Children with FASD- Related Disabilities Receiving Services from Child Welfare Agencies in Manitoba

Fetal Alcohol Spectrum Disorder (FASD) is a serious social and health problem for the child welfare, health and education systems in North America and other parts of the world. This article describes the population of children in care of the child welfare system in Manitoba. Also this article will highlight the relevance of these research findings to aboriginal populations in Canada and its implications for international aboriginal/indigenous groups. Finally, the implications for policy, practice are discussed and the article puts forward some directions for further research.     

Mental Health and Substance Abuse Services to Parents of Children Involved with Child Welfare: A Study of Racial and Ethnic Differences for American Indian Parents

American Indian (AI) parents of children involved with child welfare were compared to White, Black and Hispanic parents on mental health and substance abuse problems and access to treatment. Data came from the National Study of Child and Adolescent Well-Being, a longitudinal study of a nationally representative sample of children aged 0–14 years involved with child welfare. Weighted statistics provided population estimates, and multivariate logistic regression was used to predict the likelihood of caregivers receiving mental health or substance abuse services. There were significant disparities in the likelihood of receiving mental health, but not substance abuse, services. Unmet need for mental health and substance abuse treatment characterized all parents in this study. AI parents fared the worst in obtaining mental health treatment. Parents of children at home and of older children were less likely to access mental health or substance abuse treatment.     

Determinants of Substance Abuse in a Population of Children and Adolescents Involved with the Child Welfare System

Substance abuse is an important health issue facing children involved with child welfare, but little is known about the associated factors. The purpose of this study was to build on findings from the Canadian Incidence Study of Reported Child Abuse and Neglect-2003 and use a national sample of 10–15 year old children to examine the factors associated with substance abuse for all investigations and substantiated investigations of maltreatment. Our findings showed that almost 14% of all investigated children were abusing substances and that this proportion was even greater among those whose investigation of maltreatment had been substantiated (almost 16%). The severity of the experienced maltreatment, in addition to behavioural factors, was found to be associated with substance abuse. While the pathways to substance abuse are complex, understanding the risk factors associated with substance abuse in this population are important for targeted interventions for prevention and treatment.     

Child Welfare Recommendations to Improve Mental Health Services for Children who have Experienced Abuse and Neglect: A National Perspective

This study uses a key informant approach to understand the nature, extent, and quality of outpatient mental health services for children in the child welfare system (CWS) in the United States. We interviewed 89 county child welfare administrators to determine the status of outpatient mental health services and provide recommendations for enhancing care and service delivery. Developed for this study (Caring for Children in Child Welfare), the interview was incorporated in the second formal data collection wave (i.e., 18 months after study baseline assessment) of the National Survey of Child and Adolescent Well-Being. The results highlighted general variability in the degree to which these agencies used evidence-based interventions within outpatient services, demonstrated clinical expertise with this population, and met the needs of their families. Community agency use of evidence-based interventions was found to predict their effectiveness in improving clients’ mental health problems. Proposed suggestions for service improvement varied across domains and reflected the need for more communication/coordination, service access, options and resources, and practice refinements to accommodate families’ needs. We discuss the implications of these recommendations from CWS stakeholders for enhancing the service delivery system. We appreciate the assistance and consultation of Jennifer Rolls-Reutz, Barbara J. Burns, Barbara L. Baumann, Michael Hurlburt, and John Landsverk.     

Characteristics of Young Parents Investigated and Opened for Ongoing Services in Child Welfare

This study uses a national child welfare dataset to examine the profile of young parents who are the subject of maltreatment-related investigation and to identify which factors determine service provision from the child welfare system at the conclusion of the investigation. Specifically, it examines how workers in the child welfare system decide which young parents require ongoing services the conclusion of a maltreatment related investigation where other risk factors are also being assessed. It found that young parents are struggling with a number of issues including poverty, housing, mental health, violence and children who are exhibiting functioning concerns. Workers in the child welfare system provide ongoing services to young parents particularly in investigations where they have noted concerns around drug/solvent use, cognitive impairment, mental health issues, physical health issues and few social supports. The opportunity to target interventions for the specific concerns for this very vulnerable population is evident.     

The Relationship Between Post-Traumatic Stress Symptoms and Substance Use Among Adolescents Involved with Child Welfare: Implications for Emerging Adulthood

The purpose of the present study was to examine the role of posttraumatic stress symptoms (PTSS) in predicting substance use and substance-related problems in a sample of older youth and emerging adults involved with child welfare. The sample was drawn from the Maltreatment and Adolescent Pathways (MAP) longitudinal study (Wekerle et al. 2009). Participants were 253 youth and emerging adults (ages 15–20; M = 16.87, SD = 1.04; 61.4% female and 38.6% male) who were involved with child welfare. Multiple regression analyses were conducted to examine the impact of PTSS using subscales from the Trauma Symptom Checklist for Children (TSCC; Briere 1996). Outcome variables were past year alcohol, marijuana and illicit drug use; as well as alcohol and drug problems. Controlling for gender, age, child welfare status and child maltreatment, both dissociation and anger emerged as significant predictors of substance use and related problems. The implications of these findings for older youth and emerging adults exiting the child welfare system are discussed.     

Associations of Personality with Alcohol Use Behaviour and Alcohol Problems in Adolescents Receiving Child Welfare Services

Four specific personality factors have been theorized to put adolescents at risk for alcohol abuse: hopelessness (HOP), anxiety sensitivity (AS), sensation seeking (SS), and impulsivity (IMP). We examined relations of these personality factors to various alcohol-related indices in a sample at high risk for alcohol problems—specifically, a child welfare sample. Adolescents (n = 197; mean age = 16.8 years; 43% males) receiving services through Ontario Child Protective Services participated. Personality was assessed with the Substance Use Risk Profile Scale (SURPS). Alcohol-related outcomes were assessed with the Ontario Student Drug Use and Health Survey (OSDUHS). Results showed that, consistent with theory, HOP, SS, and IMP were all positively correlated with overall drinking levels and overall alcohol problems on the OSDUHS. Unexpectedly, AS was negatively correlated with overall drinking levels and was unrelated to the OSDUHS overall alcohol problems factor. Consistent with hypothesis, HOP was related to an increased likelihood of receiving treatment for an alcohol problem. But, despite greater drinking levels and alcohol problems, IMP was related to a decreased likelihood of receiving alcohol treatment. In addition, SS and HOP were related to earlier onset drinking. Additional exploratory analyses revealed that AS was positively associated with difficulties stopping drinking and negatively associated with discussing such difficulties with school personnel. Implications for treatment and prevention of heavy drinking and alcohol problems in child welfare youth are discussed.     

History of Family Involvement with Child Protective Services as a Risk Factor for Bullying in Ontario Schools

Background: The relationship between history of family involvement with child protective services (CPS) and bullying was examined. Method: Data were obtained from 2,516 pupils aged 12–19 in the 2007 Ontario Student Drug Use and Health Survey. The association between self‐reported history of family involvement with CPS and bullying was estimated using negative binomial hurdle regression models. Results: Females who reported family CPS involvement were more likely to have bullied and been bullied compared with females without CPS involvement. Among males, family CPS involvement was only significantly associated with bully victimisation. Conclusion: A history of family CPS involvement was a risk factor for bullying victimisation and perpetration.     

School Engagement of Youth Investigated by Child Welfare Services: Associations with Academic Achievement and Mental Health

Youth who have experienced abuse, neglect, or are involved with child welfare services are at significant risk of low academic achievement and poor mental health outcomes. The literature on children involved with child welfare services has typically focused on the impact of individual, home, and community factors, but less research has considered the impact of school engagement on maltreated youth outcomes. This study utilized data from the National Survey of Child and Adolescent Well-Being to examine the potential main effect of school engagement on youth academic achievement and mental health in a longitudinal national sample of youth who were the subject of a child welfare investigation. Predicting that school engagement would be especially critical for youth who are removed from home, this study also examined whether school engagement moderated the effect of home placement instability on youth outcomes. Results of hierarchal regression analyses showed that school engagement was an independent predictor of youth internalizing symptoms, externalizing symptoms, and academic achievement in reading and math after controlling for initial symptoms/achievement levels and relevant covariates. School engagement did not significantly moderate the association between home instability and youth outcomes. Directions for future research are discussed.     

Evaluating Child Welfare Policies with Decision-Analytic Simulation Models

The objective was to demonstrate decision-analytic modeling in support of Child Welfare policymakers considering implementing evidence-based interventions. Outcomes included permanency (e.g., adoptions) and stability (e.g., foster placement changes). Analyses of a randomized trial of KEEP-a foster parenting intervention-and NSCAW-1 estimated placement change rates and KEEP's effects. A microsimulation model generalized these findings to other Child Welfare systems. The model projected that KEEP could increase permanency and stability, identifying strategies targeting higher-risk children and geographical regions that achieve benefits efficiently. Decision-analytic models enable planners to gauge the value of potential implementations.     

A Study of the Families Included in Receiving Better Special Education Services (FIRME) Project for Latinx Families of Children with Autism and Developmental Disabilities

Family-professional partnership is an essential component of the special education process for children with intellectual and/or developmental disabilities (IDD), including autism spectrum disorder (ASD). Latinx families face systemic barriers when participating in educational decision-making for their children with IDD. Few studies have examined the effectiveness of advocacy trainings among Latinx families of children with IDD, including ASD. The purpose of this pilot study was to examine the effectiveness and feasibility of the Familias Incluidas en Recibiendo Mejor Educación Especial (FIRME), an advocacy program for Latinx families of children with IDD, with respect to increasing special education knowledge, advocacy, empowerment, and receipt of services; and decreasing stress. After completing the FIRME program, participants demonstrated significantly increased: special education knowledge; advocacy; and empowerment.

     

Improving the Mental Health of Children in Child Welfare Through the Implementation of Evidence-Based Parenting Interventions

Any comprehensive approach to children’s mental health should consider services systems such as Child Welfare that provide services to children with high rates of emotional and behavioral disorders. This paper will review what is known about efficacious parent-focused interventions that can improve the lives of children in Child Welfare and explore possible reasons why such interventions are rarely used by Child Welfare agencies. Data from a pilot study suggest key features for increasing the implementation of efficacious practices to improve children’s mental health.     

State Infant/Toddler Program Policies for Eligibility and Services Provision for Young Children with Autism

The importance of early developmental and behavioral treatment for children with autism is increasingly recognized. Little is known, however, about early intervention policies that may affect service delivery to these children. The current study describes states’ policies for providing early intervention services to children with Autistic Spectrum Disorders under the Individuals with Disabilities Education Act Part C and examines how Part C policies are associated with the proportion of school-age children diagnosed with autism served under IDEA. Results indicate few consistencies among states in policies and practices regarding the identification and care of infants and toddlers with autism. The implications of state variation for policy makers are discussed.     

Play and Joint Attention of Children with Autism in the Preschool Special Education Classroom

The purpose of this study was to examine play and joint attention in children with autism (n=27) as compared to children with other developmental delays (n=28) in public preschool special education classrooms. The participants were observed in their classroom environment for 2?h over 3 separate days. Results show that children with autism spent more of their time unengaged and less time engaged in symbolic play and joint attention behaviors as compared to children with other developmental delays. Additionally, teachers seldom focused directly on symbolic play and joint attention in their teaching. These findings suggest the importance of educating teachers to target play and joint attention skills in their preschool special education classes, specifically for children with autism.     

Use of Treatment Services for Attention-Deficit/Hyperactivity Disorder in Latino Children

This article reviews recent research that examines service use for attention-deficit/hyperactivity disorder among Latino children. Using MEDLINE, PsycInfo, and PubMed, literature searches were conducted for research published between January 2008 and April 2010 that specifically focused on Latino children or included a sufficient sample of Latino children and examined racial/ethnic differences between groups. Eight studies regarding general service use, treatment with medication, and parenting interventions were identified and are reviewed herein. Results of these studies highlight important factors associated with the continued mental health service use disparities among Latino children, such as parental attitudes toward service use. Results also provide much-needed data with regard to adapting and engaging Latino parents into parenting interventions. Suggestions for clinical practice and future research are discussed.