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1.
Am J Speech Lang Pathol ; 32(1): 358-376, 2023 Jan 11.
Artigo em Inglês | MEDLINE | ID: mdl-36538503

RESUMO

PURPOSE: Children in foster care are at an increased risk for language delays and disorders, and foster parents can play a significant role in preventing delays in early language development. This scoping review explored empirical studies that included foster parent training programs for families with foster children under the age of 5 years. METHOD: Using the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews), multiple databases were searched, and resulting article titles and abstracts were screened for inclusion in the review. Each study that met inclusion criteria was then coded for the training methods used to teach foster parents intervention strategies and the targeted outcomes of the intervention. RESULTS: A total of 24 studies were identified. Of the 24 studies reviewed, all included interventions focused on increasing parent-child relationships and decreasing child challenging behaviors, but few included opportunities for foster parents to practice using intervention strategies with their foster child. None of the studies focused specifically on strategies for promoting children's language development. When outcomes across the studies were reviewed, only two focused on children's language. CONCLUSIONS: The results of this review point to the need for more research on language interventions that can be implemented by foster parents. The discussion focuses on the important role speech-language pathologists can play in the prevention of early language delays or disorders in young foster children. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.21714311.


Assuntos
Criança Acolhida , Transtornos do Desenvolvimento da Linguagem , Pré-Escolar , Humanos , Desenvolvimento da Linguagem , Transtornos do Desenvolvimento da Linguagem/diagnóstico , Transtornos do Desenvolvimento da Linguagem/prevenção & controle , Relações Pais-Filho , Pais
2.
Prax Kinderpsychol Kinderpsychiatr ; 71(8): 705-721, 2022 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-36511596

RESUMO

The biological children of foster parents have received little attention in the literature and in research. This article presents the results of an in-depth interview study on the experiences of biological children (9 to 18 years). Data analysis showed that the children and adolescents interviewed described the relationship with the foster sibling positively overall, although they also addressed problematic and unsatisfactory aspects. In the family, they assume numerous responsibilities and actively contribute to the success of the foster relationship. However, they often feel inadequately prepared for fostering and dealing with the foster child. Recommendations for practice and further studies are derived from the results.


Assuntos
Criança Acolhida , Adolescente , Criança , Humanos , Cuidados no Lar de Adoção , Cuidado da Criança , Pesquisa Qualitativa , Pais
3.
PLoS One ; 17(10): e0275784, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36215294

RESUMO

The objective of this meta-synthesis was to systematically synthesise qualitative research that explores foster children's perspectives on participation in child welfare processes. Searches were conducted in Medline (OVID), Embase, PsycINFO, and Social Science Citation Index. Children in non-kinship foster care in any setting (high-income, middle-income, low-income countries) who self-reported their experiences of care (removal from home, foster family processes, placement breakdown) were eligible for inclusion. Selected studies took place in 11 high-income countries. A total of 8436 citations were identified and 25 articles were included in this meta-synthesis. Studies summarized the views of 376 children. Children had been in foster care between two weeks and 17 years. Findings synthesize 'facets' of children's participation (e.g., being asked vs making decisions), as well as children's perceived barriers and facilitators to participation. A main priority for children was the quality of their relationships, especially in terms of values (e.g., fairness, honesty, inclusivity). No one way of participating in child welfare processes is better than another, as some children more clearly expressed a desire for passive listening roles and others indicated a desire for active roles in decision-making. However, meaningful adults in foster children's lives have a responsibility to act in a way that strengthens the emphasis on children's needs and voices.


Assuntos
Criança Acolhida , Adulto , Criança , Proteção da Criança , Cuidados no Lar de Adoção , Humanos , Pesquisa Qualitativa
4.
Child Abuse Negl ; 133: 105866, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-36070665

RESUMO

BACKGROUND: LGBTQ+ youth frequently experience disparities in outcomes related to permanency and overall well-being while in out-of-home care. These negative outcomes often persist after youth have transitioned out of care, particularly in the domains of housing, education, employment, and mental health. Initial research has found that the ongoing COVID-19 pandemic has exacerbated negative physical and mental health outcomes, as well as decreased economic stability among transition age youth. OBJECTIVE: This study seeks to determine if COVID-19 has resulted in unique impacts on foster care alumni, and if these impacts are the same for LGBTQ+ and non-LGBTQ+ transition age youth. PARTICIPANTS AND SETTING: This study used data from the 2020 Jim Casey Youth Opportunities Initiative Opportunity Passport Survey to explore these questions. METHODS: This survey was administered electronically to a national sample of 1223 youth ages 18-26 with lived experience in foster care. RESULTS: Results indicate that relative to non-LGBTQ+ foster care alumni, LGBTQ+ foster care alumni experienced more negative outcomes in housing stability, employment, and mental health/trauma due to COVID-19. No significant differences were found for education-related impacts. Outcomes varied by sex assigned at birth, ethnicity, and sexual orientation, gender identity and expression (SOGIE) of respondents, with female respondents, black, indigenous and other people of color (BIPOC) youth and LGBTQ+ youth being most frequently impacted. CONCLUSIONS: Results indicate that relative to non-LGBTQ+ foster care alumni, LGBTQ+ foster care alumni experienced more negative outcomes in housing stability, employment, and mental health/trauma due to COVID-19. No significant differences were found for education-related impacts. Outcomes varied by sex assigned at birth, ethnicity, and sexual orientation, gender identity and expression (SOGIE) of respondents, with female respondents, BIPOC youth and LGBTQ+ youth being most frequently impacted. Implications for practice and policy are explored.


Assuntos
COVID-19 , Criança Acolhida , Adolescente , Adulto , COVID-19/epidemiologia , Feminino , Cuidados no Lar de Adoção/psicologia , Identidade de Gênero , Humanos , Recém-Nascido , Masculino , Pandemias , Adulto Jovem
5.
Health Technol Assess ; 26(35): 1-106, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35959710

RESUMO

BACKGROUND: Looked-after children are at risk of suboptimal attachment patterns and reactive attachment disorder. However, access to interventions varies widely and there are no evidence-based interventions for this disorder. OBJECTIVES: (1) To adapt an existing video-feedback intervention to meet the specific needs of foster children in the UK with reactive attachment symptoms, (2) to conduct a case series to road-test the treatment manual and study procedures, (3) to conduct a scoping study of the key hurdles in a pilot trial and (4) to conduct a pilot randomised controlled trial of the adapted intervention to determine the feasibility of a future full-scale trial. DESIGN: This was a mixed-methods study. The adapted treatment manual was developed with expert input and tested on a small case series. Qualitative interviews with key stakeholders were used in the scoping study in preparation for the trial and later with foster carers who received the new intervention. The final stage was a feasibility and pilot randomised controlled trial of the new intervention, compared with usual care. Researchers assessing the outcomes were blinded to group assignment. SETTING: The study was set in outpatient child and adolescent mental health services and partner social services departments. Sites included urban and rural/semirural areas. PARTICIPANTS: Participants were foster carers with children aged ≤ 6 years presenting with difficulties in the domain of reactive attachment disorder. Key stakeholders included children's services managers and mental health service practitioners in the scoping study. Foster carers who received the modified intervention participated in qualitative interviews. INTERVENTION: The video-feedback intervention to promote positive parenting and sensitive discipline is an extensively evaluated and effective treatment approach. This intervention was modified (based on the adapted version for foster care in the Netherlands) to suit the needs of young children with reactive attachment symptoms in foster care in the UK and was delivered to improve the sensitive responding of foster carers, foster carer-child relationships and child outcomes. The modified intervention was delivered in-home by trained mental health professionals over a period of 4-6 months. MAIN OUTCOME MEASURE: The main outcome was reactive attachment symptom scores on the Disturbances of Attachment Interview. RESULTS: A series of minor changes to the intervention programme were introduced, which focused on improving its suitability for the UK foster care context. Challenges in recruitment meant that, despite numerous modifications to the protocol and the inclusion of additional sites, only 30 families (target, n = 40) were recruited to the randomised controlled trial (15 allocated to each group). However, most other trial parameters were deemed feasible and acceptable, particularly the high levels of data and treatment completeness. All randomised families were available for baseline analyses, but two in the treatment arm were not available for post-treatment analyses. The revised intervention was positively received by practitioners and foster carers. LIMITATIONS: Only three-quarters of the target sample size was recruited. Furthermore, the sites' own exclusion of potential participants and the low return rates of screening questionnaires raise the possibility of non-randomness of non-responses. CONCLUSION: A larger-scale trial may be feasible, but only if recruitment barriers can be overcome. Dedicated resources to support recruitment within local authorities and wider inclusion criteria are recommended. Central resourcing of intervention capacity to supplement NHS staff is also recommended. TRIAL REGISTRATION: This trial is registered as ISRCTN18374094. FUNDING: This project was funded by the National Institute for Health and Care Research ( NIHR ) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 26, No. 35. See the NIHR Journals Library website for further project information.


Children in foster care typically have had a very difficult start in life, often as a result of abuse or neglect within their family of origin, and separation from caregivers. These children can find it difficult to trust new adults, and in some cases difficulties in attachment may justify a diagnosis of reactive attachment disorder. This disorder is a pattern of behaviour among young children who have received extremely insufficient early care, whereby they fail to seek or respond to comfort from carers when hurt or distressed, and they can be very withdrawn. There are currently no evidence-based treatments for reactive attachment disorder. The Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline is a treatment programme that was developed to promote secure attachments in young children and to help parents deal with difficult behaviour. A practitioner films the child and parent interacting at home and provides feedback in the following session. This treatment was previously adapted for use in foster care in the Netherlands. In this study, we modified the treatment further to ensure that it appropriately addressed the needs of young children in foster care in the UK who present with reactive attachment disorder symptoms. We then worked with local authorities and linked mental health services to develop a system for identifying young children in foster care in need of this treatment. Finally, we conducted a small (pilot) study to gather information about the best way to provide the modified treatment in this context. The revised treatment was positively received by practitioners and foster carers. The majority of the processes involved in running a trial also worked well (e.g. good levels of attendance at assessments and at the treatment sessions). However, we encountered significant difficulties in recruiting foster carers to the study. We concluded that a full-scale trial would be very valuable, and could potentially be undertaken if difficulties with recruitment are overcome. We recommend that greater resources be provided to local authorities to help them engage and recruit foster carers.


Assuntos
Criança Acolhida , Transtorno Reativo de Vinculação na Infância , Adolescente , Cuidadores , Pré-Escolar , Análise Custo-Benefício , Estudos de Viabilidade , Retroalimentação , Humanos
6.
Child Abuse Negl ; 131: 105761, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-35777338

RESUMO

BACKGROUND: Debates exist regarding whether foster youth should be asked about their placement preferences following removal, with only youth aged 12 years and older at times assumed legally competent to provide input. OBJECTIVES: The present study evaluated whether placement-related factors known to predict youth's well-being also shape their placement preferences and whether preferences differ between youth below and above the age at which they are considered legally competent to provide input. METHOD: Data (N = 1033, ages 6-17 years, 54 % female) were obtained from NSCAW-I. Youth were asked open- and closed-ended questions about their placement preferences. RESULTS: Among youth removed for shorter periods, placement with kin was related to a greater preference for their current placement (RRR = 0.31, p < .001) and desire for permanency in that placement (OR = 1.95, p = .005) relative to youth placed with non-kin. However, youth removed for longer periods (e.g., a year) were similar in their desires for their current placement to be permanent regardless of whether they were living with kin or non-kin caregivers. Among younger youth, placement with siblings (RRR = 0.42, p = .015) was linked to a preference for their current placement. Racial match between youth and their non-kin caregiver was unrelated to their placement preferences. CONCLUSIONS: Findings revealed that both younger and older youth's placement preferences were shaped by factors objectively linked to youth's well-being and thus align with best practices in placement decisions. The paper discusses the importance of asking youth as young as 6 years about their placement preferences and offers suggestions for social service and legal professionals regarding questioning strategies.


Assuntos
Criança Acolhida , Irmãos , Adolescente , Feminino , Cuidados no Lar de Adoção , Humanos , Masculino , Comportamento Sexual , Serviço Social
7.
J Child Adolesc Psychopharmacol ; 32(7): 400-407, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-35834606

RESUMO

Background: In response to concerns regarding psychotropic medication prescribing, California's foster care system implemented oversight strategies to improve prescribing and monitoring practice, particularly for antipsychotics. The impact of these policies has not been evaluated. Objectives: To examine foster youth psychotropic use data in California and their relationship to national and state policy initiatives. Methods: This study analyzed 2011-2020 data curated by the California Child Welfare Indicators Project. The platform matches Medicaid medication and laboratory claims with individual-level foster youth data to report rates of dispensed psychotropic medications, authorization status, and metabolic screening. Results: In 2011, there were 78,231 California youth in foster care, of which 10,435 (13.3%) received psychotropics and 5570 (7.1%) antipsychotics. In 2020, of 68,386 foster children, 7172 (12.2%) received psychotropics and 2068 (3.0%) antipsychotics. Proper authorizations for psychotropics were obtained for 5581 (77.8%) foster youth in 2020. Of those receiving antipsychotics, 904 (43.7%) underwent metabolic screening. The greatest declines in antipsychotic use occurred between 2013 (6.7%) and 2018 (3.1%). Overall 2011 to 2020 declines were similar for males (8.5% → 3.6%, 58% reduction, p < 0.001) and females (5.5% → 2.4%, 57% reduction, p < 0.001). Regarding age and race, greater declines occurred for children <10 years (2.33% → 0.84%, 64% reduction, p < 0.001) and Latino youth (5.4% → 2.2%, 59% reduction, p < 0.001). Conclusions: Temporal patterns in antipsychotic use suggest an impact of policies and guidelines. While 12.2% of foster youth continue to receive psychotropics, there were reductions in racial/ethnic disparities and declines in antipsychotic use. Lack of adherence to authorization and metabolic screening requirements continue to be concerning.


Assuntos
Antipsicóticos , Criança Acolhida , Adolescente , Antipsicóticos/uso terapêutico , California , Criança , Feminino , Cuidados no Lar de Adoção , Humanos , Masculino , Medicaid , Psicotrópicos/uso terapêutico , Estados Unidos
10.
Am J Community Psychol ; 70(3-4): 278-290, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-35445755

RESUMO

Grassroots movements such as Poder Quince exemplify how Latinx youth intertwine their cultural heritage and traditions with civic action to create positive change within their communities. Parents' cultural socialization messages have been shown to instill cultural pride and encourage prosocial behaviors (e.g., helping others, caring for younger siblings). However, there is a dearth of research on the sociopolitical discussions Latinx adolescents have with their parents and the mechanisms by which cultural socialization encourages prosocial civic development. Drawing on data from a sample of 269 self-identified Latinx youth from three Midwestern US schools, the present study explored the direct links between parental cultural socialization and adolescents' sense of social responsibility (i.e., concern for others and caring for community) as well as the potential indirect associations via sociopolitical and civic socialization at home. Our findings suggest direct associations between cultural socialization and caring for their communities. Additionally, we observed indirect associations between cultural socialization and youths' social responsibility via family civic socialization practices and engagement in sociopolitical discussions taking place in the home.


Assuntos
Comportamento do Adolescente , Criança Acolhida , Adolescente , Humanos , Socialização , Pais , Responsabilidade Social
11.
Washington, D.C.; OPS; 2022-04-28.
Não convencional em Espanhol | PAHO-IRIS | ID: phr-55940

RESUMO

Hemos hecho grandes progresos en la mejora de la supervivencia infantil, pero también tenemos que crear las condiciones adecuadas para ayudar a los niños y niñas a prosperar a medida que crecen y se desarrollan. El enfoque basado en el cuidado cariñoso y sensible los protege de los peores efectos de la adversidad y produce beneficios intergeneracionales y de por vida para la salud, la productividad y la cohesión social. Un mayor número de menores afectados por el VIH está sobreviviendo. Para que tanto los que tienen VIH como los que no están infectados pero viven con personas expuestas al virus puedan alcanzar su pleno potencial, debemos crear un entorno propicio y contribuir a alcanzar los objetivos de prevención perinatal y posnatal del VIH y las metas 95-95-95 del ONUSIDA. Esta publicación propone adoptar un enfoque innovador para garantizar una supervivencia libre de VIH y un desarrollo óptimo. Los servicios concebidos específicamente para prevenir y tratar el VIH pueden ir un paso más allá y proporcionar apoyo específico al cuidado cariñoso y sensible de las familias y los niños afectados por el VIH. De ese modo, los cuidadores mejorarán su percepción de la atención recibida y es más probable que regresen al centro de salud para cuidarse y cuidar a sus hijos.


Assuntos
HIV , Tuberculose , Infecções Sexualmente Transmissíveis , Saúde da Criança , Criança Acolhida
12.
Washington, D.C.; OPS; 2022-04-27.
Não convencional em Espanhol | PAHO-IRIS | ID: phr-55938

RESUMO

En el 2018, más de 29 millones de niños nacieron en zonas afectadas por conflictos, y se estima que 43% de los niños menores de 5 años en países de ingresos bajos y medianos, incluidos los contextos humanitarios, están actualmente en riesgo de no alcanzar un desarrollo óptimo. En la Región de las Américas, las situaciones humanitarias son múltiples e incluyen las emergencias causadas por desastres naturales, la migración y las epidemias, entre otras. A pesar de las circunstancias difíciles, es posible brindar protección, mitigar los efectos negativos y construir resiliencia tanto en los niños como en sus cuidadores. Este resumen temático resalta la necesidad de proteger a los niños que viven en entornos humanitarios y asegurar que reciban un cuidado cariñoso que responda a sus necesidades, y ofrece orientaciones sobre lo que los planificadores y ejecutores de programas pueden hacer para minimizar el impacto de las emergencias en la vida de los niños pequeños y sus familias. Además, facilita información sobre las intervenciones y las prácticas que podrían ser incorporadas a la respuesta de las situaciones de emergencia en la actualidad, y sobre todo, aquellas que podrían ser parte de la estrategia de preparación y respuesta ante las situaciones de emergencia en el futuro.


Assuntos
Empatia , Criança , Criança Acolhida , Saúde da Criança , Serviços de Proteção Infantil , Emergências
13.
Artigo em Espanhol | IBECS | ID: ibc-202855

RESUMO

Resultados:Los resultados confirman la estructura interna esperada para los instrumentos (tres factores de primer orden y un factor de segundo orden para PLANEA-S, modelo unidimensional para PLANEA-9-S y modelo bifactorial correlacionado para PLANEA-T-S). Los instrumentos mostraron niveles excelentes de fiabilidad (ω = .80-.97) y capacidad discriminativa. El personal informó de menor nivel de habilidades para la vida independiente que el grupo de jóvenes, pero no de autonomía en la vida diaria, lo cual estuvo mediado por el rol del informante adulto con respecto al joven.Conclusiones: Se concluye que la versión para educadores de los instrumentos PLANEA de evaluación de habilidades para la vida independiente amplía el campo de evaluación de este constructo en jóvenes en acogimiento desde una perspectiva multiinformante, lo que es clave para que los servicios de protección infantil puedan identificar y atender las necesidades individuales de estos jóvenes, seleccionando los apoyos necesarios en cada caso para la promoción de una transición exitosa desde el sistema de protección a la vida adulta.


Background:This study aimed to adapt and validate a staff version of the PLANEA Independent Life Skills Assessment tools, which were then used to explore the convergence between self-reported and staff views of independent living skills of young people in residential child care in Spain. Method: A sample of 422 care-experienced young people was evaluated by their residential or care workers (n = 219) using the staff version of PLANEA instruments. Psychometric analyses were carried out to study dimensionality and measuring properties of the instruments, while t-tests, Pearson correlations and Fisher’s z were used to study convergence between informants. Results: The results show that the internal structure of the instruments was confirmed for the staff versions (three first-order factors and one second-order factor model for PLANEA-S, unidimensional model for PLANEA-9-S, and two-factor correlated model for PLANEA-T-S). The instruments showed excellent reliability (ω = .80-.97) and discriminative capacity. Staff showed less optimistic views than young people about their independent living skills but not their autonomy to perform everyday life tasks. This was mediated by the role of the adult respondent towards the young person evaluated. Conclusions: As conclusions we can say that the validated staff version of the PLANEA Independent Life Skills Assessment tools expands the scope for assessing this construct in young people in care from a multi-informant perspective. This is key for child protection services to address young people’s individual needs and inform decision-making regarding the provision of support services that will promote a successful transition from care to adulthood for them.


Assuntos
Humanos , Ciências da Saúde , Adaptação a Desastres , Vida Independente/psicologia , Criança Acolhida/psicologia
14.
Eur Child Adolesc Psychiatry ; 31(3): 495-509, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33590310

RESUMO

Given the concerns raised regarding the effects of prenatal exposure to methadone and buprenorphine on the developmental outcomes of the children, this study assessed mental health and use of services in a national sample of school-aged children (N = 78) born to women enrolled in opioid maintenance treatment during pregnancy, compared with a group of foster children (N = 140). The majority of the opioid-exposed children lived with their birth parent(s) at the time of assessment (N = 62), while 16 lived in foster homes. Caregivers completed the Strengths and Difficulties Questionnaire (SDQ) and the Reactive Attachment Disorder scale. Teachers completed the SDQ. Three kinds of services were included in measuring service use: school-based education services, child mental health services, and hospital-based habilitation services. The main finding of the study is that children prenatally exposed to methadone or buprenorphine living with their family of origin had significantly better mental health status than their foster-placed counterparts and that of the comparison group of foster children. In addition, the exposed children living at home had less child welfare involvement, and only half of them were using any of the three services measured. The odds for using services increased significantly in accordance with increasing mental health problems, independent of group affiliation, indicating a need-based access to services. In line with other studies, we found that the odds for using one or more services was 2.3 times greater for boys than for girls. Our results contribute to a more-nuanced understanding of the developmental outcomes of prenatal exposure to methadone and buprenorphine, and factors associated with increased service use in groups of at-risk children.


Assuntos
Analgésicos Opioides , Criança Acolhida , Criança , Atenção à Saúde , Feminino , Cuidados no Lar de Adoção , Humanos , Masculino , Saúde Mental , Metadona , Gravidez
15.
Child Abuse Negl ; 130(Pt 3): 105126, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-34052020

RESUMO

BACKGROUND: Youth transitioning from foster care to college face multiple obstacles. Pre-college programs can promote college access for underrepresented students. The research on pre-college programs that prepare foster youth for college is limited. There is a paucity of research that illuminates youth voices in pre-college programs. OBJECTIVE: This article reviews key program components of a pre-college summer program designed specifically for youth transitioning from foster care, the National Social Work Enrichment Program (NSEP). Findings from a qualitative research study of NSEP are presented. Implications for policy, practice, and research for pre-college programs are discussed. PARTICIPANTS AND SETTING: Fourteen youth, who successfully completed NSEP and had enrolled in college following the program, participated in the study. METHODS: Participants completed semi-structured interviews via a video conferencing tool. Interviews were transcribed verbatim and analyzed using NVivo 12. RESULTS: Thematic analysis captured youth voices, highlighted in the themes: college aspirations, college preparation, and community building. Results suggest NSEP youth aspired to enroll in college. Results also suggests that the NSEP experience helped to prepare youth for college and facilitated the development of community among participants. CONCLUSIONS: Investment in pre-college programs could provide the right support and resources that youth need to transition from foster care to college. Pre-college programs provide an opportunity for youth to develop college readiness skills, build relationship skills, and grow personally. Further research on the efficacy of pre-college programs is needed.


Assuntos
Criança Acolhida , Adolescente , Escolaridade , Humanos , Políticas , Pesquisa Qualitativa , Universidades
16.
Clin Child Psychol Psychiatry ; 27(2): 466-479, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34632816

RESUMO

Externalizing behavior problems are a salient issue in the context of child protection services, where associations with placement stability and caregiving behavior have been documented. Moreover, although research on the association between contact with biological parents and foster child externalizing behavior problems is scarce and has yielded mixed results, several studies have shown links between the two variables. The purpose of this study is to determine the association of face-to-face contact with biological parents and externalized behaviors, while taking into account placement instability and foster parent interactive sensitivity. Fifty preschoolers and their foster parents were visited at home. Child externalizing behavior problems were self-reported by foster parents, foster parent sensitivity was measured via play observations, and information relative to placement was collected through interviews with biological parents and gathered from social services data. Results reveal that more frequent contact with biological parents and lower levels of foster parent sensitivity are independently linked to greater levels of externalizing behavior problems even after controlling for placement instability. Discussion focuses on the importance of children's relationship experiences during foster care and the necessity to investigate their role to more clearly understand foster child socioemotional development.


Assuntos
Transtornos do Comportamento Infantil , Criança Acolhida , Comportamento Problema , Criança , Comportamento Infantil , Transtornos do Comportamento Infantil/psicologia , Pré-Escolar , Cuidados no Lar de Adoção/psicologia , Humanos , Relações Pais-Filho , Pais/psicologia
17.
Child Maltreat ; 27(4): 596-604, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-34308682

RESUMO

It is perhaps surprising that we lack complete national information about why children enter foster care. While the annual Adoption and Foster Care Analysis Reporting System (AFCARS) report is informative, it leaves many questions unanswered, particularly "how many children enter foster care by means other than Child Protective Services (CPS) reports?" Drawing from a unique new integrated dataset, we examined foster care data (AFCARS) and CPS report data (National Child Abuse and Neglect Data System Child File). The linked dataset included 210,062 children with foster care placements in 2017 and no placements in the prior 5 years. We categorized each placed child along two dimensions of four levels each: Time since prior CPS report (if any) and stated AFCARS placement reason, ranging from clearly maltreated to clearly not maltreated. We also tracked the siblings of placed children, to see if non-maltreated children entered care because of maltreated siblings. We find that between 8-35% of children enter foster care for reasons other than maltreatment, depending how thresholds are set. These numbers decline somewhat when siblings are considered. A meaningfully large number of children are placed in foster care for reasons other than maltreatment investigated by CPS. Further research into these children is warranted to better inform foster care policy.


Assuntos
Maus-Tratos Infantis , Criança Acolhida , Criança , Serviços de Proteção Infantil , Família , Cuidados no Lar de Adoção , Humanos
18.
Child Maltreat ; 27(4): 658-670, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-34311552

RESUMO

Recent federal laws and state policies reflect the government's investment in improving education and employment outcomes for youth with foster care histories. However, little research has assessed the roles of these programs using national data. Drawing on data from the National Youth in Transitions Database (NYTD) (n = 7797), this study examines the roles that state-level policies and programs, youth-level participation in programs and services, and youth characteristics play in youths' connection to employment and education ("connectedness") at age 21. Results from multilevel regression analyses find that foster youth in states with widely available tuition waiver programs increases the odds of connectedness to school. The amount of time youth spend in extended foster care, as well as receipt of postsecondary education aid and services, also increases connectedness. Study findings underscore the importance of material and relational supports in supporting foster youths' connection to employment and education in early adulthood.


Assuntos
Assistência ao Convalescente , Criança Acolhida , Adolescente , Adulto , Emprego , Cuidados no Lar de Adoção , Humanos , Políticas , Adulto Jovem
19.
J Trauma Acute Care Surg ; 92(2): 362-365, 2022 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-34369437

RESUMO

BACKGROUND: Nearly half of pediatric homicides younger than 5 years are attributable to child abuse. Parents are most commonly the perpetrators, but less is known about incidents involving biological versus surrogate parents. We sought to evaluate the characteristics of fatal child abuse involving biological and surrogate parents using the Georgia National Violent Death Reporting System, which we believe may differ in demographics and incident characteristics. METHODS: This database was used to examine all homicides of children younger than 18 years from 2011 to 2017. Demographics and incident characteristics were analyzed using the existing National Violent Death Reporting System variables and incident narratives. Nonparametric and χ2 tests were used to compare fatal child abuse incidents involving biological and surrogate parents (e.g., adoptive, foster, step-parents, intimate partners of biological parent). RESULTS: There were 452 pediatric homicides and 219 cases of fatal child abuse. Of all cases of fatal child abuse, 60% involved biological and 29% involved surrogate parents. Compared with children killed by biological parents, children killed by surrogate parents were older (4 vs. 3 years), more often male (71% vs. 51%), more likely to survive the initial injury and present to the emergency department before death (96% vs. 69%), and less likely to have a medical comorbidity (2% vs. 11%; all p < 0.05). Surrogate parents were more likely to be male (90% vs. 48%) and use a firearm (20% vs. 13%) to inflict the injury, both p < 0.05. The race/ethnicity of the child was not associated with the parent's relationship. CONCLUSION: Child abuse accounts for half of all pediatric homicides. Parents are the most common perpetrators of fatal child abuse, but surrogate parent perpetrators are almost exclusively male and more likely to use firearms. Most children have a history of abuse, leaving an opportunity to intervene on potentially preventable deaths if abuse is identified in a timely fashion. LEVEL OF EVIDENCE: Prognostic and Epidemiologic, Level III.


Assuntos
Maus-Tratos Infantis/mortalidade , Homicídio/estatística & dados numéricos , Pais , Adolescente , Criança , Criança Adotada , Criança Acolhida , Pré-Escolar , Feminino , Georgia , Humanos , Lactente , Recém-Nascido , Violência por Parceiro Íntimo/estatística & dados numéricos , Masculino
20.
Sex Transm Dis ; 49(1): 86-89, 2022 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-34264902

RESUMO

BACKGROUND: Sexually transmitted infection (STI) prevention programs can decrease the economic burden of STIs. Foster youth have higher rates of STIs compared with their peers; however, information on direct costs and indirect costs averted by STI testing, treatment, and counseling among foster youth is lacking. METHODS: This study used data from a comprehensive medical center for foster youth over a 3-year study period from July 2017 to June 2020. Direct and indirect costs averted by testing and treatment of chlamydia, gonorrhea, and syphilis, as well as HIV testing and counseling, were calculated based on formulas developed by the Centers for Disease Control and Prevention and adjusted for inflation. RESULTS: Among the 316 youth who received medical services during this time, 206 were sexually active and tested for STIs and/or HIV. Among 121 positive STI test results, 64.5% (n = 78) were positive for chlamydia, 30.6% (n = 37) were positive for gonorrhea, and 5.0% (n = 6) were positive for syphilis. Treatment was provided to all. Overall, $60,049.68 in direct medical costs and $73,956.36 in indirect costs were averted. CONCLUSIONS: Given the rates of STIs among this population and the economic benefit of STI treatment, it is imperative to continue to provide intensive and comprehensive, individualized sexual health care for foster youth. Traditional care management may miss the opportunity to prevent, identify, and treat STIs that comprehensive wraparound care can achieve. This study suggests that comprehensive wraparound care is a cost-effective way to identify, treat, and prevent STIs among foster youth.


Assuntos
Criança Acolhida , Gonorreia , Infecções por HIV , Infecções Sexualmente Transmissíveis , Sífilis , Adolescente , Redução de Custos , Aconselhamento , Gonorreia/diagnóstico , Gonorreia/epidemiologia , Gonorreia/prevenção & controle , Infecções por HIV/diagnóstico , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Humanos , Infecções Sexualmente Transmissíveis/diagnóstico , Infecções Sexualmente Transmissíveis/epidemiologia , Infecções Sexualmente Transmissíveis/prevenção & controle , Sífilis/diagnóstico , Sífilis/epidemiologia , Sífilis/prevenção & controle
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