Reading and numeracy attainment of children reported to child protection services: A population record linkage study controlling for other adversities.

BACKGROUND: Maltreated children are at risk of poor educational outcomes, but also experience greater individual, family, and neighbourhood adversities that may obscure an understanding of relationships between child protection involvement and educational attainment. OBJECTIVE: To examine associations between child protection involvement and 3rd- and 5th-grade reading and numeracy attainment, while controlling multiple other adversities. PARTICIPANTS AND SETTING: Participants were 56,860 Australian children and their parents from the New South Wales Child Development Study with linked multi-agency records. METHODS: Multinomial logistic regressions examined associations between level of child protection involvement (Out-Of-Home Care [OOHC] placement; substantiated Risk Of Significant Harm [ROSH]; unsubstantiated ROSH; non-ROSH; and no child protection report) and standardised tests of 3rd- and 5th-grade reading and numeracy. Fully adjusted models controlled demographic, pregnancy, birth, and parental factors, and early (kindergarten) developmental vulnerabilities on literacy and numeracy, and other developmental domains (social, emotional, physical, communication). RESULTS: All children with child protection reports were more likely to attain below average, and less likely to attain above average, 3rd- and 5th-grade reading and numeracy, including children with reports below the ROSH threshold. Children with substantiated ROSH reports who were not removed into care demonstrated the worst educational attainment, with some evidence of protective effects for children in OOHC. CONCLUSIONS: A cross-agency response to supporting educational attainment for all children reported to child protection services is required, including targeted services for children in OOHC or with substantiated ROSH reports, and referral of vulnerable families (unsubstantiated and non-ROSH cases) to secondary service organisations (intermediate intervention).

Effectiveness of a Trauma-Informed Care Initiative in a State Child Welfare System: A Randomized Study.

Trauma-informed care (TIC) initiatives in state child welfare agencies are receiving more attention, but little empirical evidence exists as to their efficacy. The purpose of this study was to assess changes in self-reported practices and perceptions of child welfare staff involved in a multifaceted, statewide TIC intervention. Ten child welfare offices were matched and randomized to an early or delayed cohort. Staff were surveyed at Time 1 prior to any intervention, Time 2 postintervention for Cohort 1, and Time 3 postintervention for Cohort 2. The survey covered six domains: trauma screening, case planning, mental health and family involvement, progress monitoring, collaboration, and perceptions of the state's overall system performance. Linear mixed modeling assessed the effect of the intervention. Cohort by time interaction was significant for three intervention targets. We demonstrate, using a rigorous study design, the mixed results of a multimodal intervention to improve trauma-informed attitudes, practices, and system performance. TIC initiatives must account for complex, dynamic contextual factors.

Outcomes of In Situ Training for Disclosure as a Standalone and a Booster to a Child Protective Behaviors Education Program.

In this study, the effectiveness of the Observed Protective Behaviors behaviors test, a single-session, disclosure-focused, in situ skills training (IST), was evaluated as a standalone program (IST only) or as a booster to the child protective education program, Learn to be safe with Emmy and friends ™ (program + IST). Participants included 281 Year 1 children (5-7 years; 52% male), randomly assigned to IST only, program + IST, program only or waitlist, and followed across 6 months. At each assessment, children completed interviews to assess their intention and confidence to disclose unsafe situations (disclosure intentions and confidence) and their ability to identify unsafe situations (safety identification skills). Children also reported their anxiety symptoms to assess for a possible iatrogenic effect. The IST-only condition was effective, with children showing increased disclosure intentions relative to waitlist children. The program + IST condition was also effective, with children showing increased disclosure intentions relative to children in the waitlist or program-only conditions as well as greater increases in disclosure confidence relative to waitlist children. No differences were observed between conditions in children's safety identification skills, and no iatrogenic effect on anxiety was found. Future research may seek to develop an IST that will also boost children's safety identification skills.

Implementation of evidence-based home visiting programs aimed at reducing child maltreatment: A meta-analytic review.

In recent years there has been an increase in the popularity of home visitation programs as a means of addressing risk factors for child maltreatment. The evidence supporting the effectiveness of these programs from several meta-analyses, however, is mixed. One potential explanation for this inconsistency explored in the current study involves the manner in which these programs were implemented. In the current study we reviewed 156 studies associated with 9 different home visitation program models targeted to caregivers of children between the ages of 0 and 5. Meta-analytic techniques were used to determine the impact of 18 implementation factors (e.g., staff selection, training, supervision, fidelity monitoring, etc.) and four study characteristics (publication type, target population, study design, comparison group) in predicting program outcomes. Results from analyses revealed that several implementation factors, including training, supervision, and fidelity monitoring, had a significant effect on program outcomes, particularly child maltreatment outcomes. Study characteristics, including the program's target population and the comparison group employed, also had a significant effect on program outcomes. Implications of the study's results for those interested in implementing home visitation programs are discussed. A careful consideration and monitoring of program implementation is advised as a means of achieving optimal study results.

Filling potholes on the implementation highway: Evaluating the implementation of Parent-Child Interaction Therapy in Los Angeles County.

In October 2012, first 5 LA funded a unique collaboration between Los Angeles County Department of Mental Health (DMH) and UC Davis PCIT Training Center (UCD PCIT) to train county-contracted agencies to provide Parent-Child Interaction Therapy (PCIT). This $20 million dollar, 5-year grant represented the largest implementation effort of an empirically based treatment to date. The purpose of this paper was to describe the first 2 years of the implementation process of this project, beginning with project start up and pre-implementation phases, and to present agency training and client performance outcomes from our first year of training. Results presented in this evaluation suggest that it is possible to train LA County providers in PCIT, and that PCIT is an effective intervention for DMH-contracted providers in LA County. This evaluation also discusses challenges to successful implementation. Barriers to progress included unanticipated delays building county infrastructure, trainee attrition, and insufficient client referrals. We discuss the results of the current implementation with respect to theory, research, and others' training models, with the aim of evaluating and prioritizing different implementation drivers, noting the ongoing competition between knowing what to do and the need for action.

The role of collaborations in sustaining an evidence-based intervention to reduce child neglect.

Child neglect is the most prevalent form of child maltreatment and represents 79.5% of open child-welfare cases. A recent study found the evidence-based intervention (EBI) SafeCare(®) (SC) to significantly reduce child neglect recidivism rates. To fully capitalize on the effectiveness of such EBIs, service systems must engage in successful implementation and sustainment; however, little is known regarding what factors influence EBI sustainment. Collaborations among stakeholders are suggested as a means for facilitating EBI implementation and sustainment. This study combines descriptive quantitative survey data with qualitative interview and focus group findings to examine the role of collaboration within the context of public-private partnerships in 11 child welfare systems implementing SC. Participants included administrators of government child welfare systems and community-based organizations, as well as supervisors, coaches, and home visitors of the SC program. Sites were classified as fully-, partially-, and non-sustaining based on implementation fidelity. One-way analysis of variance was used to examine differences in stakeholder reported Effective Collaboration scores across fully-sustaining, partially-sustaining, and non-sustaining sites. Qualitative transcripts were analyzed via open and focused coding to identify the commonality, diversity, and complexity of collaborations involved in implementing and sustaining SC. Fully-sustaining sites reported significantly greater levels of effective collaboration than non-sustaining sites. Key themes described by SC stakeholders included shared vision, building on existing relationships, academic support, problem solving and resource sharing, and maintaining collaborations over time. Both quantitative and qualitative results converge in highlighting the importance of effective collaboration in EBI sustainment in child welfare service systems.

Child-Adult Relationship Enhancement (CARE): An evidence-informed program for children with a history of trauma and other behavioral challenges.

Child maltreatment impacts approximately two million children each year, with physical abuse and neglect the most common form of maltreatment. These children are at risk for mental and physical health concerns and the ability to form positive social relationships is also adversely affected. Child Adult Relationship Enhancement (CARE) is a set of skills designed to improve interactions of any adult and child or adolescent. Based on parent training programs, including the strong evidence-based treatment, Parent-Child Interaction Therapy (PCIT), CARE was initially developed to fill an important gap in mental health services for children of any age who are considered at-risk for maltreatment or other problems. CARE subsequently has been extended for use by adults who interact with children and youth outside of existing mental health therapeutic services as well as to compliment other services the child or adolescent may be receiving. Developed through discussions with Parent-Child Interaction Therapy (PCIT) therapists and requests for a training similar to PCIT for the non-mental health professional, CARE is not therapy, but is comprised of a set of skills that can support other services provided to families. Since 2006, over 2000 caregivers, mental health, child welfare, educators, and other professionals have received CARE training with a focus on children who are exposed to trauma and maltreatment. This article presents implementation successes and challenges of a trauma-informed training designed to help adults connect and enhance their relationships with children considered at-risk.

Trabalhando com violência sexual contra a criança e o adolescente: a perspectiva do psicodrama na formação dos profissionais da rede de proteção / Working with sexual violence against children and adolescents: the perspective of the psychodrama on the professional formation of protection nets workers

A presente dissertação está inserida no debate contemporâneo sobre as práticas profissionais junto a crianças e adolescentes em situação de violência sexual, suas famílias e redes de proteção. A partir da experiência da autora como professorasupervisora da área, traz uma leitura crítica sobre as premissas que informam e constroem as intervenções e apresenta alguns elementos para pensar os processos de formação como aportes à transformação deste cenário. Destaca como discussões preliminares os processos culturais e históricos na construção da noção de abuso sexual intrafamiliar e a política nacional que institui as diretrizes de enfrentamento. Tendo como referencial teórico-metodológico o Psicodrama, propõe como empiria da pesquisa três oficinas de Multiplicação Dramática com um grupo de trabalhadores de um serviço de referência ao atendimento da questão. A análise dos conteúdos das oficinas apontou importante discussão sobre as tensões que permeiam as ações neste campo. Dentre elas, destacaram-se a angústia dos profissionais frente às situações de sofrimento e desamparo dos usuários, os riscos da tutela moral pautada no modelo relacional dicotômico vitimização salvacionismo; os desafios quanto ao trabalho dirigido ao agressor sexual como parte dos investimentos terapêuticos e a crescente judiciarização dos conflitos como fator que pode reduzir a multiplicidade das intervenções. O trabalho sugere a metodologia psicodramática como um significativo dispositivo de formação, uma vez que esta favoreceu não só a elucidação de imaginários e conservas culturais a respeito do tema, mas também, e principalmente, mobilizou reflexões e deslizamentos de sentidos como nuances de transformação e reconhecimento de potência no trabalho. O texto finaliza enfatizando o potencial criativo dos trabalhadores da área que, ancorados no laço grupal, podem avançar em direção a uma visão e postura mais positivadas de seu fazer profissional.(AU)

The present dissertation is inserted in the contemporary debate on professional practices towards children and adolescents in situation of sexual violence, their families and protection nets. Bringing forward from the author s experience as a teacher-supervisor of the area a critical lection of the premises which inform and construct interventions, it presents a few elements for one to think of processes of professional formation as contributions to this scenery s transformation. It emphasizes as preliminary discussion the cultural and historical processes on the construction of the basis of intrafamiliar sexual abuse and the national policy which establish the directives of confrontation. Having the Psychodrama as theoreticalmethodological referential, it proposes as empiric to the research three workgroup of Dramatical Multiplication with a group of workers of a referential service of this matter. The analysis of the workgroup contents pointed out an important discussion about the tensions between actions in this field. Among them, stands out the professionals´ distress when facing the suffering and helplessness of the users, the risks of moral guardianship lying in the victimization salvationist dichotomic model relationship; the challenges when working with the sexual aggressor as part of therapeutical investiments and the growing judiciarization of conflicts as a factor which could reduce the multiplicity of interventions. The work suggest the psychodramatic methodology as a significant provision of formation, once it has benefited not just the elucidation of imaginary and cultural lines regarding this topic, but also, and mainly, it mobilized reflections and flexibility of feelings as nuance of transformation and recognition in the work power. The text finalizes emphasizing the creative potential of workers in this area which, based in group affection, can move forward a vision and posture more positive of their professional accomplishment.(AU)