Motives for Fostering Children with Alcohol-Related Disabilities

A sample of 63 licensed foster parents was asked, “What motivates you to foster a child who has a fetal alcohol spectrum disorder?” The responses to this question were grouped together by licensed foster parents. The grouped data were subjected to multidimensional scaling and cluster analysis. Results indicated that foster parents were motivated to care for children with alcohol-related disabilities by witnessing positive changes in the children in their care, helping children focus on their strengths, using their own parenting experience, earning an income, assisting children who have disabilities, and helping children stay connected to their families and communities. Foster parents who foster children with alcohol-related disabilities foster for similar reasons to those who foster children with special needs in general. Differences between the literature on foster parent motives and study results were described. Foster parents who are caring for children with alcohol-related disabilities see their care as specialized, see their roles as long-term helpers facilitators to children, their birth families and home communities, and emphasize positive experiences of fostering.     

Conceptualizing a Public Health Prevention Intervention for Bridging the 30 Million Word Gap

Early childhood experience is a social determinant of children’s health and well-being. The well-being of young children is founded on their relationships and interactions with parents and family members in the home, caregivers, and teachers in early education, and friends and families in the greater community. Unfortunately, the early language experience of infants and toddlers from low-income families is typically vastly different than children from middle- and higher-income families. Hart and Risley (Meaningful differences in the everyday experience of young American children. Brookes, Baltimore, 1995) described a “30 Million Word Gap” experienced by age four for children from poor families compared to economically advantaged families as measured by the number of words delivered by adults in the home to their children. This discrepancy between groups is associated with a deficit in vocabulary growth over time (Hart and Risley in Meaningful differences in the everyday experience of young American children. Brookes, Baltimore, 1995; in The social world of children learning to talk. Brookes, Baltimore, MD, 1999; in Am Educ (Spring), 1–9. http://isites.harvard.edu/fs/docs/icb.topic1317532.files/09-10/Hart-Risley-2003.pdf, 2003), and readiness when they enter preschool and kindergarten compared to their more advantaged classmates. The purpose of this paper is to conceptualize a population-level public health prevention approach to research addressing the harmful impacts of the Word Gap. The approach includes use of evidence-based practices to improve children’s language environments to foster their early language and literacy learning in early childhood. After a brief review of the Word Gap, we discuss four aspects: a conceptual framework, a community leadership team as driver of the local intervention, evidence-based language interventions for reducing the gap and promoting child language, and the measurements needed. Implications are discussed.     

CHILD-REARING BELIEFS WITHIN DIVERSE SOCIAL STRUCTURES: MOTHERS AND DAY-CARE PROVIDERS IN MEXICO*

The child-rearing beliefs of 32 mothers and 36 day-care providers in Mexico were compared. Day-care providers expected children to master developmental skills at an earlier age than did mothers. Day-care providers more strongly valued the development of independent and cooperative behavior, and placed less importance on obedience. They also reported employing more flexible and nonauthoritarian discipline strategies than did mothers. Mothers and caregivers did not differ in the extent to which they attributed the success of their discipline strategies to their own actions rather than to external factors. Also examined was how mothers' beliefs differed in families characterized by interdependent versus individualistic social structures. In interdependent families, mothers were more likely to believe in later mastery of developmental skills and to make external attributions. These findings suggest that Mexican children experience incongruous social norms as they move between home and day care settings, and that these norms, at least within the home, are associated with the social structural features of the setting.     

Integrated,Family‐based,Partial Hospital Treatment for Complex Pediatric Illness

This paper describes a unique treatment program for complex pediatric illness. The Hasbro Children's Partial Hospital Program uses a family systems orientation, integrated care, and a partial hospital setting to treat children with a wide range of pediatric illnesses that have failed outpatient and inpatient treatments. We have treated more than 2000 children with at least 80 different ICD‐9 diagnoses. The multidisciplinary treatment team functions as a meta‐family for children and their families who present with illness and family beliefs that impede successful outcomes with standard care. The three features: family systems orientation, integrated care, and partial hospital setting, hopefully interact to create an environment that helps families expand and modify their explanatory models regarding participating in effective medical care. The goal of treatment is for both children and their parents to feel empowered to take control of the illness. Parents completing standardized measures at intake describe their children and families as experiencing significant emotional distress, low levels of general family functioning, and poor quality of life. Although the children are described as having distinct behavioral differences, the families are described as responding to the experience of a seriously ill child in similar ways. A treatment program that addresses the noncategorical aspects of how families respond to illness while addressing the specific diseases of the children can allow children and their families to respond favorably to treatment.     

A discursive analysis of psychosocial issues: Talk in a ‘parent group’ for families who have children with chronic renal failure

Abstract

This paper illustrates a discursive approach to ‘psychosocial issues’ in health care. The analysis examines examples of talk within support groups for parents of children with chronic renal failure. These ran over a 32 month period at a Regional Paediatric Renal Unit within the UK National Health Service. All the parents are directly involved in management of home based peritoneal dialysis of their children. The analysis examines features of the organisation and content of parents' talk about what is commonplace in the management of the demands they face in the difficult circumstances of their child care. Common understandings within the groups are shown to be achieved through the parents' exploration of uncertainties in the care of their children. The value of qualitative analysis of health care talk in the evaluation of support groups for families involved in this form of paediatric care is also discussed.     

Connections between Family Centered Care and Medical Homes of Children with Neurodevelopmental Disabilities: Experiences of Diverse Families

Cultural issues tied to race/ethnicity are important aspects in delivering medical home services to children with neurodevelopmental disabilities and their families. To better understand family satisfaction with family centered care (FCC) in medical homes of children with disabilities, this study investigated whether family race/ethnicity, in addition to parent and child characteristics, significantly influenced family perceptions of FCC in three areas: family-provider partnership, care setting practices and policies, and community coordination and follow-up. Based on the life course theory for optimizing children's developmental trajectories, examining connections between family race/ethnicity and satisfaction with health care allows for identification of strengths and weaknesses in medical home services delivery, and offers opportunities for family support and improvement in outcomes for children with disabilities. This study developed an original empirical survey using a structured questionnaire developed by Family Voices, a national advocacy organization dedicated to promoting the well-being of children with disabilities and their families. The study collected data for 122 families in a large urban area in the northeastern United States. Multivariate analyses revealed that family race/ethnicity significantly contributed to the prediction of parental satisfaction with medical homes of children with disabilities, and to families' perceptions of FCC in care setting practices and policies, and community coordination and followup, but not to family provider partnership. Non-White families reported significantly lower satisfaction. Discussion emphasizes that health care providers need to become more vigilant in providing culturally sensitive care. To enhance FCC practices and policies, the study advances a checklist of ten essential areas that promote culturally sensitive interactions between families of children with disabilities and their medical and non-medical health care providers.     

Psychologists' role in family-centered approach to practice, training, and research with young children

Family-centered, community-based, coordinated care for children with special needs is presented as the best practice model for providing services to children and families. Psychologists must learn to play an active role in this frame-work that both integrates psychology with other health and education disciplines and uses the broad spectrum of psychological knowledge about families, development, community organization, and intervention strategies. Key principles of family-centered child psychology affect practice research and training. The psychologist becomes part of a team created to support families as the primary care-givers of their children. Training programs must reorganize the types of experiences both in the classroom and the field to train new psychologists within this model. As mandates for family-centered care affect policies at the state and federal levels, research will remain a critical factor in understanding the effects of these policy shifts on child and family functioning and the delivery of services.     

Predictors of Placement Outcomes in Treatment Foster Care: Implications for Foster Parent Selection and Service Delivery

Treatment foster care (TFC) is a normalizing environment in which to treat those children whose particular needs are not addressed in traditional foster care and for whom an institutional setting is a restrictive and unnecessary alternative. However, when the foster care placements of these emotionally and behaviorally disturbed children fail, as they often do, the children are shifted from one home to another without the opportunity to experience permanence or emotional attachment, resulting in poor adjustment to foster care. Placement stability, which depends in part upon effective matching of foster children with potential foster families, is critical for achieving positive outcomes in TFC. Yet, there is a dearth of information to guide placement agencies in making decisions about matching foster children with families. Moreover, once a successful match has been made, it is equally vital that service delivery be of high quality so that permanence is maintained. We review research on the predictors of positive outcomes in foster care, focusing on studies involving emotionally or behaviorally disturbed children, and provide recommendations for selecting foster parents and for ensuring high quality foster care services and placement stability.     

Child’s Play: The Role of Play in Mitigating the Fear of Death Among Pediatric Palliative Care Team Patients,Families, and Caregivers

Terror Management Theory (TMT), derived from Ernest Becker’s The Denial of Death (1974), maintains that humans are motivated by the desire to overcome our fear of death by constructing meaning and significance in our lives in various ways, including making light of our mortality. In this paper, we examine the role of play as seriously ill children involved with a hospital-based palliative care team live out what may be the remainder of their lives. We question the function that play has, if any, in mitigating the fear of death among dying children and their caregivers. We explore formal and informal manners of therapeutic play among children and adults occurring in moments of terrible stress, pain, and the looming threat of death. We draw on playful representations of death from popular culture and from extended field research conducted with a pediatric palliative care team in a large regional children’s hospital caring for seriously ill children and their families, as patients, families, and caretakers struggle to make sense of their suffering, fear and loss.     

Family-Centered Care for Military and Veteran Families Affected by Combat Injury

The US military community includes a population of mostly young families that reside in every state and the District of Columbia. Many reside on or near military installations, while other National Guard, Reserve, and Veteran families live in civilian communities and receive care from clinicians with limited experience in the treatment of military families. Though all military families may have vulnerabilities based upon their exposure to deployment-related experiences, those affected by combat injury have unique additional risks that must be understood and effectively managed by military, Veterans Affairs, and civilian practitioners. Combat injury can weaken interpersonal relationships, disrupt day-to-day schedules and activities, undermine the parental and interpersonal functions that support children’s health and well-being, and disconnect families from military resources. Treatment of combat-injured service members must therefore include a family-centered strategy that lessens risk by promoting positive family adaptation to ongoing stressors. This article reviews the nature and epidemiology of combat injury, the known impact of injury and illness on military and civilian families, and effective strategies for maintaining family health while dealing with illness and injury.     

Quality of life of adults with mental retardation/developmental disabilities who live with family

In this paper, we review the literature related to the quality of life of adults with mental retardation/developmental disabilities (MR/DD) who live at home with their families. We examine the nature of the relationships between adults with MR/DD and their parents and siblings, the social worlds of adults with MR/DD, age-related functional and health issues that affect their quality of life, the range of services and supports provided to them, and familial efforts to plan for their continued well-being when parental care is no longer viable. Individual characteristics associated with these dimensions and/or more compromised quality of life profiles are identified. The paper concludes with recommendations for expanded research on the quality of life of adults with MR/DD who live in the parental home, a topic which has received markedly less attention than the quality of life of adults who live in publicly supported residential settings. MRDD Research Reviews 7:105-114, 2001.     

Child care in rural areas: Needs,attitudes, and preferences

The purpose of this research was to assess the needs and preferences for child care services in rural areas. We examined data from interviews with 525 mothers of children up to 12 years of age in two southeastern states. Results indicated that, while rural mothers expressed a desire for more child care services, many were ambivalent about other-than-mother care. On the one hand, they had limited knowledge about and experience with a variety of child care arrangements; on the other hand, they could identify their preferences for types and specific features of day care they desired. These preferences were summarized to form a hypothetical "ideal type" of child care for rural mothers.     

Quality child care supports the achievement of low-income children: Direct and indirect pathways through caregiving and the home environment

Existing studies of child care have not been able to determine whether higher quality child care protects children from the effects of poverty, whether poverty and lower quality child care operate as dual risk factors, or whether both are true. The objective of the current study was to test two pathways through which child care may serve as a naturally occurring intervention for low-income children: a direct pathway through child care quality to child outcomes, and an indirect pathway through improvements in the home environment. Children were observed in their homes and child care settings at 6, 15, 24, and 36 months. An interaction between family income-to-needs ratio and child care quality predicted School Readiness, Receptive Language, and Expressive Language, as well as improvements in the home environment. Children from low-income families profited from observed learning supports in the form of sensitive care and stimulation of cognitive development, and their parents profited from unobserved informal and formal parent supports. Policy implications are discussed.     

Wrapping community-based mental health services around children with a severe behavioral disorder: An evaluation of project wraparound

During the past two decades there has been a significant increase in community-based mental health and educational services for children and youth with serious emotional and behavioral problems and their families. However, in the vast majority of programs there are no reliable longitudinal data on the adjustment of the children that are served. Project Wraparound was a community-based individualized treatment program which served children and youth with severely maladjusted behavior and their families by providing intensive home and school-based services. The purpose of this paper is to provide a longitudinal analysis of client and family adjustment data. Data on client adjustment within the home and characteristics of the home environment were obtained at intervals of 3 months, 6 months, and 1 year. Data on client adjustment in school was obtained at four points over a period of 2 years. The results from 19 cases indicate that substantial change occurred on measures of the home environment and client adjustment in the home with no significant change in adjustment in the school. Implications of the findings are discussed.     

TV guide: two-year-old children learn to use video as a source of information

Learning to use symbols is a challenge for young children even when the symbol in question (e.g., a live video image) is iconic and seems transparent to adults. This research examined the effect of experience on children's use of video-presented information. Two-year-old children saw themselves "live" on their family television for 2 weeks and then participated in an object-retrieval task. The children reliably used a live video presentation of an adult hiding a toy in an adjoining room to find the toy. Most also transferred what they learned to a task involving another symbol (pictures) that typically is very difficult for this age group. The results reveal flexibility in 2-year-olds' symbol use that follows from successful representation of a symbolic relation.     

Age at Adoption from Institutional Care as a Window into the Lasting Effects of Early Experiences

One of the major questions of human development is how early experience impacts the course of development years later. Children adopted from institutional care experience varying levels of deprivation in their early life followed by qualitatively better care in an adoptive home, providing a unique opportunity to study the lasting effects of early deprivation and its timing. The effects of age at adoption from institutional care are discussed for multiple domains of social and behavioral development within the context of several prominent developmental hypotheses about the effects of early deprivation (cumulative effects, experience-expectant developmental programming, and experience-adaptive developmental programming). Age at adoption effects are detected in a majority of studies, particularly when children experienced global deprivation and were assessed in adolescence. For most outcomes, institutionalization beyond a certain age is associated with a step-like increase in risk for lasting social and behavioral problems, with the step occurring at an earlier age for children who experienced more severe levels of deprivation. Findings are discussed in terms of their concordance and discordance with our current hypotheses, and speculative explanations for the findings are offered.     

Intrusive parenting,teacher sensitivity,and negative emotionality on the development of emotion regulation in early head start toddlers

Toddler emotion regulation develops within the context of relationships but is also influenced by toddlers’ individual characteristics. Drawing on transactional and differential susceptibility frameworks, this study examined direct and interactive associations of intrusive parenting, teacher sensitivity, and negative emotionality on toddler emotion regulation development in a sample of Early Head Start families utilizing center-based child care. Latent growth models indicated that, after controlling for a series of family and child care covariates, intrusive parenting at 14 months had diminishing effects on trajectories of emotion regulation across toddlerhood (14 to 36 months), whereas teacher sensitivity in child care was promotive for emotion regulation growth. Toddlers with high negative emotionality were not more susceptible to the effects of intrusive parenting or teacher sensitivity on emotion regulation development, however, results suggested emerging evidence for individual differences in the protective nature of teacher sensitivity in the context of high intrusion at home. Results are discussed in terms of their implications for informing parents and early care and education providers in nurturing relationships with the children who may be the most challenging to care for but may stand to make the greatest gains in emotion regulation development in quality caregiving settings.     

The Gift of Growing Up in a Same-Gendered Family: A Case Study

This article portrays the personal strengths of children growing up in same-gendered families from a positive psychological framework. One of the major challenges all children growing up in same-gendered families are faced with is the integration of their family experience with that of the wider society outside the home. A narrative approach was used to explore the experiences of children from their perspectives. Five children from eight families participated in the project. Data were created through interviews and a variety of other supportive qualitative techniques. The data were analyzed using a holistic analysis approach and a narrative was subsequently written to illuminate the uniqueness, the specificity and the individuality of each particular child. This article depicts one of these narratives. From this narrative the following personal strengths emerged: humor, a sense of perceived control, socially intelligent disclosure, agency, okayness and the ability to form positive relationships. I propose that remarkable personal strengths are displayed in the way in which children growing up in same-gendered families engage a heteronormative world.     

The Impact of Family Unification Housing Vouchers on Child Welfare Outcomes

This study addresses whether providing housing vouchers through the Family Unification Program (FUP) to families involved in the child welfare system reduces child maltreatment and the need for child welfare services. The study uses child welfare administrative data on 326 children in Portland, Oregon, and 502 children in San Diego, California from the point at which their families were referred to the program through 18 months post‐referral. Using a quasi‐experimental waitlist comparison design, probit regressions show little impact of FUP on preventing child removal from home, but some positive impact on reunification among children already placed out of home. Hazard estimations show receipt of FUP speeds up child welfare case closure. Impacts on new reports of abuse and neglect are mixed, but point toward reduced reports. Low rates of removal among intact comparison families and high rates of reunification for children in out‐of‐home care suggest poor targeting of housing resources. Housing vouchers are being given to families not bearing the risks the program is intended to address. The presence of some positive findings suggests that housing vouchers might help reduce child welfare involvement if better targeting were practiced by child welfare agencies.