September 2017Vol. 18, No. 6Spotlight on Kinship Care
Read about new kinship care guidelines from the American Academy of Pediatrics that highlight how doctors can take a more active role in promoting safety and well-being in kinship care families, the positive effects of kinship care on youth, a pilot study on a training program for strengthening the bonds between young children and their kinship caregivers, and additional information regarding kinship care and the child welfare system.
- Kinship Involvement Linked to Better Psychological Adjustment for Youth
Kinship Involvement Linked to Better Psychological Adjustment for Youth
Youth in foster care have fewer psychological adjustment issues and negative behaviors when extended and noncustodial family members are involved in their lives, according to a recent study.
The study looks beyond the negative effects of maltreatment on 171 youth who entered foster care to independently consider the psychological impact of nuclear family dysfunction. The authors define family dysfunction as nuclear family interpersonal relationships lacking in mutual support, free expression, and the ability to manage conflict. The study examines resulting negative external behaviors, such as aggression, delinquency, or substance use, and negative internal behaviors, such as depression, anxiety, or suicidal ideation.
Study results show that greater family dysfunction and child maltreatment are associated with greater internalizing and externalizing behavior problems. While the study finds that kinship involvement can mitigate youth's externalizing behaviors, that benefit is less obvious for internalizing behaviors. In youth from families with low levels of dysfunction, kinship involvement appears to reduce negative internalizing behaviors. As stress levels and dysfunction increase, however, those benefits are not as apparent.
"The Protective Effect of Kinship Involvement on the Adjustment of Youth in Foster Care," by Grace Jhe Bai, Scott C. Leon, James Garbarino, and Anne K. Fuller (Child Maltreatment, 21) is available at http://journals.sagepub.com/doi/abs/10.1177/1077559516669043.
- Study Examines Educational Outcomes of Youth in Kinship and Foster Care
Study Examines Educational Outcomes of Youth in Kinship and Foster Care
Children in kinship and foster care have historically lagged behind their peers in educational outcomes. A recent literature review explores the educational risk and protective factors associated with children in out-of-home care with regard to educational outcomes such as grades, test scores, attendance, expulsions, and grade retention.
The literature search probes 39 studies from eight major databases between 1990 and 2016 in order to determine if there is a correlation between kinship and foster care with educational outcomes in school-age children in first-world countries. The studies included in the review examine educational outcomes for children in care based on child-level factors such as age, gender, and mental and physical health; factors pertaining to birth families, such as early childhood disadvantages, poverty, and exposure to substance use; factors pertaining to care history, such as reason for entry into care, age at entry, length of time in care, and placement type; and the school experience of children in care, such as the prevalence of school transfers and children's educational aspirations and feelings about school.
The findings of this review demonstrate that certain factors are consistent predictors of lower educational outcomes. These factors include male gender, ethnic minority status (with certain exceptions, such as being Chinese), special education needs, behavioral problems, and longer time spent in care. Placement instability, however, is not consistently associated with worse outcomes. In addition, the review concludes that almost all studies show no difference in outcomes between kinship and foster placements. Caregiver involvement in schooling and supportive adult relationships are associated with higher educational attainment.
"What Are the Factors Associated With Educational Achievement for Children in Kinship or Foster Care: A Systematic Review," by Aoife O'Higgins, Judy Sebba, and Frances Gardner (Children and Youth Services Review, 79) is available at http://www.sciencedirect.com/science/article/pii/S0190740916305163.
- New Kinship Care Guidelines From the American Academy of Pediatrics
New Kinship Care Guidelines From the American Academy of Pediatrics
As an increasing number of grandparents and other family relatives care for children in formal or informal care arrangements, pediatricians can help by better understanding the unique needs of children in kinship care. The American Academy of Pediatrics (AAP) now offers new guidelines for how doctors can take a more active role in promoting safety and well-being in kinship care families.
The March 2017 statement provides pediatricians with a brief background history and legal information on kinship care and provides strategies for addressing the individual needs of children and families in kinship care, including how to connect them with social services and less formalized community resources.
The following are among the recommendations for pediatric practice:
- Identify guardianship arrangements during routine office visits to ensure the coordination of comprehensive care
- Identify community resources to help families providing kinship care
- Understand local statutes governing guardianship and medical consent for children in kinship care
- Follow AAP guidance regarding health care for children in foster care (since children in kinship care share similar needs)
- Offer standardized developmental screenings for children in kinship care and refer them for early intervention or behavioral health treatment, as warranted
These guidelines also suggest several opportunities for public health agencies and the health-care system to promote better and more coordinated kinship care, including training residency students on the needs of kinship families, collaborating with schools and social service agencies, and providing community leadership to help kinship families navigate across the many child-serving systems.
Needs of Kinship Care Families and Pediatric Practice is available at http://pediatrics.aappublications.org/content/pediatrics/early/2017/03/23/peds.2017-0099.full.pdf (718 KB).
- Study Shows Effectiveness of Parenting Skills Training for Kinship Caregivers
Study Shows Effectiveness of Parenting Skills Training for Kinship Caregivers
A pilot study has shown promising results for the feasibility and usefulness of a training program for strengthening the bonds between young children and their kinship caregivers. The program teaches kinship caregivers parenting skills that encourage positive behavior in young children and help to reduce caregiver stress. While previous studies have confirmed the usefulness of such training for biological and foster parents, the authors note that parenting interventions for kinship caregivers had not been investigated.
The study assessed the child-directed interaction training (CDIT) for kinship caregivers and their children who were 2–7 years old. CDIT is the first phase of parent-child interaction therapy (PCIT), an evidence-based intervention for young children with a history of child abuse and neglect. PCIT focuses on improving the quality of the parent-child relationship and changing parent-child interaction patterns. CDIT seeks to provide caregivers with concrete skills for improving the parent-child relationship by recognizing and encouraging positive behaviors and ignoring negative behaviors. The premise is to help children learn a new approach for gaining caregiver attention.
The randomized controlled trial looked at 14 kinship caregivers with young children whom they identified as having difficult behavior problems. Half the group was assigned to the CDIT group, and the other half were placed in a waitlist condition group (i.e., the group received the intervention after the study). Study eligibility was limited to caregivers who were caring for a child between the ages of 2 and 7, who expected that child to remain in their care for the duration of the study, and whose child had a caregiver rating one standard deviation above the normative mean on the problem scale of the Eyberg Child Behavior Inventory. Children with major visual or auditory impairment were excluded, as were those with a suspected diagnosis of autism spectrum disorder.
Kinship caregivers in the CDIT group reported significantly fewer disruptive externalizing behaviors and significantly more positive interactions with their children than those in the waitlist group. Follow up with these families indicates they have adopted the home practices of the positive parenting skills training and show improved caregiving skills.
"Child Directed Interaction Training for Young Children in Kinship Care: A Pilot Study," by Amanda M. N'zi, Monica L. Stevens, and Sheila M. Eyberg (Child Abuse & Neglect, 55) is available at http://ac.els-cdn.com/S0145213416300229/1-s2.0-S0145213416300229-main.pdf?_tid=4218f540-787c-11e7-b5ad-00000aab0f26&acdnat=1501786254_603fe4bf37c5a3adccd655df330c9a85.
- New Research on the Characteristics, Needs of Kinship Adoptive Families
New Research on the Characteristics, Needs of Kinship Adoptive Families
A literature review article in a recent issue of the journal Adoption Quarterly focuses on the latest research on placement decisions and outcomes for children adopted by relatives. The article, "Foster Care to Kinship Adoption: The Road Less Traveled," reviews theoretical perspectives, demographic characteristics, and the social policy context for kinship care and also provides a review of empirically based, peer-reviewed articles.
The authors note that the prevalence of kinship placements and/or adoption has been steadily increasing since the 1990s and lead to better outcomes for children in foster care. The following are among the key findings highlighted in the article:
- Most children in informal kinship care situations are being raised by their grandparents or great-grandparents, followed by aunts or uncles, with the age of these caregivers ranging from 40 to 60 years.
- The primary reason children are placed in kinship care is child neglect, often involving substance use by a parent.
- Research has shown that kinship foster families receive fewer services and supports in areas such as mental health, mentoring, and financial services than unrelated foster families, which suggests a greater need for postadoptive services for kinship parents.
Since placement patterns are increasingly showing a shift in responsibility for children from parents to their relatives, the authors conclude that more research should be conducted to explore the needs of kinship adopters to determine the services and programs that can be tailored to their unique circumstances.
"Foster Care to Kinship Adoption: The Road Less Traveled," by Rebecca L. Hegar and Maria Scannapieco (Adoption Quarterly, 20) is available through https://www.researchgate.net/publication/294104882_Foster_Care_to_Kinship_Adoption_The_Road_Less_Traveled.
Spotlight on Incorporating Youth Engagement and Lived Experience Into Child Welfare Practice
Spotlight on the Title IV-E Prevention Program and the Family First Prevention Services Act
News From the Children's Bureau
Read a recent report from the Office of Planning, Research and Evaluation that examines the prevalence of children who are overweight or obese and served by Head Start and Early Head Start programs as well as a listing of the latest updates to the Children's Bureau website.
- CB Website Updates
CB Website Updates
The Children's Bureau website hosts information on child welfare programs, funding, monitoring, training and technical assistance, laws, statistics, research, federal reporting, and much more.
Recent additions to the site include the following:
- Funding Opportunity Announcement: Hospital-Based Adoption Support Services: https://ami.grantsolutions.gov/files/HHS-2017-ACF-ACYF-CO-1282_0.pdf (2,380 KB)
- How to Send a Formal Submission: https://www.acf.hhs.gov/cb/research-data-technology/state-tribal-info-systems/managers/submit
- Statewide Automated Child Welfare Information System Assessment Reviews: https://www.acf.hhs.gov/cb/monitoring/sacwis-assessment-reviews
- Supporting Kinship Caregivers, Part 2: https://www.acf.hhs.gov/cb/resource/child-welfare-podcast-supporting-kinship-caregivers-part2
- Collaborating Between Child Welfare and Mental Health: https://www.acf.hhs.gov/cb/resource/child-welfare-podcast-collaborating-between-cw-mental-health
- Child Welfare Outcomes, 2010–2014: Report to Congress: https://www.acf.hhs.gov/cb/resource/cwo-10-14
- Rounds 1 and 2 of the Child and Family Services Reviews (CFSRs): https://www.acf.hhs.gov/cb/monitoring/child-family-services-reviews/rounds1-2
- Round 3 of the CSFRs: https://www.acf.hhs.gov/cb/monitoring/child-family-services-reviews/round3
- Fiscal Year 2017 Children's Bureau Discretionary Grant Awards: https://www.acf.hhs.gov/cb/resource/discretionary-grant-awards-2017
Visit the Children's Bureau website often to see what's new.
- OPRE Report Looks at Childhood Obesity Dilemma in Head Start Programs
OPRE Report Looks at Childhood Obesity Dilemma in Head Start Programs
One of the most pressing health concerns confronting Head Start and Early Head Start (HS/EHS) programs is the prevalence of children served by HS/EHS who are overweight and obese and their families. A recent report from the Office of Planning, Research and Evaluation (OPRE) within the Administration for Children and Families of the U.S. Department of Health and Human Services reviews this major childhood health dilemma using data garnered from the 2012–2013 Head Start Health Manager Descriptive Study (HSHMDS).
OPRE sponsored the HSHMDS to capture data on health-related programming within HS/EHS programs and understand the needs of health managers and health staff. The study included an online survey that was completed by 1,465 HS/EHS health managers that asked the following questions:
- What are the health concerns confronting the children and families you serve?
- How much time do you and your staff spend managing these issues?
Additionally, 90 health managers took part in follow-up interviews. Most programs (86 percent) reported children being overweight or obese as a major health concern. The average percentage of preschool-age children in HS programs who were overweight was 29 percent. Programs where children being overweight or obese were top concerns were likely to have a higher percentage of White children and a lower percentage of Black or biracial children.
The health-related education background of the health manager was not significantly associated with perceptions of whether obesity was cited as a major concern. There were no significant differences reported in access to healthy foods and recreational facilities between areas where programs cited obesity as a major health concern and other areas.
Programs that considered obesity a major issue were more likely to have a policy on physical activity versus those that did not (88 percent compared to 76 percent). Nearly half (45 percent) of these programs required at least an hour of physical activity per day.
The report, Addressing Overweight and Obesity in Head Start: Insights From the Head Start Health Manager Descriptive Study, is available at https://www.acf.hhs.gov/sites/default/files/opre/2016_85_hshm_obesity_161012_b508.pdf (945 KB).
Child Welfare Research
We highlight a report from Casey Family Programs that explores emerging research linking positive experiences in childhood with healthy outcomes for children and families and their ability to mitigate the effects of early adverse childhood experiences. We also feature a report from the American Academy of Pediatrics that explores a systematic approach to implementing shared decision-making when working with children with disabilities and their families.
- Pediatricians Recommend Shared Decision-Making for Families of Children With Disabilities
Pediatricians Recommend Shared Decision-Making for Families of Children With Disabilities
A new clinical report from the American Academy of Pediatrics explores a systematic approach to implementing shared decision-making (SDM) when working with children with disabilities and their families. The authors note that families of children with disabilities face many treatment decision points that might benefit from SDM, a collaborative process designed to improve patient care, health outcomes, and patient satisfaction by including the patient (when possible) and family in health-care decisions.
The report acknowledges there are several barriers to SDM, including family or patient characteristics, constraints of the health-care system (insufficient time or resources), reimbursement issues, potential language barriers, and clinician knowledge. It lists provider motivation, positive health outcomes, and patient satisfaction as common facilitators.
The June 2017 clinical report in the journal Pediatrics recommends incorporating SDM into daily clinical care, involving cognitively competent children in decisions about their care, and developing SDM decision support technologies. The report includes models for using SDM with children with intellectual, physical, and/or neurodevelopmental disabilities and their families, an overview of the literature on applying SDM techniques, and information on tools available for clinical or research use. The report recommends three areas for future pediatric research: a consensus definition of SDM; measures specific to SDM-related constructs; and yardsticks for measuring outcomes and success, such as child and family satisfaction or specific health or developmental outcomes.
Shared Decision-Making and Children With Disabilities: Pathways to Consensus is available at http://pediatrics.aappublications.org/content/pediatrics/early/2017/05/25/peds.2017-0956.full.pdf (863 KB).
- Report Points to Power of Positive Experiences to Overcome Childhood Adversity
Report Points to Power of Positive Experiences to Overcome Childhood Adversity
A new report from Casey Family Programs explores emerging research that links positive experiences in childhood with healthy outcomes for children and families and their ability to mitigate the effects of early adverse childhood experiences (ACEs). The report points to actions that lessen the adversity common in so many families by promoting positive experiences for children and families.
The science of brain development has linked ACEs with a host of negative health and emotional problems as children mature into adolescence and adulthood. The authors of the report express concern, however, that focusing too much on ACEs runs the risk of labeling children and families when the emphasis should be on investing in positive experiences to help them flourish and overcome early adversity.
The report seeks to contribute to the burgeoning "science of thriving" by introducing the Health Outcomes of Positive Experiences (HOPE) framework in support of positive child and family well-being. The report describes parenting practices and positive community norms associated with healthy child development and examines factors that moderate ACEs. For instance, children are more likely to demonstrate resilience when they and their parents are able to engage in meaningful discussions; when parents are engaged in their children's lives, such as participating in their children’s activities and knowing their friends; and when parents are able to manage their own stress related to parenting. It also considers the benefits of investing in positive experiences that support optimal child health and development.
The report, Balancing Adverse Childhood Experiences (ACEs) With HOPE: New Insights Into the Role of Positive Experience on Child and Family Development, is available at https://www.cssp.org/publications/documents/Balancing-ACEs-with-HOPE-FINAL.pdf (2,160 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.
- Podcasts Highlight Programs Connecting Kinship Caregivers With Support Services
Podcasts Highlight Programs Connecting Kinship Caregivers With Support Services
Child Welfare Information Gateway launched a two-part podcast series called Supporting Kinship Caregivers to highlight successful examples of state and local programs that connect kinship families with available services. The majority of kinship care arrangements are informal and outside of the child welfare system. As a result, many families are unaware of the many resources available to help them provide for the children in their care and ensure their safety and well-being.
Part 1 of this series focuses on a kinship navigator program in California that successfully identified informal caregivers and developed an online resource tool to help them access a wide variety of services, including assistance with daily living expenses, educational supports, and legal advice. The podcast features interviews with Serita Cox of iFoster, an online resource portal for kinship families, and Michelle Rosenthal of the Edgewood Institute for the Study of Community-Based Services. To listen to how they launched a major outreach effort to locate kinship families and inform them about available resources, visit https://www.acf.hhs.gov/cb/resource/child-welfare-podcast-supporting-kinship-caregivers-part1.
Part 2 looks at a Florida effort to connect kinship caregivers with financial assistance through the Temporary Assistance for Needy Families (TANF) program. The Kinship Interdisciplinary Navigation Technologically Advanced Model (Kin-Tech) was designed to address the large percentage of kinship families who are unaware of their TANF eligibility. The podcast features Larry Cooper of Children's Home, Inc., and Kerry Littlewood of AAJ Research and Evaluation. To listen to how the Kin-Tech model was implemented and learn more about the project and its findings, visit https://www.acf.hhs.gov/cb/resource/child-welfare-podcast-supporting-kinship-caregivers-part2.
- Webinar Focuses on Early Childhood Integrated Data Systems
Webinar Focuses on Early Childhood Integrated Data Systems
In a webinar from the Early Childhood Data Collaborative, two states describe their experiences with collecting early childhood data and the implications for state programs and policies. "Making Use of Integrated Data: State Examples of Using ECIDS Data to Inform Policies and Practices," which occurred in June 2017, features researchers from North Carolina and Minnesota discussing their respective experiences with early childhood integrated data systems.
North Carolina created a single source for integrated early childhood data for health, education, and social service programs and can now provide distinct counts of which children are being served and where, including demographics and the types of services received. In Minnesota, the Children's Defense Fund collaborated with the state Department of Education to analyze child care participation data from the Minnesota Early Childhood Longitudinal Data System (ECLDS) regarding lower income children, children of color, and American Indian children. ECLDS was launched in 2016 to combine early childhood data from Minnesota's departments of education, human services, and health.
To listen to the webinar, visit https://www.youtube.com/watch?v=7tt-IWSND3Y&feature=youtu.be. To access the webinar slides, refer to http://www.ecedata.org/wp-content/uploads/2017/06/ECIDS-NC-MN-Webinar_6-6-17_FINAL.pdf (1,080 KB).
- Tips for Child Welfare Attorneys on Understanding the Impact of Trauma
Tips for Child Welfare Attorneys on Understanding the Impact of Trauma
Attorneys representing child welfare clients should understand the impact of trauma on children, youth, and families to improve outcomes for their clients. A joint article by the National Child Traumatic Stress Network and the American Bar Association's Center on Children and the Law informs attorneys about the impact of trauma and offers practice tips and resources for working with clients with trauma histories. These tips include the following:
- Identifying known or suspected trauma clients may have experienced
- Considering the role trauma exposure may play in clients' behaviors, especially if they refuse to engage in treatment; miss court appearances or appointments; or exhibit hostility, apathy, or defiance during court proceedings
- Providing structure, predictability, and opportunities for clients to exert control over decisions pertaining to their cases
- Talking to clients about their cases, including the role of the attorney, a basic understanding of the reason for the court proceedings, and realistic expectations regarding the outcome of court proceedings
The article also defines trauma-informed legal advocacy and looks at the impact of trauma on child development, parents, and the attorney-client relationship. It includes information on screening and assessment, secondary traumatic stress, and treatment as well as exploring the importance of collaboration with service providers.
Trauma: What Child Welfare Attorneys Should Know is available at http://www.nctsn.org/sites/default/files/assets/pdfs/attorneyresourceguide_0.pdf (823 KB).
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.
- New SAMHSA Materials Inform Families About Mental Health Disorders
New SAMHSA Materials Inform Families About Mental Health Disorders
The Substance Abuse and Mental Health Services Administration (SAMHSA) created a suite of educational materials to help caregivers and youth learn about the symptoms and treatment options for a variety of mental health disorders, as well as where to find support services.
The educational materials were developed in collaboration with the American Psychological Association, the American Academy of Child and Adolescent Psychology, and the American Psychiatric Association. They include factsheets addressing anxiety, depression, bipolar disorder, attention deficit/hyperactivity disorder, first episode psychosis, and obsessive-compulsive disorder.
SAMHSA's Family Educational Materials webpage can be accessed at https://www.samhsa.gov/children/family-educational-materials.
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.
Upcoming national conferences and events on child welfare and adoption include the following:
- 5th Annual Safe & Together Model Symposium
Safe and Together Institute
September 20–22, San Antonio, TX
- 22nd International Summit on Violence, Abuse & Trauma: Building Peace by Linking Research, Practice, Advocacy & Policy to End Violence & Abuse
The Institute on Violence, Abuse and Trauma
September 22–27, San Diego, CA
- Mandated Reporter Training
October 12, Grand Rapids, MI
- 29th Annual ATTACh Conference
Association for Training on Trauma and Attachment in Children
October 12–14, Denver, CO
- International Conference on Innovations in Family Engagement
Kempe Center for the Prevention and Treatment of Child Abuse and Neglect
October 17–20, Vail, CO
- Charleston Child Trauma Conference
Dee Norton Child Advocacy Center
October 17–20, Charleston, SC
- Nexus XXI Training Conference: Violence Within the Home and Its Effects on Children
Inter-Agency Council on Child Abuse and Neglect
October 18, Universal City, CA
- Council on Social Work Education 2017 Annual Program Meeting
Council on Social Work Education
October 19–22, Dallas, TX
- JuST Conference 2017
Shared Hope International
October 24–26, New Orleans, LA
- 29th Annual NAEHCY Conference
National Association for the Education of Homeless Children and Youth
October 28–31, Chicago, IL
- 2017 CQI Conference: In Pursuit of Quality: Data Literacy
Children and Family Research Center, University of Illinois, School of Social Work, and the Foster Care Utilization Review Program
November 7–8, Champaign, IL
- Together We Can Conference
Louisiana Department of Child and Family Services, LouisianaChildren.org, NASW-Louisiana Chapter, and the Pelican Center for Children & Families
November 7–9, Lafayette, LA
- 2017 ZERO to THREE Annual Conference
ZERO to THREE
November 29–December 1, San Diego, CA
- 5th Annual Safe & Together Model Symposium
- Evidence-Based Treatments for Bipolar Disorder in Children and Youth
Evidence-Based Treatments for Bipolar Disorder in Children and Youth
A new webinar explores evidence-based treatments for bipolar disorder in children and youth. The webinar looks at criteria for juvenile-onset bipolar disorder versus adult bipolar disorder, the differences between the two types, and the evidence-based treatments and differential diagnosis for juvenile bipolar disorder.
The April 2017 webinar was hosted by Dr. Christopher Bellonci, medical director of the National Technical Assistance Network for Children's Behavioral Health, which is operated and coordinated through the University of Maryland.
View "Evidence-Based Treatments for Bipolar Disorder in Children and Youth" at https://www.youtube.com/watch?v=9uA4_nfo55s&feature=youtu.be&list=PLWv-X8-WjcQVjLuBvFMVFj9JHQAZ47JT1.