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This study conducted a randomized trial to examine the efficacy of the Boys Town In-Home Family Services (IHFS) program for families of high-risk youth. Participants were recruited from a state helpline for families struggling with poor family functioning and child emotional or behavioral issues. Consent was obtained for 300 of which 152 were randomly assigned to participate in IHFS for 3-4 months and 148 were assigned to the services as usual comparison group. For the families in the treatment group, 18% did not participant in the intervention, and 66% of families received 20 or more service hours. Parent report data were collected at intake, post, as well 6 and 12 months after post data collection. Data were collected on constructs such as caregiver strain, family functioning, parenting, family resources, and parent report of child behavior. Piecewise analyses of the intake to post data indicated significantly greater reductions in caregiver strain for the treatment condition. Given the conservative corrections for the use of multiple tests, no other measures demonstrated significant differences. For the piecewise model of the maintenance phase, there were no significant differences between groups aside from caregiver strain that showed a significant improvement for the comparison condition. Supplementary dose-response analyses indicated that for most families there was an ideal dosage of about 25-75 hr to bring about the largest improvements in caregiver strain, parenting skills, and child behavior.

Residential care has been criticized for its high cost and limited research evidence. While recent studies and reviews of the literature suggest that a number of evidence-based practices are being implemented in residential care settings, more research is needed to develop and test empirically based practices that can be successfully implemented in residential care. In this article, we offer a promising strategy to address this issue: a long-term research partnership between a large service provider agency and a university-based research center to conduct a program of research which has resulted in translation of evidence-supported practices into service provider programs, contributions to the science of residential care, and training opportunities for young applied scientists to specialize in this important work. This evolving program of research includes four core applied research topic areas in which this collaboration has had some ongoing success: program and practice implementation fidelity, therapeutic process factors, aftercare, and psychotropic medication use. We suggest that this type of long-term collaborative research partnership is an approach for others to consider for conducting research that informs effective residential care practices.

Empowerment has been established as an important factor in resilience in adolescence. It has also been deemed critical for youth with emotional and behavioral disorders to achieve successful outcomes across academic, social, and behavioral domains, especially during a major transition. There is currently one measure used to evaluate empowerment in youth with mental health difficulties, yet it is unclear if this is a reliable measure for youth in therapeutic residential care. The purpose of this study was to examine the reliability and validity of this measure of empowerment in a sample of youth departing therapeutic residential care (N = 138) and to examine whether or not specific factors contribute to varied levels of empowerment. Findings indicate that the empowerment measure is reliable and valid for use with youth departing therapeutic residential care. Overall, youth report high levels of empowerment at discharge from care. None of the predictors in the three multivariate general linear models were statistically significant. Limitations and implications are discussed.

This study examined how child and parent reports of parenting were related to early adolescent substance use and school suspensions. Data were from two time points 6 months apart on 321 families with an eighth-grade student attending one of five schools in the Pacific Northwest. Child- and parent-report measures of family management practices were moderately correlated (r = 0.29). Child report, but not parent report, of more positive family management practices uniquely predicted a lower likelihood of adolescent substance use. Also, discrepancies between child and parent report of parenting predicted substance use, with child positive report of family management losing its protective association with adolescent substance use when parents had negative reports of their parenting. Parent report, but not child report, of better parenting predicted lower likelihood of suspensions, suggesting that the salience of child and parent report may depend on the type of behavioral outcome.

The prevalence of weight problems among youth in general and youth in out-of-home care has been well documented; however, the prevalence of obesity/overweight among youth with high-incidence disabilities in more restrictive settings, such as residential care, has not been assessed. The purpose of the present study was to evaluate the prevalence of weight problems in 245 youth with learning disabilities or emotional disturbance at entrance to residential care. Youth intake files were examined to evaluate the association between youth demographic characteristics, medical conditions, prior placements and placement settings, medication usage, and internalizing and externalizing behavioral problems and clinical weight problems. Findings revealed that over one half of the youth were overweight or obese (50.6%), and weight problems were associated with gender, medical conditions, and age. Study limitations, future research efforts, and treatment implications are discussed.

Boys Town has created a program called In-Home Family Services to deliver help to families in stress. In-home family intervention programs have become widely used to help more families who are at risk and experiencing difficulties with a wide range of problems including domestic violence, child behavior problems, parent-child and family relationship problems, school behavior and performance problems, and child abuse and neglect. Boys Town In-Home Family Services operates across Boys Town sites in ten states throughout the country. Initial outcome studies suggest that the program can reduce family stressors, improve child behavior problems, and prevent out-of-home placement. In this paper, the authors describe the program, the reasons why families may be reluctant to engage in family intervention, examples of formal and informal engagement strategies found to be helpful, and conclusions about integrating engagement strategies and family intervention.

Youth in residential treatment settings often present with a complex combination of mental and physical health problems. Despite an emerging literature documenting significant associations between mental health and physical health, the relationship between these two areas of functioning has not been systematically examined in youth presenting to residential treatment. This study examines the association between youth psychopathology and physical health problems in a sample of 606 youth entering a large residential treatment program between 2003 and 2010. As a part of the intake process, youth psychopathology symptoms were assessed using the parent-report form of the Child Behavior Checklist, and youth physical health problems were assessed in a medical evaluation by a licensed child health professional. Results indicated that higher levels of youth psychopathology, particularly internalizing problems, were associated with greater risk for physical health problems and more prescription medications. Psychopathology comorbidity was also associated with physical health problems. These findings suggest an interplay between physical and mental health among youth entering residential treatment, highlighting the need for integrated assessment and intervention services that address psychological and medical needs within this population. (Contains 5 tables.)

Background: Quality assessment of children's functioning is critical for both research and service delivery. The Strengths and Difficulties Questionnaire (SDQ) is a brief, publicly-available instrument that provides such assessment. Although the SDQ has strong psychometric properties, less is known about its responsiveness or sensitivity to detecting change over time. Objective: This study examined the responsiveness of the SDQ among high-risk youth and tested the degree to which changes on the SDQ correspond to changes on the Child Behavior Checklist (CBCL), a well-established and lengthier reference measure. Methods: Longitudinal SDQ and CBCL data collected as part of routine service delivery were analyzed for 65 youth entering a large residential treatment program. Assessments were obtained both at intake and approximately 3 months into the program. Results: Paired samples t tests revealed statistically significant decreases in SDQ Conduct Problems and Emotional Symptoms scores, and McNemar's tests showed a statistically significant decrease in the proportion of Conduct Problems cases. Correlations between changes on the SDQ scales and changes on corresponding CBCL scales ranged from 0.58 to 0.83. Results from receiver operating characteristic curves indicated that the SDQ was relatively accurate in identifying changes in CBCL diagnostic cases, with overlap across corresponding problem behavior domains ranging from 68 to 81%. Conclusions: Findings suggest that the SDQ may represent a shorter, low cost alternative to longer measures, such as the CBCL, for use when researchers and practitioners are faced with time or financial constraints associated with the assessment of child functioning over time.

The purpose of this study is to identify individual-level characteristics of foster care adolescents who are more likely to not participate in, and drop out of, a life-skills HIV prevention program delivered over 8 months. Structured interviews were conducted with 320 foster care adolescents (15-18 years). Logistic regression and survival analyses (Cox Proportional Hazards Regression) determined the influence of demographics, HIV sexual risk behaviors, substance use, mental health problems, and other individual-level risk factors on nonparticipation and dropout. Older age and having vaginal intercourse without a condom were significant predictors of nonparticipation. Older age and marijuana use significantly increased the hazard of dropping out of the program. Foster care adolescents at increased risk for HIV infection were more likely to never participate in and drop out of the program. To improve initial and ongoing participation, HIV prevention efforts for adolescents in foster care should be tailored to individual-level HIV risk behaviors and incorporate early and ongoing engagement and retention strategies.

This study examined the relationship between substance use, mental health problems, and HIV sexual risk behaviors among a sample of foster care adolescents. Data were collected through structured baseline interviews with 320 adolescents (ages 15 to 18 years) who resided in foster care placements and participated in a larger evaluation study of an HIV prevention program. Final logistic regression models indicated that delinquent behavior and marijuana use were the most significant predictors of engaging in any one HIV risk behavior. Adolescents who reported delinquent behaviors, alcohol use, and marijuana use and who were female were more likely than their counterparts to engage in vaginal sex without using a condom. Future research is needed to further identify risk and protective factors for substance use, mental health problems, and HIV sexual risk behaviors among adolescents in foster care. HIV prevention efforts for these vulnerable adolescents should target those with substance use and delinquent behaviors.

Youth departing from out-of-home care settings face numerous challenges as they adapt to new settings or return to placements that have been unsuccessful in the past. Although several thousand youth face this transition annually, little is known about their specific needs and risks at departure. To better identify needs and risks, we evaluated the discharge data of 640 youth served in a residential group care setting by addressing the following questions: (a) to what settings do youth depart following a stay in residential group care, (b) what are the demographic, family, educational, behavioral, and departure characteristics of youth at departure, and (c) do these characteristics differ for youth departing to different levels of restrictiveness? Results indicate significant differences on youth characteristics based on levels of restrictiveness at departure placement. As one might expect, youth departing to more restrictive placements presented a broad host of challenges across domains, while those departing to less restrictive settings demonstrated fewer needs and departed with greater educational and behavioral gains. Results provide support for the development and planning of targeted aftercare programs designed to promote the short and long term functioning of youth served in out-of-home care.

Parent training programs have been effective interventions for middle-income families with children who have developmental, learning, and behavioral problems. Results have been mixed with low-income families, however. Tested practical parenting program with both middle- and low-income parents (n=34). Results indicated significant improvements for families of both income groups; effects were maintained at three months. (Author/NB)

Studies about the characteristics, assessment, and treatment of impulsive children are reviewed and summarized from the viewpoint of their application to school settings. Specific recommendations touch on the need for both performance measures and behavioral ratings and cite the effectiveness of such behavioral approaches as response cost. (Author/CL)

In this study the strategic constituent approach to organizational effectiveness was applied to a diagnostic program for handicapped children. Supervisors, clinicians, referring school professionals, and parents were interviewed, and resulting data was inductively categorized. A rating scale was designed and completed by internal constituents. (Author/LMO)

Parent training sessions using videotape demonstration and role playing were effective in teaching six mothers to encourage independent problem solving of household tasks by their language delayed preschoolers. Interaction during problem solving appeared to be more verbal after training. (CL)

Questionnaires were used to evaluate 59 parents' reactions and understanding of diagnostic information from written reports and conferences in a clinic for speech, learning, language, and hearing problems. (Author/CL)

Illustrates the basis for misleading statements about the relationship between pH and acid content in acid rain. Explains why pH cannot be used as a measure of acidity for rain or any other solution. Suggests that teachers present acidity and pH as two separate and distinct concepts. (RT)

Although high correlations were obtained between both forms of the Perkins-Binet and the Wechsler scales of intelligence, there were substantial differences in the standard deviations for the different tests. (Author/SW)