Abstract In recent years there has been an increase in the popularity of home visitation programs as a means of addressing risk factors for child maltreatment. The evidence supporting the ...effectiveness of these programs from several meta-analyses, however, is mixed. One potential explanation for this inconsistency explored in the current study involves the manner in which these programs were implemented. In the current study we reviewed 156 studies associated with 9 different home visitation program models targeted to caregivers of children between the ages of 0 and 5. Meta-analytic techniques were used to determine the impact of 18 implementation factors (e.g., staff selection, training, supervision, fidelity monitoring, etc.) and four study characteristics (publication type, target population, study design, comparison group) in predicting program outcomes. Results from analyses revealed that several implementation factors, including training, supervision, and fidelity monitoring, had a significant effect on program outcomes, particularly child maltreatment outcomes. Study characteristics, including the program's target population and the comparison group employed, also had a significant effect on program outcomes. Implications of the study's results for those interested in implementing home visitation programs are discussed. A careful consideration and monitoring of program implementation is advised as a means of achieving optimal study results.
Early studies examining parenting in the setting of intimate partner violence (IPV) often focus on abuse by the IPV perpetrator or effects of long term exposure. This review addresses how intimate ...partner violence impacts victim parenting. Seven databases were searched for the time period 1970–2015. Included were comparative studies involving children 11 years or younger. Quality ranking was based on: confirmation of victim status, consideration of co-perpetration, heterogeneity of the population, and standardization of measurements. Of 13,038 studies reviewed, 33 included studies showed that victimization is associated with negative parenting practices. Based on data presented within individual studies, 21 studies were eligible for meta-analysis which demonstrated modest effect sizes with high levels of heterogeneity. There was a negative correlation between IPV and positive parenting (r = -0.08; 95% CI: −.12, − .04); positive correlation between IPV and physical aggression (r = .17; 95% CI: .11, .23) and neglect (r = .12; 95% CI: .01, .23); and a trend toward positive correlation between IPV and psychological aggression (r = .23; 95% CI: −.94, .47). A synthesis of studies unsuitable for meta-analysis reinforced these findings. The review demonstrated ongoing methodological issues with extant literature.
Adverse childhood experiences (ACEs) are associated with health-risk behaviors in general samples of adults and adolescents. The current study examined the association between ACEs and these ...behaviors among a high-risk sample of early adolescents. Five hundred fifteen 9- to 11-year-old children placed in foster care due to maltreatment were interviewed about their engagement in violence, substance use, and delinquency. A multi-informant ACEs score was derived based on exposure to six adverse experiences. Regression analyses examined the relationship between ACEs and risk behaviors and the potential moderating effects of age, sex, and minority status. ACE scores were predictive of risk behaviors after controlling for age, sex, and minority status. Although males and older youth were more likely to engage in risk behaviors, none of the demographic characteristics moderated the ACE-risk behavior association. This study extends previous research by demonstrating an association between ACEs and risk behaviors in extremely vulnerable early adolescents.
Highlights
Fostering Healthy Futures (FHF) is a preventive intervention for preadolescent youth in foster care.
95% of those offered FHF started the program, 92% completed it, and there was over 85% ...attendance.
FHF reduced mental health symptoms, especially trauma, and mental health service utilization.
Effects were consistent across almost all subgroups, suggesting FHF benefits diverse children.
Positive youth development programming is acceptable and can be beneficial for vulnerable children.
Preventing the negative impact of maltreatment on children's mental health requires interventions to be contextually sensitive, grounded in theory and research, and effective in reaching and retaining children and families. This study replicates and extends previous findings of the Fostering Healthy Futures (FHF) program, a 30‐week mentoring and skills group intervention for preadolescent maltreated children in foster care. Participants included 426 children recently placed in out‐of‐home care who were randomized to intervention or control conditions. Outcomes measured 6–10 months postintervention included a multi‐informant (child, caregiver, teacher) index of mental health problems as well as measures of posttraumatic stress symptoms, dissociative symptoms, quality of life, and use of mental health services and psychotropic medications. There were high rates of program initiation, retention, and engagement; 95% of those randomized to FHF started the program, 92% completed it, and over 85% of the mentoring visits and skills groups were attended. The FHF program demonstrated significant impact in reducing mental health symptomatology, especially trauma symptoms, and mental health service utilization. These program effects were consistent across almost all subgroups, suggesting that FHF confers benefit for diverse children. Results indicate that positive youth development programming is highly acceptable to children and families and that it can positively impact trauma and its sequelae.
Child maltreatment and foster care placement are strong risk factors for delinquency and juvenile justice involvement, and there is substantial crossover between youth in the child welfare and ...juvenile justice systems. This study examines the long-term impact of the Fostering Healthy Futures (FHF) program, a 30-week mentoring and skills group preventive intervention for preadolescent maltreated children in foster care. Participants included 426 children recently placed in out-of-home care who were randomized to intervention or control conditions. Outcomes included both self-reported delinquency, measured at multiple time points between 6 months and 12 years post-intervention, as well as court records of delinquency charges, which were measured for 7 consecutive years beginning 3 months after the intervention began. Results from multilevel models indicated that the intervention group self-reported 30–82% less total and non-violent delinquency than the control group between ages 14 and 18. Court charges for total and violent delinquency in mid-adolescence were also 15–30% lower for the intervention group. These findings indicate that a mentoring and skills training program in preadolescence can reduce delinquency and justice involvement for children who are at high risk for these outcomes.
Abstract Objectives Attempts to understand the effects of maltreatment subtypes on childhood functioning are complicated by the fact that children often experience multiple subtypes. This study ...assessed the effects of maltreatment subtypes on the cognitive, academic, and mental health functioning of preadolescent youth in out-of-home care using both “variable-centered” and “person-centered” statistical analytic approaches to modeling multiple subtypes of maltreatment. Methods Participants included 334 preadolescent youth (ages 9–11) placed in out-of-home care due to maltreatment. The occurrence and severity of maltreatment subtypes (physical abuse, sexual abuse, physical neglect, and supervisory neglect) were coded from child welfare records. The relationships between maltreatment subtypes and children's cognitive, academic, and mental health functioning were evaluated with the following approaches: (1) “ Variable-centered ” analytic methods : a. Regression approach : Multiple regression was used to estimate the effects of each maltreatment subtype (separate analyses for occurrence and severity), controlling for the other subtypes. b. Hierarchical approach : Contrast coding was used in regression analyses to estimate the effects of discrete maltreatment categories that were assigned based on a subtype occurrence hierarchy (sexual abuse > physical abuse > physical neglect > supervisory neglect). (2) “ Person-centered ” analytic method : Latent class analysis was used to group children with similar maltreatment severity profiles into discrete classes. The classes were then compared to determine if they differed in terms of their ability to predict functioning. Results The approaches identified similar relationships between maltreatment subtypes and children's functioning. The most consistent findings indicated that maltreated children who experienced physical or sexual abuse were at highest risk for caregiver-reported externalizing behavior problems, and those who experienced physical abuse and/or physical neglect were more likely to have higher levels of caregiver-reported internalizing problems. Children experiencing predominantly low severity supervisory neglect had relatively better functioning than other maltreated youth. Conclusions Many of the maltreatment subtype differences identified within the maltreated sample in the current study are consistent with those from previous research comparing maltreated youth to non-maltreated comparison groups. Results do not support combining supervisory and physical neglect. The “variable-centered” and “person-centered” analytic approaches produced complementary results. Advantages and disadvantages of each approach are discussed.
Collin-Vezina discuss the current issues in child sexual abuse, gender and health outcomes to shed new lights to inform worldwide policy and practice. The experience of sexual abuse in childhood or ...the teenage years is self-reported by 1 out of 8 people worldwide (18.0% of women and 7.6% of men). This alarming rate has clearly called for extensive and powerful policy and practice efforts, both international and national communities have acknowledged the urgent need to do more to prevent and respond appropriately to cases of child sexual abuse. Regarding institutional responses to disclosure, services for sexually abused children and youth have gone through an extensive transformation in the past decades, which include: the implementation of a standardized forensic interview protocol in several Western countries to promote good interviewing practices; as well as inter-agency protocol agreements between child welfare agencies and the police to enhance collaboration between services, particularly through specialized Child Advocacy Centers that provide a wide-range of services under one roof.
Abstract Objective Maltreated children placed in out-of-home care are at high risk for exhibiting symptoms of psychopathology by virtue of their exposure to numerous risk factors. Research examining ...cumulative risk has consistently found that the accumulation of risk factors increases the likelihood of mental health problems. The goal of the current study was to elucidate the relation between cumulative risk and mental health symptomatology. Methods The study consisted of a sample of 252 maltreated youths (aged 9–11) placed in out-of-home care. Results Analyses confirmed the high-risk nature of this sample and identified seven salient risk variables. The cumulative risk index comprised of these seven indicators was a strong predictor of mental health symptoms, differentiating between children who scored in the clinical range with regard to mental health symptoms and those who did not. Finally, the data supported a linear model in which each incremental increase in cumulative risk was accompanied by an increase in mental health problems. Conclusion This is the first known study to examine cumulative risk within a sample of youths in out-of-home care.
Objective:
Teen dating violence (TDV) affects the lives of millions of adolescents each year. The current study examined the association between intimate partner violence (IPV) exposure and TDV ...perpetration and victimization. In addition, positive parenting practices and prosocial peer relationships were examined as potential moderators of the association between IPV and TDV.
Method:
Participants were 41 adolescents (ages 12-15) and their caregivers. Youth were currently or recently in an out-of-home placement due to maltreatment. Youth reported on their exposure to violence, involvement in TDV, and association with prosocial peers. Caregivers reported on their parenting practices.
Results:
There was a significant, positive association between IPV exposure and TDV victimization, but not between IPV and TDV perpetration. In addition, positive parenting practices and prosocial peer relationships moderated the association between IPV and TDV perpetration, such that there was a positive association between IPV exposure and TDV perpetration at lower, but not higher levels of these moderators. Similarly, there was a positive association between IPV exposure and TDV victimization at lower, but not higher levels of positive parenting practices.
Conclusions:
These results highlight the importance of positive parenting practices and prosocial peers as key protective factors that may attenuate TDV involvement for high-risk adolescents.
Previous studies find that childhood exposure to family and community violence is associated with trauma symptoms. Few studies, however, have explored whether community violence exposure (CVE) ...predicts trauma symptoms after controlling for the effects associated with family violence exposure (FVE). In the current study, CVE and FVE were examined in a sample of 179 youth with a recent history of maltreatment. CVE was associated with trauma symptoms after controlling for FVE, but FVE was not associated with trauma symptoms after controlling for CVE. In addition, negative coping strategies (e.g., self-harm, interpersonal aggression) partially mediated the association between CVE and trauma symptoms. These findings are discussed in terms of their implications for interventions aimed at addressing the needs of children exposed to violence.
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