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December/January 2018Vol. 18, No. 9Spotlight on Safety and Decision-Making

Read about the two domains recently added to the North Carolina Family Assessment Scale for General and Reunification Services, how predictive risk modeling can ameliorate the shortcomings of the current approaches to risk assessment and decision-making used by child protective services, and the Children's Bureau's Child Welfare Virtual Expo Learning Experience and its resources to help improve the quality of assessments and best practices for data-informed decision-making.

Family speaking with a professional

 

 

Issue Spotlight

  • Predictive Risk Modeling in Context

    Predictive Risk Modeling in Context

    Child maltreatment, both chronic and acute, is a growing concern within the field of child welfare. Of the 6.6 million children referred to child protective services (CPS) in the United States in 2014, 702,000 were found to be victims of abuse or neglect. However, an understanding of how to best screen for maltreatment and serve those affected by maltreatment is still a work in progress.

    An article in Children and Youth Services Review assesses the strengths and weaknesses of current risk assessment tools used by CPS professionals. The article then describes how predictive analytics or predictive risk modeling (PRM) can ameliorate the shortcomings of these current approaches.

    Currently, two general categories of tools have been developed to help standardize CPS risk and safety assessments. Theoretical tools, which are guided by a theoretical approach, look at child maltreatment identified by experts through clinical experience or research. The risk factors are then combined into an instrument or scale that CPS workers and others can use to help them gather information during assessments. Actuarial tools examine risk factors that are empirically related to maltreatment. These risk factors are then validated statistically. Although both tools have been adopted by CPS agencies, they carry limitations, such as being prone to operator error during application and interpretation as well as often containing subjective measures that require clinical judgment to score.

    The article describes PRM as the application of data mining, modeling, and analytical techniques to existing data to find patterns and make predictions. As such, PRM can address the shortcomings of other assessment tools in the following ways:

    • The vast amounts of data used in PRM can identify previously unobserved relationships between variables.
    • PRM models are learning models that can adjust to new relationships within the data.
    • PRM models can use existing data on the population for which it is being used.
    • The PRM approach is more consistent because its variable selection is mathematical with no arbitrary selection of predictors.
    • Unlike operator-driven assessment tools, which can lead to operator error, PRM does not rely on worker training and compliance.

    The authors conclude that PRM, when used in combination with careful clinical practice, shows promise in the field of child protection as an effective and reliable risk assessment tool.

    "Risk Assessment and Decision Making in Child Protective Services: Predictive Risk Modeling in Context," by Stephanie Cuccaro-Alamin, Regan Foust, Rhema Vaithianathan, and Emily Putnam-Hornstein (Children and Youth Services Review, 79), is available at http://www.sciencedirect.com/science/article/pii/S0190740917300452#!.

  • Two Domains Added to the NCFAS G+R

    Two Domains Added to the NCFAS G+R

    Recent research has fueled increasing interest among child welfare practitioners on the effects of trauma on families and children in the child welfare system. Adverse experiences (e.g., emotional, physical, and sexual abuse), emotional and physical neglect, and forms of family dysfunction (e.g., domestic violence, substance use, mental illness) leave a lasting impact on family functioning and well-being.

    An article in the Journal of Public Child Welfare discusses the two new trauma-focused domains of the North Carolina Family Assessment Scale for General and Reunification Services (NCFAS G+R). The two new domains are trauma and posttrauma well-being, which were added to help child welfare workers provide children and their families with trauma-informed supports and services that connect the fields of public health, mental health, and social work.

    The assessments conducted with these domains are intended for use during in-home visits as well as other practice settings. To determine the efficacy of the trauma and posttrauma domains, a field test was conducted over 6 months in three states with long-standing, high-fidelity family preservation programs and that had previous experience using the NCFAS scales. States were instructed to apply the trauma domain to all families and not just those who already had a history of trauma to ensure that the trauma domain was capable of assessing both inclusion and exclusion of previous and reoccurring trauma. The posttrauma domain was used at closure only for families whose responses were below baseline for at least one item on the trauma scale.

    The reported findings include the following:

    • Workers had little to no trouble using the two new domains, which were created to be similar to previous NCFAS domains.
    • As a practice tool, the trauma domain was able to include and exclude families based on trauma history and trauma symptoms, and the posttrauma domain was able to show that manifestations of trauma can be diminished with appropriate in-home and other services.
    • Child welfare workers using the domains in their assessments delivered effective services if they already had basic trauma-informed practice training by social workers specializing in trauma and mental health professionals.

    Trauma-informed practice can mitigate the effects of adverse experiences for children and families in the child welfare system. According to the article, the recently added NCFAS G+R domains of trauma and posttrauma work as intended, making them valuable tools for working with this vulnerable population.

    "Psychometric Properties of the Trauma and Post-Trauma Well-Being Assessment Domains of the North Carolina Family Assessment Scale for General and Reunification Services (NCFAS G+R)," by Raymond S. Kirk (Journal of Public Child Welfare, 9), is available at http://www.tandfonline.com/toc/wpcw20/9/5?nav=tocList.

  • Child Welfare Virtual Expo 2017 Learning Experience

    Child Welfare Virtual Expo 2017 Learning Experience

    The Children's Bureau's Child Welfare Virtual Expo 2017 Learning Experience provides child welfare professionals with resources to help improve the quality of assessments and best practices for data-informed decision-making as well as promote dialogue, critical thinking, and practice improvement.

    Based on the Virtual Expo 2017, the on-demand Learning Experience includes the following four modules:

    • The Right Information at the Right Time: Supporting the Field With Relevant, Actionable Data: This module explores the current challenges and innovative practices in the areas of data sharing, collaboration, and the use of various data sources to inform assessments and decision-making.
    • Assessment and Decision-Making in Cases With Co-Occurring Issues: This module explores how collaboration among child welfare service providers can impact child welfare assessments as well as how to identify strategies to improve collaboration.
    • The Full View: Comprehensive Assessment of Parents: This module explores the role of frontline staff in creating positive interactions with parents as well as how to identify strategies to improve these interactions.
    • Safety Decision-Making: Using Protective Capacities and Protective Factors: This module explores how protective capacities and factors can be combined to improve the assessment process, case planning, and ongoing case management and how this can positively affect family engagement and prevent repeat maltreatment.

    The learning modules include learning activities, personal stories, and supplemental resources, and most sessions can be used to earn continuing education units. A free registration is required to access the Learning Experience.

    To learn more about the Child Welfare Virtual Expo 2017 Learning Experience, visit https://learn.childwelfare.gov/content/2017-child-welfare-virtual-expo-0.

    Related Item

    The Capacity Building Center for States released Decision-Making in Child Welfare for Improved Safety Outcomes, which describes the need to explore evidence-based approaches to current safety decision-making practices, the relationship between decision-making factors and tools commonly used to support agencies in improving safety outcomes, and more. To read this brief about strategies to improve decision-making and safety, visit http://bit.ly/2zeq2sw.

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News From the Children's Bureau

We highlight a recent brief from the Office of Planning, Research and Evaluation that describes the service models of the first cohort of programs that implemented the Evaluation of Domestic Victims of Human Trafficking Demonstration Project as well as a list of the latest updates to the Children's Bureau website.

Child Welfare Research

Read a report that aims to improve data reporting on children and families based on 41 key indicators of important aspects of children's lives, such as family and social environment, economic circumstances, health care, physical environment and safety, behavior, education, and health. We also point to a resource that discusses estimates of poverty among children in foster care compared with children living with grandparents or other relatives and children living with their parents.

  • Key National Indicators of Child Well-Being

    Key National Indicators of Child Well-Being

    The Federal Interagency Forum on Child and Family Statistics, or the Forum, has produced a report that centers on 41 key indicators of important aspects of children's lives in seven domains: family and social environment, economic circumstances, health care, physical environment and safety, behavior, education, and health. The report, America's Children: Key National Indicators of Well-Being, 2017, aims to improve data reporting on children and families; make data available in an easy-to-use, nontechnical format; foster discussions among stakeholders; and more.

    The highlights of the 2017 report include the following:

    • Family and social environment: In 2016, 69 percent of children in the United States aged 17 and younger lived with two parents (65 percent with two married parents and 4 percent with two unmarried cohabiting parents), 23 percent lived with only their mothers, 4 percent lived with only their fathers, and 4 percent lived without a parent in the household.
    • Economic circumstances: Twenty percent of all children aged 17 and younger lived in poverty in 2015, and more children lived in families with a medium income than in families in any other income group.
    • Health care: In 2015, 4 percent of children below the age of 17 had no usual source of health care. Approximately one-third (29 percent) of uninsured children had no usual source of care, which is higher than for children with private insurance (2 percent) or public insurance (4 percent).
    • Physical environment and safety: In 2015, 39 percent of U.S. households with children experienced one or more of the following three housing problems: physically inadequate housing, crowded housing, or housing cost greater than 30 percent of the household income.
    • Behavior: From 2015 to 2016, reports of illicit drug use in the past 30 days decreased significantly for students in 8th grade (7 percent) but remained steady for students in 10th and 12th grades (16 percent and 24 percent, respectively).
    • Education: In 2015, 93 percent of young adults between the ages of 18 and 24 had completed high school with a diploma or an alternative credential such as a GED certificate.
    • Health: In 2015, parents reported a higher percentage of serious emotional or behavioral difficulties among boys than girls for children aged 4-7 (5 percent versus 2 percent), aged 8-10 (8 percent versus 5 percent), aged 11-14 (9 percent versus 6 percent), and aged 15-17 (6 percent versus 5 percent).

    The report, America's Children: Key National Indicators of Well-Being, 2017, is available at https://www.childstats.gov/americaschildren/index.asp.

  • Estimates of Poverty Among Children By Using the Supplemental Poverty Measure

    Estimates of Poverty Among Children By Using the Supplemental Poverty Measure

    Research shows that children and families involved with child welfare are disproportionately poorer, and children in foster care are largely drawn from families living at or below the poverty level. Using the Supplemental Poverty Measure (SPM), the article "Poverty Among Foster Children: Estimates Using the Supplemental Poverty Measure" provides estimates of poverty among children in foster care compared with children living with grandparents or other relatives and children living with their parents. (Grandparents or other relatives can serve as kinship foster parents, but this study relied on caregivers' self-designation of the relationship [e.g., grandchild, foster child] to categorize the families.)

    The sample of children was gleaned from the Current Population Survey's Annual Social and Economic Supplement, which is an annual household survey that includes information on sources of income as well as other characteristics. The children were all under the age of 18 at the time of the survey, with an average age of 8.5 years among children in foster care and those living with their parents. Children living with their grandparents or other relatives were slightly older (9.1 and 10.5 years, respectively). Children who lived with their parents were predominantly White, whereas children living in foster care were predominately African-American. Poverty was determined using the SPM poverty thresholds, which take into account  the core necessary expenses faced by families in the United States, such as food, clothing, shelter, and utilities, as well as other necessary expenditures.

    The report's findings include the following:

    • The proportion of children living in poverty varied by setting, with poverty rates of 20.1 percent for children in foster care, 32.3 percent for children living with their grandparents, 29.5 percent for children living with other relatives, and 17.5 percent for children living with their parents.
    • Compared with children living with their parents, children in foster care or children living with their grandparents and other relatives have much higher odds of living in deep poverty (income below 50 percent of the SPM poverty line).
    • For children who live with their grandparents, transfer benefits (e.g., food stamps, welfare) mitigate their odds of living in poverty since grandparents often do not receive foster care payments.

    "Poverty Among Foster Children: Estimates Using the Supplemental Poverty Measure," by Jessica Pac, Jane Waldfogel, and Christopher Wimer (Social Service Review, 91), is available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5484162/pdf/nihms865172.pdf (425 KB).

Strategies and Tools for Practice

This section of CBX offers publications, articles, reports, toolkits, and other instruments that provide either evidence-based strategies or other concrete help to child welfare and related professionals.

  • Eight Reasons to Use a Partnership When Providing Support Services

    Eight Reasons to Use a Partnership When Providing Support Services

    Partnerships among public, state, tribal, and territorial agencies and nonprofit and other community-based organizations can be beneficial in implementing and sustaining programs and support services for adoptive, foster, and kinship care families.

    A tip sheet from AdoptUSKids lists the following eight benefits public agencies can see from partnering with nonprofit organizations:

    • Partnerships can facilitate program implementation. Nonprofit organizations typically have more flexibility in hiring staff, have fewer regulations or protocols to follow than public agencies, and can provide services across county and state lines.
    • Partnerships can help programs reach families who need support. Parent or youth support groups, parent associations, and other nonprofit organizations typically have well-established and ongoing relationships with parents and families in their communities. These groups often have mailing lists of families, knowledge about events these families attend, and proven strategies for reaching target families in the community.
    • Partnerships with nonprofit groups and organizations help families feel more comfortable asking for support. Parents and other caregivers may feel reluctant to contact public agencies for help, especially if they or other family members have had children removed from their homes or they fear their children might be put into foster care.
    • Partnerships can reach and successfully serve a diverse community. Collaborating with community-based organizations that have connections with and expertise serving different populations can enable a program to be more culturally competent and effective in reaching diverse groups.
    • Partnerships build on each partner's strengths. Child welfare systems can leverage the strengths of their partners to improve program effectiveness. Private partners are often better able to initiate action quickly, have specialized services, respond better to larger populations, maintain consistent funding, and more.
    • Partnerships enable public agencies to maintain their priorities while also adjusting to shifting prioritiesNonprofit organizations can alleviate the burden on public agency staff, who often take on large caseloads, by continuing to offer support services even if the public agency is called to focus its resources elsewhere.
    • Partnerships can increase access to other financial resources. Nonprofit organizations can access United Way and foundation funding, which are not options for public agencies.
    • Partnerships can make it easier to sustain programs. A network of agencies invested in the success of a project is key to sustainability.

    Public Agencies Don't Need To Do It Alone: Eight Reasons to Use a Partnership When Providing Support Services to Adoptive, Foster, and Kinship Care Families is available at http://nrcdr.org/_assets/files/NRCDR-org/8-reasons-to-partner-with-others.pdf (88 KB).

  • National Family Preservation Network Celebrates 25 Years

    National Family Preservation Network Celebrates 25 Years

    This year, the National Family Preservation Network (NFPN), which was established in 1992, is celebrating its 25th anniversary. NFPN's mission is to preserve vulnerable families and prevent unnecessary out-of-home placements of children through four initiatives in the areas of family preservation, reunification, father involvement, and assessment.

    NFPN has worked tirelessly throughout the last 25 years to uphold its mission of keeping families together through research and training efforts that have made them national leaders in developing and testing family assessment tools; developing training materials for frontline workers on father involvement; and linking cutting-edge research, tools, and resources to direct services. NFPN has conducted six research projects that have demonstrated the effectiveness of intensive family preservation and reunification services, leading to an 80 percent success rate nationwide. In addition, NFPN provides a comprehensive, research-based father involvement curriculum for frontline workers that aims to keep fathers involved in case planning, visitation, and placement decisions.

    NFPN has collaborated with over 50 organizations to bring research findings, resources, trainings, and technical assistance to family-serving agencies. NFPN collaborated with Dr. Ray Kirk from the University of North Carolina, Chapel Hill, to further develop assessment tools that measure family functioning, such as the North Carolina Family Assessment Scale, which has been included in NFPN's research projects on family preservation and reunification. Today, NFPN's assessment tools, which are available online at http://www.nfpn.org/, are used in the child welfare, juvenile justice, mental health, behavioral health, education, and other systems, including over 1,000 agencies nationwide as well as in 20 countries.

    NFPN is also the national voice for Intensive Family Preservation Services (IFPS), which is a model of services used in the child welfare system in most states to help keep families together. NFPN has recently developed a continuous quality improvement (CQI) instrument to assess, sustain, and enhance the quality of IFPS on state and local levels. This tool helps providers assess current levels of effectiveness and also areas needing improvement. The CQI-IFPS Instrument (http://www.nfpn.org/assessment-tools/cqi-ifps-instrument) provides resources, including information on the benefits of family preservation interventions and quality assurance, a tally sheet for conducting specific case studies, and instructions for how to utilize the tool effectively.

    In 25 years, NFPN has matured from being grant dependent to self-sufficient through the sales of tools, trainings, and technical assistance. Although NFPN's main focus continues to be on the child welfare system, it has greatly expanded its services to include the juvenile justice, mental and behavioral health, home visiting, and education systems.

    In looking toward the next 25 years, NFPN plans to continue assisting states with reinvigorating and expanding family preservation and reunification programs and services; provide resources, training, and technical assistance to prevention programs; and bring more resources and trainings to rural areas.

    Related Items

    More information about NFPN and IFPS can be found in the following previous issues of CBX:

    Resources for Family Reunification Services, May 2009, Vol. 10, No. 4

    Intensive Family Preservation Services Toolkit, September 2009, Vol. 10, No. 7

    Father Involvement Course for Continuing Education Credits, February 2010, Vol. 11, No. 1

    Meeting CFSR Standards of Father Involvement, October 2010, Vol. 11, No. 8

    New IFPS Survey Available, February 2012, Vol. 13, No. 1

    Father Involvement Curricula, April 2012, Vol. 13, No. 3

    Optimizing Father-Child Visits, May 2012, Vol. 13, No. 4

    Engaging Reluctant Families Training, August 2012, Vol. 13, No. 7

    Intensive Family Preservation Services Turns 40, May 2014, Vol. 15, No. 5

    New Research on Family Reunification, June 2014, Vol. 15, No. 6

    Tool for Quality Intensive Family Preservation Services, March 2015, Vol. 16, No. 2

    Trauma and Well-Being Assessment Tool, June 2015, Vol. 16, No. 5

    Nationwide Survey Celebrates 40 Years of IFPS, April 2016, Vol. 16, No. 3

    Reviewing 15 Years of Father Involvement Initiatives, July/August 2017, Vol. 18, No. 5

  • Helping Maltreated Children Understand and Recognize Emotions

    Helping Maltreated Children Understand and Recognize Emotions

    Maltreatment has been shown to stunt a child's ability to recognize and understand the emotions of others, which can lead to difficulties in navigating and cultivating interpersonal relationships, such as parent-child and peer relationships.

    The Practice Notes issue, "Helping Maltreated Children Understand and Recognize Emotions," provides suggestions for child welfare workers and others who interact with children who have been maltreated, including the following:

    • Maintain a higher level of awareness about these children's potential for misinterpreting emotional cues and corresponding behaviors
    • Help resource and kinship families understand the underlying reasons behind a child's challenges in perceiving emotions
    • Support children and families during times of high stress, as these may be the times when a child can experience increased misperceptions
    • Work with key stakeholders, such as school personnel and mental health providers, to increase their understanding of these children's challenges in reading emotional cues

    The issue also includes a case example as well as reflection questions child welfare workers can keep in mind as they work with children with a history of maltreatment, such as "How can you bring this research/information to your work team(s) or into supervision?" and "What are some examples you've seen in your work that might be explained by children misreading facial emotional cues?"

    "Helping Maltreated Children Understand and Recognize Emotions" is available at https://www.cascw.org/wp-content/uploads/2015/09/PracticeNotes_rev.WEB_.pdf (339 KB).

Resources

This section of CBX provides a quick list of interesting resources, such as websites, videos, journals, funding or scholarship opportunities, or other materials that can be used in the field or with families.

  • Pediatric Medical Traumatic Stress Toolkit for Health-Care Providers

    Pediatric Medical Traumatic Stress Toolkit for Health-Care Providers

    The National Child Traumatic Stress Network offers the Pediatric Medical Traumatic Stress Toolkit, which is a set of tools intended for medical professionals to help them effectively assess and treat medical traumatic stress in children. The toolkit centers on the D-E-F Protocol for trauma-informed care, which focuses on helping providers respond to distress, offering emotional support, and providing family-centered care for children who have experienced trauma and their families.

    The toolkit includes an introduction to traumatic stress as it relates to children facing illness, injury, and other medical issues; practical tips and tools for health-care providers; and handouts for parents that present evidence-based tips for helping their child cope. The toolkit also features the stories of two children, Tommy and Maria, as composite cases to illustrate the ways the toolkit materials could be useful to providers at different points in the continuum of care.

    Pediatric Medical Traumatic Stress Toolkit is available at http://www.nctsn.org/trauma-types/pediatric-medical-traumatic-stress-toolkit-for-health-care-providers?utm_source=Youth.gov&utm_medium=Announcements&utm_campaign=Resource.

  • Adopting an Older Child

    Adopting an Older Child

    When adopting an older child, the adoptive family should understand that the child may feel abandoned, distrustful, fearful, and resistant to accepting his or her place in the adoptive family. These feelings can stem from previous experiences with birth families or from their time in foster care.

    The article Adopting an Older Child from the Michigan Adoption Resource Exchange discusses ways adoptive parents can mitigate the transition from being a child in foster care to being a child in a forever family. The article reviews different emotions and situations that newly adopted older children might express, such as grief and a sense of separation or abandonment. The child may also express behavioral issues, such as lying, stealing, and bed wetting.

    The article offers suggestions for countering negative behaviors and emotions in the following ways:

    • Allow the child time to get used to his or her new identity as a member of a permanent family. An older child may have past attachments to previous parental figures and caregivers and may feel that accepting a new permanent family is an act of betrayal.
    • Set limits and enforce discipline when needed. This provides the child with structure and consistency.
    • Be demonstrative in their positive feelings toward their adopted child. Adoptive parents should reassure them by telling them, "I love you," "You're a good person," and "You're important to us."
    • Listen to what the child means instead of just what they said. If a child says, "You're not my real parents!" or "I don't like it here!," adoptive parents should understand that the child may be acting out of fear of rejection.

    The article also discusses the importance of helping the child gain an understanding of his or her past experiences and the ways he or she came to be with the new adoptive family.

    Adopting an Older Child is available at http://bit.ly/2zePfDe.

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.

  • Conferences

    Conferences

    Upcoming national conferences and events on child welfare and adoption include the following:

    December

    January

    February

  • Bringing the Protective Factors Framework to Life

    Bringing the Protective Factors Framework to Life

    The National Alliance of Children's Trust and Prevention Funds is offering a series of online training courses, called Bringing the Protective Factors Framework to Life in Your Work: A Resource for Action, to support the implementation of the Strengthening Families Protective Factors Framework.

    The seven-part curriculum includes the following courses, which each take about 2 hours to complete:

    • Introduction to the Protective Factors: Includes an introduction to the key concepts behind the Strengthening Families Protective Factors Framework, including descriptions of the five protective factors, seven program strategies, and strengths-based work with families
    • Concrete Support in Times of Need: Focuses on the importance of linking families to services and opportunities and observing and responding to early warning signs
    • Knowledge of Parenting and Child Development: Highlights the need to strengthen parenting skills
    • Parental Resilience: Focuses on how to respond to family crises as well as facilitate friendships and mutual support
    • Social Connections: Highlights the importance of facilitating friendships and mutual support
    • Social and Emotional Competence: Focuses on the social and emotional competence of children and the importance of children's social and emotional development
    • Moving From Knowledge to Action: Wrap-Up Course: Reviews the previous courses and describes how to apply lessons learned in the field

    The online training also includes a global glossary, short instructional videos, downloadable outlines, and more. A certificate of completion is given at the end of each course.

    Bringing the Protective Factors Framework to Life in Your Work: A Resource for Action is available at http://www.ctfalliance.org/onlinetraining.htm.