Foster Care Placement Improves Children's Functioning

Horwitz, Sarah McCue; Balestracci, Kathleen M.B.; Simms, Mark D.

doi:10.1001/archpedi.155.11.1255

Cited by 61 publications

(31 citation statements)

References 31 publications

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“…Concerns about time in care need to be balanced, however, against the child's needs for physical and emotional safety and evidence suggesting that stable foster care placement may be a positive and therapeutic intervention for some children. 46,47 The importance of a competent, caring, nurturing, stable foster or kinship parent in supporting and advocating for a child's health and well-being cannot be stressed enough. Significant improvements in a child's health status, development, intelligence, school attendance, and academic achievement have been noted consequent to foster care placement.…”

Section: The Effects Of Foster Care On Children and Familiesmentioning

confidence: 99%

Health Care Issues for Children and Adolescents in Foster Care and Kinship Care

Rosen¹,

Rubin²,

Zlotnik³

et al. 2015

Pediatrics

165

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Children and adolescents involved with child welfare, especially those who are removed from their family of origin and placed in out-of-home care, often present with complex and serious physical, mental health, developmental, and psychosocial problems rooted in childhood adversity and trauma. As such, they are designated as children with special health care needs. There are many barriers to providing high-quality comprehensive health care services to children and adolescents whose lives are characterized by transience and uncertainty. Pediatricians have a critical role in ensuring the well-being of children in out-of-home care through the provision of high-quality pediatric health services in the context of a medical home, and health care coordination and advocacy on their behalf. This technical report supports the policy statement of the same title.

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Section: The Effects Of Foster Care On Children and Familiesmentioning

confidence: 99%

Health Care Issues for Children and Adolescents in Foster Care and Kinship Care

Rosen¹,

Rubin²,

Zlotnik³

et al. 2015

Pediatrics

165

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“…The importance of early relationships in the development of these skills was emphasized in a recent report by the National Research Council’s Institute of Medicine (Shonkoff & Phillips, 2000): “The scientific evidence on the significant developmental impacts of early experiences, caregiving relationships, and environmental threats is incontrovertible.” Not surprisingly, recent data indicate that a large proportion (as high as 61%) of young children in CW exhibit developmental and behavioral deficits (Reams, 1999), in sharp contrast to the much smaller proportion (10–12%) of children in the general population who exhibit such deficits (First & Palfrey, 1994). Delays in toddlers and preschoolers in CW appear in a variety of domains including developmental and cognitive skills (Egeland & Sroufe, 1981; Kinard, 1999; Klee, Kronstadt, & Zlotnick, 1997; Landsverk, Davis, Ganger, & Newton, 1996; Zimmer & Panko, 2006), language skills (Allen & Oliver, 1982; Coster, Gersten, Beeghly, & Cicchetti, 1989; Simms, 1989), behavior problems (Leslie, Gordon, Ganger, & Gist, 2002; Reams, 1999; Simms, 1989; Stahmer et al, 2005; Urquiza, Wirtz, Peterson, & Singer, 1994), and adaptive skills (Stahmer et al, 2005; Horwitz, Balestracci, & & Simms, 2001). Although most studies have addressed children residing in out-of-home care, recent data suggest that similar levels of need are seen in young children who remain at home (Leslie et al, 2002; Stahmer et al, 2005).…”

mentioning

confidence: 99%

Associations between intensity of child welfare involvement and child development among young children in child welfare

Stahmer

Hurlburt

Horwitz

et al. 2009

Child Abuse & Neglect

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Objective-To examine developmental and behavioral status of children in child welfare (CW) over time, by intensity of CW involvement using a national probability sample.Methods-As part of the National Survey of Child and Adolescent Well-Being (NSCAW), data were collected on 1,049 children 12-47 months old investigated by CW agencies for possible abuse or neglect. Analyses used descriptive statistics to characterize developmental and behavioral status across four domains (developmental/cognitive, language, adaptive functioning, and behavior) by intensity of CW involvement (in-home with CW services, in-home with no CW services or out-ofhome care) over time. Multivariate analyses were used to examine the relationship between independent variables (age, gender, home environment, race/ethnicity, maltreatment history, intensity of CW involvement) and follow-up domain scores.Results-On average, children improved in developmental/cognitive, communication/language status over time, but these improvements did not differ by intensity of CW involvement. Analyses revealed a positive relationship between the home environment and change in language and adaptive behavior standard scores over time, and few predictors of change in behavioral status. An interaction between intensity of CW involvement and initial developmental/cognitive status was present.Conclusions-Across domains, intensity of CW involvement does not appear to have a significant effect on change in developmental and behavioral status, although out-of-home care does have differential relationships with children's developmental/cognitive status for those with very low initial cognitive/developmental status. Facilitating development in children in CW may require supportive, enriched care environments both for children remaining at home and those in foster care.Practice Implications-Toddler and preschool age children known to child welfare are likely to have difficulties with development whether they are removed from their homes or not. It would be helpful if child welfare workers were trained to screen for developmental, language, adaptive behavior and behavioral difficulties in children in foster care, and those remaining at home.Address all correspondence to: Aubyn C. Stahmer, Ph.D., Child and Adolescent Services Research Center, 3020 Children's Way, MC, 5033, San Diego, CA 92123, Phone: (858) Fax: (858) 966-7704, astahmer@casrc.org. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public Access Author ManuscriptChild Abuse Negl. Author manuscript; available in PMC 2010 October 8. Published in final edited ...

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“…Favorable and stimulating environments for infants and young children decrease the adverse effects of prior negative environments. 33 The Arkansas Child Maltreatment Act requires the immediate reporting of medical neglect by a caregiver when there is reasonable cause to suspect that it has occurred, and it is a criminal offense for medical personnel to willfully fail to make a report. 34 The laws in other states are likely to be similar, and it is important that medical workers familiarize themselves with the statutes that relate directly to their duties.…”

Section: Discussionmentioning

confidence: 99%

Nonadherence With Pediatric Human Immunodeficiency Virus Therapy as Medical Neglect

Roberts¹,

Wheeler

Tucker

et al. 2004

Pediatrics

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ABSTRACT. Objective. To examine the results of an interventionist approach applied to human immunodeficiency virus (HIV)-infected children for whom caregiver nonadherence was suspected as the cause of treatment failure.Methods. The medical records of a cohort of 16 perinatally HIV-infected children whose care was managed at the Arkansas Children's Hospital Pediatric HIV Clinic for an uninterrupted period of >3 years were reviewed through July 2003. Data collected included date of birth, dates of and explanations for clinic visits and hospitalizations, dates of laboratory evaluations, CD4 ؉ T cell percentages, plasma HIV-1 RNA levels, antiretroviral medications, viral resistance tests (eg, phenotype and genotype), and physician-initiated interventions to enhance adherence to the medication regimen. A stepwise interventionist approach was undertaken when patients continued to demonstrate high viral loads, despite documented viral sensitivity to the medication regimen and caregivers' insistence that medications were being administered regularly.Step 1 was prescribing a home health nurse referral, step 2 was administering directly observed therapy (DOT) while the patient was hospitalized for 4 days, and step 3 was submitting a physicianinitiated medical neglect report to the Arkansas Department of Human Services.Results. The results for 6 patients for whom this stepwise approach was initiated are reported. Home health nurse referrals failed to result in sustained improvements in adherence in all 6 cases. Viral load assays performed before and after DOT provided an objective measure of the effect of adherence, with 12 hospitalizations resulting in a mean ؎ SD decrease in HIV RNA levels of 1.09 ؎ 0.5 log 10 copies per mL, with a range of 0.6 to 2.1 log 10 copies per mL. Four families responded to DOT hospitalization, and sustained decreases in the respective patients' viral loads were noted. In 2 cases, medical neglect reports were submitted when DOT did not result in improved adherence. These patients were eventually placed in foster care, with subsequent improvements in their viral loads and CD4 ؉ T cell percentages.Conclusions. Nonadherence with antiretroviral therapy can be established on the basis of persistently elevated HIV RNA levels that decrease with DOT. Nonadherence poses a danger to the child that is grave and potentially irreversible. Caregivers should be offered all available resources to help them adhere to a sound treatment plan. In cases of demonstrated inability to provide needed care, it is necessary to consider seeking child protection, even for apparently healthy children. Pediatrics 2004;114:e346 -e353. URL: http://www.pediatrics.org/ cgi/content/full/114/3/e346; adherence, HIV, pediatric, neglect.

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Foster Care Placement Improves Children's Functioning

Cited by 61 publications

References 31 publications

Health Care Issues for Children and Adolescents in Foster Care and Kinship Care

Health Care Issues for Children and Adolescents in Foster Care and Kinship Care

Associations between intensity of child welfare involvement and child development among young children in child welfare

Nonadherence With Pediatric Human Immunodeficiency Virus Therapy as Medical Neglect

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