Child Welfare

Traditionally, the American child welfare system intervenes in cases of evident and severe maltreatment. Families in need of help, but who have not reached a crisis, are excluded from typical services. Some suggest that if these families were served, few would be rereferred to the child welfare system. California’s Differential Response (DR) has three tracks, of which ‘‘Track 1’’ targets families screened out of child protective services (CPS) and refers them to agencies that provide voluntary, home-based services and referrals. This study examined child-welfare trajectories for families receiving Track 1 DR services in one California county. Using survival analysis, treatment group children (N = 134) were compared to children eligible for services but denied due to program capacity (comparison group N = 511). Findings suggest no statistically significant differences between groups on the likelihood of a re-report following program participation, timing of maltreatment reports, or r...

The termination of parental rights of parents with mental disabilities is a growing and crucial issue.  In 2010, an estimated 45.9 million adults in the U.S. had experienced a mental illness in the past year. This represents 20% of the adult population.  More than five million children in the U.S. have a parent with a serious mental illness such as schizophrenia, bipolar disorder, or major depression.  Courts and child welfare systems too often assume that a parent is not amenable to treatment and is a danger to his or her child when strong symptoms of mental turmoil surface.  Some studies report that as many as 70 to 80% of mentally ill parents have lost custody.  Public systems are overwhelmed by this matter in an era of shrinking resources for such systems.  However, often parents with mental health needs are willing to accept treatment, are able to participate in programming, and are worthy of regaining custody. 
• There are gaps in federal and state law on this issue.  The federal Adoption and Safe Families Act (ASFA) requires that state child welfare agencies and courts make “reasonable efforts” towards family reunification before the termination of parental rights (TPR) can take place.  However, federal statutes and case law provide little guidance to states about what “reasonable efforts” means, and states have been left to interpret that concept individually.  Many state statutes even enable a “bypass” of the “reasonable efforts” standard when “clear and convincing” evidence allegedly shows that a parent's mental condition cannot be changed.  Many states likewise place unjust, statutory and common law time limits on family reunification efforts in TPR cases. 
• Gaps in legal scholarship are also evident here.  Legal scholars have begun to discuss the inadequacy of reunification services for mentally challenged parents, the tenuous link between mental health services and child welfare agency action, the need for enhanced attorney and child welfare worker preparation in this arena, and a need for cultural competence in reunification services.  Others have even suggested that there be a rebuttable presumption in favor of family reunification.  However, those discussions lack a sound theoretical basis and a practical application of solutions. 
• As is featured in previous work of this author, a new theoretical framework of Family Systems Theory-- which is utilized in clinical behavioral health and human rights arenas-- must first be applied.  Under this theoretical framework, the vague and outdated “best interests of the child” standard, which is a legal standard used exclusively in family law cases, must be replaced with a more sound standard of “holistic family wellbeing.”  Vulnerability Theory can add credence to this theoretical framework.
• The discussion of reunification services for families featuring parents with mental disabilities should then be conducted utilizing Family Systems Theory and a legal standard of “holistic family wellbeing.”  Under these circumstances, the “family integrity” defended by our highest courts through the “reasonable efforts” provision should be upheld through the delivery of highly effective family reunification services.  The application of Family Systems Theory ultimately requires reform in the law, service delivery, and professional practice.  State and federal legislators must revisit the “reasonable efforts” standard, to include specific statutory language about the types of reunification services required and the need for flexible timelines.  Courts, child welfare agencies, and service providers need to deliver proven reunification services and coordinated mental health treatment.  In specific court cases, attorneys for the parent(s), the child(ren), and the state should focus on “holistic family wellbeing” utilizing collaborative family law and alternative dispute resolution, while advancing the agency of their clients.  Child welfare workers and practitioners likewise require training in advanced methods of conflict resolution and clinical practice.  These recommendations can ensure more effective family law practice and more successful family - serving systems.

Delving behind Canada’s veneer of multiculturalism and tolerance, Policing Black Lives traces the violent realities of anti-blackness from the slave ships to prisons, classrooms and beyond. Robyn Maynard provides readers with the first comprehensive account of nearly four hundred years of state-sanctioned surveillance, criminalization and punishment of Black lives in Canada.

While highlighting the ubiquity of Black resistance, Policing Black Lives traces the still-living legacy of slavery across multiple institutions, shedding light on the state’s role in perpetuating contemporary Black poverty and unemployment, racial profiling, law enforcement violence, incarceration, immigration detention, deportation, exploitative migrant labour practices, disproportionate child removal and low graduation rates.

Emerging from a critical race feminist framework that insists that all Black lives matter, Maynard’s intersectional approach to anti-Black racism addresses the unique and understudied impacts of state violence as it is experienced by Black women, Black people with disabilities, as well as queer, trans, and undocumented Black communities.

A call-to-action, Policing Black Lives urges readers to work toward dismantling structures of racial domination and re-imagining a more just society.

In recent years, legal scholars and practitioners as well as policymakers have focused unprecedented attention on the rights of parents with disabilities, particularly intellectual disabilities, and their children. At the same time, social scientists have developed a breadth of literature on the needs and experiences of these families. Nonetheless, a clear divide remains between the fields, resulting in ongoing discrimination and the unnecessary separation of many families headed by a parent with an intellectual disability. Hence, the overarching goal of this article is to explore how legal scholarship, advocacy, and policymaking can be better informed by social science. This Article begins with a brief historical perspective on how the rights of parents with intellectual disabilities have evolved over time. Analyzing the language in state dependency statutes and judicial decisions, this Article demonstrates the implicit and explicit bias that exists and the need for informed policies and adjudication. Next, the Article examines how the law can learn from social science by highlighting findings from current social science research concerning these families. Finally, the Article offers concluding thoughts about how decision-making in dependency cases as well as public policy can and should benefit from social science research.

Error! Bookmark not defined. 1 Introduction 2 Methodology 2.1 Poverty calculation in Australia 2.2 Spatial Microsimulation 3 Data 3.1 Census of Population and Housing 3.2 Survey of Income and Housing (SIH) 3.3 The use of Census and SIH data in SpatialMSM 4 Combining Survey and Census: Are they telling us the same thing? 4.1 Distribution of income among persons 4.2 Distribution of income among children 5 Implications for simulated poverty estimates 5.1 Which poverty line? 5.2 Differences in poverty rates 5.3 Validity 6 Conclusion Reference

Recent reports have suggested that the problem of childhood and adolescent obesity has been exaggerated in Australia, and that community-wide obesity prevention initiatives are not warranted; we argue that this is not an accurate reflection of the situation. Available data indicate that obesity affects 6%-8% of Australian schoolchildren, and that the proportion has continued to increase in recent years. Childhood and adolescent obesity is associated with a wide range of immediate health concerns, as well as increasing the risk of disease in adulthood. Some weight-related health problems are also found in overweight children. A range of strategies, including whole-of-community obesity prevention programs, will be required to tackle this problem. Concerns about disordered eating in children and adolescents should not preclude appropriate action on childhood obesity.

The majority of research on the psychosocial impact of intimate partner violence (IPV) exposure for children has focused on IPV occurrence. The current study extended this research by examining three dimensions of IPV exposure: frequency, proximity, and severity, and tested whether these dimensions predicted variance in adolescents' psychosocial problems over-andabove that accounted for by IPV occurrence. Participants included 140 adolescents and their caregivers, who were recruited for an intervention involving maltreated youth placed in out-ofhome care. After controlling for IPV occurrence, exposure to community violence, and severity of maltreatment, results indicated a positive association between the multidimensional IPV index and youth report of psychosocial problems. There was also a trend for a positive association between the IPV index and caregiver report of psychosocial problems for boys. The study's results are discussed in terms of their implications for prevention researchers and child welfare agencies.

As a preliminary investigation of the effectiveness of medical-legal partnership in pediatrics, we conducted a 36-month prospective cohort study of the impact of clinic-and hospital-based legal services. We hypothesized that integration of legal services into pediatric settings would increase families' awareness of and access to legal and social services, decrease barriers to health care for children, and improve child health. Methods. Health care providers referred families with legal or social needs to the Peninsula Family Advocacy Program (FAP). results. Fifty four families completed both baseline and six-month follow-up assessments. Comparison of follow-up with baseline demonstrated significantly increased proportions of families who utilized food and income supports and significantly decreased proportions of families avoiding health care due to lack of health insurance or concerns about cost. Two-thirds of respondents reported improved child health and well-being. Conclusions. This study suggests that adding an attorney to the medical team increases awareness of and access to social and legal services.

Two recent issues of The Future of Children have examined programs that support families with young children: the Winter 1993 issue on home visiting and the Winter 1995 issue on the long-term outcomes of early childhood programs. In both issues, the legislation creating the Family Preservation and Support Services Program was discussed as a possible funding source for such programs. This Revisiting article summarizes the key elements of that federal program and discusses some of the challenges states have faced as they have tried to implement the new law. Thus far, the legislation has had only a modest impact on the availability of services, but it has triggered a comprehensive and broad-based planning process that is likely to have lasting benefits. 1

Children with asthma living on the northern Mexico border suffer not only from the physical aspects of this condition, but also from the lack of a clear biomedical definition and treatment plan for the illness. An ethnographic study involving participant observation and focused interviews in Tijuana, Mexico, sought to understand the intersection of diagnostic uncertainties surrounding childhood asthma on the part of parents, particularly mothers, living in acute poverty. Environmental factors such as dust and insects in impoverished homes probably acted as asthma triggers among many of the children in the study. Furthermore, management of children's asthma took place not only in biomedical clinics, but also in homes, traditional medical settings, and pharmacies, where mothers often sought remedies for their children's asthma attacks on an emergency basis. In all treatment settings, including biomedical ones, they often faced significant barriers to effective care, including the misuse of antibiotics. Thus, the role of pharmaceutical sales clerks, as well as pediatric asthma specialists, is explored in this article. [pediatric asthma, northern Mexico border, illness narratives, doctor-patient interaction, pharmaceuticals, poverty]

In this second part of a two-part report, further findings of a postal questionnaire sent in March 2005 to dentists with an interest in paediatric dentistry working in varied UK settings are presented and discussed in the context of current multiagency good practice in safeguarding and promoting the welfare of children.

The decade of 1980 was perhaps one of the most crucial period for Child Health in India. It is during this decade that child health issues, child health problems and child health policies were identified, recognized and announced by the Government of India. I took over as Editor of Indian Pediatrics in 1980 with a relatively young committee that included Dr.

The field of medical (health) informatics broadly addresses the cognitive, information processing, and communication tasks of medical practice, education, and research by focusing on the development of computer-based patient records, decision support systems, information standards, data aggregation systems, communication systems, and educational programs for patients and health providers. 1 This expanding field is facing challenges to develop, for special populations, technology solutions that acknowledge the unique needs of these groups. On September 21 and 22, 2000, the Agency for Healthcare Research and Quality (AHRQ), with the assistance of the American Academy of Pediatrics' Center for Child Health Research, convened a meeting of experts and knowledgeable stakeholders to identify special information needs of pediatric care and health service research questions related to the use of information technology in children's health care. Participants included representatives from the informatics, health care provider (pediatrics, family practice, and nursing), public policy, business, and consumer communities (see Appendix). Several background papers were prepared to serve as a foundation

The maxim ''parents should do what is in the best interests of their child'' seems like an unassailable truth, and yet, as I argue here, there are serious problems with it when it is taken seriously. One problem concerns the sort of demands such a principle places on parents; the other concerns its larger social implications when conceived as part of a national policy for the rearing of children. The theory of parenting that creates these problems I call ''optimizing parentalism.'' To avoid them, I define and defend a new and more morally appealing theory, ''satisficing parentalism.''

Children who experience maltreatment are at increased risk of engaging in delinquent behavior. Although little is known about the mechanisms responsible for this increased risk, the use of substitute care placement and placement instability are often identified as correlates. It is not clear from prior studies, however, whether delinquency precedes or follows placement instability. The current study adds significantly to the literature by identifying selected factors related to child maltreatment and delinquency and disentangling the timing of delinquency petitions relative to movements within the child welfare system. The results indicate that substantiated victims of maltreatment average 47% higher delinquency rates relative to children not indicated for abuse or neglect. In addition, approximately 16% of children placed into substitute care experience at least one delinquency petition compared to 7% of all maltreatment victims who are not removed from their family. Placement instability further increases the risk of delinquency for male foster children, but not for female foster children. Other characteristics related to delinquency include race, age, and recurrence of maltreatment.

This article examines the community-level impact of concentrated child welfare agency involvement in African American neighborhoods. Based on interviews of 25 African American women in a Chicago neighborhood, the study found that residents were aware of intense agency involvement in their neighborhood and identified profound effects on social relationships including interference with parental authority, damage to children's ability to form social relationships, and distrust among neighbors. The study also discovered a tension between respondents' identification of adverse consequences of concentrated state supervision for family and community relationships and neighborhood reliance on agency involvement for needed financial support. The author discusses the implications of these findings for a new research paradigm aimed at understanding the community-level effects of racial disproportionality.

Diarrhea and respiratory infections account for more than two-fifths of all deaths among children under five. Parental education and economic status are well-known risk factors for child morbidity, but little is known about whether education and economic status operate synergistically or independently to influence children's health. Confirming the presence and direction of such interactions is important to better target education and development policies. Our objective is to test for interactions between parental education and economic status in predicting the risk of diarrhea and respiratory illness among children under five, before and after adjusting for key proximate risk factors.

This qualitative study explores the experiences of emerging adults with serious mental health conditions (e.g., bipolar disorder, posttraumatic stress disorder) before and after they emancipate from the child welfare system and exit a transitional living program. Sixteen participants were interviewed before and 13 were interviewed after aging out. Findings suggest that transitional living programs services were appreciated for the relationships and safety net they fostered. Future plans were positive, but vague, and worries about the future were prevalent. Struggles with independence post-emancipation were common despite adult service use. Additional research is needed to understand how to best support these at-risk emerging adults.

message. Links to source documents are in blue. Hover mouse over orange text for explanatory notes. Click HERE and enter e-mail address to be alerted to new studies and reviews Integrated substance abuse and child welfare services for women: a progress review. Marsh J.C., Smith B.D., Bruni M. Request reprint Children and Youth Services Review: 2011, 33, p. 466-472.

The Client Outcomes in Child Welfare (COCW) Project was designed to examine the state of knowledge about outcomes measurement in Canada and initiate a consensus building process for a coordinated strategy in tracking outcomes across Canada. Through interviews with key informants, reviews of the literature and analysis of legislation, policy documents, information systems, the COCW Project identified some of the challenges to outcome measurement that may explain the limited progress made in this field. These include a needs driven service delivery system, competing objectives of child welfare, definitional confusion, and differences between clinical and administrative use of outcomes. The Outcomes Indicator Matrix was developed as a first stage in a strategy that focuses initially on the administrative use of outcomes information, allowing the clinical use of outcomes measures to develop in a more gradual fashion. Indicators were selected in four domains which reflect the breadth of the child welfare mandate in Canadian jurisdictions: child protection, child functioning, permanence and continuity of care for the child, and family and community support.

The erroneous claim that 50 percent of U.S. schoolchildren have never had a cavity has taken on the virtues of truth through frequent and widespread restatement. The 50-percent caries-free statement is an excessively optimistic misrepresentation by the media of the 1986-87 survey of oral health among schoolchildren by the National Institute of Dental Research because it only tells part of the story--it ignores dental disease in the primary dentition. This article documents that numerous public policy papers reflect failure to consider primary tooth caries data. Consequently, a significant disease burden has been overlooked. The article reviews the persistent underreporting of children's caries experience in policy documents and the dental literature, and reviews additional epidemiologic studies of caries reported in U.S. dental literature since 1985. Dental caries remains the single most common disease of childhood that is not self-limiting or amenable to a course of antibiotics...

Several states and providers have embarked on initiatives to reduce using restraint and seclusion in residential programs. Restraint and seclusion are associated with harm to youth and staff, significant costs, reduced quality of care, and less engagement of youth and families. Successful reduction/prevention strategies have been identified, implemented, and reported. Both states and residential providers have implemented prevention approaches, made significant changes, reduced restraint/seclusion use, and offered their experience and positive outcomes.

Mass casualty incidents and large-scale disasters involving children are likely to overwhelm a regional disaster response system. Children have unique vulnerabilities that require special considerations when developing pediatric response systems. Although medical and trauma strategies exist for the evaluation and treatment of children on a daily basis, the application of these strategies under conditions of resource-constrained triage and treatment have rarely been evaluated. A recent report, however, by the Institute of Medicine did conclude that on a day-to-day basis the U.S. healthcare system does not adequately provide emergency medical services for children. The variability, scale, and uncertainty of disasters call for a set of guiding principles rather than rigid protocols when developing pediatric response plans. The authors propose the following guiding principles in addressing the well-recognized, unique vulnerabilities of children: (1) terrorism prevention and preparedness...

Foster care Alcohol and drug use Termination of parental rights Using mixed methods, we compared appellate court foster care cases where parents' rights were terminated to those in which decisions to terminate parental rights were reversed or remanded to better understand the experiences of parents struggling with alcohol and drug use. A content analysis of 60 cases was conducted; 30 cases in which parental rights were terminated, and 30 where decisions to terminate parental rights were overturned or remanded to the lower court. Parents whose rights were terminated were more likely to have mental health problems and experienced incarceration. In addition, when a composite score of risk factors was analyzed, parents whose rights were terminated had significantly more risk factors. For both groups, poverty was an equally common risk factor. Implications include universal assessments for alcohol and drug abuse for parents involved in the child welfare system and timely referrals to appropriate treatment. Further, collaboration between mental health providers, substance use treatment programs, and caseworkers to address the integration of potential risk factors may help promote successful outcomes for parents whose children are in foster care.

In the last decade, molecular epidemiological studies have provided new perspectives on studying environmental risks in pediatric populations, based on the growing understanding that children may be more susceptible to toxicants than adults. Protecting children's health is a social priority, and specific research programs have been initiated with this purpose in the United States and Europe. These programs address the development of (i) less invasive methods for biological specimens collection, (ii) specific tools for interpretation and validation of biomarkers, (iii) methods for translating biomarker results into intervention strategies and for integrating them with environmental monitoring and health data, (iv) optimal ways to obtain consent and provide information to children and/or their parents participating in the studies and (v) techniques for the effective communication with policy makers and the public. Critical issues in children's environmental research discussed in this paper include specific needs of study design, exposure assessment, sample collection and ethics. Special consideration is given to the autonomy of the child in giving consent, the details and nature of the information provided, and the need to warrant controlled access to sensitive information. The use of incentives such as gifts and payment to ensure the participation of school-aged children is specifically discussed. Examples of field studies that are focused on the effects of pesticides, air pollution and formaldehyde are used to illustrate advantages and limitations of biomarker studies in children. #

in group D. The Ramsay Sedation Score (RSS) in group D was significantly higher than in group P during awakening [2.0 (2.0-2.0) in group D and 4.5 (4.0-5.0) in group P] (p = 0.0001). Conclusion: Dexmedetomidine premedication followed by intravenous infusion of ketamine was effective in decreasing OCR, agitation, pain, analgesic requirement in agitated children undergoing strabismus surgery.

... Journal,, 707721. 730 Pierce and Pierce Lopez, S., Grover, K., Holland, D., Johnson, M., Kain, C., Kanel, K., Mellins, C., Rhyne, M. (1989). Development of culturally sensitive psychotherapists. Professional psychology: Research and practice, 89, 36976. Lum, D. (1992). ...

obtained from other sources such as websites from international organisations, including UN and WHO. Some information came from earlier reviews and books of particular relevance; these works are in the public domain and are referenced here. We also had access to unpublished offi cial reports about the health of Indigenous people in Australia.

Barth et al. (2021) published an article in this journal identifying ten topics in the field of child welfare that are frequently discussed among professionals, advocates, and researchers in an effort to shape discussions of practice and policy reform. Concerned that these discussions are often poorly informed by the research evidence, Barth et al. intended to offer a corrective to these common, erroneous narratives. The Editor-in-Chief, Bruce Thyer, asked for suggestions for commentators and then invited some number of respondents to offer their perspectives on the original article. Here, we respond to each of the submitted papers, highlighting areas of agreement, and addressing other topics where we-sometimes sharply-disagree. We welcome an ongoing, fact-based, respectful dialogue to help shape child welfare reform. Efforts to improve the child welfare system are urgently needed; we stand by our view that large-scale practice and policy reform, in particular, must be guided by the best available research evidence.