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Suicide in children and young people is a major public health concern. However, it is unknown whether individuals who have been in the care of the child welfare system are at an elevated risk. Care is presently defined as statutory provision of in-home care (e.g. child living with birth family but in receipt of legal order involving supervision by social workers) or out-of-home care (e.g. foster care, residential care and kinship care). This paper presents a systematic review and meta-analysis comparing the prevalence of suicidal ideation, suicide attempt and suicide in children and young people placed in care with non-care populations. A systematic search was conducted of 14 electronic bibliographic databases and 32 websites. Of 2811 unique articles identified, five studies published between 2001 and 2011 met the inclusion criteria. Studies reported on 2448 incidents of suicidal ideation, 3456 attempted suicides and 250 suicides. The estimated prevalence of suicidal ideation was 24.7% in children and young people in care compared to 11.4% in non-care populations. The prevalence of suicide attempt was 3.6% compared to 0.8%. Two studies reported on suicide. Suicide risk in children and young people in care was lower in one study (0% vs 0.9%) and higher in the second (0.27% vs 0.06%). The results of the systematic review and meta-analysis confirm that suicide attempts are more than three times as likely in children and young people placed in care compared to non-care populations. Targeted interventions to prevent or reduce suicide attempt in this population may be required. Further comparative studies are needed to establish if children and young people in care are at an elevated risk of suicidal ideation and suicide. [ABSTRACT FROM AUTHOR]

Trauma and behavioral health problems among children in foster care are significant and prevalent, affecting their well-being and permanency. Despite the wide scope and magnitude of social and emotional problems among youth in out-of-home care, few child welfare systems have an integrated service response into their routine procedures and practices. This paper describes three federally-funded statewide demonstration sites, which represent northeast, south, and Midwest regions of the U.S., and that aimed to implement trauma and evidence-informed initiatives. Applying implementation science frameworks, we share our experiences with three key stages of implementation: exploration, installation, and initial implementation. During the exploration stage, each state engaged community stakeholders in a comprehensive data mining process to define the needs of children in care and relevant gaps in the evidence-informed service array. To respond to trauma and behavioral health needs of children, these states' initiatives established implementation plans for screening, functional assessment, data-driven case planning, ongoing progress monitoring, and service array reconfiguration. Each state's distinct installation and initial implementation experiences are described as well their shared successes and challenges. While vast differences existed within the administrative and policy context of these three states, the study demonstrates both unique and common experiences of successes and setbacks. Across the exploration, installation, and initial implementation, these analyses revealed six themes of common successes to include collaboration, building consensus, conducting trainings, teaming, optimizing opportunity, and establishing data systems. Additionally, nine themes of common challenges were workforce, turf, client voice, data sharing, coaching and support for fidelity, time, competing priorities, momentum, and policies and leadership. Implications for practice, policy, and future research are discussed. [ABSTRACT FROM AUTHOR]

[Display omitted] • Evidence review of reunification programs promoting safety, security and stability. • Utilised a common elements approach to identify practices to support reunification. • Most practices utilised behavioral or social learning theories in driving change. • Practices identified include coaching, awareness-raising, and role modelling. • Common elements offer potential to tailor interventions and develop frameworks. A proliferation of programs and interventions aim to promote permanency for children and young people in contact with the child welfare system. Many are manualized and evaluated at the program-level rather than at practice-level. Interest is growing in the common elements approach, to determine which individual program components are most useful for informing practice. This paper draws from the findings of a systematic review that assessed current research on permanency programs and utilized a common elements approach to identify practices that support permanency via reunification, guardianship or adoption. The focus of this paper is on practice elements that are common for supporting parents towards reunification. Twelve publications met inclusion criteria: seven experimental (randomized controlled trial) studies, two quasi-experimental studies, and three pretest–posttest studies. From these, 10 programs were identified that aim to build the capacity of parents undertaking reunification efforts to promote their children's safety, stability, and security. Using content analysis, a total of eight distinct practices in reunification programs were identified; these practices applied a structured and individualized approach to improve parent–child interactions and build parent skills to recognize and respond to child behavioral issues. The common elements approach reveals the components of evidence-based interventions to support reunification and can be useful for tailoring interventions, developing frameworks, upskilling workforce and identifying effective practices within existing interventions. [ABSTRACT FROM AUTHOR]

Abstract: This paper explores the mechanisms behind the disturbingly high occurrence of placement disruption among young people in out-of-home care. Discussions have usually been framed in a vocabulary of risk and protection, with the bulk of research designed for singling out factors that correlate with stability and discontinuity in care arrangements. From this research tradition, we have learned that ‘behavioral problems’ are by far the strongest predictor for disruptions in care. By exploring the quality of care as experienced by young people themselves, this study suggests an alternative strategy. Findings suggest that disruptions occur as a result of complex social relations, as when young people struggle to fit in among other troubled youth in demanding residential settings. The paper concludes that labels such as ‘behavioral problems’ may have a reifying effect that individualizes the problem of care disruption while not being particularly helpful in explaining the phenomenon. [Copyright &y& Elsevier]

Adverse family conditions, abuse and neglect during childhood present important risk factors for the appearance of emotional and behavioral problems. The main aim of this paper is to describe the presence of these kinds of disorders in children in residential child care and to explore individual, socio-family and care process factors associated with the use of mental health services. The sample consisted of 1216 children 6–18 years old in residential care in several Spanish regions. Information about emotional and behavioral problems was gathered according to two criteria: receiving some kind of treatment services and/or being identified as within the clinical range in the Child Behavior Checklist (CBCL). Results showed that 49% of cases were receiving some kind of mental health treatment and 61% were identified as within the clinical range in some of the broad band scales of the CBCL. In terms of agreement between referral to treatment and CBCL scores, results showed that four out of ten cases identified as within the clinical range were not receiving any kind of treatment. Several factors related to the type of problems detected in the CBCL, personal variables, and child care arrangements are associated with greater use of mental health services. [ABSTRACT FROM AUTHOR]

• Adolescents' belief in a just world negatively predicts conduct problems. • Sense of security mediated the relationship between belief in a just world and conduct problems. • Adolescents' belief in a just world also influences conduct problems through the use of cognitive reappraisal. • The relationship between BJW and conduct problems can be mediated sequentially via sense of security and cognitive reappraisal strategy. In this study, we explored the possible patterns of relationship between belief in a just world (BJW), sense of security, emotion regulation strategies, and conduct problems, and then further tested the moderating role of gender with a sample of 1,018 junior high school students. Participants responded to a series of scales evaluating the levels of BJW, sense of security, emotion regulation strategies, and conduct problems. The results revealed that BJW was significantly related to conduct problems. Meanwhile, sense of security, cognitive reappraisal (one kind of emotion regulation strategies), and the chain from sense of security to cognitive reappraisal played mediating roles in the relationship between BJW and conduct problems. Besides, there were also significant gender differences in the patterns of the relationships between the four constructs. For details, compared with girls, for boys, the association of BJW with conduct problems was stronger and the association of cognitive reappraisal with conduct problems is weaker. The implications and limitations of the results were discussed at the end of the paper. [ABSTRACT FROM AUTHOR]

Abstract: The purpose of this paper was to compare children placed out-of-home because of parental substance abuse (PSA) with children placed for other reasons (NPSA), and to explore the association between PSA and mental health problems in a Norwegian sample of 6- to 12-year-old children in out-of-home care (N =109). Several group differences were found related to the children themselves, their families and the Child Welfare case. The PSA children had less total difficulties, conduct problems and emotional problems than the NPSA children assessed by the teachers on the Revised Rutter Scale. However, both groups had far more mental health problems than children in general. The most important variable explaining the group difference in all subgroups of mental health problems was the extent of prosocial behavior in the children, but being placed for behavioral problems also explained a significant part of total difficulties and conduct problems. Variables like gender, discipline problems and socioeconomic conditions did not have a significant effect. The conclusion of the study was that prosocial behavior might be regarded as an important protective factor against mental health problems, which is an argument for investing in programs focusing on enhancing the placed children''s mastering strategies. [Copyright &y& Elsevier]

Abstract: Using a national, representative sample of children who received child welfare services, this paper builds longitudinal path models that examine four effects: prior change in living situation or placement on subsequent change, prior behavior problems on subsequent problems, behavior problems on change in living situation or placement, and change in living situation or placement on behavior problems. The first three just-mentioned effects were significant (positive associations) in all models. At some time points, living situation and placement change predicted internalized behavior problems (positive association) but, overall, the effects of change in living situation or placement on children''s behavior problems, if any, were small. Implications for practice and policy are discussed. [Copyright &y& Elsevier]

Abstract: This study examined the effect of school change on academic progress and behavioral problems. While the effect of placement change on behavioral problems, and case outcome has received considerable attention in the literature; its close correlate school change has largely been ignored. This paper addresses that gap. Structured interviews were used to collect retrospective data on youth''s educational experiences while in foster care (n =159). Youth reported a mean of 7.35 placement changes, and a mean of 8.26 school transfers during their average of 6.6years in care. Almost 50% of youth lagged behind their expected grade in school according to their age. Results showed no statistically significant relationships between number of school changes and academic progress as hypothesized. However, school change was significantly correlated with an increase in behavioral problems. [Copyright &y& Elsevier]

Abstract: When experimental designs are infeasible, researchers must rely on observational data to discern differential impacts of social services on treated and untreated clients. More generally, when assignment to conditions is nonrandom, analyses of services data require special procedures to correct biased selection into conditions. This paper reviews the rationale and history of propensity score matching (PSM). It then illustrates its use in estimating the causal effects of child welfare and parental substance abuse services on maltreatment re-reports and developmental well-being for children of substance abuse treatment service recipients and nonrecipients. The use of 12 variations of PSM methods that rely on one-to-one matching strategies and secondary event history analysis results in the generation of comparable treated and nontreated cases and directional consistency in the findings. The difference-in-differences estimation, of behavioral problems, using one-to-many matching, illustrates the ability of this method to preserve statistical power and generate interpretable findings without additional analyses. Strategies for employing and interpreting PSM are discussed. [Copyright &y& Elsevier]

• 65% of French parents report >1 special need in their internationally adopted child. • Child SN were associated with different feelings and perceptions among parents. • Parents reported that children with SN more often experienced exclusion and prejudice. • Special needs (SN) may complicate stigma due to adoption or ethnic differences. Both adoption status and ethnic differences may contribute to stigmatization and microaggressions experienced by adopted individuals and their families. Internationally adopted children have been increasingly recognized to have elevated rates of special needs (SN), especially learning disabilities, attention deficit hyperactivity disorder (ADHD), emotional-behavioral problems, and medical-physical issues. However, relatively little is known about the feelings, perceptions, and stigma experienced by families of internationally adopted children with SN. 461 French parents responded to a questionnaire (308 on-line, 153 paper) regarding their feelings and perceptions after international adoption (feelings of difference, ease of attachment, similarities to and dissimilarities from their child), as well as their views of their child's feelings and experiences (difference, exclusion, and prejudice). Parents were asked if their children were diagnosed by professionals as having special needs, specifically: (1) medical/physical conditions, (2) ADHD, (3) learning disabilities, or (4) emotional-behavioral difficulties. Results were compared for parents of children with or without SN. The children (57%M; 43%F) of the parent respondents were adopted from 47 countries. The children were age (mean ± SD) 3.19 ± 2.59 years old at arrival and 11.33 ± 5.03 years old at the time of the survey. 301 (65%) parents reported that their child had at least one SN: physical-medical SN (13% of children) were reported significantly less often than the other 3 categories (ADHD 39%, learning disabilities 36%, emotional-behavioral problems 40%). Overall, parents reported 652 distinct SN among these 301 children: 102/301 (34%) had a diagnosis in a single category, whereas 199/301 (66%) had diagnoses in at least two categories. SN diagnoses varied by continent of origin: Eastern European children had proportionally more ADHD, learning disabilities, and emotional-behavior problems, as well as more diagnoses per child. Compared with parents of non-SN children, parents of SN children (especially those with learning disabilities or emotional-behavioral problems) significantly more often endorsed feelings of difference, more difficulties attaching to their child, and fewer similarities to and more dissimilarities from their child. The SN parents also more often reported that their child experienced exclusion and/or prejudice. The more SN diagnosed in their children, the more likely their parents' feelings and perceptions differed from parents of children without SN. These relationships remained significant after controlling for arrival age, current age, gender, and adoption visibility, and after adjusting for exclusion due to adopted status or country of origin. Compared to adoptive parents of children without SN, parents of children with SN report differing patterns of perceptions and feelings. Child SN represent an additional burden for parents of internationally adopted children, and for their children's feelings and experiences (difference, exclusion, and prejudice, as reported by the parents). These perceptions and feelings are present, even when the SN are not physically obvious. SN must be recognized as an increasingly common, complex, and added dimension to the issues of adoptive status and (often) ethnic differences faced by internationally adopted children and their parents. [ABSTRACT FROM AUTHOR]

• The gender disparities in DCM vary among different maltreatment subtypes. • DCM's negative effect was more severe for girls than for boys. • Gender heterogeneity is less evident than gender homogeneity in the risk factors. Currently, gender disparities in domestic child maltreatment (DCM) have become an important and highly controversial issue worldwide. This study aims to provide panoramic evidence from China on this issue. Data were derived from a survey of 4,308 children (M age = 12.13, 48.7% were boys) conducted in seven provinces in rural China from June to December 2019. This study used multistage cluster sampling to select respondents, and modified versions of the JVQ Scale and the DSM-5 Scale (11–17 years old) were adopted. This study reached three significant conclusions. First, the gender disparities in DCM vary among different maltreatment subtypes. Compared with girls, boys are more likely to experience physical abuse. A higher prevalence of neglect is observed among girls than among boys. Second, although DCM significantly increased the likelihood of posttraumatic depression for all children, its negative effect was more severe for girls than for boys. Third, gender heterogeneity is less evident than gender homogeneity in the risk factors for DCM. In rural China, children's problematic behaviours, family structure, parents' experiences of childhood violence and family relationships are common predictors of maltreatment for all children. This paper highlights gender differences in the risk of DCM among children in rural China, reveals the Confucian culture behind DCM and gender, and provides Chinese evidence for building an international dialogue. [ABSTRACT FROM AUTHOR]