Psychosocial Consequences of Caregiver Transitions for Maltreated Youth Entering Foster Care: The Moderating Impact of Community Violence Exposure

Youth who experience a greater number of caregiver transitions during childhood are at risk for developing a host of psychosocial problems. Although researchers have examined individual-level factors that may moderate this association, no known studies have examined the impact of community-level factors. The current study investigated whether community violence exposure (CVE) moderated the association between number of prior caregiver transitions and increases in levels of externalizing and internalizing problems for a sample of youth entering foster care. Participants included 156 youth (aged 9-11 at first assessment) removed from their homes because of maltreatment. Youth provided reports of caregiver transitions and CVE at baseline, and caregivers, teachers, and youth reported on externalizing and internalizing problems 18-22 months later. Results from hierarchical multiple regression analyses indicated that youth with a greater number of caregiver transitions and higher levels of CVE evidenced significant increases in levels of psychosocial problems. The results of the study are discussed in terms of their implications for child welfare services

Children's appraisals of their experiences in out-of-home care

Few studies have asked children directly about their experiences in out-of-home care. This study uses data collected from 180 nine-to-11-year-old children currently in out-of-home care who were asked about their perceptions and appraisals of out-of-home care. Analysis of variance and chi-square analyses were used to examine whether children's appraisals of their lives following removal from their families of origin differ as a function of age, gender, race/ethnicity, type and severity of maltreatment, length of time in out-of-home care, placement type, attachment to current caregivers, and rating of current caregiver/home. Youth who were sexually and emotionally abused, youth who were satisfied with their current caregivers and placements, and girls were more likely to state that their lives would have been worse had they remained with their families of origin. Youth who were physically abused were more likely to report that their lives would have remained the same. Children living in group care were more likely than those living in family foster care or with kin to report that their lives would have been better had they remained with their families of origin. Differences were not found between children living in family foster care and those living with kin nor did children's appraisals differ based on age, race, ethnicity, length of time in out-of-home care, neglect, or severity of maltreatment.Foster care Kinship care Out-of-home care Appraisals Child maltreatment Abuse and neglect

Cumulative risk exposure and mental health symptoms among maltreated youth placed in out-of-home care

a b s t r a c t Objective: Maltreated children placed in out-of-home care are at high risk for exhibiting symptoms of psychopathology by virtue of their exposure to numerous risk factors. Research examining cumulative risk has consistently found that the accumulation of risk factors increases the likelihood of mental health problems. The goal of the current study was to elucidate the relation between cumulative risk and mental health symptomatology. Methods: The study consisted of a sample of 252 maltreated youths (aged 9-11) placed in out-of-home care. Results: Analyses confirmed the high-risk nature of this sample and identified seven salient risk variables. The cumulative risk index comprised of these seven indicators was a strong predictor of mental health symptoms, differentiating between children who scored in the clinical range with regard to mental health symptoms and those who did not. Finally, the data supported a linear model in which each incremental increase in cumulative risk was accompanied by an increase in mental health problems. Conclusion: This is the first known study to examine cumulative risk within a sample of youths in out-of-home care

Do youth in out-of-home care receive recommended mental health and educational services following screening evaluations?

For children in out-of-home care, a significant gap exists between those who need services and those who receive them. Screening all children in out-of-home care is recommended to reduce this gap. This study was designed to determine if recommendations from mental health and educational screening evaluations were related to service implementation for youth in out-of-home care. Screening evaluations were completed with 171 maltreated youth (ages 9 to 11) who had been placed in out-of-home care within the prior year. Written reports summarizing the findings were provided to children's caseworkers. Service utilization was assessed at baseline (T1; before screening reports were completed) and follow-up (T2; 9-12 months later) interviews. For children not already receiving services at T1, logistic regression analyses tested the association between T1 recommendations for services and new service implementation by T2. Mental health (youth-report) and educational (teacher-report) outcomes were analyzed separately. Screening evaluations identified 22% of children with unmet mental health needs and 36% with unmet educational needs at T1. Children who received a recommendation for new services (i.e., all of those with unmet needs) were more likely to receive mental health (OR = 2.50, p = .06) and/or educational (OR = 3.54, p = .04) services by T2 than children who did not receive recommendations for services. While recommendations increased the odds of receiving services, almost half of the children with unmet mental health needs did not receive services, and 84% of children with unmet educational needs did not receive services by T2. Much work remains to ensure youth receive needed services.Maltreatment Foster care Out-of-home care Screening evaluations Mental health services Educational services

Does subtype matter? Assessing the effects of maltreatment on functioning in preadolescent youth in out-of-home care

a b s t r a c t Objectives: Attempts to understand the effects of maltreatment subtypes on childhood functioning are complicated by the fact that children often experience multiple subtypes. This study assessed the effects of maltreatment subtypes on the cognitive, academic, and mental health functioning of preadolescent youth in out-of-home care using both "variable-centered" and "person-centered" statistical analytic approaches to modeling multiple subtypes of maltreatment. Methods: Participants included 334 preadolescent youth (ages 9-11) placed in out-ofhome care due to maltreatment. The occurrence and severity of maltreatment subtypes (physical abuse, sexual abuse, physical neglect, and supervisory neglect) were coded from child welfare records. The relationships between maltreatment subtypes and children's cognitive, academic, and mental health functioning were evaluated with the following approaches: (1) "Variable-centered" analytic methods: a. Regression approach: Multiple regression was used to estimate the effects of each maltreatment subtype (separate analyses for occurrence and severity), controlling for the other subtypes. b. Hierarchical approach: Contrast coding was used in regression analyses to estimate the effects of discrete maltreatment categories that were assigned based on a subtype occurrence hierarchy (sexual abuse > physical abuse > physical neglect > supervisory neglect). (2) "Person-centered" analytic method: Latent class analysis was used to group children with similar maltreatment severity profiles into discrete classes. The classes were then compared to determine if they differed in terms of their ability to predict functioning. Results: The approaches identified similar relationships between maltreatment subtypes and children's functioning. The most consistent findings indicated that maltreated children who experienced physical or sexual abuse were at highest risk for caregiver-reported externalizing behavior problems, and those who experienced physical abuse and/or physical & Neglect 36 (2012) 633-644 neglect were more likely to have higher levels of caregiver-reported internalizing problems. Children experiencing predominantly low severity supervisory neglect had relatively better functioning than other maltreated youth. Conclusions: Many of the maltreatment subtype differences identified within the maltreated sample in the current study are consistent with those from previous research comparing maltreated youth to non-maltreated comparison groups. Results do not support combining supervisory and physical neglect. The "variable-centered" and "person-centered" analytic approaches produced complementary results. Advantages and disadvantages of each approach are discussed