November 2004Vol. 5, No. 9Print issueSpotlight on National Adoption Month

According to a study published recently in the journal Research on Social Work Practice, a good client-worker relationship can have a positive impact on parents' discipline and emotional care of their children.

This study was conducted using 100 families formerly involved with the child welfare system in Long Beach, CA. Of these families, 45 percent were from a family preservation (FP) program and 55 percent were from a traditional family management casework program (FM). Researchers used the Parent Outcome Interview to measure children's academic adjustment, children's conduct, physical child care, discipline and emotional care of children, children's symptomatic behavior, parents' coping, and parents' relationship with the social worker. Findings from the study included:

• Higher scores in discipline and emotional care were related to parents' perceptions of their relationship with the caseworker as positive.
• There was a somewhat weaker association between client-worker relationship and the physical care of children and parent coping.
• There were no associations between client-worker relationship and child outcomes (i.e., academic adjustment, children's conduct, or children's symptomatic behavior).
• Ability to openly communicate and frequency of visits were predictors of a good client-worker relationship.
• FP clients, who have more frequent visits with their caseworkers, were generally more satisfied with their worker than FM clients.

Based on these findings, the authors conclude that the client-worker relationship can directly impact parents' actions but not a child's outcomes. In addition, they suggest that relationship-building between caseworkers and families should be a priority for child welfare agencies and training programs.

The full article, "Is the Client-Worker Relationship Associated with Better Outcomes in Mandated Child Abuse Cases?," is available in the September 2004 issue of Research on Social Work Practice (http://rsw.sagepub.com/content/14/5/351.abstract).

In a study of efforts to support New York State's TANF-eligible families after adoption, parents reported a significant positive impact of postadoption services on their families' happiness and ability to stay together. The study, "Strengthening and Preserving Adoptive Families: A Study of TANF-Funded Post Adoption Services in New York State," was published in April 2004.

Thirteen community-based agencies were awarded TANF funds in June 2000 to establish Regional Adoption Centers and provide postadoption services. The study is based on data from worker-completed intake forms and from parent satisfaction surveys sent to 815 of the 1,053 families (both TANF and non-TANF eligible) who were served during the first 18 months of project funding. The author cautions that a low overall response rate (19 percent, or 153 surveys) limited the type of analyses that could be performed with the data.

Some key findings include:

• 29 percent of responding families reported that when they first contacted the agency they felt one or more of their children could not continue living with them.
• Among the families that had a child at risk of no longer being able to live with the family, 73 percent reported that the child was able to remain in the home as a result of the help and support they received from the agencies.
• Of all respondents, 82 percent indicated that their family was better off or happier as a result of receiving services.
• The most frequently requested and used services were parent support groups, parent training, and counseling.

Characteristics of the families served by the project varied. Approximately 58 percent of the families were nonkin adoptions, 26 percent were kin adoptions, and in 16 percent of cases the relationship could not be determined. Nearly 62 percent of the cases were known to be adoptions from foster care; in another 28 percent of cases the type of adoption was not identified. The majority of the children had special needs, including behavioral problems (40 percent) and emotional problems (36 percent). These special needs appeared to become more prominent as the children aged.

Report appendixes include information on the services provided by participant agencies, the survey instruments, and extensive verbatim survey responses by families. The report can be downloaded from the New York State Citizen's Coalition for Children website at http://nysccc.org/wp-content/uploads/tanfaverypasrpt.pdf (PDF - 400 KB).

Characteristics of successful adolescent adoptions, factors influencing the adoption decision, and testable models for adolescent adoption were the subject of a research project by the Center for Child and Family Studies at the University of South Carolina's College of Social Work. Funded by a grant from the Children's Bureau, researchers set out to identify the factors that produce positive outcomes for adolescent adoptions.

A qualitative approach to data collection and analysis was used that included interviewing 58 adoptive parents and 37 of their children who had been adopted when 12 to 18 years old and whose adoptions had never dissolved. The children were also asked to complete an instrument designed to measure life satisfaction.

When asked about keys to success in their adoptions, parents and adolescents cited a variety of factors:

• Commitment
• Realistic expectations
• Support from professionals, family, and friends
• Personality characteristics, including flexibility, good communication skills, and a sense of humor
• Compatibility
• Positive attitude

Based on the interviews and life satisfaction instrument, a number of recommendations were proposed for agencies to promote the successful adoption of adolescents:

• Offer opportunities for adults in the community to get to know adolescents in foster care. Research showed that many of the adults had never considered adoption until they met a particular teen. By creating opportunities for adults to become acquainted with teenagers in need of homes (through such programs as Big Brothers/Big Sisters), the pool of possible adoptive families is expanded.
• Promote coordination among public and private agencies so that parents do not have to contact many different places to find information. A number of parents cited the frustration of having to contact multiple agencies before finding one that fit their needs, and many were discouraged early in the process.
• Allow adults and teens enough visitation before moving teens into the home. Adolescents and adults needed to be allowed time to get to know each other before having to make the adjustment to living together.
• Employ caseworkers who specialize in adolescent adoptions and have positive attitudes about teenagers. In this study, several of the adolescents were not considered for adoption until their cases were turned over to agencies that specialized in placing older children.
• Prepare adolescents for adoption through steps that include explaining their legal status, offering adoption as an option, explaining the adoption process, and providing support.
• Provide postadoption support services, and make sure that families know about the services and how to access them. A number of parents in this study called on their agencies for counseling or other support before and after the adoption was finalized.

Information on this study, "Field-Initiated Research on Successful Adolescent Adoptions," can be accessed on the Center for Child and Family Studies' website at http://ccfs.sc.edu/images/pdfs/fullfinalreport.pdf (PDF - 1,065 KB).

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"Permanency for Adolescents" in the October 2004 issue of Children's Bureau Express highlights some programs that offer permanency options for adolescents.

Since 1998, New York City's Administration for Children's Services (ACS) has been collaborating with the New York police department and district attorneys in an effort to reduce trauma to children when allegations of severe abuse and neglect are present and to effect the speedy arrest and prosecution of the perpetrators. This collaboration, called the Instant Response Team (IRT) Program, was the subject of a study recently published by the Vera Institute of Justice.

The IRT Program brings together child protective workers, police, and prosecutors to respond to child abuse and neglect accusations within a 2-hour timeframe. All interviews with the children are conducted in a child-friendly environment. Protocols are in place to coordinate the investigation, and information sharing is encouraged among all agencies involved in the investigation.

Vera researchers analyzed data from the IRT Program and compared it with data from the State Central Registry in New York, which maintains all allegations of child maltreatment in the State. Researchers also conducted interviews with program staff and shadowed child protective workers on one case. Vera identified many strengths of the IRT Program, including:

• Ninety-nine percent of IRT cases examined met the established IRT protocol.
• IRT cases were more likely to have an allegation substantiated than other New York City cases (52 percent vs. 35 percent).
• IRT staff reported better information sharing among agencies, stronger working relationships, and more efficient case processing since the program began.
• Incidents of multiple exams and interviews decreased.
• Prior to the start of the IRT Program in 1998, if a removal was necessary following an incident of abuse or neglect, the child was more likely to be removed (57 percent of cases) than an alleged perpetrator. However, by 2002, the perpetrator was more likely to be removed (68 percent of cases).

Vera noted that the main challenge the IRT Program faced was rapid growth. IRT caseloads have increased 160 percent from 1999 to 2002. This increase allows for more efficient use of child welfare resources but has placed a larger burden on law enforcement and prosecutors.

More information on the Vera Institute of Justice report is available on the website at http://www.vera.org/sites/default/files/resources/downloads/Responses_to_allegations_of_child_abuse.pdf (PDF - 967 KB).

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Another recent publication from the Vera Institute, "Youth Who Chronically AWOL from Foster Care: Why They Run, Where They Go, and What Can Be Done" (http://www.vera.org/pubs/youth-who-chronically-awol-foster-care-why-they-run-where-they-go-and-what-can-be-done) reports on interviews with foster care staff and adolescents in foster care with a history of AWOL behaviors. It discusses where the youth go when they leave foster care and how staff can prevent this pattern of behavior.

The Center for the Study of Social Policy (CSSP) has developed a new strategy to build on evidence-based protective factors for children and families to prevent the occurrence child abuse and neglect. Information on the CSSP website suggests this strategy, referred to as "Strengthening Families Through Early Care and Education," differs from past efforts in that:

• It is based in the early childhood education (ECE) system.
• It focuses on building protection for children within their homes and communities, not only on identifying risks in their homes and communities.
• It seeks to overcome or mitigate manageable individual causes of child neglect and abuse such as parental isolation, lack of knowledge about child development, and mental, physical, or financial crisis in the family, rather than removing children from their homes.

CSSP has been studying the role of early care and education in helping to prevent child abuse and neglect and strengthen families since 2001. They find this environment a promising one for prevention due to the relationships between caregiver/teacher and parent, the opportunity for daily observations with parents, the resources early childhood programs provide for parents, and the fact that parents are bringing their children to these programs by choice rather than as recipients of services.

CSSP lists the following as additional advantages of this strategy:

• It is doable. Most ECE programs can make additions or enhancements to current activities and curricula to introduce this prevention method.
• It is affordable. Both public and private programs can add prevention components rather inexpensively. In addition, some State welfare officials are looking into whether child abuse and neglect funds may be used more effectively if this new strategy is applied at an early age.
• It has widespread support. CSSP is working closely with social science researchers, State welfare officials, and early childhood programs to create a strategic framework around policy development.
• The new early childhood workforce is ready to go to work. A study conducted by the National Association for the Education of Young Children (NAEYC) showed that 97 percent of teachers and administrators want to do more to prevent child maltreatment and would want prevention training if it were available.

Evidence has shown that this approach can have an impact on child abuse and neglect rates. An 18-year longitudinal study at the University of Wisconsin found resource coordinators in federally funded childcare programs in Chicago helped parents obtain services they needed to care for their children at home. Children who attended this preschool intervention program had a 52 percent lower rate of maltreatment by age 17 than those who did not.

For more information about Strengthening Families Through Early Care and Education, visit the CSSP website at www.cssp.org/doris_duke/index.html. (Editor's note: This link is no longer active. To learn about CSSP's Strengthening Families initiative, visit http://www.cssp.org/reform/strengthening-families.)

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For more information on the study conducted by the University of Wisconsin, read "Study Shows Preschool Can Help Prevent Child Abuse" in the March 2003 issue of Children's Bureau Express.

In 2002, NAEYC embarked on a national initiative to help early childhood educators play a key role in the primary prevention of child abuse and neglect. Find more about the initiative, Supporting Teachers, Strengthening Families, on the NAEYC website at http://www.naeyc.org/ecp/trainings/stsf.

A recently released final evaluation report from the Permanency Planning Mediation Pilot (PPMP) Program in Michigan suggests mediation in child welfare cases can result in positive outcomes for children, families, professionals, and systems without increasing the overall costs of judicial and administrative handling of child welfare cases. The report, released in June 2004, provides a retrospective look at the first 3 years of child protection mediation in seven pilot program sites.

Researchers analyzed case characteristics and outcomes for 207 (86 percent) of the 289 mediation referrals during 1999, 2000, and 2001. Cases represented all types of child maltreatment and were referred to the program at all stages in the legal process, from preadjudication through completion of petitions to adopt. Some key findings included:

• Achievement of permanency was higher for mediated cases than nonmediated cases, and this difference was statistically significant.
• Time from petition to permanency also was shorter for mediated cases, compared to cases referred but not mediated.
• The time from petition to any type of permanency averaged 17 months for all cases referred to mediation, regardless of the referral point (e.g., pre- or postadjudication).
• The average time from mediation referral to any form of permanency averaged just over 13 months. (Following referral to mediation, family reunification was achieved in 11 months while adoptions were finalized in an average of 15 months.)
• Comparison of averages for time to permanency from Michigan's AFCARS data suggests that permanency was achieved through mediation in a more timely manner in adoption cases, with some modest time savings in foster care cases resulting in reunification.

In addition to the positive permanency outcomes, the evaluation data suggest participants in all roles were satisfied with the mediation process:

• In the great majority of cases in which a mediation agreement was finalized, there were high rates of parental compliance with the terms of the agreement. (Comparison data for nonmediated cases were not available for analysis.)
• Parent participants reported that they had been included in case planning and had their viewpoints considered during the process.
• Involved judges, attorneys, and child welfare professionals all indicated high levels of satisfaction with the mediation process.

From their findings, authors conclude that mediation is a reasonable option in the range of legal responses to child maltreatment and protection. The authors also suggest that while precise financial savings were not demonstrated by this study, it is reasonable to conclude there are financial benefits to be gained from a mediation program staffed with trained volunteers.

The 75-page report, including lessons learned and recommendations for future study, can be downloaded from the Michigan Courts website at http://courts.mi.gov/scao/resources/publications/reports/%20PPMPevaluation2004.pdf (PDF - 515 KB).

Providing children with the caring, nurturing environment necessary for healthy physical and emotional development is difficult when one or more caregivers are addicted to drugs or alcohol. A recently released book, The Lowdown on Families Who Get High: Successful Parenting for Families Affected by Addiction, by Patricia O'Gorman and Philip Diaz, describes the impact of addiction on children and families and offers parenting strategies for each stage of a child's life.

The first two sections of the book use a combination of research and personal stories to describe the issues from various perspectives, including the addicted parent, the recovering parent, the partner of an addicted parent, parents who are adult children of addicts, and caregivers of children of addicted parents. The section on parenting strategies emphasizes a 12-step approach, revised for parents and caregivers. The third section of the book, written specifically for professionals, provides the legal framework for substance abuse and child welfare issues, as well as information on how to engage families in treatment.

The book can be ordered online from the Child Welfare League of America at https://www.cwla.org/pubs/pubdetails.asp?PUBID=8739.

The Brookdale Foundation's Relatives as Parents Program (RAPP) provides seed grants to local agencies and State grantees to establish programs that support grandparents or other kin who are caring for children. Each year, grants of $10,000 are awarded over a 2-year period to up to 15 local community-based agencies and up to 5 State agencies. Local grants focus on providing services and developing or strengthening linkages between community-based agencies. State grants focus on developing statewide networks of service providers and establishing inter-system task forces to address issues related to relatives as caregivers.

Currently, RAPPs provide extensive services to grandparents and other relative caregivers in 41 States. Examples of services include linking caregivers to trainings and other sources of information, providing assessment and referrals, providing respite care, and developing or expanding support groups.

RAPP requests for proposals (RFPs) and their guidelines are disseminated on an annual basis. This year, applicants must apply for local grants by January 13, 2005; State grant applications are due February 10, 2005. The 2005 RFP, along with a more complete description of the program, is available on the foundation's website at www.brookdalefoundation.org.

A new book puts a personal face on the challenges of youth aging out of foster care. On Their Own: What Happens to Kids When They Age Out of the Foster Care System by Martha Shirk and Gary Stangler tells the stories of 10 youth and their struggles to take on adult responsibilities once they became too old for foster care. Some of the common challenges faced by these youth included finding employment, finishing their education, finding affordable housing, and, in too many cases, dealing with life on the street.

The final chapter of the book suggests strategies at the local, State, and national levels that can help improve the lives of these youth by improving their experiences with education, employment, housing, health care, and personal and community engagement. The Jim Casey Youth Opportunities Initiative is cited as an example of a national effort aimed at helping youth transition out of foster care. Currently, the Initiative is focusing on demonstration projects in up to 18 cities in which youth are provided with an "opportunity passport" to gain access to services, funds, and programs that will help them work toward independence.

On Their Own is published by Westview Press; more information can be found at www.westviewpress.com.

Related Items

For more information about youth aging out of foster care, see the following articles in previous issues of Children's Bureau Express:

• "Foster Youth Receive Some, Not All, Independent Living Services They Need" (May 2004)
• "Casey Foster Alumni Achieve Success in High School Graduation, Employment" (February 2004)
• "Supporting Successful Transitions for Youth" (November 2003)
• "Youth Aging Out of Foster Care Face Uphill Climb to Adulthood" (May 2003)
• "Study Reports Employment Outcomes for Youth Aging Out of Foster Care, Creates Baseline" (November 2002)

Munchausen by proxy (MBP) refers to a form of child maltreatment in which a parent or other primary caretaker repeatedly falsifies, exaggerates, or induces symptoms in a child in order to gain medical attention. A new book by Louisa Lasher and Mary Sheridan serves as a primer on MBP for child welfare workers, as well as for physicians, judges, and law enforcement personnel who might be unfamiliar with this form of child abuse. Munchausen by Proxy: Identification, Intervention, and Case Management presents clear, informative descriptions of MBP, the investigation and confirmation process, and case planning when MBP is confirmed. Interspersed with this information are examples of MBP cases.

The usefulness of this book for child welfare personnel lies in its clear outline of the procedures to be followed when MBP is suspected, including how to gather and report information, suggested interview questions, and steps to take in making the confirmation/disconfirmation decision. In cases in which MBP is confirmed, there is a risk assessment worksheet that can be used to plan for the victim's protection. A chapter on legal activities provides guidance on preparing to present a case of MBP in court, and an appendix provides recommended case plan elements.

Munchausen by Proxy is published by the Haworth Maltreatment and Trauma Press; more information can be found at www.haworthpressinc.com.

With the passage of the Keeping Children and Families Safe Act of 2003, the most recent amendment to the Child Abuse Prevention and Treatment Act, States were explicitly granted the flexibility to determine their own policies on opening child protection hearings to the public. A new Technical Assistance Brief from the National Council of Juvenile and Family Court Judges (NCJFCJ), To Open or Not to Open: The Issue of Public Access in Child Protection Hearings, offers guidance on the issues States need to consider to make these decisions.

The publication presents arguments both for and against open hearings in three topical areas:

• Best interests of the child
• Public awareness of child abuse and neglect
• Economic and procedural consequences

A State-by-State listing of the current legislation and hearing status and a brief overview of research on the effects of open hearings also are presented. The publication was funded by the Office of Juvenile Justice and Delinquency Prevention, U.S. Department of Justice. Copies may be purchased for $5.00 each by contacting NCJFCJ by e-mail at ppcd@ncjfcj.org or by telephone at (775) 327-5300.

Child abuse and neglect can take many forms, and it is important for child welfare professionals to be informed on the best practices for all kinds of abuse and neglect. Munchausen by proxy (MBP) is a pervasive type of abuse where the caregiver fabricates, exacerbates, or exaggerates symptoms or illness in a child. The American Professional Society on the Abuse of Children, in partnership with the New York Foundling, published a set of practice guidelines for any professionals involved in reporting, assessing, or treating children affected by this kind of abuse. Medical providers, mandated reporters, law enforcement professionals, and others can use this guide to get a better understanding of what MBP is, how to recognize it, and what they can do.

The guidelines are divided into two components: (1) identification, assessment, and initial management of suspected cases of abuse or neglect, caregiver-fabricated illness in a child, or medical child abuse, regardless of the motivation of the abuser, and (2) education, assessment, and management guidance for cases of these forms of abuse and neglect. This resource is broken into several sections, covering the following:

• Definitions of terms
• Background information
• Approaches to identification and psychiatric evaluation
• Reporting requirements
• Specific guidance for case management and treatment

Munchausen by Proxy: Clinical and Case Management Guidance is available at https://docs.wixstatic.com/ugd/4700a8_89b1aa4bae954798b5ce62fc70f0c302.pdf (981 KB). 
 

Two programs designed to teach computer skills to foster families and to relative caregivers offer promising models for bringing technology skills to these populations. These groups traditionally have had less exposure to computer use and training due to lower incomes and residential instability; in addition, grandparent caregivers may have had only limited exposure to computer training due to their age. Training these groups in technology skills may promote both educational success and job marketability for caregivers and the children in their care.

The "Building Skills-Building Futures" project was developed by Casey Family Services, with the help of outside experts, to promote information technology skills for 32 foster families in the Bridgeport, CT, area. The model integrates foster family access to information technology training with ongoing foster care service activities. As part of the program, foster families are provided with computer hardware, software, and supplies, as well as with monthly Internet access; ownership of these items is transferred to the foster parents. Social workers use an individualized technology plan (ITP) to assess technology skills, set goals, and refer foster families to training opportunities. Progress is measured against the ITP at regular intervals, and goals are refined when necessary. Preliminary evaluation of the training has focused on collecting baseline data and evaluating the program implementation and costs; outcomes are not yet available.

Using a different training approach, researchers in Florida provided computer training for kin caregivers and found that they made gains in both skills and social opportunities. In this model, 46 kinship caregivers (the majority of whom were grandmothers) attended an 8-week computer training course. Results from participant interviews and from computer efficacy scales completed before and after the training show that the caregivers gained in self-efficacy, career skills confidence, and confidence in helping with their children's education, as well as in awareness of the need to monitor their children's use of the Internet. In addition, the participants developed new friendships with others in the course, which led to greater social support.

An article about the Casey Family Services project, "Building Skills-Building Futures: Providing Information Technology to Foster Families," can be found in the April - June 2004 issue of Families in Society: The Journal of Contemporary Social Services and can be accessed at http://alliance1.metapress.com/content/284w78243681310w/?p=0246058c4a7042958dfb363e345daabb&pi=2. "Developing a Network of Support for Relative Caregivers," about the Florida program, can be found in the July 2004 issue of Children and Youth Services Review and can be accessed at http://www.sciencedirect.com/science/article/pii/S0190740904000477.