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The article discusses the transition involves numerous stakeholders including the child, service providers, caregivers, educational professionals, and legal professionals. Preparing for this transition involves numerous stakeholders including the child, service providers, caregivers, educational professionals, and legal professionals.

The Family Empowerment Scale (FES) is one of the most widely used measures for assessing the empowerment of caregivers of youth with emotional difficulties. The purpose of this study was to examine the internal factor structure, score reliability, and convergent validity of the FES scores with caregivers of youth who had recently departed therapeutic residential care. Results indicated that the hypothesized three-factor model fit the data adequately with caveats. FES scores were reliable based on coefficient alpha and omega, and evidence of convergent validity with caregiver self-efficacy was moderate to strong. [ABSTRACT FROM AUTHOR]

Although newly passed federal regulations mandate the provision of family-based aftercare supports for adolescents served in therapeutic residential care, very little research has been conducted to determine best practice. This efficacy and replication study compares the outcomes of youths and caregivers randomly assigned to On the Way Home (OTWH; n = 98) or traditional aftercare supports (n = 89) following discharge from therapeutic residential care (TRC). Findings were mixed. At posttest (12-months) no significant differences were found between groups on indicators of placement stability and school involvement, however, significant differences were found between groups on several indicators of caregiver empowerment and self-efficacy, with caregivers in OTWH reporting greater levels of self-efficacy and empowerment across the domains of family and community. At follow-up (21-months), moderate to large differences were found between groups on indicators of placement stability and school involvement, with odds ratios indicating youths in OTWH were 2 and 3 times more likely to be engaged in school and living in the community, respectively. Implications, limitations, and future research are discussed. [ABSTRACT FROM AUTHOR]

Multiple placements in therapeutic residential care is expensive, and is associated with poor outcomes; thus, identifying barriers to successful reintegration into the home and community school settings is essential for developing appropriate post-discharge supports, and reducing societal costs. Participants were seven youth (four female; three White/Caucasian, one Black/African American, one Hispanic/Latino, two multi-racial) recently readmitted to a therapeutic residential care program and five of their primary caregivers (four female; four White/Caucasian, one Black/African American). Through semi-structured interviews with caregivers and youth, this exploratory study investigated (1) the perceptions of preparedness for the youth’s successful transition from therapeutic residential care to the home setting, (2) the post-discharge factors that contributed to the youth’s return to care, and (3) the lessons learned about the youth’s transition from therapeutic residential care to home. The results of this exploratory, qualitative study revealed rich information about youth and their caregivers’ perspectives about their experiences prior to returning to care, such as the importance of healthy relationships (family and peers), transition planning, and post-discharge supports at the individual, family, and school levels. [ABSTRACT FROM AUTHOR]

While much is known about the educational, behavioral, and social needs of adolescents receiving school-based special education services, one critical domain, health literacy, has been largely unexamined. Given the impact of health and health management on the well-being of all persons, and the likelihood of additional challenges for students receiving special education supports, this study sought to examine and compare the health needs and transition preparedness of 341 adolescents with and without Individualized Education Programs (IEPs). Survey items were selected from widely used health literacy, health risk, and health related quality of life measures. Findings revealed that for students with IEPs, the risk for having limited health literacy was 128% higher than for their peers without IEPs. Students with IEPs were also significantly more likely to demonstrate risk across indicators of health related quality of life, health risk, and access. Limitations, research recommendations, and implications are addressed. [ABSTRACT FROM PUBLISHER]

Empowerment has been established as an important factor in resilience in adolescence. It has also been deemed critical for youth with emotional and behavioral disorders to achieve successful outcomes across academic, social, and behavioral domains, especially during a major transition. There is currently one measure used to evaluate empowerment in youth with mental health difficulties, yet it is unclear if this is a reliable measure for youth in therapeutic residential care. The purpose of this study was to examine the reliability and validity of this measure of empowerment in a sample of youth departing therapeutic residential care (N = 138) and to examine whether or not specific factors contribute to varied levels of empowerment. Findings indicate that the empowerment measure is reliable and valid for use with youth departing therapeutic residential care. Overall, youth report high levels of empowerment at discharge from care. None of the predictors in the three multivariate general linear models were statistically significant. Limitations and implications are discussed. [ABSTRACT FROM AUTHOR]

Residential care is one of the most restrictive out-of-home care settings; however, this is a temporary placement and youth eventually reintegrate into the home and community setting. Reintegration presents many challenges, and aftercare becomes critical for maintaining youth gains and promoting family stability. Aftercare programs and supports should align to individual family needs that entail understanding individual and familial characteristics. Previous studies have explored characteristics related to family functioning, mental health, behavior, and perceptions of need during reintegration; yet little is known regarding how affective characteristics (i.e., self-efficacy, empowerment) factor into reintegration, or the implications this may have for providers. The purpose of this study was to address this gap by exploring empowerment and self-efficacy in caregivers (N = 120) who had a child return home within 1 month of departing residential care. Overall, caregivers reported high levels of empowerment and self-efficacy during the initial transition period. Significant differences for empowerment and self-efficacy were present in characteristics such as race, income, number of children in the home, and free/reduced lunch status. [ABSTRACT FROM PUBLISHER]

The article presents information on a study conducted to compare parent and family teacher ratings of perceptions of aftercare services for youth. Participants in the study included parents of youth undergoing treatment in a residential Treatment Family Home (TFH), and family teachers working at the TFH. The study concluded that large number of differences were identified between family teachers and parents, due to which treatment providers should increase communication between them.

While much is known about youth struggles after reintegration into the home and community settings following stays in out-of-home care, little is known about appropriate supports for aftercare, or parent (see Note ) and youth perceptions during this critical transition period. This study seeks to begin to address these questions through surveys evaluating youth ( n = 48) and parent ( n = 48) perceptions of (i) transition planning, family preparedness and aftercare; (ii) youth preparedness for the transition period across major life domains (e.g. education, health care, relationships); and (iii) the importance of specific aftercare supports and services. Results indicate differences between youth and parents on perceptions of need for continued supports, likelihood of participation in aftercare programs; and youth preparedness for success in relationships, family and independent living domains. In contrast, similarities were found on youth and parent ratings regarding the importance of specific services and supports, with both groups indicating supports in education as most important and supports in mental health as least. Study limitations, future research and implications are provided. [ABSTRACT FROM AUTHOR]

The provision of aftercare services for youth and families is an important topic in residential care. Focus groups were conducted with seven service professionals working with youth in residential care in the United States. Providers responded to two questions: Based on your involvement in residential care 1) what barriers do providers experience when trying to access aftercare services for youth who are departing residential care; and 2) what solutions have providers attempted or recommended to overcome barriers so that aftercare services are made available to youth? Common themes for barriers included: 1) Youth/Family barriers to engagement; 2) Aftercare programming issues and concerns; 3) State, local, and agency policy; 4) Lack of funding; and 5) Lack of interagency collaboration. Common themes for solutions included: 1) Continuity of care; 2) State, local, and agency policy recommendations; 3) Family engagement; 4) Funding solutions; 5) Discharge planning; 6) Agency collaboration; and 7) Technology. Study limitations, future research, and implications are discussed. [ABSTRACT FROM PUBLISHER]

The prevalence of weight problems among youth in general and youth in out-of-home care has been well documented; however, the prevalence of obesity/overweight among youth with high-incidence disabilities in more restrictive settings, such as residential care, has not been assessed. The purpose of the present study was to evaluate the prevalence of weight problems in 245 youth with learning disabilities or emotional disturbance at entrance to residential care. Youth intake files were examined to evaluate the association between youth demographic characteristics, medical conditions, prior placements and placement settings, medication usage, and internalizing and externalizing behavioral problems and clinical weight problems. Findings revealed that over one half of the youth were overweight or obese {50.6%), and weight problems were associated with gender, medical conditions, and age. Study limitations, future research efforts, and treatment implications are discussed. [ABSTRACT FROM AUTHOR]

This study compares the On the Way Home (OTWH) aftercare program to traditional aftercare supports on placement and school stability for 82 youth (43 treatment, 39 control) with disabilities discharging from residential care. One-year-post-discharge results revealed that negative event occurrence (i.e., returning to care or discontinuing enrollment in the community school) was three to over five times less likely for OTWH youth compared to youth in the control condition. [ABSTRACT FROM AUTHOR]

Abstract: Reintegrating into the home, school, and community settings following a stay in out-of-home care can present significant challenges to school-aged youths. During this transition, social, behavioral, and educational challenges can result in placement instability, academic failure, and ultimately school drop-out. This article describes a home and school-focused transition program, On the Way Home, which was designed to support youths, families, and schools during this critical reintegration period. The intervention model, preliminary data on program effects on youth placement and educational stability, and future research are discussed. [Copyright &y& Elsevier]

Abstract: For many adolescents with disabilities the reintegration into the home and school settings following a stay in out-of-home care is fraught with difficulties. Although many return to environments that do not facilitate school success, few services and supports are available. As a result these youth are more likely to demonstrate poor homework completion, academic failure, and dropout prior to graduation. To date, no known empirically based intervention exists to address these risks and support these youth and their families during this critical reintegration period. This article reports the findings from Phase 1 in the development of an academic-based aftercare for adolescents reintegrating into the home and community school settings following a stay in out-of-home care. Data were collected from 31 youth, parents, and school professionals through 9 structured nominal group technique focus groups to determine factors that would contribute to participant buy-in and long-term participation. Common themes identified include the desire for program flexibility, 24-hour on-call support, and well trained, supportive staff. Service and training implications, study limitations, and future research are discussed. [Copyright &y& Elsevier]

Purpose: Undiagnosed language impairment (LI) for youth in residential care is a concern as similar populations have shown elevated levels of language delays. Therefore, the purposes of this study were to identify the percentage of youth in residential carewho are at risk for LI and to compare the demographic, academic achievement, and functional academic skills of youth with or without possible LI. Method: Participants were 80 youth in residential care. Risk for LI was determined using the Clinical Evaluation of Language Fundamentals-4 Screening Test (E. Semel, E. H. Wiig, & W. A. Secord, 2004). Independent-samples t tests and chi-square analyses were conducted to assess the differences between groups. Measures used included the Woodcock-Johnson Test of Achievement (R. W. Woodcock, K. S. McGrew, & N. Mather, 2001) and the Kaufman Functional Academic Skills Test (A. S. Kaufman & N. L. Kaufman, 1994). Results: More than half of the sample (54%) were identified as being at risk for LI. Statistically significant differences between youth with and without LI were found on academic variables. Specifically, youth who were at risk for LI presented academic achievement and functional academic scores in the low to low-average ranges. Conclusion: Findings suggest that there is a need to screen youth entering residential programs for possible LI. Implications for treatment and program planning are discussed. [ABSTRACT FROM AUTHOR]

While estimates suggest that 10% to 31% of children in residential care are identified as with a disability, little is known about their characteristics or functioning as compared to nondisabled peers. This study evaluated data of 123 children with (n=34) and without (n=89) disabilities in residential care to determine demographic, behavioral, mental health, and educational characteristics. Data included demographic, behavior checklist, and standardized mental health and academic measures. Results indicated that both groups presented elevated risks; however, scores for children with disabilities revealed even greater levels of need. Primary risks were found on indicators of behaviors (e.g., social functioning), mental illness (e.g., anxiety), and academic performance (e.g., general knowledge and reading). Implications, limitations, and recommendations for future research are discussed. [ABSTRACT FROM AUTHOR]

Abstract: This literature review examined the status of the published research on the academic and school functioning behaviors of students in out-of-home care. Twenty-nine studies were identified and evaluated to assess the (a) characteristics of the children and youth studied, (b) academic and school functioning areas evaluated, (c) reports of overall academic performance, and (d) quality of the reported research. Results suggest that overall, children in out in out-of-home care demonstrate several academic risks across placement settings and academic areas. However, despite an increase in attention to the academic functioning of this population, significant limitations in the published literature exist. For example, incomplete reporting of student information, inadequate research on specific academic skill sets, and limited numbers of studies reporting school functioning behavior narrow our understanding of the specific academic strengths and limitations of this population, and further hinder our abilities to develop targeted intervention programs. Study limitations, implications, and recommendations for future research are discussed. [Copyright &y& Elsevier]

This review examines interventions intended to improve the literacy functioning of adolescent students with emotional and/or behavior disorders. Seventeen studies met inclusion criteria and included a variety of interventions designed to affect a variety of literacy areas, including spelling, writing, and reading fluency. Findings from these studies indicate that, overall, several different intervention types produced increases across areas of literacy functioning. However, both participant and setting characteristics were poorly described and were not representative of the population with emotional and/or behavioral disorders. The lack of research on interventions to increase adolescent literacy limits the generalizability of the results to a broader population. Considerations for practice implications and future research are discussed. [ABSTRACT FROM AUTHOR]

Children with attention-deficit/hyperactivity disorder (ADHD) are at risk for academic failure. Although studies have evaluated the effects of medication on academic outcomes, the literature on non-medication interventions has not received equal attention. This review examined 41 studies that evaluated the impact of non-medication interventions on the academic functioning of students with ADHD. The findings revealed that a broad range of traditional and nontraditional interventions has been used to improve students' academic outcomes, yet systematic lines of research were clearly missing. Moreover, important demographic and descriptive information, such as participant characteristics and classroom settings, were often poorly defined and generally did not reflect the current population of students with ADHD. Despite some indications of promise, significant limitations in the literature allow for few conclusions about intervention effects and generalization. Further systematic research is needed to determine which academic intervention methods hold the most promise for children and youth with ADHD. [ABSTRACT FROM AUTHOR]

As prevention and early intervention opportunities for young children at risk of emotional disturbance (ED) increase, questions regarding the effectiveness of these programs for specific subpopulations of children have emerged. To date, few investigators have examined young children entering early school prevention/intervention programs to determine if clear subpopulations can be identified, and if so, which characteristics are most distinguishing. This study examined the risk factors of 140 kindergarten and first-grade students, identified by teachers as at risk of ED, to determine if distinct profiles exist. Cluster analysis procedures using teacher, child, and parent reports of family, academic, and social/emotional data revealed five distinct clusters: Parent nominated (n = 24), Elevated risks (n = 43), Primarily behavior (n = 25), Primarily academic (n = 27), and False positives (n = 21). Validation techniques revealed that the five clusters were distinguished by clear profiles, which differed across level of severity (i.e., high or low levels of risk per domain) and primary focus of risk (i.e., academic, social/emotional, or familial). Similarities and differences across cluster groups, possible implications for targeted prevention or early intervention programs, study limitations, and directions for future research are presented. [ABSTRACT FROM AUTHOR]

Current recommendations for the treatment of attention deficit/hyperactivity disorder (ADHD) call for a multimodal approach including a combination of medication, behavior modification, school accommodations, and ancillary services. One method that has been proposed as an effective and efficient means for increasing students' attention and academic productivity is self-regulation. This article reports the results of a meta-analysis of the literature on the use of four self-regulation interventions (self-monitoring, self-monitoring plus reinforcement, self-management, and self-reinforcement) for children with ADHD. Combined effect sizes for these four treatments were greater than LO for on-task behavior, inappropriate behavior, and academic accuracy and productivity, indicating that self-regulation interventions are effective for children with ADHD. [ABSTRACT FROM AUTHOR]

This review conducted a comprehensive examination of the current state of the literature on the academic status of students with emotional and behavioral disorders (EBD). The authors examined the literature to assess (a) student characteristics, (b) placement settings, (c) academic subject areas, and (d) measures used to assess academic achievement. Second, when possible, the functioning level of students was examined. Third, trends in the research over the past 4 decades were assessed. Although several investigators have researched the academic status of these students, significant limitations exist in the research, including incomplete reporting of student information, inadequate research on specific academic skill sets, and limited numbers of studies assessing students served in general education settings. Implications of the findings are discussed. [ABSTRACT FROM AUTHOR]

As the field of mental health services shifts its focus to early intervention, the need to develop valid and reliable measures of young children's behavioral functioning is clear. Traditional assessment instruments have focused on deficits, problems, and pathologies to the exclusion of strengths and competencies. However, assessing child strengths provides parents, direct service providers, and educators with a more holistic view of the child's functioning and an understanding of skills from which individualized treatment and education plans may be written. The Behavioral and Emotional Rating Scale (BERS; Epstein & Sharma, 1998) is a strength-based instrument designed to identify children's behavioral and emotional strengths. The psychometrics of the BERS has been demonstrated through several studies; however, the focus has mainly been on older age students. We sought to assess the convergent validity of the BERS with kindergarten children. The results of these two studies provide further support of the psychometric characteristics of the BERS and indicate its appropriateness with young children. [ABSTRACT FROM AUTHOR]

Presents a study which assessed the outcomes of a supplemental daily Direct Instruction reading curriculum and fluency building program on reading skills of students at risk for emotional disturbance and reading deficits. Academic status of students with emotional disturbance; Details of the intervention research; Importance of direct instruction to reading skills of students.

• Children and families are not well prepared for reunification. • Existing supports are only somewhat effective for the transition period. • Mental health supports are most important for children and families. • A total of 36 independent barriers were generated for the first question. • The biggest barrier is a lack of parental desire to implement long-term changes. • A total of 27 unique supports were identified for question two. • Effective and accessible supports for families during reunification is necessary. Supports following reunification play an important role in successful transitions from out-of-home care to home and school settings for children and their families. There are several stakeholders who play critical roles supporting families during this transition. One key role is tied to legal professionals, who often work closely with the child or family while in care and then continue to monitor family progress during the transition from foster care to the home setting. Although work has been conducted to understand what supports other stakeholders feel children and families need during this transition, little is known about the perspectives of legal professionals. This exploratory study gathered perspectives from legal professionals regarding the challenges these youths and families face and necessary supports to promote successful reunification. Three research questions guided this work: (1) How prepared do legal professionals feel youth and families are for the reunification period? (2) What do legal professionals perceive as existing barriers for youth and families during reunification? and (3) What services do legal professional perceive as necessary to promote successful reunification and the effectiveness of existing supports? Participants (N = 13) completed a brief survey including demographic items and questions on reunification supports following departure from foster care. Participants also engaged in a focus group using the nominal group technique to address two primary questions that addressed challenges faced by families during reunification and necessary supports or services to promote positive youth and family outcomes. Participants felt that families were not well prepared for reunification and that current supports were somewhat effective to support this transition period. They also indicated supports in the mental health domain to be most important. A total of 36 independent barriers were generated for the first question and 27 supports were identified for question two. Establishing effective and accessible supports for families during reunification is necessary for positive family outcomes. This study highlighted barriers in preventing successful reunification, namely limited access to resources and supports in preventing successful reunification and the importance of mental health support for the entire family in promoting successful outcomes. [ABSTRACT FROM AUTHOR]

Parents who are knowledgeable of special education are more likely to engage in their child's education. Parents seek information about special education from a number of sources including State Departments of Education (SDEs). However, little is known about the web-based special education resources SDEs provide to parents. We sought to address this gap by conducting a comprehensive review of SDE websites and special education resources. Two-thirds of SDEs provided special education resources in a parent-designated section of their website. The number of resources provided varied greatly by state and the majority of resources were specific to conflict/dispute resolution. Future research should explore how information provided can best support increased parental knowledge to improve parental engagement. Limitations and implications are discussed. [ABSTRACT FROM AUTHOR]

Aftercare has been suggested to improve the outcomes of youth who depart group homes. This project used a survey method to collect data from 38 agency leaders from across the United States on the aftercare supports they believed were available for youth departing group homes and returning to their homes/schools prior to high school graduation. The results revealed that 34% of agencies provided an aftercare service with a model, and 29% of agencies received external funding for aftercare. The findings are summarized and limitations and implications for future research are discussed. [ABSTRACT FROM PUBLISHER]

This study evaluated the characteristics related to a successful reintegration among youth from a residential facility. Specifically, this study describes the transition skills of youth at departure in five areas: (a) education and employment goals, (b) self-determination skills, (c) social support, (d) life skills, and (e) hopefulness. Further, self-report and teacher ratings of youths' self-determination and life skills were examined to determine possible differences in perception between youth and their school and Family Teachers (house-parents). One hundred four youth departing the Boys Town Treatment Family Home residential program participated in the study. The majority of youth reported average to above average skills in the five domains. However, significant differences were found between youth and schoolteacher reports of self-determination skills. The results indicate the need to provide transition services related to success post-discharge, including individualized transition plans and family involvement during treatment. [ABSTRACT FROM AUTHOR]

Over the past decade, there has been an increased need for the development and use of psychometrically acceptable measures to assess the behavioral and emotional strengths of young children served in statewide preschool and Head Start programs. One measure developed to address this need is the Preschool Behavioral and Emotional Rating Scale (PreBERS), which is a strength-based instrument designed to evaluate the behavioral and emotional strengths of preschool children aged 3 to 5 years old. In a previous study with a nationally representative sample, researchers found that (a) the items of the PreBERS can best be described by a four-factor structure model (Emotional Regulation, School Readiness, Social Confidence, and Family Involvement), (b) the subscales and total measure have highly acceptable levels of internal consistency, and (c) differences were obtained for levels of strength for preschool children with and without disabilities. The findings of this investigation replicate these previous results with a national sample of children (N = 962) enrolled in Head Start programs. Confirmatory factor analysis and analyses of internal consistency and criterion validity provide support for the use of the PreBERS with children served in Head Start programs. Study limitations and implications are addressed. [ABSTRACT FROM PUBLISHER]

Background: There is a growing emphasis of evidence-based program requirements being integrated into social welfare policies for youth care services in the U.S. This trend highlights the need for increased practitioner understanding and involvement in the research process to develop and implement evidence-based programs for youth with emotional and behavioral disorders who receive residential services. Objective: The purpose of this review was to provide residential care practitioners and researchers with an understanding of a transdisciplinary translational research approach for social service agencies and the research activities that can be included. Method: A review of the literature from a collaborative project between a social service agency and university that resulted in the development and testing of an aftercare intervention for youth departing residential programs was used to explain the framework. Result: The DO BETTER framework outlines a process that (1) focuses on input from practitioners and consumers to help determine problems that impact youth and families, (2) involves research and practitioner partnerships to conduct a variety of research activities to create solutions and (3) provides results that are useful for practitioners. The research activities of the project illustrate the iterative processes of practice to research and back to practice that included youth, caregivers, practitioners, researchers, and experts from other disciplines. Conclusion: The framework is provided to help researchers plan for collaborative research with social service agencies, and to help non-researchers in agencies become more familiar with research activities to increase their involvement in program design, testing, implementation and sustainability. [ABSTRACT FROM AUTHOR]

Parent empowerment involves the ability of caregivers to meet the needs of their family while maintaining feelings of control and is particularly important for families of children at-risk. It is necessary to establish reliable and valid tools to measure parent empowerment. The purpose of this study was to examine the internal factor structure, score reliability, and convergent validity of the FES scores with caregivers of middle school youth who had an Individualized Education Plan for Emotional Disturbance (ED) or Other Health Impairment (OHI) due to emotional or behavioral needs. A confirmatory factor analysis (CFA) was used to examine the internal structure the FES . Score reliability was examined by computing coefficient alpha (Cronbach, 1951) for each subscale score and computing Coefficient omega and coefficient omega hierarchical for good-fitting factor models and bifactor models. Convergent validity was examined by generating composite scores for each subscale, followed by computing Pearson correlations between FES subscale scores and scores from the PAM , CGSQ and the SDQ . Results indicated that the hypothesized three-factor model fit the data adequately. FES scores were reliable based on coefficient alpha and omega, and evidence of convergent validity with measures of parent activation, caregiver strain, and child behavior were moderate to strong. The results support the use of the FES with parents of middle school youth who have ED and further validate the three factor structure identified in the initial measure development. Practical and clinical implications of these findings include support for the use of the FES with this particular group of parents. [ABSTRACT FROM AUTHOR]

Residential care has been criticized for its high cost and limited research evidence. While recent studies and reviews of the literature suggest that a number of evidence-based practices are being implemented in residential care settings, more research is needed to develop and test empirically based practices that can be successfully implemented in residential care. In this article, we offer a promising strategy to address this issue: a long-term research partnership between a large service provider agency and a university-based research center to conduct a program of research which has resulted in translation of evidence-supported practices into service provider programs, contributions to the science of residential care, and training opportunities for young applied scientists to specialize in this important work. This evolving program of research includes four core applied research topic areas in which this collaboration has had some ongoing success: program and practice implementation fidelity, therapeutic process factors, aftercare, and psychotropic medication use. We suggest that this type of long-term collaborative research partnership is an approach for others to consider for conducting research that informs effective residential care practices. [ABSTRACT FROM AUTHOR]

The purpose of this article is to describe the health-related quality of life (HRQoL) of adolescents in residential care and to examine selected correlates. A sample of 229 adolescents (mean age = 17 years) living in a residential care setting completed a validated measure of HRQoL (PedsQL 4.0 Generic Scales). Mean-level scores for Total HRQoL, Physical HRQoL, and Psychosocial HRQoL were examined, and the percentage of youth scoring below a clinical cutoff value was reported. Demographic and psychotropic medication data for each youth were accessed from an electronic database maintained by the residential care program and used to examine correlates of HRQoL. Approximately 25% of youth had at least 1 HRQoL score in the "at risk" range, indicating a significant proportion of youth in residential care have significant impairments in HRQoL. Younger age and female gender were associated with poorer HRQoL. Psychotropic medication prescriptions were associated with poorer HRQoL. A significant percentage of adolescents in residential care may experience suboptimal HRQoL, and certain demographic and clinical factors appear to be associated with greater risk. Systematic assessment of HRQoL is recommended for youth in residential care, and interventions to promote better HRQoL among youth at particularly high risk may be beneficial. [ABSTRACT FROM AUTHOR]

Purpose: The Pediatric Quality of Life assessment (PedsQL™) is the most widely used measure for assessing adolescent health-related quality of life (HRQoL). While youth in residential treatment facilities face many physical and mental health, behavioral, education, and familial challenges that could impact their HRQoL, no research has sought to assess the factor structure of the PedsQL™ among youth receiving residential care. Methods: High school–aged youth ( N = 229) attending a large residential treatment center in Omaha, NE were recruited to complete a data collection packet comprised of various health assessments including the PedsQL. Four competing confirmatory factor analysis models were used to test the hypothesized internal structure of the PedsQL™ 4.0 Teen Report. Results: Models A, B, and C had acceptable CFI (≥.90), TLI (≥.90), and RMSEA (≤.08) fit indicators. However, factor loadings for items 5 and 6 were problematic. After removing the two problematic items, Model D was fit to the data and proved to be the superior of the four models. This model included two first-order factors (physical health problems; school attendance problems) and one second-order factor (psychological health problems). Conclusions: The findings suggest that researchers and practitioners studying youth in residential settings can reliably use the PedsQL™ to assess their HRQoL. [ABSTRACT FROM AUTHOR]