Raymond H. Starr

Children in kinship care: How do they fare?

Abstract The placement of children in need of out-of-home care with relatives (i.e., kinship care) has been an increasing trend. The study summarized in this paper represents the first comprehensive assessment of the physical and mental health and educational status of children in kinship care. The anticipated high risk status of these children was supported by study findings in all areas of assessment. These findings are discussed and recommendations are offered for policy, practice and future research.

Behavior problems of children in kinship care.

ABSTRACT. An increasing number of children needing out-of-home care are being placed with relatives. Despite this pervasive policy, there has been scant research on children in this arrangement called kinship care. The objectives of this study were (1) to assess the behavior of children in kinship care and (2) to identify predictors of their behavior. The caregivers of 346 children in kinship care completed the Child Behavior Checklist (CBCL). Background information was obtained from caregivers and caseworkers. Forty-two percent of boys and 28% of girls had overall CBCL scores in the clinical range, compared with an expected 10% in the general population. Logistic regressions revealed several variables significantly associated with behavior problems including: reason for placement, gender, race, caregivers perception of the child, caregivers educational level, number of contacts between caregiver and caseworker, long-term plan, and childs age. The frequent behavior problems among these high-risk children in kinship care suggest they all deserve mental health evaluations; at a minimum, periodic screening is indicated. J Dev Behav Pediatr 14:386–393, 1993. Index terms: kinship care, foster care, behavior.

Early intervention and recovery among children with failure to thrive: follow-up at age 8.

OBJECTIVES. We sought to examine the impact of a randomized, controlled trial of home visiting among infants with failure to thrive on growth, academic/cognitive performance, and home/classroom behavior at age 8. METHODS. Infants with failure to thrive (N = 130) or adequate growth (N = 119) were recruited from pediatric primary care clinics serving low-income, urban communities. Eligibility criteria included age <25 months, gestational age >36 weeks, birth weight >2500 g, and no significant medical conditions. Evaluation included anthropometries, Bayley scales, maternal anthropometries, demographics, negative affect, IQ, and the Home Observation for Measurement of the Environment scale. Infants with failure to thrive were treated in an interdisciplinary growth and nutrition clinic and randomized into clinical-intervention-plus-home-intervention or clinical-care-only groups. The home-visiting curriculum promoted maternal sensitivity, parent-infant relationships, and child development. Follow-up visits were conducted by evaluators who were unaware of the childrens growth or intervention history. At age 8, the evaluation included anthropometries, the Wechsler Intelligence Scale for Children III, and the Wide Range Achievement Test, Revised. Mothers completed the Child Behavior Checklist and teachers completed the Teacher Report Form. ANALYSIS. Multivariate analyses of variance were used to examine differences in growth, cognitive/academic performance, and home/school behavior, adjusted by maternal education, public assistance, and, when appropriate, infant Bayley score, maternal BMI, height, negative affect, IQ, and Home Observation for Measurement of the Environment scores. RESULTS. Retention was 74% to 78%. Children in the adequate-growth group were significantly taller, heavier, and had better arithmetic scores than the clinical-intervention-only group, with the clinical-intervention-plus-home-intervention group intermediate. There were no group differences in IQ, reading, or mother-reported behavior problems. Children in the clinical-intervention-plus-home-intervention group had fewer teacher-reported internalizing problems and better work habits than the clinical-intervention-only group. CONCLUSIONS. Early failure to thrive increased childrens vulnerability to short stature, poor arithmetic performance, and poor work habits. Home visiting attenuated some of the negative effects of early failure to thrive, possibly by promoting maternal sensitivity and helping children build strong work habits that enabled them to benefit from school. Findings provide evidence for early intervention programs for vulnerable infants.

The Contribution of Handicapping Conditions to Child Abuse

The literature on the contribution of low birthweight, perinatal problems, congenital disorders, and mental retardation to child abuse is reviewed. While existing transactional and ecological theories suggest such child factors should contribute to abuse, a careful analysis of studies indicates handicapping conditions are not major causal factors. Results of prospective, longitudinal research suggest that minor deviations in child behavior rather than major handicaps are related to the occurrence of abuse. Efforts to help families adjust to having a handicapped child, while helpful in alleviating the stresses in such families, will not have a major impact on the incidence of abuse.

Community and professional definitions of child neglect

This study examined the views on child neglect among African American and White community members of middle and low socioeconomic status and contrasted their views with those of professionals in the field of child maltreatment. Vignettes concerning an imaginary 18-month-old child were factor analyzed into Physical and Psychological Care scales. There were small but significant differences, with both middle-class African American and White community groups showing greater concern for psychological care than the lower class African American group. Both groups of African Americans were more concerned than middle-class Whites about physical care. Overall, there is considerable agreement among the community samples in their views of what circumstances are harmful to children; professionals in the field appear to have a higher threshold for concern.

THE EPIDEMIOLOGY OF CHILD MALTREATMENT

Articles about child maltreatment appear daily in almost every metropolitan newspaper. It seems that children are being injured, molested, and even killed at an alarming rate. In an attempt to understand child maltreatment, the first question to ask is what do we really know about the extent of the problem? Answering that question is the purpose of this chapter.

Cognitive development of children in poverty with failure to thrive: a prospective study through age 6

BACKGROUND This study examined the cognitive development of children in poverty with normal growth and those with a history of failure to thrive (FTT) prospectively from infancy through age 6. METHOD Participants were 226 low-income infants with normal birthweight and no perinatal complications, congenital problems, or chronic illnesses. One hundred and twenty-eight children experienced FTT and were treated in an interdisciplinary clinic, and 98 had normal growth. RESULTS Cognitive development declined in both groups to 1.0-1.5 SD below the norm. Children with FTT had lower cognitive scores than children with adequate growth through age 4, followed by recovery. By ages 5 and 6, there were no differences in cognitive scores based on the childrens growth history. Using hierarchical linear modeling, child-centered home environment and small family size were related to better cognitive performance. CONCLUSIONS The low scores of both groups point to the need for programs promoting a child-centered home environment.

Pre- and perinatal risk and physical abuse

Abstract Ecological models and research suggest that abnormal perinatal events and handicapping conditions predispose children to later physical abuse. However, results of prospective studies do not suggest that low birth weight, prematurity or perinatal problems are risk factors. A number of studies have compared abused children with siblings, thus controlling for parental factors, but the results are inconclusive. This article reviews the literature and presents the results of a retrospective study of relevant risk factors using both between and within family methods. Subjects were 87 abusive and 87 control families matched for social class, race, and child age and gender. Within the abuse group, 54 children had siblings for whom comparative data were available. Comparisons were made for 38 variables. Prenatal measures included prenatal care, complications, and maternal hospitalizations and physical problems. There were no significant differences between index children and their siblings. The only diffe...

The need for child maltreatment research and program evaluation

The knowledge base supporting child abuse treatment and prevention rests upon clinical experience and applied research. An analysis of program funding in the United States indicates that unevaluated clinical programs are funded rather than research or program evaluation projects. Grant funding patterns for the National Center on Child Abuse and Neglect were analyzed for 4 years. Overall, 66% of projects had no research or evaluation component. Without such programs, we cannot determine the effectiveness of treatment and prevention efforts that, while well intended, may have no effects on the participating parents and children, or, worse still, may have unintended negative consequences. Quality programs must be based on the maintenance of a balance between research and clinical efforts with evaluation being an important component of the latter.