Pub Date : 2020-06-01DOI: 10.1177/2516103220940326
R. Nelson, G. Chadwick, M. Bruce, Genevieve Young-Southward, H. Minnis
Reactive Attachment Disorder (RAD), is characterized by failure to seek and accept comfort in maltreated children. This lack of activation of the attachment system has profound developmental disadvantages yet, in early childhood, usually resolves quickly after placement in nurturing care. Persistence of RAD into middle childhood has been demonstrated in children reared in Romanian Institutions but, in family-reared children older children, there is controversy regarding whether RAD-like behaviors are genuinely attachment-related and stable from early childhood or are, in fact, related to PTSD. We conducted two pieces of research to investigate this: 1. a systematic review to examine persistence/resolution of RAD and 2. a case series of three boys whose RAD symptoms persisted despite living in placements judged by both social and child health services to be of good quality. Our systematic review revealed a paucity of longitudinal data. Except in atypical institutionalized samples, RAD had not been evidenced beyond pre-school. All three boys in the case series met DSM 5 criteria for RAD in late childhood/early adolescence and had stable RAD symptoms since before age 5. Qualitative interviews with their families revealed common themes of family strain, frustration and resentment at the lack of support from services. This paper provides the first opportunity to generate testable hypotheses about environmental circumstances and coexisting symptomatology that may influence RAD trajectories. Persistence of RAD has profoundly negative implications for children and their families. Recognition of RAD symptoms is challenging but crucial in order to improve care of these children and their families.
{"title":"Can reactive attachment disorder persist in nurturing placements? A systematic review and clinical case series","authors":"R. Nelson, G. Chadwick, M. Bruce, Genevieve Young-Southward, H. Minnis","doi":"10.1177/2516103220940326","DOIUrl":"https://doi.org/10.1177/2516103220940326","url":null,"abstract":"Reactive Attachment Disorder (RAD), is characterized by failure to seek and accept comfort in maltreated children. This lack of activation of the attachment system has profound developmental disadvantages yet, in early childhood, usually resolves quickly after placement in nurturing care. Persistence of RAD into middle childhood has been demonstrated in children reared in Romanian Institutions but, in family-reared children older children, there is controversy regarding whether RAD-like behaviors are genuinely attachment-related and stable from early childhood or are, in fact, related to PTSD. We conducted two pieces of research to investigate this: 1. a systematic review to examine persistence/resolution of RAD and 2. a case series of three boys whose RAD symptoms persisted despite living in placements judged by both social and child health services to be of good quality. Our systematic review revealed a paucity of longitudinal data. Except in atypical institutionalized samples, RAD had not been evidenced beyond pre-school. All three boys in the case series met DSM 5 criteria for RAD in late childhood/early adolescence and had stable RAD symptoms since before age 5. Qualitative interviews with their families revealed common themes of family strain, frustration and resentment at the lack of support from services. This paper provides the first opportunity to generate testable hypotheses about environmental circumstances and coexisting symptomatology that may influence RAD trajectories. Persistence of RAD has profoundly negative implications for children and their families. Recognition of RAD symptoms is challenging but crucial in order to improve care of these children and their families.","PeriodicalId":36239,"journal":{"name":"Developmental Child Welfare","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2516103220940326","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45805909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-05-06DOI: 10.1177/2516103220915482
Rebecca Greenhalgh, Siana Fflur, K. Donnelly, Helen Kirkaldie, L. Mcdonnell
Background: The Gwent Attachment Service trained four pupil referral units (PRUs) staff in attachment- and trauma-informed work. Education staff received 2 days of training and then attended six skills development sessions (SDSs) on a monthly basis to embed the training concepts into their work. This model takes a “whole systems approach” to intervention, drawing on evidence suggesting that having a supportive and consistent system around a child that takes into account their attachment needs leads to better outcomes. Methods: Self-reported knowledge of attachment- and trauma-informed work, confidence in carrying out this work, and worries about implementing this work were collected from 64 education staff members across the four PRUs. Measures were repeated at three time points: pre-training, post-training, and post-SDS. Results: Knowledge and confidence increased from pre- to post-training. Knowledge did not significantly differ between post-training and post-SDS. Confidence was lower at post-SDS than post-training but remained above pre-training ratings. Worries decreased from pre- to post-training and decreased again post-SDS. Conclusion: Training and SDSs can improve teaching staffs’ perception of their knowledge and confidence, while reducing worries about working in an attachment- and trauma-informed way. SDSs decreased worries about working in an attachment- and trauma-informed way over and above training alone, indicating that the SDSs contribute added value. This study presents a promising starting point for improving the lives of children and young people who have experienced trauma and have attachment difficulties.
{"title":"An evaluation of the impact of attachment and trauma training for pupil referral unit staff","authors":"Rebecca Greenhalgh, Siana Fflur, K. Donnelly, Helen Kirkaldie, L. Mcdonnell","doi":"10.1177/2516103220915482","DOIUrl":"https://doi.org/10.1177/2516103220915482","url":null,"abstract":"Background: The Gwent Attachment Service trained four pupil referral units (PRUs) staff in attachment- and trauma-informed work. Education staff received 2 days of training and then attended six skills development sessions (SDSs) on a monthly basis to embed the training concepts into their work. This model takes a “whole systems approach” to intervention, drawing on evidence suggesting that having a supportive and consistent system around a child that takes into account their attachment needs leads to better outcomes. Methods: Self-reported knowledge of attachment- and trauma-informed work, confidence in carrying out this work, and worries about implementing this work were collected from 64 education staff members across the four PRUs. Measures were repeated at three time points: pre-training, post-training, and post-SDS. Results: Knowledge and confidence increased from pre- to post-training. Knowledge did not significantly differ between post-training and post-SDS. Confidence was lower at post-SDS than post-training but remained above pre-training ratings. Worries decreased from pre- to post-training and decreased again post-SDS. Conclusion: Training and SDSs can improve teaching staffs’ perception of their knowledge and confidence, while reducing worries about working in an attachment- and trauma-informed way. SDSs decreased worries about working in an attachment- and trauma-informed way over and above training alone, indicating that the SDSs contribute added value. This study presents a promising starting point for improving the lives of children and young people who have experienced trauma and have attachment difficulties.","PeriodicalId":36239,"journal":{"name":"Developmental Child Welfare","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2516103220915482","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46309287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-04-16DOI: 10.1177/2516103220915624
Delphine West, J. Vanderfaeillie, L. Van Hove, Laura Gypen, F. Van Holen
Foster children often had negative experiences in the past, which can contribute to attachment problems. In their meta-analysis, van den Dries et al. found that foster children were more often disorganized attached when compared to the general population. It is to be expected that the quality of attachment between the foster children and their foster parents is related to various factors. However, research into which factors are associated with the development of secure attachment is scarce. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses method, a total of 13 articles were included in this review. This review provides an overview of the associated characteristics with the quality of attachment between foster carers and foster children. In the articles included in this review, the foster carers’ characteristics were often described as more important than characteristics of the foster child and placement when it comes to developing a secure attachment. The most consensus, although not unanimous, existed on the finding that a positive, sensitive parenting style of foster parents was positively related to a secure attachment between the foster children and their foster carers.
寄养儿童过去经常有负面的经历，这可能会导致依恋问题。在他们的荟萃分析中，van den Dries等人发现，与一般人群相比，寄养儿童更容易出现无组织依恋。可以预见，寄养儿童与养父母之间的依恋质量与多种因素有关。然而，关于哪些因素与安全依恋的发展有关的研究很少。采用系统评价首选报告项目和荟萃分析方法，本综述共纳入13篇文章。本综述概述了寄养照顾者与寄养儿童之间依恋质量的相关特征。在这篇综述中包含的文章中，当涉及到建立安全依恋时，寄养照顾者的特征通常被描述为比寄养儿童的特征和安置更重要。虽然不是一致的，但大多数人都同意养父母积极、敏感的养育方式与寄养儿童和养父母之间的安全依恋呈正相关。
{"title":"Attachment in family foster care: Literature review of associated characteristics","authors":"Delphine West, J. Vanderfaeillie, L. Van Hove, Laura Gypen, F. Van Holen","doi":"10.1177/2516103220915624","DOIUrl":"https://doi.org/10.1177/2516103220915624","url":null,"abstract":"Foster children often had negative experiences in the past, which can contribute to attachment problems. In their meta-analysis, van den Dries et al. found that foster children were more often disorganized attached when compared to the general population. It is to be expected that the quality of attachment between the foster children and their foster parents is related to various factors. However, research into which factors are associated with the development of secure attachment is scarce. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses method, a total of 13 articles were included in this review. This review provides an overview of the associated characteristics with the quality of attachment between foster carers and foster children. In the articles included in this review, the foster carers’ characteristics were often described as more important than characteristics of the foster child and placement when it comes to developing a secure attachment. The most consensus, although not unanimous, existed on the finding that a positive, sensitive parenting style of foster parents was positively related to a secure attachment between the foster children and their foster carers.","PeriodicalId":36239,"journal":{"name":"Developmental Child Welfare","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2516103220915624","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45897651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-01DOI: 10.1177/2516103220908043
E. Neil, M. Morciano, Julie K. Young, L. Hartley
This study explored how child maltreatment, alongside a range of other variables, predicted adverse outcomes for children adopted from the foster care system in England. The participants were 319 adoptive parents who completed an in-depth online survey about their most recently adopted child. The mean age of children at placement for adoption was 28 months (range 0–11 years) and their ages at the time of the survey ranged from 0 years to 17 years (mean = 7 years). Detailed information was collected about children’s backgrounds, including their experiences in the birth family and the care system before adoption. Adoptive parents also reported on how well children were getting on in a range of areas of functioning and how well they felt the adoption was going overall. Child maltreatment and child adverse outcomes were modeled as two factors in a latent factor structural equation model. The relationship between these two factors was explored alongside a range of covariates. Associated with worse outcomes for children were potentially heritable factors (parental learning disability), the pre-birth environment (exposure to drugs or alcohol in utero) and the period between birth and moving to the adoptive family (higher levels of maltreatment, spending more than a year in care, having two or more foster placements). The child’s distress on moving from the foster home to the adoptive family was also highly significant in linking to poorer outcomes, suggesting the detrimental effect of poorly managed transitions. Implications for child welfare practices before and after adoption are discussed.
{"title":"Exploring links between early adversities and later outcomes for children adopted from care: Implications for planning post adoption support","authors":"E. Neil, M. Morciano, Julie K. Young, L. Hartley","doi":"10.1177/2516103220908043","DOIUrl":"https://doi.org/10.1177/2516103220908043","url":null,"abstract":"This study explored how child maltreatment, alongside a range of other variables, predicted adverse outcomes for children adopted from the foster care system in England. The participants were 319 adoptive parents who completed an in-depth online survey about their most recently adopted child. The mean age of children at placement for adoption was 28 months (range 0–11 years) and their ages at the time of the survey ranged from 0 years to 17 years (mean = 7 years). Detailed information was collected about children’s backgrounds, including their experiences in the birth family and the care system before adoption. Adoptive parents also reported on how well children were getting on in a range of areas of functioning and how well they felt the adoption was going overall. Child maltreatment and child adverse outcomes were modeled as two factors in a latent factor structural equation model. The relationship between these two factors was explored alongside a range of covariates. Associated with worse outcomes for children were potentially heritable factors (parental learning disability), the pre-birth environment (exposure to drugs or alcohol in utero) and the period between birth and moving to the adoptive family (higher levels of maltreatment, spending more than a year in care, having two or more foster placements). The child’s distress on moving from the foster home to the adoptive family was also highly significant in linking to poorer outcomes, suggesting the detrimental effect of poorly managed transitions. Implications for child welfare practices before and after adoption are discussed.","PeriodicalId":36239,"journal":{"name":"Developmental Child Welfare","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2516103220908043","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45368900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-01DOI: 10.1177/2516103219894599
Sandra H. Jee, Anne-Marie Conn, Andrea Milne-Wenderlich, C. Krafft, Michael Chen, M. Steen, J. T. Manly
National organizations call for providing trauma-informed care (TIC) to those who have experienced adverse childhood experiences (ACEs) and to the population as a whole. All providers and staff are at risk for experiencing stress and burnout when they care for patients with multiple complex needs and insufficient resources. All are at risk but not all develop burnout. This study shares findings from a pilot project to implement training on ACEs and toxic stress in a busy urban pediatric primary care practice. Using a mixed-methods approach, we assessed pre and post self-reported knowledge and attitudes via surveys (n = 52), baseline in-depth interviews (n = 16), focus groups (three groups, n = 36), and follow-up interviews (n = 13). After training, staff reported a marginally significant increase in rating the office as doing a good job meeting the needs of families around childhood trauma (72% vs. 46%, p = 0.057). Key themes from baseline in-depth interviews and focus groups identified the following: (1) pervasiveness of trauma and adversity among families in the practice, (2) empathy for families with significant social needs, (3) feelings of frustration to alleviate stressors identified during visits, (4) need for social support and coping mechanisms to alleviate workplace stress, and (5) receptiveness to enhance knowledge and understanding. Key themes from follow-up interviews and focus groups highlighted the impact of compassion fatigue and strategies to promote self-care. We discuss these findings and challenges in relation to providing TIC and professional development.
{"title":"Providing trauma-informed pediatric care for underserved populations: Reflections on a teaching intervention","authors":"Sandra H. Jee, Anne-Marie Conn, Andrea Milne-Wenderlich, C. Krafft, Michael Chen, M. Steen, J. T. Manly","doi":"10.1177/2516103219894599","DOIUrl":"https://doi.org/10.1177/2516103219894599","url":null,"abstract":"National organizations call for providing trauma-informed care (TIC) to those who have experienced adverse childhood experiences (ACEs) and to the population as a whole. All providers and staff are at risk for experiencing stress and burnout when they care for patients with multiple complex needs and insufficient resources. All are at risk but not all develop burnout. This study shares findings from a pilot project to implement training on ACEs and toxic stress in a busy urban pediatric primary care practice. Using a mixed-methods approach, we assessed pre and post self-reported knowledge and attitudes via surveys (n = 52), baseline in-depth interviews (n = 16), focus groups (three groups, n = 36), and follow-up interviews (n = 13). After training, staff reported a marginally significant increase in rating the office as doing a good job meeting the needs of families around childhood trauma (72% vs. 46%, p = 0.057). Key themes from baseline in-depth interviews and focus groups identified the following: (1) pervasiveness of trauma and adversity among families in the practice, (2) empathy for families with significant social needs, (3) feelings of frustration to alleviate stressors identified during visits, (4) need for social support and coping mechanisms to alleviate workplace stress, and (5) receptiveness to enhance knowledge and understanding. Key themes from follow-up interviews and focus groups highlighted the impact of compassion fatigue and strategies to promote self-care. We discuss these findings and challenges in relation to providing TIC and professional development.","PeriodicalId":36239,"journal":{"name":"Developmental Child Welfare","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2516103219894599","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42160991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-02-17DOI: 10.1177/2516103220902778
H. Minnis, C. Messow, A. McConnachie, P. Bradshaw, A. Briggs, P. Wilson, C. Gillberg
Background: Co-occurring trauma-related and neurodevelopmental problems are common in maltreated children. In population research and clinical practice, these tend to be considered separately. Overlapping health problems, that is, “multi-morbidity,” in adulthood is associated with increased service burden and costs, but this has not been investigated in childhood. Methods: Using well-validated parent-report questionnaires, we examined the overlap between symptoms of the neurodevelopmental disorder autism (autism spectrum disorder, ASD) and symptoms of the trauma- and stressor-related disorders (reactive attachment disorder [RAD] and disinhibited social engagement disorder [DSED]) in a representative general population sample of over 3,300 children aged 5–6 years of age. We investigated sociodemographic factors, service burden, and costs in association with these problems when considered separately and when co-occurring. Results: Nearly 2% of this population had symptoms suggestive of both ASD and RAD/DSED. High symptom scores for ASD were associated with male gender, (younger) age of mother at birth, and being in a single-parent family, while high symptom scores for RAD/DSED were associated with (younger) age of mother at birth, being in a single-parent family, and the number of accidents reported. Service use costs per likely case of both ASD and RAD/DSED in the preschool years were increased by £348.62 (95% confidence interval 121.04–391.11)—nearly double the costs of ASD alone. Conclusions: There is considerable overlap between symptoms of ASD and RAD/DSED in the general population, indicating that multi-morbidity is already present in childhood and is associated with increased service use and costs even in the preschool years.
{"title":"Autism and attachment disorder symptoms in the general population: Prevalence, overlap, and burden","authors":"H. Minnis, C. Messow, A. McConnachie, P. Bradshaw, A. Briggs, P. Wilson, C. Gillberg","doi":"10.1177/2516103220902778","DOIUrl":"https://doi.org/10.1177/2516103220902778","url":null,"abstract":"Background: Co-occurring trauma-related and neurodevelopmental problems are common in maltreated children. In population research and clinical practice, these tend to be considered separately. Overlapping health problems, that is, “multi-morbidity,” in adulthood is associated with increased service burden and costs, but this has not been investigated in childhood. Methods: Using well-validated parent-report questionnaires, we examined the overlap between symptoms of the neurodevelopmental disorder autism (autism spectrum disorder, ASD) and symptoms of the trauma- and stressor-related disorders (reactive attachment disorder [RAD] and disinhibited social engagement disorder [DSED]) in a representative general population sample of over 3,300 children aged 5–6 years of age. We investigated sociodemographic factors, service burden, and costs in association with these problems when considered separately and when co-occurring. Results: Nearly 2% of this population had symptoms suggestive of both ASD and RAD/DSED. High symptom scores for ASD were associated with male gender, (younger) age of mother at birth, and being in a single-parent family, while high symptom scores for RAD/DSED were associated with (younger) age of mother at birth, being in a single-parent family, and the number of accidents reported. Service use costs per likely case of both ASD and RAD/DSED in the preschool years were increased by £348.62 (95% confidence interval 121.04–391.11)—nearly double the costs of ASD alone. Conclusions: There is considerable overlap between symptoms of ASD and RAD/DSED in the general population, indicating that multi-morbidity is already present in childhood and is associated with increased service use and costs even in the preschool years.","PeriodicalId":36239,"journal":{"name":"Developmental Child Welfare","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2516103220902778","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42566455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-15DOI: 10.1177/2516103219899668
Conor O’Brien, J. Rapp, Erica D. Kierce
Approximately one third of children in foster care in the U.S. receive psychotropic medication; however, few studies have evaluated the extent to which either the number or dosage of drugs changes across time. We conducted a retrospective descriptive study of Medicaid files for 30 individuals placed in a foster care system that included an analysis of 10 consecutive visits with a prescribing practitioner spanning 8–14 months. Specifically, we evaluated the data for evidence of deprescribing. Results indicate practitioners changed psychotropic medication during 70% of visits and most changes involved removing and adding psychotropic medication within the same class. Results also show 60% of visits across participants involved prescriptions for four or more psychotropic medications, whereas only 0.33% of trials involved no psychotropic medication. Furthermore, results show the mean number of psychotropic medications per foster child at the end of the study (M = 3.97) did not decrease in comparison to the start of the study (M = 3.53). Taken together, these results indicate that prescribers do not regularly engage in a clear deprescribing process for psychotropic medication when serving foster youth. We discuss some limitations to the current study and directions for future research on prescribing patterns with foster children.
{"title":"Do prescribers deprescribe psychotropic medication for children in foster care?","authors":"Conor O’Brien, J. Rapp, Erica D. Kierce","doi":"10.1177/2516103219899668","DOIUrl":"https://doi.org/10.1177/2516103219899668","url":null,"abstract":"Approximately one third of children in foster care in the U.S. receive psychotropic medication; however, few studies have evaluated the extent to which either the number or dosage of drugs changes across time. We conducted a retrospective descriptive study of Medicaid files for 30 individuals placed in a foster care system that included an analysis of 10 consecutive visits with a prescribing practitioner spanning 8–14 months. Specifically, we evaluated the data for evidence of deprescribing. Results indicate practitioners changed psychotropic medication during 70% of visits and most changes involved removing and adding psychotropic medication within the same class. Results also show 60% of visits across participants involved prescriptions for four or more psychotropic medications, whereas only 0.33% of trials involved no psychotropic medication. Furthermore, results show the mean number of psychotropic medications per foster child at the end of the study (M = 3.97) did not decrease in comparison to the start of the study (M = 3.53). Taken together, these results indicate that prescribers do not regularly engage in a clear deprescribing process for psychotropic medication when serving foster youth. We discuss some limitations to the current study and directions for future research on prescribing patterns with foster children.","PeriodicalId":36239,"journal":{"name":"Developmental Child Welfare","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2516103219899668","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44336294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-12-01DOI: 10.1177/2516103219892276
Brett Greenfield, Abigail Williams-Butler, K. Fay, Jacquelynn F. Duron, E. Bosk, Kate Stepleton, M. Mackenzie
The intergenerational influence of adverse childhood experiences on individual outcomes demonstrates a need for research that considers both personal and environmental contributors to risk. As such, the current study explored how maternal cumulative risks influence the relationship between maternal Adverse Childhood Experiences (ACEs) and their children’s behavioral dysregulation among families involved with the child welfare system (N = 314). The importance of child age is also considered. The sample was stratified by age groups of children (1.5–5 years and 6–18 years), and the relationship between maternal ACEs, cumulative risk, and child behavior was assessed using OLS regressions. For younger children, maternal ACEs were only associated with externalizing behaviors when not controlling for cumulative risk, but cumulative risks were independently and significantly associated with both internalizing and externalizing behaviors. For older children, ACEs were independently associated with both types of behavior, but controlling for cumulative risk attenuated the strength of this relationship. Cumulative risks were also independently associated with older children’s internalizing and externalizing behaviors. Findings suggest the need to consider both individual and environmental risks for parents and children involved in the child welfare system, and the developmental timing and stability of that risk, in order to adequately support parent-child relationships as well as caregiving environments.
{"title":"Maternal adverse childhood experiences, current cumulative risk, and behavioral dysregulation among child welfare involved children","authors":"Brett Greenfield, Abigail Williams-Butler, K. Fay, Jacquelynn F. Duron, E. Bosk, Kate Stepleton, M. Mackenzie","doi":"10.1177/2516103219892276","DOIUrl":"https://doi.org/10.1177/2516103219892276","url":null,"abstract":"The intergenerational influence of adverse childhood experiences on individual outcomes demonstrates a need for research that considers both personal and environmental contributors to risk. As such, the current study explored how maternal cumulative risks influence the relationship between maternal Adverse Childhood Experiences (ACEs) and their children’s behavioral dysregulation among families involved with the child welfare system (N = 314). The importance of child age is also considered. The sample was stratified by age groups of children (1.5–5 years and 6–18 years), and the relationship between maternal ACEs, cumulative risk, and child behavior was assessed using OLS regressions. For younger children, maternal ACEs were only associated with externalizing behaviors when not controlling for cumulative risk, but cumulative risks were independently and significantly associated with both internalizing and externalizing behaviors. For older children, ACEs were independently associated with both types of behavior, but controlling for cumulative risk attenuated the strength of this relationship. Cumulative risks were also independently associated with older children’s internalizing and externalizing behaviors. Findings suggest the need to consider both individual and environmental risks for parents and children involved in the child welfare system, and the developmental timing and stability of that risk, in order to adequately support parent-child relationships as well as caregiving environments.","PeriodicalId":36239,"journal":{"name":"Developmental Child Welfare","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2516103219892276","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45782849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-12-01DOI: 10.1177/2516103219893383
S. Whitcombe-Dobbs, M. Tarren‐Sweeney
In families where child abuse and neglect have already occurred, there is a strong imperative to provide interventions that reduce or eliminate harm done to children. Parenting programs lack tailoring for the needs of maltreating parents, and maltreating parents themselves are a heterogeneous group with varying needs. The literature on the effectiveness of parenting interventions for high-risk parents is limited, and this scarcity of knowledge can result in child protection cases being treated as a natural experiment. For children who experience ongoing maltreatment by their parents, the most stringent test for effectiveness goes beyond an improvement in positive parenting skills—child abuse and neglect must reduce or be eliminated. The present review addressed the research question What evidence is there that parenting interventions conducted with parents who maltreat their children, reduce the incidence of further child maltreatment? Databases were searched for trials of parenting interventions where participants were maltreating parents and outcome data included an objective measure of child abuse and neglect. Nine studies satisfied the selection criteria and are summarized. Four studies reported a statistically significant difference between groups in favor of the intervention group for two parenting interventions, Parent–Child Interaction Therapy and SafeCare. However, the review concludes that none of the reviewed parenting interventions have been demonstrated to be effective at reducing all types of child maltreatment through a high-quality RCT. Previous research is compromised by several critical methodological limitations, including low participant recruitment and retention, and narrow selection criteria. Recommendations are offered for future research on parenting interventions that aim to reduce child abuse and neglect.
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Pub Date : 2019-12-01DOI: 10.1177/2516103219892274
M. Berlin, B. Vinnerljung, A. Hjern, L. Brännström
Parental education is a robust predictor of children’s educational outcomes in general population studies, yet little is known about the intergenerational transmission of educational outcomes in alternative family settings such as children growing up in foster care. Using Swedish longitudinal register data on 2.167 children with experience of long-term foster care, this study explores the hypothesized mediating role of foster parents’ educational attainment on foster children’s educational outcomes, here conceptualized as having poor school performance at age 15 and only primary education at age 26. Results from gender-stratified regression analyses suggest that there was an association between foster parental educational attainment and foster children’s educational outcomes but that the educational transmission was weak and inconsistent and differed somewhat between males and females. For males, lower educational attainment in foster parents was associated with poor school performance but was not associated with educational attainment at age 26. The reverse pattern was found among females: the educational gradient was inconsistent for poor school performance but appeared in educational attainment. The results indicate that supported interventions for improving foster children’s educational achievements are needed, even when placements are relatively stable and foster parents have a long formal education.
{"title":"Educational outcomes of children from long-term foster care: Does foster parents’ educational attainment matter?","authors":"M. Berlin, B. Vinnerljung, A. Hjern, L. Brännström","doi":"10.1177/2516103219892274","DOIUrl":"https://doi.org/10.1177/2516103219892274","url":null,"abstract":"Parental education is a robust predictor of children’s educational outcomes in general population studies, yet little is known about the intergenerational transmission of educational outcomes in alternative family settings such as children growing up in foster care. Using Swedish longitudinal register data on 2.167 children with experience of long-term foster care, this study explores the hypothesized mediating role of foster parents’ educational attainment on foster children’s educational outcomes, here conceptualized as having poor school performance at age 15 and only primary education at age 26. Results from gender-stratified regression analyses suggest that there was an association between foster parental educational attainment and foster children’s educational outcomes but that the educational transmission was weak and inconsistent and differed somewhat between males and females. For males, lower educational attainment in foster parents was associated with poor school performance but was not associated with educational attainment at age 26. The reverse pattern was found among females: the educational gradient was inconsistent for poor school performance but appeared in educational attainment. The results indicate that supported interventions for improving foster children’s educational achievements are needed, even when placements are relatively stable and foster parents have a long formal education.","PeriodicalId":36239,"journal":{"name":"Developmental Child Welfare","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2516103219892274","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42674272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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