John Landsverk

Children and youth in foster care: disentangling the relationship between problem behaviors and number of placements

OBJECTIVEnThe purpose of this research was to provide a prospective look at the relationship between change in placement and problem behaviors over a 12-month period among a cohort of foster children.nnnMETHODnThe sample contained 415 youth, and was part of a larger cohort of children who entered foster care in San Diego, California and remained in placement for at least 5 months. The Child Behavior Check List was used to assess behavior problems. Every change of placement during the first 18 months after entry into the foster care system was abstracted from case records.nnnRESULTSnThe results suggest that volatile placement histories contribute negatively to both internalizing and externalizing behavior of foster children, and that children who experience numerous changes in placement may be at particularly high risk for these deleterious effects. Initial externalizing behaviors proved to be the strongest predictor of placement changes for the entire sample and for a sub-sample of those who initially evidenced problem behaviors on at least one broad-band CBCL scale. Our findings also suggest that children who initially score within normal ranges on the CBCL may be particularly vulnerable to the detrimental effects of placement breakdowns.nnnCONCLUSIONSnOn the basis of these findings we argue for an analytical approach that views behavior problems as both a cause and as a consequence of placement disruption. Children who do not evidence behavior problems may in fact constitute a neglected population that responds to multiple disruptions of their primary relationships with increasingly self-defeating behaviors.

Mental Health Problems of Children in Foster Care

We compared the rates of mental health problems in children in foster care across three counties in California. A total of 267 children, ages 0 to 17, were assessed two to four months after entry into foster care using a behavioral screening checklist, a measure of self-concept and, in one county, an adaptive behavior survey. Results confirmed previous research and indicated consistently high rates of mental health problems across the three counties. Behavior problems in the clinical or borderline range of the CBCL were observed at two and a half times the rate expected in a community population. Fewer children fell within the clinical range on the self-concept measure. No significant differences in rates between the three county foster care cohorts were observed, despite the different demographic characteristics of the counties. On the adaptive behavior scale, the mean scores for children in foster care were more than one standard deviation below the norm. Our findings suggest that the most important mental health screening issue with children in foster care is to identify what specific mental health problems need to be addressed so that the most effective treatment services can be provided.

Children who prosper in unfavorable environments: The relationship to social capital

Objective.u2003Social capital describes the benefits that are derived from personal social relationships (within families and communities) and social affiliations. This investigation examined the extent to which social capital is associated with positive developmental and behavioral outcomes in high-risk preschool children. Design.u2003A cross-sectional case-control analysis of young children “doing well” and “not doing well” at baseline in four coordinated longitudinal studies. Participants.u2003A total of 667 2- to 5-year-old children (mean age, 4.4 years) and their maternal caregivers who are participating in the Longitudinal Studies of Child Abuse and Neglect Consortium. At recruitment, all children were characterized by unfavorable social or economic circumstances that contributed to the identification of the children as high risk. Measures.u2003Social capital was defined as benefits that accrue from social relationships within communities and families. A social capital index was created by assigning one point to each of the following indicators: 1) two parents or parent-figures in the home; 2) social support of the maternal caregiver; 3) no more than two children in the family; 4) neighborhood support; and 5) regular church attendance. Outcomes were measured with the Child Behavior Checklist, a widely used measure of behavioral/emotional problems, and with the Battelle Developmental Inventory Screening Test, a standardized test that identifies developmental deficits. Children were classified as doing well if their scores on these instruments indicated neither behavioral nor developmental problems. Results.u2003Only 13% of the children were classified as doing well. The individual indicators that best discriminated between levels of child functioning were the most direct measures of social capital—church affiliation, perception of personal social support, and support within the neighborhood. The social capital index was strongly associated with child well-being, more so than any single indicator. The presence of any social capital indicator increased the odds of doing well by 29%; adding any two increased the odds of doing well by 66%. Conclusions.u2003Our findings suggest that social capital may have an impact on childrens well-being as early as the preschool years. In these years it seems to be the parents social capital that confers benefits on their offspring, just as children benefit from their parents financial and human capital. Social capital may be most crucial for families who have fewer financial and educational resources. Our findings suggest that those interested in the healthy development of children, particularly children most at risk for poor developmental outcomes, must search for new and creative ways of supporting interpersonal relationships and strengthening the communities in which families carry out the daily activities of their lives.

Children in foster care: factors influencing outpatient mental health service use.

OBJECTIVEnTo determine factors influencing outpatient mental health service use by children in foster care.nnnMETHODnDetailed survey and administrative data were collected on 480 children who entered long-term foster care in San Diego County from May 1990 through October 1991. These data were linked with claims data from Medicaid and San Diego County Mental Health Services information systems. A Poisson regression model was used to determine whether the following factors influenced outpatient mental health service use: age, race/ethnicity, gender, maltreatment history, placement pattern, and behavioral problems as measured by the Achenbach Child Behavior Checklist (CBCL).nnnRESULTSnExcept for maltreatment history, all independent variables included in the multivariate regression model were statistically significant. The total number of outpatient mental health visits increased with age, male gender, and non-relative foster placements. Relative to Caucasians, visits were lower for Latinos, and Asian/Others, but comparable for African-Americans. Concerning maltreatment history, differences were only found in one category; children experiencing caretaker absence received fewer visits compared to children who did not experience caretaker absence. Children with CBCL Total Problem Scale T-scores of 60 or greater had significantly more visits than those with a score less than 60.nnnCONCLUSIONSnBoth clinical and non-clinical factors influence outpatient mental health service use by foster children. Limitations imposed by gender, race/ethnicity, and placement setting need to be addressed by child welfare policies. These finding suggest that guidelines are needed to systematically link children in foster care with behavioral problems to appropriate services.

Longscan: A consortium for longitudinal studies of maltreatment and the life course of children

The National Research Council (1993) has issued an urgent call for theory-based, longitudinal research to examine the antecedents and consequences of child maltreatment. Many of the concerns raised by the National Research Council are addressed by LONGSCAN (LONGitudinal Studies of Child Abuse and Neglect), a consortium including a coordinating center and five independent prospective longitudinal investigations sharing common protocols for data collection, entry, and management. The children in the five investigations vary by their level of risk, ranging from a community sample with no identified risk beyond low income status, to children placed in foster care. The longitudinal study has been designed with six age-specific data collection points extending from 4 through 20 years of age. The conceptual model, organization, and analytic strategy for LONGSCAN are described.

Deaths from falls in children: how far is fatal?

The outcome of injury was determined in 317 children who were brought to a childrens trauma center with a history from the caretaker that the child had fallen. Cases in which the clinicians judgment was that an incorrect history had been given were included along with cases in which the history was not questioned. Seven deaths occurred in 100 children who fell 4 feet or less. One death occurred in 117 children who fell 10 feet to 45 feet. The 7 children who died in short falls all had other factors in their cases which suggested false histories. When children incur fatal injuries in falls of less than 4 feet, the history is incorrect. Long falls with an outdoor component are likely to be reliable data points for studies of childrens injuribility.

Impact of child psychosocial functioning on reunification from out-of-home placement

Abstract This study examined the impact of child psychosocial functioning on the probability of reunification over an eighteen month period for 669 children, ages 2–16, who had been removed from their birth home and placed in either kinship care or foster care. Psychosocial functioning was measured from two sources, a standardized measure of behavior problems, and information abstracted from case files on emotional/behavioral problems, developmental/learning problems, and physical handicap or acute medical problems. Results indicated a separate and significant negative impact of externalizing behavior problems and behavioral/emotional problems on reunification from out-of-home placement. Children with problems were one-half as likely to be reunified as children without problems, even after controlling for background characteristics and type of maltreatment. The impact of externalizing behavior problems was observed in foster care but not in kinship care. Developmental and medical problems were not significantly related to reunification.

Parental visiting and foster care reunification

Abstract Parental visiting has long been a crucial factor in reunification decisions for children in foster care. The purposes of the present study, part of a larger follow-up investigation of permanency planning for children in foster care, were to correlate parental visiting with permanency planning outcomes and to develop a logistic regression model predicting family reunification. Findings show that the majority of children with maternal and paternal visits at the level recommended by the court were reunified, but no association was found between parental visiting and recidivism of reunified children at a 12 month follow-up. Maternal visiting at the recommended level was the strongest predictor of reunification among the five study variables included in the regression model, indicating that a child visited by the mother as recommended was approximately 10 times more likely to be reunified. The paper also includes information on parental visiting in traditional and kinship foster homes and across three ethnic groups. Implications of study findings for child welfare practice and future research are discussed.

Racial/Ethnic Representation Across Five Public Sectors of Care for Youth:

We examined service representation patterns of four racial/ethnic groups (African Americans, Asian/ Pacific Islander Americans, Caucasian Americans, and Latinos) across five public youth service sectors (alcohol/drug treatment, child welfare, juvenile justice, mental health, and public school services for children with serious emotional disturbance) in San Diego County. A full enumeration of children ages 0 to 18 served by those sectors during a 6-month period was analyzed to determine representation of each racial/ethnic group. Comparison groups of San Diego children were culled from three sources: 1996 census estimates, 1996 census estimates at or below 200% of poverty level, and the 1997 San Diego County school enrollment census. Results varied by racial/ethnic group and comparison group used, indicating that race/ethnicity affects service use patterns and that socioeconomic status should be taken into consideration when examining racial/ethnic representation. When socioeconomic status was taken into account, African Americans and Caucasian Americans were overrepresented across most sectors, Latinos were underrepresented across all sectors, and Asian/ Pacific Islander Americans demonstrated a mixed pattern. Results are discussed in terms of methodological and policy implications.

An Examination of Measurement Characteristics and Factorial Validity of the Revised Conflict Tactics Scale

The present study investigated descriptive statistics for and factor validity of scores on the Revised Conflict Tactics Scale (CTS2) based on the responses of 295 high-risk postpartum women. The CTS2 yielded results for this sample similar to results obtained from a sample of college students in a previous study. Furthermore, confirmatory factor analytic results indicated that a five-factor model, specifying factors of Negotiation, Minor Psychological Aggression, Severe Psychological Aggression, Minor Physical Assault, and Severe Physical Assault, yielded better fit statistics than a three-factor model that combined the minor and severe scales within the domains of psychological aggression and physical assault.