Showing papers in "Child Welfare in 1999"

The status of older adolescents at exit from out-of-home care.

Abstract: Administrative data and case record reviews were used to assess the exit status of a sample of older youths leaving out-of-home care in one midwestern state. Results show that most left without a job or a high school diploma, and that many left with neither. The most common living arrangement at the time of exit was with relatives, some through planned reunification and some through unplanned reunification. The majority of the youths exited out-of-home care in unplanned ways. The number of placements and the completion of high school predicted employment status. High school completion was associated with age and a history of inpatient psychiatric care, running away, and mental retardation. Implications for independent living programs for older youths are discussed. Information about older youths in out-of-home care provides an interesting glimpse into the workings of the public child welfare system. The status of older youths at the time of their exit from the child welfare system serves as one indicator of the system's effectiveness at preparing them for life after placement. Discovering what kinds of youths stay in out-of-home care until they are older adolescents offers a backdoor look into who is best served by permanency planning efforts. The placement histories of these youths also provide information on system priorities and service gaps. This study explores these issues with a randomly selected sample of older adolescents leaving out-of-home care in a midwestern state. After a review of the literature on older youths in care, the exit status of the youths in the sample is described, and variables related to these outcomes are examined. The implications of these findings for the design of out-of-home care placements and independent-living programs are discussed. Literature Review The kinds of youths who remain in care until their late teens and beyond may be changing due to efforts to find permanent homes for youths in out-of-home care. Aldgate et al. [1988] categorized adolescents in out-of-home care into three main groups: (1) those placed at an early age with a stable placement history; (2) those placed at an early age with an unstable placement history; and (3) those placed as teens, usually because of behavior or relationship problems. What percentages fall into these categories today is unknown. Some programs designed to help older adolescents exit out-of-home care have noted that their clients typically have experienced many placements and exhibit severe emotional and behavioral problems [Moore 1995; Stehno 1987]. Few members of a sample of older youths leaving out-of-home care in California had entered care as small children [Courtney & Barth 1996]. Improved permanency planning efforts may have served best those children who were placed early, had stable placement histories, and did not exhibit major behavior problems. As a result, those teens remaining in out-of-home care may be the most troubled of all children in out-of-home care. In a recent study of teenagers in out-of-home care in one jurisdiction in Great Britain, 67% met the criteria for a psychiatric disorder [McCann et al. 1996]. It has been suggested that the adults involved with older youths in out-of-home care have the responsibility of helping them exit "with adequate skills, connections to family, as well as the economic and social supports necessary to allow for a successful transition to independent living" [Child Welfare League of America 1990: 25]. To help states meet this responsibility, the federal government passed legislation to fund independent living services (see DeWoody et al. [1993] for a review of these services). It is difficult, however, to ascertain at what level to set expectations for youths leaving care as a group, given the potential emotional and behavioral problems they exhibit, and the economic realities of being a young adult in society today. Participants in a roundtable discussion of research on readiness for independent living concluded that "perhaps it is unrealistic that these youth are ready for anything at age 18" [Lyman et al. …

Caregiver substance abuse among maltreated children placed in out-of-home care.

Abstract: Child protective services (CPS) case records of 639 children placed in out-of-home care due to maltreatment were reviewed, and substance abuse by the child's caregiver prior to the child's placement was evaluated systematically. Based on several different sources of information, 79% of the caregivers were found to meet the criteria for caregiver substance abuse (CSA). Children with and without evidence of CSA differed on age, ethnicity, family composition, and type of maltreatment. The importance of operational specificity in defining CSA and implications for policy and service delivery are discussed. Parental substance use and abuse have become major issues for the child welfare system [Dore et al. 1995]. Although the link between child abuse and parental substance abuse was identified more than three decades ago [Behling 1979; Leonard & Jacob 1988; Young 1964], the nature and extent of this relationship has yet to be clearly delineated. Many theories about the causal relationships between these two behaviors have been postulated. Some writers have argued that the disinhibitory effects of alcohol and other substances make those who use them more apt to engage in violent behavior [Mitchel & Savage 1991]. Alternatively, the substances may have a sedating effect on users, resulting in their inability to respond to their children's needs appropriately [Hindman 1977]. Others have proposed that the fussiness and difficult behaviors of babies born to substance-abusing women place these children at increased risk for abuse [Griffith 1988]. Still others purport that a third factor, such as poverty, stress, or maltreatment experienced by the parents, could account for both the substance use by and the abusive behavior among caregivers [Orme & Rimmer 1981]. Before attempting to disentangle the complexities of the relationship between substance use/abuse and child maltreatment, basic questions must be answered. First, the prevalence rate of caregiver substance abuse among families of maltreated children must be established. Current estimates vary widely, and methodologies for classifying substance abuse are not only not standardized, but frequently lack operational definitions within studies. For example, even the terms substance use or involvement versus abuse cause some degree of confusion and are responsible for a lack of comparability across reports. Many writers have used these terms almost interchangeably, particularly in reports put forth by committees conducting surveys within the child welfare system [NCCAP 1994; NCPCA 1989]. It is virtually left to readers to draw their own conclusions about what distinguishes the various terms employed to describe parental consumption of alcohol and drugs. In the review that follows, therefore, the terms used in the actual studies will be maintained, rather than arbitrarily selecting one for use in this article for the sake of consistency. Coincidence of Child Maltreatment and Substance Abuse A survey by the National Center on Child Abuse Prevention Research (NCCAP) [1994] attempted to investigate the association between parental substance abuse and reported cases of child maltreatment. When the NCCAP committee asked each state to estimate the number of substantiated cases of child abuse in which substance abuse was implicated, only eight of the 50 states were able to respond. This poor response rate demonstrates the lack of empirical data available to estimate the prevalence of parental substance abuse in maltreated populations. Nevertheless, some information was gathered in the report that substantiated the suspected high frequency of cases in which both parental substance abuse and child abuse are present. For example, in the eight states responding, 26% of the total number of maltreatment cases involved parental substance abuse as well, with a range of 3% to 80% in these states. Among all states that noted increases in the rates of maltreatment reports for 1993, substance abuse was named as a likely contributing factor. …

Risk assessment in child protective services: consensus and actuarial model reliability.

Abstract: Three widely used child protective service risk assessment models (two consensus based, one actuarial) were examined to determine their reliability. Although no system approached 100% interrater reliability, raters employing the actuarial model made consistent estimates of risk for a high percentage of the cases they assessed, and interrater reliability for the actuarial model was much higher than that of the other systems. The decisions that child protective service (CPS) workers make at the conclusion of a child abuse or neglect investigation are critical to the protection of children. At that point, the worker must decide whether to: (1) close the case, (2) open the case for protective service intervention or intensive in-home family preservation services, or (3) remove the child to out-ofhome care. Because this decision has important consequences for children, their families, and protective service agencies, it must be made as consistently and accurately as possible. Frontline CPS workers must base their decisions on the best interest of the child, a determination that is largely dependent on the worker's estimation of the risk of future harm. If conclusions regarding risk in a particular case vary widely (depending on who does the rating), then some children will be left in situations with a high potential for continued maltreatment, while others who could have remained at home in relative safety will be placed in out-of-home care. Mistakes can have enormous consequences, ranging from unnecessary expenditures to emotional upheaval and trauma, to serious injury to and even the death of a child. Clearly, decisionmaking in human services is difficult-personal relationships in families served are dynamic and difficult to assess. Those charged with protecting children--CPS investigative staff and managers-represent a wide spectrum of educational backgrounds and personal and professional experiences, and bring different values and perspectives to the job. This mix of conditions-the potentially grave consequences of "error," the inherent difficulty of accurately assessing family situations and relationships, and the range of "skills" evident in the nation's CPS staff-presents a near-perfect equation for widespread disparity in case decisionmaking. CPS Risk-Assessment Systems and the NCCAN Study Risk-assessment systems are simply "formalized methods that provide a uniform structure and criteria for determining risk" [Keller et al. 1988: 21. CPS risk-assessment systems have developed to help workers accurately estimate the future risk of abuse/ neglect and thus make better service decisions for families. The expectation is that such systems will increase the reliability and accuracy of CPS worker decisionmaking. The use of risk-assessment systems, although widespread, is relatively recent. In 1996, the American Public Welfare Association (APWA) conducted a survey of 54 states, territories, and large county child welfare agencies to determine their use of and satisfaction with CPS risk-assessment systems. Of the 44 jurisdictions that responded, 38 had some risk assessment or safety assessment in place. Of these, 26 first implemented their risk assessment after 1987 [Tatara 19961. Although risk-assessment models continue to be developed, experts have expressed concern that the theoretical and empirical support for these systems is inadequate [Cicchinelli 1991]. As noted by Murphy-Berman [1994], risk-assessment procedures vary on a number of dimensions, and the task of comparing one to another is quite complex. Generally, CPS risk-assessment systems fall into two basic types: 1. Consensus-based systems are those in which workers assess specific client characteristics identified by the consensus judgement of experts and then exercise their own clinical judgment about the risk of future abuse or neglect. 2. Actuarial systems are based on an empirical study of CPS cases and future abuse/neglect outcomes. …

Satisfaction of children in out-of-home care.

Abstract: A randomly selected sample of 1,100 children in out-ofhome care in Illinois from 1993 to 1996 were interviewed in person regarding their satisfaction with the homes in which they lived and with their caregivers. They were also asked whether they felt loved and safe, and rated the quality of their lives before and after placement into care. The children rated their satisfaction with their living arrangements and with their caregivers as high, especially those who had lived in family foster care. In 1995, an estimated 486,000 children were living in out-ofhome care in America's child welfare systems [Petit et al. 1997]. Despite the increasing number of children in out-of-home care, few studies document their satisfaction with their current homes, the services they are receiving, and the quality of their lives. Those studies that have documented interviews with children were based on small samples of fewer than 60 children [Johnson et al. 1995 (N = 59); Gardner 1996 (N = 51)] or were conducted with children postplacement [Benedict et al. 1996]. A holistic evaluation of the quality of out-of-home care should include interviews with the children. Among the many quality of life outcomes that are measurable, consumer satisfaction is certainly one of the most important. No system can consistently improve unless it receives feedback. As one researcher has said, "The children themselves should be consulted... they are a key source of information that has too often been overlooked" [Dubowitz 1994]. Child welfare systems have popularized the term empowerment as they have implemented reforms [Dunlap 1997]. This word is used most often when referring to the children's biological parents or the children's caregivers. Empowerment, however, is also vital to children, since opportunities for self-determination during childhood impact their adult lives. One of the first steps in making children feel empowered is to seek out their input and to value their opinions. The consistency of the results of the four years of interviews documented in this article reflects the children's ability to report on their own circumstances and assess their own needs. Although children should be considered key members of their permanency planning teams, as their lives are impacted by the judgments adults make, they are frequently neither asked for nor heard when they offer an opinion on the quality of their lives or their dreams for the future. This article describes selected results from four years of directly asking children in out-of-home care about their lives, level of satisfaction, and preferences. Background The four Annual Client Evaluations (ACE) summarized in this article consisted of interviews with 1,100 children in out-of-home care in Illinois' child welfare system during calendar years 1993, 1994, 1995, and 1996. The children were asked about the overall quality of their lives before and after placement, and about their level of satisfaction with their current homes, caregivers, caseworkers, and the services they received from the child welfare agency and its contracted provider agencies. The characteristics of the children were also documented.* Nearly 86% of the 1,100 children interviewed were living in family foster care, kinship care, or nonrelative care (n = 942); 14% of the children were living in residential group care placements (group homes, child care institutions, shelters, or any placement that was not family foster care) (n = 158). The living arrangements of the children in the study sample were comparable to those documented by the state child welfare agency's tracking system. In September 1996, the state agency was serving 50,611 children in out-of-home care: 91% of the children were living in family foster care; 9% of the children were living in some type of residential group care [IDCFS 1996]. The percentage of children in family foster care in Illinois was within a few percentage points all four years and reflects the state's emphasis on family foster care in placement decisions. …

Responding to children's disclosure of familial abuse: What survivors tell us.

Abstract: This study is based on the reports of 384 adults who were abused physically, sexually, and/or emotionally in childhood by family members. It describes the survivors' attempts, as children, to get help by disclosing the abuse to someone who might intervene; those who did not disclose explain their reasons. The results indicate that disclosure usually did not bring an end to the abuse, and that little action was taken to control the perpetrator, even after disclosure took place. The responses received by the children to their disclosure are linked to their levels of self-esteem and family functioning as adults.

Adopting Children with Attachment Problems.

Abstract: This article describes children with significant attachment problems and summarizes the actions needed to increase the probability that such children can be successfully adopted. Healthy and disordered attachment patterns are detailed, as well as the principles and strategies that are important in parenting such children and the parenting characteristics that should be sought in selecting families for children with attachment disorder. Psychological treatment and other postadoption services necessary to support the adoption and the child's ability to successfully form a secure attachment with the adoptive parents are also highlighted.

Starting Young: Improving the Health and Developmental Outcomes of Infants and Toddlers in the Child Welfare System

Abstract: The number of infants and toddlers entering out-of-home care has increased dramatically in the past few years, yet few published reports examine their needs. This article describes a collaborative, multidisciplinary developmental follow-up program for infants and toddlers that builds on the community-based family support model described in the Family to Family Foster Care Reform Initiative. The children's health and developmental status, as well as the program's effectiveness, are highlighted.

Professional Foster Care : A Future Worth Pursuing?

Abstract: This article reports on a study comparing the performance of a professional foster care program and two specialized programs in Cook County, Illinois, with random samples of kinship and nonrelative family foster homes. Professional and kinship foster care consistently outperformed the specialized programs and the nonrelative care in terms of stability, sibling placement, restrictiveness of care, and proximity to the child's community of origin. While the former two program types also do slightly better than the latter in achieving permanent living situations, the professional foster care program had difficulty moving children to adoptive homes or subsidized guardianship. Implications of these differences for the evolution of family foster care in the next century are considered. The professionalization of foster parenting is the latest trend in the evolution of family foster care. As more women enter the paid labor force, child-placing agencies are facing new difficulties in recruiting sufficient numbers of families willing to volunteer to become foster parents [Kahn & Kammerman 1990; U.S. General Accounting Office 1989]. The shortage is especially acute in central-city neighborhoods where the loss of a stable employment base and the declining presence of two-parent families have sharply reduced the supply of adults who can afford to care voluntarily for foster children at the prevailing boarding rates offered by public and private agencies [Chamberlain et al. 19921. Consequently, most family foster home vacancies are located in suburban communities far away from the central-city neighborhoods where the families of a majority of children in out-of-home care reside. The shortage of voluntary family foster homes and the spatial mismatch between placement needs and foster home supply are trends that are likely to intensify in the next century. Public policy appears to be evolving in two different directions to deal with these developments. The first consists of tapping into the natural altruism of kin to look after related children by adapting licensing standards and boarding rates to the particular circumstances of extended family care. Since the mid-1980s, kinship foster care has been the fastest growing component of formal foster care in the United States [Testa et al. 1996]. The second direction being taken involves paying foster parents for their labor, either indirectly by placing children in need of specialized foster care with them, or directly by hiring them as paid professional staff. Specialized foster care is the care of children with behavioral, developmental, emotional, or medical needs above and beyond those of average children in out-of-home care. Specialized foster caregivers typically receive a monthly board payment that is larger than that received by foster parents caring for children who do not fall into a special-needs category. Professional foster care, in the context of this paper, involves trained, professional foster parents who are paid an annual salary for foster parenting above and beyond any board payments made by the state on behalf of the children; most of them care for children with special needs. The movement toward specialized and professional foster care has been accelerating since the early 1990s [Barth et al. 1994]. Both strategies for dealing with the dual problems of foster home shortage and the spatial mismatch between need and supply are bringing to the surface long-standing controversies over the appropriate balance between family altruism and monetary incentives as motives for becoming foster parents [Zelizer 1985]. On the one hand, critics of kinship foster care are raising warning flags about kinship care's subverting the aims of welfare reform by becoming an "Aid to Relatives with Dependent Children" program [Charen 1997]. On the other hand, critics of professional foster care are voicing concerns about robbing family foster care of the essential qualities of family life-informality, spontaneity, and unconditionality [Lemay 1991]. …

Resilience in maltreated children: Implications for special needs adoption.

Abstract: Children in the child welfare system face renewed issues of loss as they enter adoptive placements. Every move is a loss and an exercise for the child in establishing the perception of a "safe" environment. Resilient children who have been abused develop coping skills to adapt to their abusing "unsafe" environments. When these children become part of an adoptive family, these coping skills need to be recognized as providing important cues to the child's world, rather than as challenging behaviors. The author deconstructs the words of resilient children into five themes that can help provide access into the children's world, a fresh viewpoint from which to assess the adopted children's reactive behaviors, and a foundation on which an adoptive relationship can be built. A bused children develop a variety of behaviors to cope with and adapt to their abusive environments and to the positive and negative aspects of their relationships with their parents. For many, these coping behaviors are the strengths that enable them to survive in an unsafe environment. When entering new placements (to the children, a new, strange, and "unsafe" environment), children transfer these patterns of relating to their new parenting relationships. Often, the occurrences of these coping behaviors in the new families are viewed not as strengths, but as challenges to parents and placement professionals. Yet these behaviors provide important cues to help parents and professionals access the child's world and begin building new relationships. Resilient children who have adapted to their abusive environments have gained a sense of control in their lives. When they come into new families, they are asked to give up that control to the new parent-child relationship. Understanding the past allows the integration of the child's survival skills and allows the children to grieve their losses, build attachments, and begin the task of identity formation. This article deconstructs the words of resilient children into themes that provide cues to the reoccurrence of behaviors once needed to survive in abusive environments, but now challenging parents and professionals. A qualitative research study of resilient maltreated adolescents identified five themes that provide a basis from which to view children's behaviors during their adjustment to new placements, including adoption. These themes are: loyalty to parents, normalizing the abusive environment, invisibility to the abuser, self-value, and future vision. The research is summarized in the context of risk factors and protective factors, methodology, child narratives, and the emerging themes. Implications for the usefulness of these findings are discussed in relation to current and future practice. Literature Review The concept of resilience was created to help explain why some children do well under disadvantaged circumstances [Baldwin et al. 1993]. Resilience is attributed to children who grew up under unfavorable circumstances without showing unfavorable consequences [Masten 1989; Okun et al. 1994; Radke-Yarrow & Brown 1993; Werner 1993]. It is defined as the capacity for successful adaptation, positive functioning, or competence despite high risk, chronic stress, or prolonged or severe trauma [Egeland et al. 1993]. Interest has grown in the past two decades in identifying factors associated with resiliency in high-risk children [Arend et al. 1979; Beeghly & Cicchetti 1994; Crittenden 1985; Earls et al.1987; Farber & Egeland 1987; Kaufman et al.1994; Masten 1989; Richters & Martinez 1993; Werner 1993]. The research on resilience primarily has identified factors that increase the risk of stress and factors that protect against stress. The risk research has been retrospective, whereas the protective factor research has been progressive [Gero 1992]. No research has been conducted specific to resilience factors for children for whom adoption has been planned. …

Child Welfare Professionals' Attitudes toward Kinship Foster Care.

Abstract: This article reports on a survey of 261 urban, metropolitan, and rural child welfare professionals regarding their perceptions of kinship foster care. Most professionals had generally positive perceptions of kinship foster parents' motivations and competence, and of kinship foster care. Participants also believed that kinship placements were more difficult to supervise than nonkin placements, and that agencies needed to make changes in practice and policy to accommodate kin. Differences in perceptions by race of the child welfare professionals are included. Kinship foster care-the formal placement of children into the care of relatives or others with close familial ties by the state or county child protection agency-is a rapidly growing form of out-of-home placement for children. In most states, kinship foster care is the preferred option for out-of-home placement [Gleeson & Craig 1994]; according to one national survey, the percentage of children placed in kinship foster care grew from 18% in 1986 to 31% in 1990 [Kusserow 1992]. Kinship foster care's growth is due to multiple factors: the increasing number of children in placement, the declining number of available nonkin foster families, and the growing acknowledgment of kin as a resource [Child Welfare League of America 1994]. Kinship foster care brings both new possibilities and new challenges to child welfare professionals, yet little is known about child welfare professionals' perceptions and attitudes about kinship foster care and the families it serves. Do child welfare professionals support the placement of children with kin? Do they view kinship foster care differently than nonkinship foster care? This article reports on the results of a survey of child welfare professionals in Minnesota regarding their attitudes toward kinship foster care. Background Although research on kinship foster care has increased over the past several years, most studies have focused on the characteristics of children in kinship foster care, including their health and mental health needs [Dubowitz et al. 1992, 1993, 1994; Inglehart 1994; Landsverk et al.1996], on the characteristics of kinship foster parents [Berrick et al.1994; Dubowitz et al.1993,1994; LeProhn & Pecora 1994; Thornton 1987], and on the outcomes for children in kinship foster care [Link 1996; Benedict et al.1996]. Other publications have proposed practice models for kinship foster care [Ingram 1996; Scannapieco & Hegar 1996; Jackson 1996; Mills & Usher 1996]. Missing from the literature, however, is research describing child welfare professionals' views of kinship foster care. Although some have speculated that child welfare professionals and child welfare agencies are reluctant to fully support kinship foster care [Goerge et al.1994; Gray & Nybell 1990; Laird 1979; Meyer & Link 1990; Johnson 1994], few studies have collected data directly from workers. A review of the literature uncovered only two studies that focused on the perceptions and attitudes of child welfare professionals toward kinship foster care [Thornton 1987; Berrick et al. 1995]. Yet the experiences and perceptions of child welfare professionals are important in understanding the strengths and weaknesses of current social work practice in kinship foster care. As child welfare agencies struggle to fit kinship foster care within the existing system of out-of-home care, the perspective of workers will play a vital role in successful kinship foster care practice. Method Research Questions This study sought to answer the following research questions: What are child welfare professionals' perceptions of kinship foster parents? Do they perceive of the kinship foster parents' role as different from that of nonkinship foster parents? Do they see their role and the role of the agency as different when they work with kinship versus nonkinship foster parents? What is their experience in working with kinship foster parents and how is it similar to or different from their work with nonkinship foster parents? …

Impact of university/agency partnerships in child welfare on organizations, workers, and work activities

Abstract: Critiques of child welfare services in the public sector point to problems both in the training and skill level of workers, and in the organizational structure and rigidity of the agencies. University/agency partnerships have been developed to provide educational curricula to enhance public child welfare workers' skills and to stimulate agency change. This article uses findings from focus group interviews of supervisors and workers to explore the impact of M.S.W. education on changes in personal behavior, structure, and technological organization. Benefits and challenges for both agencies and universities are discussed. Criticisms of the performance of public child welfare agencies focus on the decisions and actions of agency case workers, and the culture, organization, and procedures of the public agencies. Those who have studied the delivery of child welfare services in the public sector point to problems both in the training and skill level of workers [Bibus & Rooney 1995; Leighninger & Ellett 1998; Olsen & Holmes 1982; Pecora 1989; Stein 1982; Vinokur-Kaplan & Hartman 1986], and in the organizational structure and procedural rigidity of the agencies [Cohen 1992; Cohen & McGowen 1994; Gregoire 1994; Packard 1993, 1989]. These two areas of concern are linked to the extent that inadequately trained staff who do not consider themselves professionals may be unable to move their organizations to support more effective means of delivering services. Conversely, overly bureaucratized agencies may be unable to value and support professional staff. In an effort to modify one side of this equation, the federal government in recent years has used its child welfare training moneys to professionalize public child welfare work by supporting B.S.W and M.S.W education for these workers (e.g., U.S. Department of Health and Human Services, Administration on Children, Youth and Families, Children's Bureau). Reflecting the concern that such training should not only affect the worker, but the agency, universities and public agencies were urged by the Children's Bureau to form partnerships and to collaborate on educational curricula and course delivery. This article presents findings from an exploratory study of the outcomes and experiences of workers who were also students (workers/students) and their supervisors in two urban and two rural county child welfare agencies engaged in a university/ agency partnership for M.S.W education. The study examined both the impact on the workers and the impact on the agency, and highlights what public child welfare workers who are also students report they have gained from their educational experiences, the impact of the students' experiences on organizational change and service delivery in the agency from the perspective of agency supervisors, and both the workers' and their supervisors' concerns regarding the continuing support of the workers' learning, practice, and new skill acquisition beyond the educational program. Professional Education and Effective Child Welfare Work Profiles of public child welfare workers over the last 20 years show that despite the enormous difficulties that clients experience and the complexity of workers' tasks, many practitioners lack professional social work education and opportunities for professional development [Olsen & Holmes 1982; Pecora 1989; Russell & Hornby 1987; Shyne & Schroeder 1978; Stein 1982; VinokurKaplan & Hartman 1986]. According to Rycus and Hughes [1994: x], who spearheaded the development of national child welfare competencies, "child welfare is a difficult and complicated field of practice, wrought with uncertainties and dilemmas. Decisions can literally mean the difference between life and death for children, and disruption or preservation of families. The knowledge and skill requirements for skilled, family-centered, culturally relevant child welfare practice are considerable." The discrepancy between the limited skills that workers possess and the complex skills that are required to effectively do the job contribute to role ambiguity, job dissatisfaction, and staff turnover [Ellett & Ellett 1996; Erera 1989; Stein 1982; Vinokur-Kaplan et al. …

Delivering health and mental health care services to children in family foster care after welfare and health care reform.

Abstract: As the 20th century draws to a close, fundamental changes in the organization, financing, and delivery of health care and welfare services, principally directed at poor families, are likely to result in an increased number of children entering out-of-home care. These children typically have significant physical, mental health, and developmental problems. Whether the quality of health care services they receive will improve as a result of health care reform efforts and new approaches to service delivery remains to be seen. This article addresses some of the major changes wrought by welfare and health care reform and describes the essential features of a health care system that can meet the special needs of children in care.

Severe vs. nonsevere firesetters revisited.

Abstract: The study reported here compares a group of 75 severe firesetters with a group of 105 nonfiresetters and minor firesetters along 32 variables that have been positively correlated with juvenile firesetting behavior. A chisquare analysis of the data revealed that the frequencies observed in the 75 "severe" cases differ significantly from those in the "nonsevere" group. A prediction equation was derived from the 14 most salient variables. This equation can be used to differentiate severe/high-risk from minor/low-risk firesetters 95% of the time.

Concurrent planning: benefits and pitfalls.

Abstract: Concurrent planning-working with families toward reunification while developing alternative permanency plans-was designed to fit an out-of-home care population much like that projected for the year 2000 and beyond: very young, chronically neglected children from multiproblem families. As large-scale programs begin to develop nationally, those implementing concurrent planning must be aware of the pitfalls that can undercut its effectiveness, while keeping in mind the benefits it can bring by reducing the trauma experienced by children in placement. Concurrent planning: To work towards family reunification while, at the sane time, developing an alternative permanent plan. [Katz et al. 1994] As the child welfare field prepares for the new millennium, it is timely to consider ways in which practice might be adapted to better serve children in placement in the future. Concern over the growing national foster care census and continuing dissatisfaction among social work professionals and government leaders with efforts to improve outcomes for children in care add further impetus to such efforts. Additional support is found in the Adoption and Safe Families Act of 1997 (ASFA) (P.L. 105-89), which reduces from 18 to 12 months the scheduling of the permanency hearing, defines parental conduct that obviates the need for reunification efforts, and cites concurrent planning as an appropriate practice. Concurrent planning, pioneered in Washington State in the early 1980s, was specifically designed for the population expected to be in out-of-home care after the year 2000: the very young child whose family's chronic pathology (often drug/ alcohol related) has left the child drifting in out-of-home care [Katz & Robinson 1991]. The concurrent planning model addresses this difficult-to-treat family constellation by combining vigorous family outreach, expedited timelines, and potentially permanent family foster care placements to improve the odds of timely permanency for young children. Roots of the Model Between 1959 and 1979, a number of clinicians and researchers published seminal works on the existence of foster care drift and suggested solutions. Heymann and her colleagues in Chicago produced two reports that led directly to the present model, suggesting that an agency's focus on permanency from intake and a diagnostic use of parental visiting patterns could greatly reduce drift and facilitate earlier permanency [Epstein & Heymann 1967; Chestang & Heymann 1973]. This clinical perspective fit well with the overwhelming statistical evidence showing the scope of foster care drift between 1950 and 1980, the extraordinary length of time needed to effect an adoption for a child in out-of-home care, the diminishing options for those children still in care after one year, the particularly slow process of case resolution for infants entering care, and the efficacy of court review in speeding case movement [Maas & Engler 1959; Festinger 1976; Fanshel 1978, 1979]. During this fertile period in child welfare's evolution, attachment theorists entered into the out-of-home care field, spotlighting the psychic damage caused by repeated placements, which were endemic to the system [Littner 1972; Bowlby 1979]. Their theories caused a tidal wave of controversy when presented as a basis for redesigning the way courts handle children's cases (e.g., the proposal that case movement be determined by "the child's sense of time," rather than adult and organizational considerations [Goldstein et al. 1973]). In a related development, placement agencies began to report on their efforts to create a hybrid program, called foster/ adoption, that would benefit children in care who were unlikely to return home [Gill 1975; Gill & Amadio 1983; Mica & Vosler 1990]. Although many positive outcomes were described, the concept had its critics, who were concerned with possible inherent ethical dilemmas [Lee & Hull 1983]. …

Experiences, concerns, and service needs of families adopting children with prenatal substance exposure: summary and recommendations.

Abstract: Parents who adopted children from out-of-home care with prenatal substance exposure were interviewed four months after the child's placement in the home, and again after the first year regarding their experience with adoption and their concerns about their child's development, attachment, and behavior; aspects of parenting and the adoption process; effects of prenatal substance exposure; and availability and helpfulness of resources. Adoptive parents found parenting children with prenatal substance exposure to be both more rewarding and more difficult than they had imagined. Parental substance abuse, especially when it involves the prenatal exposure of children to drugs or alcohol, has been called "the biggest threat to the well-being of children entering care today and in the next century" [Barbell & Wright 1999: 13]. Escalating parental use of drugs and alcohol has resulted in an increasing number of children born with prenatal drug exposure and an increase in the number of such children in need of out-of-home care [Barth 1991; Goerge & Wulczyn 1999]. These atrisk children require safe, nurturing, permanent families to help ensure their well-being and overcome their difficult beginnings. For many, adoption will be the permanency plan of choice. It follows, then, that factors that optimize the adoption of these children must be identified and quality services provided to support their adoptive families. Significant obstacles exist to the adoption of children exposed prenatally to alcohol and/or other drugs. Many prospective adoptive parents and professionals are frightened by the uncertainties regarding the long-term outcomes of substance-exposed children. Their fears are fueled by sensational headlines and television soundbites. They may fear the children will be unmanageable or develop abnormally, or that the guidance, services, professionals, and resources needed to meet the children's needs will not be available [Groze et al. 1994; Edelstein et al. 1995; Edelstein et al. in press]. When children with histories of prenatal substance exposure are placed with adoptive families, even minor incidents of acting-out by the child during the transition can generate anxiety and cause adoptive parents to attribute the problems to prenatal substance exposure. These fears, and the challenges presented by children with a history of prenatal substance exposure, highlight the need for postadoption services. The TIES (Training, Intervention, Education, and Services) for Adoption program attempts to reduce obstacles to adopting children in out-of-home care who have a history of prenatal substance exposure and to ensure the success of such adoptions.* One TIES component is a program of support and services for families during the child's transition from out-of-home care to placement with the adoptive family, and during the first year after placement. Parents who participate in TIES for Adoption initially receive nine hours of education and preparation focused specifically on exploring issues pertinent to the adoption of children with prenatal substance exposure. Once a potential match has been made between parent and child, the program offers a continuum of services, including interdisciplinary reviews of the child's records and preplacement consultation with the prospective parents regarding the child's strengths, vulnerabilities, and needed services; mental health services, including parent counseling, child therapy, and inclusion in a support group; and pediatric, psychiatric, and educational consultation (for a detailed description see Edelstein et al. [in press]). This article examines the experiences of adoptive parents at the time of the placement of a child affected by prenatal substance exposure, including their concerns and their perceptions of service needs. It also describes how adoptive parents' needs, experiences, and perceptions changed in the first year after placement, and implications for future service with these families. …

Evaluation of a Training Program for Foster Parents of Infants with Prenatal Substance Effects

Abstract: The lack of prepared and available foster parents for children with prenatal substance effects is of increasing concern to the child welfare field. Effective foster parent training is needed to assure infants are fostered by knowledgeable, skilled foster parents and that the foster parents feel supported and effective in taking on their responsibilities. The training was designed so that the foster parents would have opportunities to achieve highly specific learning objectives. True random assignment of subjects was impossible because of the voluntary nature of foster parent training; the samples of foster parents for both the treatment group and the comparison groups were therefore self-selected. The possibility exists that some foster parents who attended the training decided as a result of the training not to foster infants with prenatal substance effects. Infants with prenatal substance effects may require specialized care and foster parents need to be prepared to provide it.

Using Benefit-Cost Analysis to Assess Child Abuse Prevention and Intervention Programs

Abstract: Benefits and costs are discussed when child abuse prevention and intervention programs are proposed and evaluated, but systemic benefit-cost analysis as developed by economists has not been applied to such programs. This article presents the case for using benefitcost analysis to structure evaluations of child abuse prevention and intervention programs. It presents the basic concept of benefit-cost analysis, its application in the context of assessing these types of child welfare programs, and limitations on its application to social service programs. Benefit-cost analysis has become a widely applied, but often controversial and misunderstood, tool of program evaluation. Initially used to assess the economic soundness of infrastructure projects such as dams and highways, it is now routinely applied in evaluations of a broad range of public policies, including environmental and occupational safety and health regulations [Cropper & Oates 1992], health and mental health interventions [Ginsberg & Shouval 1992; Keeler & Cretin 1987; Weisbrod 1981], and a variety of human resources programs, such as early education [Schweinhart et al. 1993], family planning services [Levey et al. 1988], job training [Kemper et al.1983; Long et al.1981; Orr et al.1996], alcohol and drug abuse [Rundell et al.1991; Hubbard & French 1991; Plotnick et al. in press], vocational rehabilitation [Lewis et al.1992], HIV testing [Gelles 1993], and welfare-to-work programs [Gueron & Pauly 1991]. When child abuse prevention and intervention programs are proposed and evaluated, their costs and the various benefits they may produce are discussed [Daro 1988; Panel on Research on Child Abuse and Neglect 1993]. Systematic benefit-cost analysis, however, has not been applied in assessing such programs. A survey of the child welfare literature covering 1990-1995 uncovered no benefit-cost analyses of child abuse prevention or intervention programs. One comprehensive study [Daro 1988], drawing on research from the 1970s and 1980s, briefly critiques benefit-cost methods and summarizes potential benefits of effective interventions, but does not cite any actual benefit-cost analyses of specific interventions produced during these years. The comprehensive National Research Council report, Understanding Child Abuse and Neglect [Panel on Research on Child Abuse and Neglect 1993] does not mention the term, though it does include a short discussion of some of the economic benefits of reducing child maltreatment [pp. 39-40]. The report, as well work by Daro [1988] and Vondra [1993], also points out the contributions to improving interventions that can be made by cost-effectiveness studies, which are closely related to benefit-cost studies, and Daro [1988] discusses two major cost-effectiveness studies from the 1970s and 1980s. This article argues that benefit-cost analysis can and should be used to help structure evaluations of the impact of child abuse prevention and intervention programs, and, in general, any program aimed at promoting child welfare. It presents the basic ideas of benefit-cost analysis and of cost-effectiveness analysis, a closely related tool. These include the concepts of economic benefits and costs; the identification, measurement, projection, and discounting of benefits and costs likely to arise in child abuse prevention and intervention programs; the incorporation of equity effects; and how costs and benefits differ depending on whether they are assessed by participants, nonparticipants, or society as a whole. For expositional simplicity, the article discusses the issues in terms of child abuse, although the analysis and arguments also apply to programs to treat or prevent child neglect.1 Applications of benefit-cost analysis to human services programs generally analyze efforts to remedy problems after they have appeared, not efforts to prevent them. Benefit-cost analysis applies equally well, however, to both prevention and intervention programs. …

Skin Color in Transracial and Inracial Adoptive Placements: Implications for Special Needs Adoptions

Abstract: This article examines the historical, social, and political factors associated with skin color dynamics in American society and provides excerpts from interviews about this topic with African American adults who were adopted either transracially or inracially. Implications for special needs adoption practitioners and adoptive families are highlighted. As children of color make up over 60% of the estimated 500,000 children in out-of-home care and are likely to wait at least twice as long for adoptive homes than other children, greater attention is being placed on increasing the likelihood that these children will be placed [National Adoption Information Clearinghouse 1998; Barth 1997]. Many believe the delay in finding adoptive families for children of color may have been due, in part, to race-matching policies [Barth 19971. The Multi-Ethnic Placement Act of 1994 and the Interethnic Adoption Provisions of 1996 were designed to eliminate race-related obstacles to adoption, and, in fact, the 1996 provisions mandate that race cannot "even be one of a group of reasons routinely used when making placement decisions" [Nadel 1998: 4]. In Texas, state law stipulates that any employee who attempts to remove a child from transracial family foster care for the purpose of samerace adoptive placement or who denies or delays a placement in order to seek a same-race family is subject to immediate dismissal [Texas Family Code 1995]. Although the issue of race has been legislatively removed from the process of adoption decisionmaking, American society is still race conscious. Adopting a child of color means much more than checking off a different ethnic category on a census form or adoption application. Many underlying racial dynamics must be addressed, including racial identity formation, race socialization experiences, and differences in phenotypic characteristics such as skin color within families. African Americans and children of African-mixed backgrounds have skin tones that range from very fair (almost white) to very dark. Although some researchers on transracial adoptions have addressed racial socialization and racial identity [McRoy 1996; McRoy & Freeman 1986; McRoy & Zurcher 1983; Hollingsworth 1997], minimal attention has been given to the issue of skin color differences in the adoption literature or training curricula for adoptive families. The literature on the implications of skin color consciousness, however, is growing [see Harvey 1995; Bond & Cash 1992; Porter 1991; Keith & Herring 1991]. This article examines the historical, social, and political issues associated with skin color in American society, provides interview data on how skin color influences transracial and inracial adoptive experiences in the home and community, and presents implications for special needs adoption practice. Historical Evolution of Skin Color Dynamics A review of the lay as well as the academic literature reveals a relationship between one's skin color and experiences with discrimination. According to Porter [1991: 149], historically, "individuals of lighter complexion were preferred as friends and marital partners [Hill 1944; Holtzman 1973; Marks 1947; Seeman 1946], were more likely to be employed in status occupations, were more socially mobile [Edwards 1972; Freeman et al. 1966; Ransford 1970]," and had more educational advantages [Reuter 1917]. This preferential treatment occurred because persons with light skin tones and "Caucasoid" features were presumed to have white ancestry, and many whites considered them genetically superior to darker-complexioned blacks with more "African features." These skin color assessments can be traced back to slavery, in which "mulattoes" (interracial offspring) were often given higher status positions and often brought higher prices at slave auctions [Drake & Cayton 1962; Myrdal 1962; Poussaint 1975; Neal & Wilson 1989]. Lighter-complexioned slaves (who often were the offspring of slave owners) were more likely to serve as house slaves while darker-complexioned slaves were more likely to work in the fields. …

The Impact of Drug-Exposed Children on Family Foster Care

Abstract: To determine whether infants exposed to drugs during gestation present special challenges in family foster care, data on 204 infants were reviewed. Developmental functioning, health and caregiving needs, visits by biological parents, and case dispositions were compared across drug-exposure groups. Infants with verified drug exposure presented with significantly more health and caregiving needs, had fewer biological parent visits, and were more frequently placed with relatives after family foster care. Findings are discussed in terms of their impact on family foster care in the next century.

School-based peer sexual harassment.

Abstract: Peer sexual harassment in schools is an often overlooked problem that contributes to a hostile school environment: one major study found that 85% of girls and 76% of boys reported experiencing some form of sexual harassment in school. This article describes the extent and impact of peer sexual harassment in schools and the responses of the victims, school personnel, and perpetrators to peer sexual harassment. It discusses and analyzes the evolution of peer sexual harassment lawsuits and the recent U.S. Supreme Court decision concerning such actions. It concludes steps that social workers and other school personnel should take to prevent or alleviate such problems.

Constructing Genograms with Children in Care: Implications for Casework Practice.

Abstract: Through case studies, this article highlights the use by caseworkers of genogram construction with children in care Genogram construction can be an initial engagement tool as well as a way to garner information about the children's view of care and their family systems It can enhance rapport between caseworkers and children of different ethnicities, support permanency planning efforts for children in kinship foster care, and make it possible for the voices of the children in care to be heard Genograms are visual maps that graphically display complex multigenerational patterns in families [McGoldrick & Gerson 1985] Social workers have used genograms in assessment to identify supportive relationships, areas of need, and targets for interventions [Beck 1982, 1987; Hartman 1978] Developing a genogram with a client can elicit information regarding demographics (births, deaths, marriages, divorces, age, gender), family structures, and relationships among family members (degree of closeness and distance, boundaries, conflicts, allances) Genograms have been used as tools for assessment and engagement with families and individuals in social work in a variety of practice settings [Guerin & Pendagast 1976; Hartman 1978; Hartman & Laird 1983; McGoldrick & Gerson 1985; Wachtel 1982] In child welfare, however, genograms have been used primarily with foster parents in adoption planning [Pinderhughes & Rosenberg 1990; Young et al 1992] Variations and innovations such as the Time-Line Genogram [Friedman et al 1988] and the Placement Genogram [McMillen & Groze 1994] extend the use of genograms to other areas in child welfare These genograms incorporate changes over time, which allow caseworkers to include in them changes of placement and other events in the lives of children placed in out-of-home care This information can help caseworkers make more accurate assessments of the needs of the children Despite these advantages, genograms continue to be underused by caseworkers in child welfare and are rarely created in partnership with the children in care This article discusses the potential benefits for casework practice of using genograms with children placed in out-of-home care The process of initiating genogram construction with children in care is first discussed to provide ideas for caseworkers to implement in their practice Benefits of genogram construction for practice are explored next Benefits include the use of the genogram as an initial engagement tool with children in care; as a tool to improve caseworker-child rapport, particularly in cases of ethnic differences; as a window for learning about the children's perceptions of their relationships with foster parents or kinship caregivers, birth parents, and extended family members; and as a guide for permanency planning The discussion in this article is supported by pertinent case studies from a preliminary research study of child well-being that used genogram development as an initial engagement tool with children in kinship foster care Initiating Genogram Construction with Children in Care The case studies reported in this article were drawn from a random sample of cases from a federally funded research and demonstration project to increase the number of children in kinship foster care who exit state custody through adoption, transfer of guardianship, or reunification with parents The author interviewed three boys and three girls between the ages of 10 and 15 who were in the legal custody of the state child welfare system and living in kinship foster care placements maintained by a voluntary child welfare agency for at least one year The names and identifying information regarding these children have been altered to protect their confidentiality The author is Caucasian; all of the interviewed children are African American The author and children had never met prior to the scheduled interviews …

Behaviorally impaired children in out-of-home care.

Abstract: This study was undertaken to determine the nature of the out-of-home care placement experience for 131 behaviorally impaired children entering care over the course of a year in Nebraska. Variables analyzed included behavioral impairment, age at entry, age at termination, gender, race/ethnicity, family violence, geographical area before and at termination, closeness to home of most recent placement, and length of time in care. Multiple regression analysis showed that behavioral impairment was the strongest predictor of length of time in care, accounting for 2.4% of the variability. The nature of out-of-home care for children considered to be "behaviorally impaired" may be different from that of children who do not have such impairments. Mental health needs are particularly prevalent in children in out-of-home care. "When available studies are viewed in aggregate, they suggest that foster children have extensive mental health needs" [Rosenfeld et al. 1997: 450]. Attempts have been made to understand the out-of-home care experiences of children with behavioral impairments, but interpretations have varied. Part of the difficulty is due to differing definitions of "behavioral impairment" and the use (or nonuse) of standardized instruments. Some researchers have had to work with limited information pertaining to the diagnoses and classifications of the children studied. Regardless of the limitations of the research, a general conclusion can be drawn: children with behavioral impairments have a different experience in out-ofhome care than those children without such impairments. These differences warrant examination. In light of the emphasis on permanency planning and the changes brought about by the Adoption Assistance and Child Welfare Act of 1980 (P.L. 96-272), the efficacy of efforts such as family reunification or adoption for children with behavioral impairments must be evaluated. Fanshel [1992: 55] suggests that "'permanency planning' does not seem to apply to about a quarter of the children in out-of-home care." An alternative subsystem of care for these children may be necessary, as their behavior problems may reflect "the consequences of abuse or neglect or other sources of trauma that are unlikely to be ameliorated sufficiently by concentration upon family status changes" [Fanshel 1992: 59]. Literature Review In studying the length of time in care of 689 children first entering out-of-home care in urban/suburban Maryland between January 1,1980 and December 31,1983, Benedict and White [1991] examined the issue of children with behavioral problems. They found no significant differences in median length of stay for children with or without behavioral or mental health problems. Participation in special education, however, was significantly associated with longer median stays in care (18-20 months) as compared to the seven-month median for children performing at grade level. In contrast, Lawder et al. [1986], in a follow-up study of 185 foster children five years after placement, found that children with emotional or personality problems remained in care for longer periods of time, substantiating Jenkins' [1967] earlier findings. Courtney and Wong [1996] used the "Cox Proportional Hazards Model" to examine the time of exit from out-of-home care for 8,625 children who experienced a first episode in California's out-of-home care system between January 1 and June 30, 1988. To identify children with behavioral impairments, they assumed that children placed in settings other than a family foster home were those with behavioral problems. These children's exits were associated with a reduced likelihood of both "return to family/ guardian" and "adoption." "These behavior problems may make it more difficult for parents or parental surrogates to care for children who experience group care, and less likely for potential parents to adopt them" [p. 331]. A study of 50 Canadian children in out-of-home placements [Thompson & Fuhr 1992] showed that 72% of the children were rated by their social workers as displaying emotional disturbance, with 56% being recommended for counseling. …

The role of birth/previously adopted children in families choosing to adopt children with special needs.

Abstract: Engaging birth/previously adopted children during the adoption process is crucial to laying the groundwork for successful placements. When families choose to adopt children with special needs, however, the role their other children will play in the adoption's success is often overlooked. This article presents a practical model that recognizes the dynamics of strength and vulnerability in adoptive families, then applies this model in preparing and supporting the family through the changes that are inevitable in special needs adoption. The model can also be used to assist adoptive parents in identifying and developing the skills they need to manage these shifts within the family. Families who already have children (either by birth or adoption) and who are adopting children with special needs* must be aware of the significant role that their birth/previously adopted children can play in "making or breaking" the adoptive placement. Preparing children and families to identify and deal effectively with the changing family dynamics that accompany adoption can ease the transition for everyone concerned, and help ensure a successful outcome. A review of the literature makes clear the emotional complexities that attend the adoption of children with special needs by families with birth/previously adopted children. Reitz and Watson [1992], citing the 1982 Delaware Family Study by Hoopes, pointed out that families who had children both by birth and by adoption were at greatest risk of difficulties. Churchill and colleagues [1979: 96] viewed the adopted child as a new member of the family whose arrival is bound to "disrupt an established system of relationships." In situations where children who have special needs are added to families with birth/previously adopted children, the equilibrium of the family is subject to disturbance. Reestablishing a level of comfort and "normality" in such families, which are critical to the success of the adoption, requires additional preparation and support. Inevitably, the adoption of a child with special needs will have an effect on birth/previously adopted children. The emotional atmosphere in the home may be altered, energies drained, parents' attention diffused and diminished for each child, and life, as it was known, changed significantly [Keck & Kupecky 1995]. Many prospective adoptive parents already anticipate this impact. For example, prospective parents with birth/previously adopted children who are enrolled in the adoption education classes required by the Children's Home Society of Minnesota are often anxious about the potential negative impact and even harm that might befall their children should they proceed with their plans to adopt a child with special needs. When birth/previously adopted children live in the home and the parents are prepared to recognize and handle the behavioral and emotional responses of those children, the addition of a child with special needs can be smoothed and adoption outcomes enhanced. Melina [1986] emphasizes the need for agencies to prepare children for the arrival of an adoptive sibling with special needs. Barth and Berry [1988] identify aspects of adoptive family life that serve as potential indicators of adjustment and outcome. They found that disrupted adoptions occurred more often when families did not receive sufficient training. Family Dynamics in Special Needs Adoption In examining the dynamics of adoptive families, two concepts stand out-strength and vulnerability. Jewett [1978] cites the parents' sense of "being out of control" as a major cause of adoption failure while noting that birth/previously adopted children can relax when they see their parents "in control." Being "in control" implies strength, while being "out of control" implies vulnerability. Parents who sense that they have sacrificed the well-being of their birth/previously adopted children in attempting to meet the special needs of their adopted child may feel vulnerable, and they may communicate this feeling of insecurity and ambivalence to their youngsters [Rosenberg 1992]. …

Measuring Performance in Child Welfare: Secondary Effects of Success.

Abstract: The Adoption and Safe Families Act of 1997 mandates the development of a system to rate the performance of state child welfare programs. The resulting system, built on broader efforts to measure outcomes for children and families who receive support and services from the child welfare system, will inform perspectives on family foster care in the next century. Drawing on findings from evaluations of recent reform initiatives in Alabama, North Carolina, and Ohio, this article suggests that performance measurement systems must be adaptable to changing circumstances, particularly when improvements in one area can affect standards and expectations in others. Concerns about the well-being of children in out-of-home care have led to a variety of efforts to reform the child welfare system. Over the past 20 years, federal legislation has produced the policy framework known as permanency planning [the Adoption Assistance and Child Welfare Act of 1980, PL. 96-272], new financial resources for family preservation and support services [the Omnibus Budget Reconciliation Act of 1993, P.L. 10346], and most recently, a national commitment to move more children from out-of-home care into adoptive homes [the Adoption and Safe Families Act of 1997, P.L. 105-89]. At the state and local level, efforts to bring about change have come in three forms: (1) consent decrees arising from legal actions advocates have brought in the courts [e.g., R.C. v. Hornsby 1991]; (2) reform initiatives embarked on by governors, child welfare leaders, and other stakeholders [Usher et al.1995]; and (3) demonstration programs authorized by waivers of federal regulations based on Title IV-E of the Social Security Act, under which state out-of-home care programs obtain federal funding. Unfortunately, a recent assessment by the U.S. General Accounting Office concluded that "[a]lthough initiatives are in place, most... states have not systematically evaluated the impact of them, and data concerning these efforts [are] limited" [U.S. GAO 1997: 3]. A number of factors contribute to this lack of information. A subtle obstacle may be an organizational culture within child welfare agencies that discourages performance measurement for fear that additional data will fuel attacks from the system's detractors, who evaluate performance "more on the basis of tragedies than successes" [Vincent 1997: 19]. A recent series of focus groups with frontline workers suggest that the perceptions of those closest to practice may be dominated by the tremendous difficulty of the work and by a strong sense that their efforts lack support from the public, policymakers, and management [Gibbs 1997]. Continued reliance on measures based on point-in-time data also obscures improvements in outcomes. In spite of repeated warnings that they are biased toward the experience of children who have the worst experience with the child welfare system (e.g., Usher et al. [1995]; Wulczyn [1996]), data based on snapshots of child welfare caseloads continue to be used inappropriately by many child welfare administrators, policymakers, advocates, and some researchers. Even the Adoption and Foster Care Analysis and Reporting System (AFCARS) established by the federal Administration for Children and Families falls prey to this problem. The pessimistic perspective created by these data has made the challenge of improving the performance of child welfare agencies seem so daunting that those seeking change have tended to ignore the possibility that their efforts might actually succeed. Results emerging from two child welfare reform efforts, the Family to Family initiative sponsored by the Annie E. Casey Foundation, and the Families for Kids initiative sponsored by the W.K. Kellogg Foundation, as well as anecdotal information from the U.S. General Accounting Office, indicate that significant improvements are, in fact, being made [U.S. GAO 1997]. Cognizant of repeated failures to measure the impact of reform efforts, the foundations sponsoring these initiatives insisted that the states and localities partnering with them accede to rigorous evaluation. …

Identifying obstacles to adoption in new york state's out-of-home care system

Abstract: An in-depth case study of the out-of-home care histo ries of 77 children who have been waiting the longest in the New York State child welfare system for adop tive placement (as of August 1998) sought to identify obstacles to the adoptive placement of this vulnerable population. The results provide valuable insights into delays in the system of service for the state's out-of home care population and have important implications for waiting children nationwide. In 1996, approximately 100,000 children were waiting for adoptive families; by March 1998, estimates suggested that an additional 10,000 children were waiting in out-of-home care for adoption [North American Council on Adoptable Children 1998]. President Clinton focused attention on adoption as a central policy issue in 1996 by declaring his goal to provide incentives to states to double adoptions of children in out-of-home care by the year 2002. As impetus, he directed the U.S. Department of Health and Human Services to make specific strategy recommendations to move children more quickly from out-of-home care to permanent families and to meet the goal of doubling adoptions and other permanent placements over the following five years. The result was Adoption 2002, a multifaceted effort to address existing obstacles in the system, to expedite the placement of children from out-of-home care to permanent families, and to focus on delays in timely permanency planning. Some of the specific obstacles identified were delays in child welfare agency practices, court/judicial practices, staff beliefs and attitudes about the adoptability of children, the limited pool of permanent families for children with special needs, and varied interpretation of the "reasonable efforts" requirement to reunify children in out-of-home care with their birth families. The report highlighted delays in child welfare agency practices, such as agencies not offering or providing services in a timely fashion, well-intended but misguided attempts to preserve families through prolonged and extensive reunification services without adequate consideration of the permanency needs of children, and delays in implementing adoption plans. With regard to delays in court/judicial practices, the report identified the extensive time commitments and resources required for preparation of cases for court hearings, the backlog of cases on the court's calendar, and the failure to implement family reunification efforts in a timely manner, thus precluding an appropriately early termination of parental rights. Delays were also attributed to staff beliefs and attitudes, particularly caseworker reluctance to terminate birth parents' rights based on beliefs that a child is not adoptable or that long-term out-ofhome care is not detrimental to the child or on resistance to place across racial/ethnic boundaries or in certain family types. Finally, the report focused on delays related to the limited pool of permanent families for children with special needs resulting from insufficient or inadequate recruitment efforts in behalf of children. Further impetus was given to the goals of Adoption 2002 when President Clinton signed into law the Adoption and Safe Families Act (ASFA) in 1997, which strongly encourages states to increase adoptions by providing both policy and fiscal incentives. The Act requires state child welfare agencies to initiate or join in court proceedings to terminate parental rights for children who have been in out-of-home care for 15 of the last 22 months and in those cases in which parents have killed or seriously injured another child in the family. In addition, ASFA permits concurrent planning, allowing agencies to place children with foster families who would be willing to adopt them should reunification with the birth family not be possible, even as the agency makes diligent efforts to reunite the same children with their families of origin [American Human Society 1998]. …

Hope for the children: a community-based approach to supporting families who adopt children with special needs.

Abstract: This study explored the need for and use of support by preadoptive families of children with special needs in the Hope for the Children program. The families live in a community alongside other foster and adoptive parents, senior citizen volunteers, tutors, therapists, mentors, and family advocates, and receive extensive community supports. Descriptive results from the study provide a basis for recommendations about the use of coordinated service delivery systems to promote adoption success. Efforts by the states, combined with federal initiatives such as President Clinton's Adoption 2000 and the Adoption and Safe Families Act of 1997, are resulting in an increased number of adoptions. Illinois has seen a spectacular increase in adoption during the past year alone as the number of children adopted from out-of-home care almost doubled from 2,229 in fiscal year 1997 to 4,293 in fiscal year 1998 [Illinois Department of Child and Family Services (IDCFS) 1998]. Although this historic increase in adoptions is laudable, it appears that insufficient attention is being devoted to ensuring that adoptions are sustained over time and that the quality of adoptive home environments are suitable to each child's long-term developmental needs [Howard & Smith 1997]. The benefits of placing a record number of children with special needs with families will be undermined if the rate of adoption disruption is high. Thus, it is important to understand the circumstances under which families are best able to sustain their commitment to a child with special needs. The successful adoption of children who have spent some portion of their lives in out-of-home care generally requires a great deal of planning, preparation, and ongoing support [Eheart & Power 1995; Groze & Gruenewald 1991; Rosenthal & Groze 1992]. Children who are removed from their parents' custody as a result of abuse or neglect typically have complex medical, emotional, developmental, and behavioral needs [Berry 1990; Berry & Barth 1990; Lakin 1992; Partridge et al.1986; Rosenthal & Groze 1992; Smith & Howard 1994]. When adoptive parents cannot meet these needs, the stability of the adoption may be threatened [Barth & Berry 1988 1991; Eheart & Power 1995]. The situation may be exacerbated if services designed to preserve the family (e.g., inhome services, respite care, parent education, parent support groups) are not initiated until after a family crisis has occurred [Smith & Howard 1994]. If services are provided on a preventive basis and as a matter of course, however, the stability of adoptive placements may be enhanced. The support that families with children with special needs receive is an important factor in the attainment of permanency [Barth & Berry 1988; Groze 1996; Nelson 1985; Partridge et al. 1986]. Winkler and associates [1988] suggest that involvement with supportive resources and mental health services should be considered a normative part of the adoptive family's experience. Given the multitude and diversity of problems that children with special needs and their families may experience, it is important to ascertain which types of supports and resources are most important, who should provide those resources, and how those resources should be provided. Kramer and Houston [1998] made some progress answering these questions through their study of 40 parents who were in the process of adopting children with special needs through a traditional service system, the Illinois Department of Children and Family Services (IDCFS). Their study revealed that families rely on a variety of formal and informal resources. Families used formal resources such as the adoption agency and professionals to help with health, medical, and educational problems, but they also reported turning to their indigenous support system of family members and friends for assistance with a wide range of adoption-related issues. Although these informal sources of support typically possessed little specific knowledge about the adoption process, parents sought their help with child behavior problems and family adjustment difficulties. …

Shared Family Care: Providing Services to Parents and Children Placed Together in Out-of-Home Care

Abstract: Shared family care involves the planned provision of out-of-home care to parents and their children so that the parent and the host caregivers simultaneously shared the care of the children and work toward independent in-home care by the parent. This article describes several innovative types of shared family care arrangements that demonstrate promise in the protection of children and the promotion of family well-being. Emphasis is placed on the shared family foster care model, including its key elements, funding, and evaluation.

Openness: a critical component of special needs adoption.

Abstract: Openness in adoption is both a philosophical concept and a description of relationships. Regardless of the age of the adoptee or the circumstances of the adoption, the goal of openness is to minimize loss and to maintain connections. This article presents a model for expanding the principles learned from openness in infant adoptions to the field of special needs adoptions.

Social Work Intervention with Bedouin-Arab Children in the Context of Blood Vengeance.

Abstract: Blood vengeance is a culturally specific phenomenon that can place Bedouin-Arab children at high risk of neglect. This case study examines the psychological and social implications of vengeance on children, the children's coping strategies, and the role of social work. The social work function includes nonauthoritarianism, strategies for forming a positive helping alliance, and various forms of culturally sensitive assessment and intervention. The study therefore yields insight into bridging the emic-etic gap in conceptualizing and responding to child neglect in a non-Western society The literature has long recognized that such social conditions as poverty, unemployment, inadequate housing, poor health care, and low educational opportunities increase the incidence of child abuse and neglect [Doyle 1996]. Considerable progress has also been made in discerning some of the culturally specific parameters of what may be perceived to be abuse or neglect [Hogan & Siu 1988; Krajewski-Jaime 1991; Saunders et al. 1993]. Authors have distinguished an emic perspective, the viewpoint of members of the cultural group in question, from an etic perspective, that is, one that is interpreted from an outside viewpoint [Korbin 1980, 1981; Korr 1986; Lum 1995]. Some studies have looked into childbearing and child-rearing practices in instances where emic and etic conceptions are in conflict and where they are in agreement [Beavers 1986; Siegel 1994]. But few crosscultural studies have as yet moved beyond the immediate family to consider the emic and etic perspectives in relation to broad societal factors that may be associated with abuse or neglect. The present article examines how the widespread BedouinArab practice of blood vengeance is a serious factor in child neglect. For purposes of this article, neglect occurs "when the basic needs of children are not met, regardless of cause" [Dubowitz et al. 1993: 10]. It includes such criteria as a lack of parental/guardian supervision, nutrition, clothing and hygiene, physical health care, mental health care, and developmental/educational care [Trocme 1996]. The practice of blood vengeance-the obligation to kill in retribution for the death of a member of one's family or tribe-is illegal in most of the world [Jabbur 1995]. To many in the West, the practice appears frightening, violent, and mysterious, occurring in societies that are foreign and unfamiliar. To other cultures, however, among them the Bedouin-Arab, blood vengeance is an accepted fact of life: a longstanding tradition that ensures the maintenance of familial and tribal honor, a collective guarantee provided by an extended family or tribe to all of its members [AlKrenawi & Graham 1997a; Ginat 1987]. Not only can vengeance reduce families to the most destitute of economic situations, but under some circumstances, it also significantly impairs children's psychosocial development by limiting their interaction networks, access to education, and instrumental, emotional, and affective forms of social support. Ameliorating the effects of vengeance, therefore, requires that the worker have not just knowledge of cultural sensitivity, but also culturally specific intervention techniques [Al-Krenawi 1996; AlKrenawi & Graham 1996; Landsman 1988; Sue & Zane 1987]. This article is a beginning point for conceptualizing micro and macro aspects of intervention in the context of blood vengeance. It provides an opportunity for the emic (Bedouin-Arab) and etic (social work) perspectives to enter into a dialogue, and thus a basis upon which to improve social work practice among societies such as the Bedouin. Data are based on a case study analysis of a family selected by one of the authors, himself a Bedouin social worker, who visited the family once a week over a period of three months. Part of the text is therefore written in the first person. The discussion briefly outlines Bedouin society, the significance of blood vengeance, and the context in which a blood vengeance family found itself. …

The Child Well-Being Scales as a Clinical Tool and a Management Information System

Abstract: In June 1992, a family services agency in the Niagara region of southern Ontario began implementing and operating a computerized version of the Child Welfare League of America's Child Well-Being Scales [Magura & Moses 1986]. The scales are completed on all cases at the point of transfer from intake to long-term family service, and then again every 120 days until case closure. The scales have been useful in clinical and administrative practice for case planning in aggregate form, service planning, community profiling, and outcome measurement. Decisionmaking and service planning in child welfare are complex and difficult tasks, made more so by the limited number of empirically tested client outcome measures and structured decisionmaking models available to guide practice [DePanfilis & Scannapieco 1994]. As a result, workers' decisions may become idiosyncratic over time, perhaps leading to biases, culturally insensitive services, and a misunderstanding of culturally specific child-rearing practices [Gray & Cosgrove 1985; Rubin 1992; Stein & Rzepnicki 1983]. In the field of child protection, one approach to this problem has been the development of structured risk-assessment models to facilitate practice. Pecora [1991] delineated four types of risk-assessment model. One is the matrix approach representative of the earliest models developed, which uses a table composed of risk factors that are then rated in terms of their severity (e.g., Coler [1982]). The second is the empirical predictor model [Baird 1988; Johnson & L'Esperance 1984], in which a small set of factors predictive of maltreatment recurrence are provided to Child Protective Service (CPS) intake workers. The third is the family assessment scales model, which tends to use behaviorally anchored scales to assess levels of parent, child, and family functioning, with the Child Well-Being Scales (CWBS) [Magura & Moses 1986] being one of the prime examples of this type. The fourth is the Child at Risk Field (CARF) model, which uses an ecological approach, organized around five "force fields," (child, parent, family, maltreatment, and intervention) [Holder & Corey 1987]. A fifth type, computerized "expert systems," was recently added to this taxonomy [English & Pecora 1994]. The use of risk-assessment models has engendered much controversy. In general, criticism has been leveled at the widespread use of models because of inadequate design, a lack of validation research, and methodological limitations [Doueck et al. 1992; Lyons et al. 1996; McDonald & Marks 1991; Pecora 1989; Wald & Wolverton 1990]. The Child Well-Being Scales, however, are much more than a risk-assessment instrument. The Child Well-Being Scales The Child Well-Being Scales were originally designed to meet the needs of program evaluation in child welfare services rather than to measure individual case outcomes [Magura & Moses 1986). The CWBS consist of 43 behavior-rating scales that are multidimensional measures of potential child maltreatment situations. The items represent four critical dimensions linked to child wellbeing: (1) parenting role performance; (2) familial capacities; (3) child role performance; and (4) child capacities. They focus on considerations common to a broad range of child- and familyoriented services, with a particular emphasis on problems encountered by child welfare agencies. Each item consists of four or five behaviorally specific response categories, with clearly described anchoring points and examples. In addition, each scale point is weighted in terms of a common dimension, the seriousness of the condition. The weightings for seriousness are based on opinions collected from a sample of several hundred practitioners and administrators of child welfare services. Testing of the subscales indicates that three factors-household adequacy (10 scales), parental disposition (14 scales, including measures of parenting skills, disabilities, problem recognition, motivation, and adult/child relationships), and child performance (4 scales) accounted for 43% of the variance [Magura & Moses 1986]. …