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Multiple attempts have been made to address the perspectives of biological parents in cases of foster care. Despite this, there is a lack of research that adequately reflects these parents' perspectives on parenthood following an out-of-home placement. In addition, Western welfare systems tend to be primarily concerned with the rights of children and their foster parents. As we know little about how parenthood takes shape in the day-to-day practice of foster care, this study addresses what can be a possible (new) role for biological parents when an out-of-home placement is required. Qualitative research was performed by means of an interview guide, divided in (sub)themes, with 13 biological parents whose children were still in foster care. The thematic analysis of the interviews revealed three main topics: the sudden entry into foster care, the foster care process and feeling like a parent. Our analysis revealed that parents, despite their own reservations or objections about foster care, tend to commemorate or redefine their parenting role after their child(ren) have been placed out of home.

Background: Childhood abuse is associated with increased lifetime suicidal risk (SR). Among victims of abuse, children in out-of-home care are also at risk. Out-of-home placement is aimed at stopping further exposure to maltreatment and at providing the necessary security for proper development. Research suggests that placement arrangements may impact children’s mental health outcomes. Objective: The study was aimed at examining (1) the direct effects of different placement characteristics (i.e. age at first placement, number of placements, placement disruptions, total time in care, contact with biological parents, contact with siblings, placement with siblings) on SR and (2) whether these characteristics moderate the link between maltreatment and SR. Participants: The sample consisted of 77 adults (52 women; 25 men; mean age: 26.6 years) who received out-of-home care during childhood. Method: Participants completed the Childhood Trauma Questionnaire and the Mini International Neuropsychiatric Interview (for SR). Participants’ records were used to determine placement characteristics and maltreatment. Results: PLS-PM analyses suggest a significant role of risk (age at first placement, number of placements, placement disruptions, contact with biological parents) and protective factors (contact with siblings, foster home placement) on SR. Risk factors also moderate the link between maltreatment and SR. Conclusions: Interventions aimed at limiting risk factors during placement seem important to reduce SR.

Purpose: This research aimed to understand the views of social workers on factors influencing decision making toward child placement and any possible differences in perception of these factors among social workers with experience in placement decision making and those without it. Methods: The Q sort methodology was used to analyze the opinions of 64 social workers by presenting them 54 statements on single sheets and asked to rank them on a grid. Results: Analysis showed five distinct paradigms: family-centered; veiled shared concept; child-centered; paternalistic; and professional evidence-based, which influence the entire process and outcomes of the decision making process. Both groups (those with experience in decisions towards placement and those without such experience) believed in family centeredness. Workers without prior experience of deciding to place children, regarded highly the role of workers in the decision-making process. They highlighted the need for data to guide decisions and the responsibility of workers to protect the child's welfare. Workers with prior experience focused mostly on generalized concepts and highlighted a detachment of the social worker from the decisions made. They attributed responsibility for decisions to the wider environment. Conclusion: Reflecting on the paradigms within which decisions concerning child welfare are made is essential to improving on the decision-making processes and has implications for both research and practice.

Hospital and residential treatment bed utilization rates were measured before and after foster home placement in individuals with serious mental illness. Medical records of all Veterans consecutively enrolled in a Department of Veterans Affairs Community Residential Care (CRC) program during a 6 year period (N = 140) were reviewed retrospectively. Treatment bed days were tabulated by bed type (psychiatric hospital, inpatient detoxification, medical hospital, physical rehabilitation, and psychosocial residential treatment) for each patient during symmetric pre- and post-placement time intervals. Pre- and post-placement bed days were compared using the paired-sample t test in a naturalistic one-group pretest–posttest analytic design. Psychiatric hospital and residential treatment bed days were significantly reduced post-placement (−77.5% and −99.8%, respectively). Most patients (89.0%) had fewer psychiatric hospital bed days post-placement, and all patients with pre-placement residential treatment program bed days had fewer of those days post-placement. Longer CRC placements were associated with greater reductions in bed utilization.

For over three decades federal child welfare policy has promoted three goals to achieve permanent outcomes for children: 1) making reasonable efforts to prevent out of home placement; 2) reunifying...

This qualitative study explores the youth-initiated mentoring (YIM) approach for youth at risk for out-of-home placement. In this approach, a youth nominates someone from within their social network, and positions this person as a YIM to function as an ally for the youth and as a partner for parents and professional caregivers. Through interviews with six youth, six YIMs, and seven parents ( N = 19), we examined the positioning of a YIM and sustainability. The results indicated that attitudes from participants toward asking someone or being asked to become a YIM varied from enthusiastic to cautious. Participants reported increased contact intensity and relationship quality. Two parents did not experience YIM as beneficial. Most participants expected that the YIM–mentee relationship lasts after professional care terminates. The results reveal that YIM is experienced as an ally, but it also has the potential to increase relational conflicts between social network members.

Early institutional-deprivation has been found to increase risk for inattention/hyperactivity (ADHD). Notably, studies suggest that children with a history of adversity evidencing an enhanced ERP (the error-related-negativity; ERN) may be protected against attention problems. However, such protective effects of the ERN have been studied in children whom typically experienced residential instability. It is unknown whether error-monitoring is similarly protective for children with stable post-deprivation placements. The present study examined the protective effect of the ERN in a sample of children who experienced at least 3-years of stable, relatively enriched caregiving after being internationally-adopted as infants/toddlers from institutional-care. We included two groups of children adopted internationally before age three, one group adopted from institutional-care (PI:n = 80) and one comparison group adopted from foster-care (FC;n = 44). A second comparison group consisted of non-adopted children (NA;n = 48) from demographically comparable families. At five-years of age, we assessed child ADHD symptoms (parent-report) and behavioral performance and neural correlates of error-monitoring (Go/No-Go task). PI children displayed lower Go/No-Go accuracy relative to FC children, and higher levels of ADHD symptoms relative to NA controls. In both FC and PI groups, longer duration of pre-adoptive out-of-home placement was associated with inattention, especially for children with deficits in error-monitoring. Enhancing cognitive control in the form of error monitoring might be a useful intervention target to protect children from some of the negative outcomes associated with adverse early care. Furthermore, results underscore that regardless of type of pre-adoptive care, we should aim to place children in stable/permanent homes as early as possible.

Decisions regarding out-of-home placement of children are complicated and of high impact for children and parents. Previous studies show low agreement between professionals on these decisions, and research regarding the influence of characteristics of decision-makers on the content of the decisions taken remains inconclusive. This study explored the relation between general and psychological characteristics of 144 professionals (child welfare professionals, children’s court judges, and master students) using vignettes and questionnaires. Professionals’ mind-set regarding the ability of parents to achieve change (parent-specific mind-set) and their attitude toward the harmfulness of out-of-home placements were related to their decision-making. General decision-maker factors (the professional’s background and work experience), the mind-set toward the ability of people in general to change (dispositional mind-set), and professionals’ attitude toward the effectiveness of out-of-home placements were not related to their decisions. This field of practice needs to reflect on the role of implicit beliefs in making placement decisions about children.

Key predictors of trauma were examined using a multi-group analysis of a nationally representative sample of 716 child welfare involved youth ages 11-17. Results indicate that co-occurring clinical depression was associated with trauma across all racial/ethnic groups. Results also support that youth's ethnicity moderates the relationship between gender, history of sexual abuse and sexual orientation and the development of trauma. Contrary to prior research, trauma was not significantly associated with substance abuse or having experienced out of home placement for all ethnic groups. Implications for policy, practice with child welfare involved adolescents and future research in this area are discussed.

Objectives: We hypothesized that the number and length of hospital admissions in people with Parkinson’s disease (PD) would increase immediately prior to admission to a care home relative to those who were able to continue living at home or who died. Method: PD patients at Hoehn and Yahr Stages III to V were followed-up over two and a half years with deaths and care home placements recorded. Hospital admissions data were collected over this period. Results: Of 286 patients included in the study, 7.3% entered a care home and 28.3% died. In the final 120 days prior to the study exit point (care home placement, death, or continued living at home), longer hospital stay was significantly associated with care home placement, after adjusting for the competing risk of death. Conclusion: Our data provide evidence that, for many people with PD, a period of crisis is reached immediately prior to care home placement.

OBJECTIVES: Little is known about risk of custody loss or out-of-home placement among children whose mothers experience postpartum mental disorders, and whether this risk differs from that of children whose mothers had earlier onset of their mental disorder.METHODS: National Danish registers comprising 1 868 467 births (1982-2012) were used to determine how the timing of maternal illness onset influences out-of-home placement risk up to age 18 years among children exposed to a maternal mental disorder.RESULTS: Compared to children unexposed to maternal mental illness, risk was higher for children exposed to a maternal mental disorder whose mothers had a first contact for a mental disorder in the 0-12 months of predelivery (8.17/1000 person-years; aIRR 4.56, 95% CI 4.08-5.09), the first 3 months postpartum (4.60/1000 person-years; 3.55, 2.95-4.26) and 4-12 months postpartum (6.49/1000 person-years; 3.93, 3.50-4.41). Risk was even higher for children exposed to a maternal mental disorder when illness onset was more than 1-year predelivery (9.11/1000 person-years; 5.48, 5.32-5.66).CONCLUSION: Risk of out-home placement in children exposed to mothers with a new-onset postpartum mental disorder is almost as high as in children whose mothers have long-standing illness. A better understanding of the trajectories of these mothers and children is warranted.

Placement instability negatively impacts the lives of youth placed in out-of-home care, and research on the topic indicates that it is related to negative long-term outcomes for youth in care. This study uses information gathered from two waves of interviews conducted with a representative sample of 1136 Quebec youths who were first met at around 16 years of age when they were still in out of home placement, and at around age 18 when most of them had left placement. The youths’ associated administrative child welfare data were also used to examine the relationships between placement instability, education outcomes, and occupational status. We find that youth who experience more placement instability have a much higher probability of dropping out of school early, and not to be acquiring work experience. Our results also indicated that these youths have a much lower probability to receive a high school degree.

•Poor housing conditions highly affected OOH placement than other economic factors.•Neglect highly affected OOH placement compared to other types of maltreatment.•The coexistence of any economic hardship and maltreatment increased the odds of OOH.•Providing affordable housing is a priority to prevent unnecessary child removal.

•Adapting and testing a measure of connectedness with caring adult for foster children•Dimensions include the number, strength and types of supportive connections.•Instrument shows strong test-retest reliability when piloted with children ages 9–14.

This study proposes to examine the phenomenology of home among 46 Israeli adults who had been deemed "at-risk children" and removed from their home by court order in their childhood on the grounds of parental mistreatments, such as abuse and neglect. For a comprehensive understanding of the long-term impact of out-of-home placement, adults of different ages were interviewed. The research findings reflect the close connection between home concept and self-concept, a long-standing internal dialectic between the home that did not exist and the home (as an internal-emotional space) that the adults would have liked to have. Furthermore, our findings reveal what we term the life career of the home concept, that is, the various diachronic phenomenological definitions that adults grant to the home-self in childhood, anchored in the family home, during their time in a residential care setting, their adolescence, and their adulthood. The discussion addresses the unique self-concept and home concept of care leavers.

Poverty is consistently associated with a higher risk of experiencing child maltreatment, and children from poor families are the majority of children involved in child protective services (CPS). However, the mediators in the relationship from income to CPS involvement are not entirely understood. Using theoretically-informed mediating path models and data from the second National Survey of Child and Adolescent Well-Being (NSCAW II), this study tests the role of harsh physical punishment as a mediator between family income and CPS involvement. CPS involvement was measured by subsequent report of maltreatment and removal to out-of-home care. The direct paths from income to re-report and to removal were significant; with higher income associated with lower risk of report and removal. Lower income was significantly associated with higher rates of harsh physical punishment. However, harsh punishment did not mediate the relationship between income and the outcomes. These results suggest that even within a population primarily comprised of low-income families, lower income is a risk for subsequent reports and removals as well as a risk for higher rates of harsh physical punishment. However, in this sample harsh physical punishment is not the mechanism that results in higher subsequent-reports or removal rates.

Introduction The impact and outcome of hip fractures are well described for people living in the community, but inpatient hip fracture (IHF) have not been extensively studied. In this study, we examine the patient characteristics, common falls risk factors and clinical outcomes of this condition. Methods Between January 2016 and December 2017, we analysed all inpatient falls that resulted in hip fracture within Aneurin Bevan University Health Board (ABUHB) in Wales. Results The overall falls rate was 8.7/1000 occupied bed days (OBD). Over the 2 years, 118 patients sustained an IHF, giving a rate of 0.12/1000 OBD. The mean age was 81.8 ± 9.5 (range 49–97) years and 60% were women. Most patients (n = 112) were admitted from their own home. Mean Charlson Comorbidity Index and the number of medications on admission were 5.5 ± 1.9 and 8.5 ± 3.7, respectively. Fifty-three patients (45%) sustained the IHF following their first inpatient fall. Twenty-four IHF (20%) occurred within 72 h. Mean length of stay was 84.9 ± 55.8 days. Only 43% were discharged back to their original place of residence following an IHF; 27% were discharged to a care home (26 new care home discharges), and 30% died as an inpatient. One-year mortality was 54% (n = 64/118). The most common comorbidity was dementia (63%). Conclusion Mortality and need for care home placement are both much higher after IHF than following community hip fracture. Most people who suffer a hip fracture in hospital have already demonstrated their need for falls risk management by having fallen previously during the same admission.

This paper examines the extent to which regional variations in poverty and health and social services spending impact the risk of placement, after controlling for individual-level risk factors and regional latent differences in delivery of child protection services. Clinical administrative child protection data were merged with income and health and social services spending data for the province of Quebec; the final data set included all children ( N = 122,466) investigated for maltreatment for the first time between April 1, 2002 and March 31, 2010, of which 22.6% ( N = 27,710) were placed in out-of-home care. Multilevel hazard results indicate that poverty, controlling for health and social services spending, contributes to the increased risk of placement. Specifically, poverty and health and social services spending account for 57.1% of the variation in regional placement for younger children

Much literature exists on social, emotional, and behavioral outcomes for children in care of their grandparents (i.e., grandfamilies), however little is known about academic performance among children living in grandfamilies when compared to other types of nonparental care. We conducted a cross-sectional analysis using secondary data from the United States 2013 National Survey of Children in Nonparental Care. We compare the academic functioning in math and reading/writing of school-aged children (N = 809) cared for by grandparents with two other types of nongrandparental caregivers. Using logistic regression models, we found that compared to children in care of their grandparents, children in care of foster caregivers and nonrelatives in nonfoster settings were approximately 45% less likely to have high academic performance in math and reading/writing. With this research we add to the literature on academic performance of children in out of home placement, setting the stage to compare arrangement options.

Children growing up in families experiencing complex and multiple problems (FECMP) are at an increased risk of developing problems in multiple areas of life. A wide array of home-visiting interventions has been developed to address the complex care needs of these families. The aim of this study is to investigate out-of-home placement rates and child outcomes of these home-visiting interventions. A systematic review and meta-analysis was conducted using five scientific databases (PsycInfo, ERIC, SocIndex, MedLine, & Picarta). The systematic search of these databases yielded 8,377 hits. Forty-two publications reporting on 50 studies were included in the review. A random-effects survival curve meta-analysis model was estimated for out-of-home placement and random-effects meta-analysis models were estimated for children’s behavioral problems and stressful experiences. Out-of-home placement increased from 7.5% at case closure to 24.3% one year after case closure. On average there was a moderate decrease in emotional and behavioral problems (d = 0.50) and stressful experiences (d = 0.50) during intervention, but considerable problems remained after case closure. More research is needed to investigate family and service characteristics that may explain heterogeneity in outcomes. Furthermore, there is a need to adopt a broader perspective in evaluations of home-visiting services by including outcomes related to the skills, development, and wellbeing of children.

Objectives This study aimed to develop and explore feasibility of SettleIN, a staff-led programme about healthy adjustment for people with dementia following care home placement. The main foci were intervention feasibility and the impact of the programme on resident quality of life and mood. Method A manualised intervention developed through consultation with 47 experts was trialled using a mixed-method design. Thirteen new residents with dementia and 24 staff were recruited from six UK care homes. Outcomes were measured at baseline, intervention completion and four-week follow-up. Analysis of staff interviews and field notes is reported. Results Most experts deemed SettleIN to be well structured, comprehensive and appropriate. However, uptake of SettleIN was low. When implemented, staff emphasised integration ease and staff benefits, but that SettleIN may not be universally suitable. High attrition, most commonly due to death and hospitalisation, and partial results from only four participants meant that there was a lack of support for the positive outcomes. Feasibility problems included a lack of staff time and dependency on families for some components. Conclusion SettleIN is acceptable to a wide range of stakeholders though does not appear to be feasible in its current form and improvements are recommended. A second pilot phase is required, which will address the reasons for the high attrition rate in this study and amend the methodology accordingly. This is an important work, as a manualised and standardised approach to healthy adjustment in care is unique and could have huge clinical significance if effective.

Group care is a frequent placement for adolescents placed in out of home care when their birth parents’ care is deemed unsafe. In the present study, we assessed whether foster parents show greater commitment to children than group care providers. Given that group care represents a number of living arrangements, we considered both shift care (where staff work shifts and do not live with the children) and cottage care (where staff live for extended periods of time with the children in a group living context). Commitment was assessed using the This Is My Child Interview (adapted for adolescents). Thirty-one foster parents, 18 shift workers, and 28 cottage care providers were interviewed. As predicted, foster parents showed higher levels of commitment than both shift care workers and cottage care providers, and the associations held when children’s externalizing behaviors and the number of children the caregivers had cared for were controlled. The results suggest that foster care promotes greater commitment among caregivers than other out of home placements, and add to other findings that favor foster care as the out of home placement of choice for adolescents.

© The Author(s) 2017. Extra care housing facilities in the UK are intended to offer a community-based alternative to care home placement. However, little is known about staff’s views of the appropriateness of extra care housing for people with dementia. This paper describes a mixed-methods study which explored this issue using statistical modelling of frontline staff’s recommendations of the best care setting for care home entrants; thematic analysis of transcripts from a simulated Resource Allocation Management Panel meeting; and content analysis of care coordinators’ reasons for not considering extra care housing in actual care home applications. Frontline practitioners saw extra care housing as a valuable alternative for a significant minority of care home entrants. However, extra care housing was not recommended if people needed care at night. Social care managers expressed general support for the idea of extra care housing, but appeared overwhelmingly focused on maintaining people at home and unsure where in the care pathway extra care housing sat. More evidence is needed on whether extra care housing can be an alternative to care homes and how services should be arranged to meet the needs of people living in extra care housing.

Increased attention has been given to domestic violence as a risk factor for out-of-home placement; however, few previous studies have examined the influence of race/ethnicity. This analysis used data from the National Survey of Child and Adolescent Well-Being to longitudinally compare time to out-of-home placement among a sample of 630 children with African American (n = 162), Hispanic (n = 95), and White (n = 373) female caregivers who reported domestic violence. Propensity score analysis was used to balance the group of caregivers based on observed characteristics. Findings indicated race was not a determinant factor of out-of-home placement; rather, other characteristics may better predict out-of-home placement among families affected by domestic violence. Recommendations for future research and practice are provided.

Child maltreatment and household dysfunction have long been linked to delinquency, adult criminality, and sexual offending. However, the association between adverse childhood experiences (ACEs), factors related to out-of-home placement, and the onset of maladaptive behaviors has not thoroughly been explored in adolescents who have engaged in sexually abusive behavior. In the present study, we examined archival records of 120 male youths who have received treatment for sexually abusive behavior. As expected, the male adolescents in this sample have experienced higher rates of ACEs than samples of adult males in the community, adult males who committed sexual offenses, and juvenile justice-involved males as reported in the literature. Discrete-time survival analyses yielded increased risks of onset of aggression and sexually abusive behavior during early childhood and mid-to-late childhood, with significant associations between higher ACE scores and a greater number of out-of-home placements. Implications and future directions are discussed.

The child is a major stakeholder in the decision whether to continue placement in fostercare or to reunify her or him with the biological family. This study investigated whether Dutch social workers are influenced by the child’s wish in their recommendations about reunification. Data were gathered from 120 child welfare professionals and 120 students whoreadavignetteaboutachildinfoster-careandcompletedaquestionnaireabouttheir reunification recommendation. Results showed a weak, but significant relationship betweenthechild’swishandtherecommendation(Cramer’sV ¼ 0.295and0.188,respectively). Also, a moderating effect was found: participants who explicitly mentioned the child’swishintheirjustificationsgavearecommendationthatwassignificantlyassociated with the child’s wish (p , 0.05) while, with those who did not mention the child’s wish, there was no association. The results might seem obvious, but they are not consistent with prior research. The findings show that children might influence the decisionmaking process by stating their wishes. Raising children’s awareness about this could be useful;believingthattheyare activeagentsregarding their owncaremightenhancemotivation, co-operation and faith in their future. Explanations and implications of the results are discussed.

The vast majority of children and youth with chronic and complex health conditions who also have intellectual and developmental disabilities are cared for in their homes. Social, legal, policy, and medical changes through the years have allowed for an increase in needed support within the community. However, there continues to be a relatively small group of children who live in various types of congregate care settings. This clinical report describes these settings and the care and services that are provided in them. The report also discusses reasons families choose out-of-home placement for their children, barriers to placement, and potential effects of this decision on family members. We examine the pediatrician’s role in caring for children with severe intellectual and developmental disabilities and complex medical problems in the context of responding to parental inquiries about out-of-home placement and understanding factors affecting these types of decisions. Common medical problems and care issues for children residing outside the family home are reviewed. Variations in state and federal regulations, challenges in understanding local systems, and access to services are also discussed.

Children in the United States are exposed to alarmingly high rates of violence and trauma. Notable are the rates of maltreatment among children and the heightened risk for both out of home placement and an array of developmental, behavioral, and psychosocial sequelae. Despite these risks, little information is available on effective interventions and services designed to address the complex needs of youth in residential treatment settings. To effectively respond to their unique developmental, behavioral, and emotional needs, trauma-informed interventions and services must be provided to support optimal outcomes. To this end, this paper delineates the prevalence of children in residential care secondary to chronic maltreatment and other trauma exposures, identifies behavioral and emotional issues through the theoretical framework of complex trauma, highlights the importance of organizational capacity to deliver trauma-informed services, and describes effective clinical interventions that are often used in residential treatment. Clinical considerations and recommendations are also provided.

In this article it is assumed that the documentary impulse that gave the impetus to Courage, a photobook on people in poverty published in Belgium in 1998, is related to how the General Report on P...

Increased attention is being given to domestic violence as a risk factor for out-of-home placement; however, no studies have longitudinally assessed this relationship. Further, the existing studies have yielded mixed findings, indicating a need for analyses that apply the most rigorous methods. This analysis uses data from the National Survey of Child and Adolescent Well-Being to examine the rate of out-of-home placement (i.e., time to out-of-home placement following a child welfare investigation of alleged child maltreatment) across time among a sample of 1,965 children with female caregivers. Among the caregivers, 657 reported domestic violence and 1,308 did not report domestic violence. To best determine whether domestic violence contributes to greater likelihood of out-of-home placement, we use propensity score analysis to statistically mimic a randomized clinical trial by balancing both groups of caregivers based on observed characteristics. Findings indicate children whose caregivers report domestic...

Guided by a developmental epidemiology framework, this study examines the extent to which first experiences of child maltreatment and use of emergency housing are predictive of out-of-home placement in early childhood. The study sample is a population of 12,045 second-grade students in a large, urban school district. Information on birth, maternal, and social risk factors was obtained and linked through an integrated data system. Life table analyses were used to develop a descriptive picture of the timing of first out-of-home placement experience. Findings demonstrate that children are most likely to experience a first out-of-home placement during their first year of life. Cox regression analyses are used to examine the extent to which variables for risk factors (specifically child maltreatment and use of emergency housing) predict the first out-of-home placement experience while controlling for demographics, birth risks, and maternal risks. Results demonstrate that children with histories of child maltre...

Children and adolescents with significant intellectual and developmental disabilities and complex medical problems require safe and comprehensive care to meet their medical and psychosocial needs. Ideally, such children and youth should be cared for by their families in their home environments. When this type of arrangement is not possible, there should be exploration of appropriate, alternative noncongregate community-based settings, especially alternative family homes. Government funding sources exist to support care in the community, although there is variability among states with regard to the availability of community programs and resources. It is important that families are supported in learning about options of care. Pediatricians can serve as advocates for their patients and their families to access community-based services and to increase the availability of resources to ensure that the option to live in a family home is available to all children with complex medical needs.

Intake and termination data from two samples of substance-using and/or HIV-positive mothers of minor children were collected from 17 projects across the U.S. Service utilization data collected from the initial sample was modeled using hierarchical classes (HICLAS) analysis. HICLAS identified three basic classes of service utilization: Services to Meet Basic Needs , Treatment and Support Services , and Pediatric and Developmental Services . After computing propensity score adjustments, we evaluated whether these service classes predicted child placement at termination: living with biological mother without Child Protective Service (CPS) involvement, living with biological mother with CPS involvement, or not living with biological mother. In both the initial and the replication samples, participating mothers who received Services to Meet Basic Needs and/or Pediatric and Developmental Services were more likely to be living with their index children without CPS involvement. Pediatric and Developmental Services was the only significant predictor of this outcome for the subsample of biological mothers who were not living with their index children at program intake. Findings are discussed in terms of the possible benefits derived from the process of receiving services in the Pediatric and Developmental Services category.

Using NCANDS data of US child maltreatment reports for 2009, logistic regression, probit analysis, discriminant analysis and an artificial neural network are used to determine the factors which explain the decision to place a child in out-of-home care. As well as developing a new model for 2009, a previous study using 2005 data is replicated. While there are many small differences, the four estimation techniques give broadly the same results, demonstrating the robustness of the results. Similarly, apart from age and sexual abuse, the 2005 and 2009 results are roughly similar. For 2009, child characteristics (particularly child emotional problems) are more important than the nature of the abuse and the situation of the household; while caregiver characteristics are the least important. All these models have low explanatory power.

Despite their overrepresentation in the child welfare system (Crosse, Kaye, & Ratnofsky, 1992; Sullivan & Knutson, 2000), little is known about the permanency and placement experiences of young people with disabilities in out-of-home placement. Using state administrative data, this study examined the experience of older youth with disabilities in foster care, focusing on placement stability, permanency planning, and placement outcomes. Findings include that older youth with disabilities were more likely to experience longer time in out-of-home placement, and higher rates of placement instability than their peers without disabilities. Additionally, analysis found that only 60% of the youth in the sample had a concurrent plan on file, and that youth with disabilities have different placement plans than their peers without disabilities. Implications for research, policy, and practice are discussed.

The present study aims to review empirical research focusing on traumatic events and posttraumatic stress among children and adolescents in out-of-home placement and identify future directions for research. A search in PsychInfo, ISI, and PubMed for the period 1985–2010 and use of citation alerts from 2006 to 2010 yielded 27 studies meeting our inclusion criteria. The included studies applied a diversity of assessment instruments and methods. Only six studies reported when the traumatic event(s) had occurred and/or time of assessment posttrauma. The studies comprised two main categories of traumatic events: war related trauma and sexual/physical abuse. There was a male majority exposed to studies focusing on war-related trauma, and studies on sexual trauma had a female majority. Studies on war-related trauma included foster children from Africa and Asia, whereas studies on abuse trauma included mainly North American samples. The review reflects a scarcity of empirical studies with a trauma perspective in ...

As part of a state-wide study of group home care, approximately 500 youth were followed for eight months after discharge from participating group homes. This article discusses challenges of such post-discharge data collection and presents methods and tools for following this highly mobile population. Methods include determining a specific sequence of protocol, designing a concise transferrable form for following youth, and holding regular meetings with all involved staff to problem-solve and develop/revise protocol. Suggestions are made for following this population by youth serving agencies as well as other researchers attempting longitudinal data collection with youth experiencing out-of-home placement.

Background: The decision of out-of-home placement for the Arab population is a very stressful event that sometimes causes a real crisis situation for them, because of cultural assumptions and attitudes against placement. The tradition in the Arab culture is to take care of their offspring at home, no matter how serious the situation is. Mental health is also a case of chronic illness and it is very important for us to understand who are those who are willing to place their adult child and what the factors are that make them to do this decision. Better understanding will lead to better use of the services that the state offers them. The rate of placement in Arab society remains significantly lower than among the Jewish population of Israel. The aim of this study was to examine the attitudes of Arab parents who have an adult son or daughter with a psychiatric disability toward out-of home placement. Method: A convenience sample of 189 parents of adult children with a mental disability from the Arab population of Israel. The questionnaires included were assessing social support, emotional stress, cognitive appraisal of the situation, and various socio-demographic characteristics. Results: Parents who chose home placement reported being in a better financial position and were more religious than parents who chose out-of-home placement. Parents who chose to care for their children at home had a significantly higher perception of this as a challenge. The decision regarding the child's placement appears to depend mainly on the parents' education and financial situation. Conclusions: Financial situation, social support and perceiving the illness as a challenge are the most important factors in the process of the decision.

This article explores the prevalence and characteristics of children with disabilities within the child welfare system using administrative data from the State of Minnesota. This study finds that more than a fifth (22%) of children with substantiated maltreatment are labeled in administrative records as having a disability, and more than one quarter of children (27.9%) over age five. The most common type of disability among children with substantiated maltreatment was emotional disturbance, while other common disabilities included intellectual and developmental disabilities and learning disabilities. Using logistic regression, this study finds that children with substantiated maltreatment with disabilities were about two times more likely to be in out of home placement than children with substantiated maltreatment without disabilities.

Aims and methodTo examine the association between the use of cholinesterase inhibitors (ChEIs) and time to care home placement. We compared patients who were prescribed ChEIs in 2006 with those who were not with respect to their placement in care homes over a 4-year period, using survival analysis.ResultsDuring the first 30 months of follow-up there was a delay in care home placement by a median of 12 months in those who took ChEIs compared with those who did not. However, at the end of the follow-up there was no significant reduction in the probability of being in a care home setting between those who had taken ChEIs compared with those who had not (hazard ratio 0.75, 95% CI 0.25–6, P = 0.1).Clinical implicationsThe study provides some evidence to suggest that prescribing ChEIs may be associated with a delay in the timing of care home placement as observed in the first 2.5 years of treatment. However, based on purely observational data, no conclusion can be made as to whether such association is causal.

In Norway, about 8,000 children live in foster homes (about 3.300 in age group 13–17). What does ‘family’ mean to these children? We explored the views and feelings about ‘family’ among 22 adolescents who are living in long-term foster care. Three patterns emerged. Most of the participants expressed confidence and adjustment in the foster home placement and felt bonded to both their foster family and to their birth family. Other adolescents expressed a strong sense of membership to their birth family but not to their foster family, and the remaining adolescents described a weak bond to birth family but a strong bond to their foster family. The main implications of the three patterns are discussed in the light of policy and practice.

The purpose of this study was to examine behavioral outcomes in an out of home placement depending on whether youth's ethnicity was congruent with the ethnicity of the caregiver (family teacher). It was hypothesized that African American children in transracial out of home placements would exhibit significantly more internalizing and externalizing behavior problems compared to either Caucasian children in transracial out of home placements, or African American or Caucasian children placed with the same race caregivers. Results provide support for hypotheses related to some youth externalizing behaviors, while hypotheses regarding youth internalizing behaviors were not supported. We discuss the need to consider the ethnicity congruence between out of home placement caregivers and youth. Additionally, the results of this study reflect the need for caregiver training in multicultural competence.