available at http://www.granite.edu/students/fostertraining.php.

For more information about the completed study (Part I), ongoing evaluation efforts, or to request a manuscript, please contact:

John B. Cook
Education & Training Partnership
College for Lifelong Learning
117 Pleasant Street, Dolloff Bldg.
Concord, NH 03301
Phone: 603.271.6625
Email: etp@cll.edu