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Pub Date: |
2013-01-00 |
Pub Type(s): |
Journal Articles; Reports - Research |
Peer Reviewed: |
Yes |
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Descriptors:
Child Abuse; Child Welfare; Foreign Countries; Incidence; Child Neglect; Placement; American Indians; Caseworkers; Public Agencies; Statistical Analysis; Computer Software; Decision Making; Eskimos; Surveys; Comparative Analysis
Abstract:
Objective: Fluke et al. (2010) analyzed Canadian Incidence Study on Reported Child Abuse and Neglect (CIS) data collected in 1998 to explore the influence of clinical and organizational characteristics on the decision to place Aboriginal children in an out-of-home placement at the conclusion of a child maltreatment investigation. This study explores this same question using CIS data collected in 2003 which included a larger sample of Aboriginal children and First Nations child and family service agencies. Methods: The decision to place a child in an out-of-home placement was examined using data from the "Canadian Incidence Study of Reported Child Abuse and Neglect-2003" and a reanalysis of CIS-1998 data (Fluke et al., 2010). The CIS-2003 dataset includes information on nearly 12,000 child maltreatment investigations from the time of report to case disposition. The CIS-2003 also captures information on the characteristics of investigating workers and the child welfare organizations for which they work. Multi-level statistical models were developed to analyze the influence of clinical and organizational variables using MPlus software. MPlus allows the use of dichotomous outcome variables, which are more reflective of decision-making in child welfare and facilitates the specific case of the logistic link function for binary outcome variables under maximum likelihood estimation. Results: Final models revealed the proportion of investigations conducted by the child welfare agency involving Aboriginal children was a key single agency level predictor of the placement decision. Specifically, the higher the proportion of investigations of Aboriginal children, the more likely placement was to occur. Contrary to the findings in the first paper (Fluke et al., 2010), individual Aboriginal status also remained significant in the final model at the first level. Conclusions: Further analysis needs to be conducted to further understand individual and organizational level variables that may influence decisions regarding placement of Aboriginal children. There is also a need for research that is sensitive to differences among, and between, Metis, First Nations and Inuit communities. Results are not generalizable to Quebec because data from this province were excluded. (Contains 7 tables and 3 figures.)
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Pub Date: |
2013-01-00 |
Pub Type(s): |
Journal Articles; Reports - Research |
Peer Reviewed: |
Yes |
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Descriptors:
Child Abuse; Placement; Child Welfare; Foreign Countries; Incidence; Centralization; Canada Natives; American Indians; Public Agencies; Decision Making; Sampling; Hierarchical Linear Modeling; Computer Software; Databases
Abstract:
Objective: This paper builds upon the analyses presented in two companion papers (Fluke et al., 2010 and Fallon et al., 2013) using data from the 1998 and 2003 cycles of the "Canadian Incidence Study of Reported Child Abuse and Neglect (CIS-1998 and CIS-2003)" to examine the influence of clinical and organizational characteristics on the decision to place a child in out-of-home care at the conclusion of a child maltreatment investigation. This paper explores various model specifications to explain the effect of an agency-level factor, proportion of Aboriginal reports, which emerged as a stable and significant factor through the two data collection cycles. It addresses the issue of data comparability between the two cycles and explores various re-specifications and descriptive analyses of reported models to evaluate their solidity with regards to the sampling schemes and the precise contribution of a multi-level specification. Methods: The decision to place a child in out-of-home care was examined using data from the "CIS-2003". This child welfare dataset collected information about the results of nearly 12,000 child maltreatment investigations as well as a description of the characteristics of the workers and organization responsible for conducting those investigations. Multi-level statistical models were developed using MPlus software, which can accommodate dichotomous outcome variables and are more reflective of decision-making in child welfare. The models are thus multi-level binary logistic regressions. Results: Final models revealed that two agency-level variables, "Education degree of majority of workers" and "Degree of centralization in the agency" clarify the nature of the effect of "Proportion of Aboriginal reports", a stable, key second level predictor of the placement decision. The comparability of the effect of this agency-level variable across the 1998 and 2003 cycles becomes further evident through this analysis. By using a unified database including both cycles and various specifications of models, the comparability was found to be robust, in addition to clarifying the precise contribution of a multi-level specification. Conclusions: This third paper in a series establishes the "Proportion of Aboriginal reports" received by the child welfare agency as an important agency level predictor associated with a child's likelihood of being placed in the Canadian child protection system. While the more complex models give support to the notion that unequal resources subtend those results, more analyses are needed to confirm this hypothesis. Unequal resources for agencies with larger Aboriginal caseloads may explain the persistence of the results. These findings suggest that specific resource constraints related to worker education may be explanatory. (Contains 6 tables and 5 figures.) [For Part A, see EJ995515.]
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Pub Date: |
2013-04-00 |
Pub Type(s): |
Information Analyses; Journal Articles; Reports - Evaluative |
Peer Reviewed: |
Yes |
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Descriptors:
Health Services; Mental Health; Child Welfare; Mental Health Programs; Mental Disorders; Therapy; Children; Outcomes of Treatment; Intervention; Placement; Family Involvement; Trauma
Abstract:
Background: Children involved in the child welfare system (CWS) have a greater need for mental health treatment relative to children in the general population. However, the research on mental health treatment for children in the CWS is sparse with only one known previous review of mental health services with children in the CWS. Objective: This review reports on an evaluation of the literature examining mental health interventions for children within the CWS. Methods: The Grades of Recommendation Assessment, Development and Evaluation (GRADE) process was used as the basis of the evaluation. Results: The results reflect that, while the overall quality of research in this area is low and findings are, at times, inconsistent, detailed, manualized interventions using multiple treatment components that focus on family, child, and school factors showed the most promise in regards to child mental health outcomes and placement stability. These interventions not only report the best quality outcomes for children and families, but they were also most highly recommended within the GRADE analysis. Conclusions: These findings emphasize the importance of comprehensive intervention efforts that involve the family and community, as well as the child. The inconsistent positive outcomes may be partially explained by the lack of trauma-informed practices incorporated into treatment for these often traumatized children. Recommendations for research in regards to mental health interventions for children in the CWS are discussed.
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Pub Date: |
2013-02-00 |
Pub Type(s): |
Journal Articles; Reports - Research |
Peer Reviewed: |
Yes |
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Descriptors:
Health Care Costs; Alzheimers Disease; Anxiety; Depression (Psychology); Caregivers; Patients; Delivery Systems; Nursing Homes; Crisis Intervention; Outcomes of Treatment; Symptoms (Individual Disorders); Dementia; Incidence; Profiles; Interdisciplinary Approach; Measures (Individuals); Psychiatry; Hospitals; Conceptual Tempo; Behavior Problems; Placement; Family (Sociological Unit); Family Relationship
Abstract:
Purpose: Although declines in memory and attention are hallmark symptoms of Alzheimer's disease (AD), noncognitive symptoms are prevalent. Over 80% of individuals will experience neuropsychiatric symptoms, which complicates symptom profiles. Research indicates a community-integrated response to dementia crisis can reduce negative consequences attributed to crisis including increased caregiver burden, increased health care costs, and premature institutionalizations. Design and methods: The Kansas Dementia Crisis Bridge Project is a multidisciplinary collaboration to provide direct support in critical situations to reduce psychiatric rehospitalizations. Coordinators provided counsel and dementia education to families throughout critical period of acute neuropsychiatric symptoms, facilitated professional involvement, and provided crisis prevention planning through crisis review. The Neuropsychiatric Inventory Questionnaire and Geriatric Depression Scale were used to measure the impact of neuropsychiatric symptoms and Bridge interventions on patient and caregivers. Results: The Bridge project significantly reduced patient anxiety, depression, resistance to care, impulsive behavior, verbal outbursts, and wandering. Caregivers reported significantly reduced anxiety, apathy, resistance to care, and less distress over patient neuropsychiatric symptoms. Caregivers also reported increased confidence in managing difficult behaviors, and the project effectively reduced or resolved neuropsychiatric crisis. The project delayed nursing home placement for community-dwelling patients. Implications: Crisis support models like the Bridge project reduce strain on care-delivery systems by incorporating nonpharmacological interventions, assisting families with communication, and reducing family distress during symptom crises. Although much of AD research focuses on disease-modifying medical interventions, aging and care systems in the state must simultaneously move towards dependency-modifying care interventions.
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Author(s): |
Rhodes, Anne E.; Boyle, Michael H.; Bethell, Jennifer; Wekerle, Christine; Tonmyr, Lil; Goodman, Deborah; Leslie, Bruce; Lam, Kelvin; Manion, Ian |
Source: |
Child Abuse & Neglect: The International Journal, v37 n2-3 p139-149 Feb-Mar 2013 |
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Pub Date: |
2013-00-00 |
Pub Type(s): |
Journal Articles; Reports - Research |
Peer Reviewed: |
Yes |
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Descriptors:
Child Abuse; Prevention; Foreign Countries; Probability; Suicide; Intervals; Children; Youth; Comparative Analysis; Health Services; Records (Forms); Identification; Statistical Analysis; Correlation; Hospitals; Placement; Social Services
Abstract:
Objectives: To identify factors associated with repeat emergency department (ED) presentations for suicide-related behaviors (SRB)--hereafter referred to as repetition--among children/youth to aid secondary prevention initiatives. To compare rates of repetition in children/youth with substantiated maltreatment requiring removal from their parental home with their peers in the general population. Methods: A population-based (retrospective) cohort study was established for children/youth with a first ED SRB presentation at risk for repetition in the Province of Ontario, Canada between 1 January 2004 and 31 December 2008. Children/youth legally removed from their parental home because of substantiated maltreatment (n = 179) and their population-based peers (n = 6,305) were individually linked to administrative health care records over time to ascertain social, demographic, and clinical information and subsequent ED presentations for SRB during follow-up. These children/youth were described and their repetition-free probabilities over time compared. To identify factors associated with repetition we fit multivariable, recurrent event survival analysis models stratified by repetition and present unadjusted and adjusted hazard ratios (HRs) and 95% confidence intervals (CIs). Results: Children/youth with substantiated maltreatment (as noted) were two times more likely to have repetition than their peers after adjustments for social, demographic, and clinical factors (conditional on prior ED SRB presentations). A number of these factors were independently associated with repetition. No one factor distinguished between having a first and second repetition nor was more strongly associated with repetition than another. Conclusions: The risk of repetition is higher in children with substantiated maltreatment (as noted) than their peers. No one factor stood out as predictive of repetition. Implications for secondary prevention initiatives include a non-selective approach, sensitive to family difficulties and the need to better contextualize repetition and harness data linkages. (Contains 2 figures and 2 tables.)
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Author(s): |
Cheney, Douglas |
Source: |
Intervention in School and Clinic, v48 n1 p22-29 Sep 2012 |
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Pub Date: |
2012-09-00 |
Pub Type(s): |
Journal Articles; Reports - Descriptive |
Peer Reviewed: |
Yes |
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Descriptors:
Transitional Programs; Individualized Instruction; Individualized Education Programs; Individualized Programs; Behavior Disorders; Behavior Problems; Emotional Problems; Developmental Studies Programs; Program Descriptions; Accessibility (for Disabled); Self Determination; Student Evaluation; Placement; Change Strategies; Educational Diagnosis; Normalization (Disabilities); Community Based Instruction (Disabilities); Self Advocacy; Achievement Need
Abstract:
Students with emotional and behavioral disabilities (EBD) have had difficulties in achieving educational, vocational, and community outcomes that would lead to personal success and satisfaction. Some of these outcomes relate to how special education transition programs integrate effective approaches to support success with these students. In this article, five primary suggestions, (1) self-determination, (2) appropriate assessment, (3) personal future's planning, (4) individualized education programs carefully linked with transition plans, and (5) naturally supported, successful academic, vocational, and community placements, are described to improve the transition planning of youth with EBD. (Contains 4 tables, 1 figure and 1 note.)
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Pub Date: |
2012-12-00 |
Pub Type(s): |
Journal Articles; Reports - Evaluative |
Peer Reviewed: |
Yes |
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Descriptors:
Evidence; Placement; Foster Care; Parents; Children; Resilience (Psychology); Intervention; Child Abuse; Sexual Abuse; Child Neglect; Risk; Child Development; Interpersonal Relationship; Databases; Delivery Systems; Adolescents
Abstract:
Background: An increasing number of children are placed in foster care (i.e., a kin or nonkin family home other than the biological parent) due to experiences of physical, sexual, emotional, or psychological abuse, and/or neglect. Children in foster care are at increased risk for a host of negative outcomes encompassing emotional, behavioral, neurobiological, and social realms. Methods: Areas of risk and vulnerability among foster children are described, including emotional and behavioral deficits, impaired neurobiological development, and social relationship deficits. Evidence suggesting the significance of family placement changes and prenatal exposure to substances as contributing mechanisms is presented. Based on a systematic search of the PsycINFO database (to March 2012), eight efficacious evidence-based interventions for foster families are summarized. Findings: Although the development of evidence-based interventions that improve outcomes for foster children has lagged behind the delivery of interventions in other service sectors (e.g., mental health and educational sectors), several interventions across childhood and adolescence offer promise. Service system constraints offer both challenges and opportunities for more routine implementation of evidence-based interventions. Conclusions: Given the increased likelihood of poor outcomes for foster children, increased efforts to understand the pathways to vulnerability and to implement interventions shown to be effective in remediating risks and improving outcomes for this population are indicated. Evaluation of efficacious interventions in countries outside of the United States is also needed. (Contains 1 table and 1 footnote.)
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