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PURPOSE Black birthing parents and their newborns disproportionately experience newborn drug testing for prenatal substance exposure by health care professionals (HCPs), which contributes to Child Protective Services (CPS) reporting, family separation, and termination of parental rights. This qualitative study aims to interrogate dominant power structures by exploring knowledge, attitudes, and experiences of HCPs and CPS professionals regarding the influence of structural racism on inequities in newborn drug testing practices. METHODS We conducted semistructured interviews with 30 physicians, midwives, nurses, social workers, and CPS professionals guided by an explanatory framework, and conducted inductive, reflexive thematic analysis. RESULTS We identified 3 primary themes: (1) levels of racism beyond the hospital structure contributed to higher rates of drug testing for Black newborns; (2) inconsistent hospital policies led to racialized application of state law and downstream CPS reporting; and (3) health care professionals knowledge of the benefits and disproportionate harms of CPS reporting on Black families influenced their decision making. CONCLUSION Health care professionals recognized structural racism as a driver of disproportionate newborn drug testing. Lack of knowledge and skill limitations of HCPs were barriers to dismantling power structures, thus impeding systems-level change. Institutional changes should shift focus from biologic testing and reporting to supporting the mutual needs of birthing parent and child through family-centered substance use treatment. State and federal policy changes are needed to ensure health equity for Black families and eliminate reporting to CPS for prenatal substance exposure when no concern for child abuse and neglect exists. Key words: child abuse; health inequities; racism; implicit bias; qualitative research https://doi.org/10.1370/afm.3139, INTRODUCTION The United States Child Abuse and Prevention Treatment Act requires states to enact policies to identify newborns affected by substance use disorders or prenatal substance exposure (PSE) during pregnancy. [...]

Scioto County, pronounced 'sigh-oh-tah,' is the largest county, geographically, in the state of Ohio. It sits at the southern tip of the state on the Ohio River and just across [...]

Using an iterative rapid development process, a diverse committee at the Illinois Department of Children and Family Services that included individuals with lived experiences with the state's child welfare system, [...]

Introduction Infant-Toddler Court Teams (ITCTs) are a collaborative practice designed to improve timely identification and receipt of needed services for families of infants and toddlers involved in the child welfare system and their families. The goal of the study was to explore the impact of the first year of COVID compared to the previous year, in the context of ITCT support, on: (1) parents' access to services; (2) parents' services receipt and access within 30 days and within 14 days from referral; and (3) predictors of services access and receipt. Methods Overall, 897 instances of services needs were analyzed, 411 pre-COVID and 486 during COVID. Logistic regression models were used to test for differences pre- and during COVID, controlling for covariates. Results A reduction in service access was found across all services during COVID (OR = 0.2, CI: 0.1-0.3, p < .0001). Nevertheless, if a service was still available, parents were able to maintain similar levels of receipt within 30 days and within 14 days as before COVID. Moreover, a higher percentage of parents in need received mental health services in 30 or fewer days and substance use disorder services in both 14 and 30 or fewer days during COVID compared to pre-COVID. Discussion This success is notable given the significant disruption to the availability of services and barriers to accessing services caused by the pandemic. ITCTs provided a robust platform for supporting the health and well-being of families with very young children in the face of a severely reduced service landscape due to COVID-19., Author(s): Cecilia Casanueva [sup.1] , Marianne Kluckman [sup.1] , Sarah Harris [sup.1] , Joli Brown [sup.1] , Jenifer Goldman Fraser [sup.2] Author Affiliations: (1) grid.62562.35, 0000000100301493, RTI International, , PO [...]

Safe and stable housing is a critical social determinant of health (SDOH). For families at the intersection of child welfare involvement and unstable housing, being connected to housing resources can [...]

Reinforced by stigmatizing drug war policies, some responses to parental substance use have caused trauma to families, paradoxically increasing the risk of problematic substance use for children and parents. Solutions [...]

A child raised in foster care who could make her way to college, but instead finds herself living on the streets. A commitment to high-quality early childhood programs without knowing [...]

For several years now, I have been fortunate to work with a phenomenal group of public servants dedicating this portion of their professional lives to the noble work of child [...]

Objective To examine predisposing, enabling, and need-related factors associated with dental utilization by children involved with the child welfare system (CWS). Methods Data were analyzed from the National Survey of Child and Adolescent Well-Being (NSCAW; Wave II), a national probability sample of children (2-17 years) following a welfare assessment during 2008-2009 (n = 2806). Caregiver-reported child receipt of dental services in the past year was the outcome in weighted logistic regression models. Results Two-thirds of children had a recent dental visit. Older children (OR 2.95, 95% CI 2.06,4.21 for ages 6-11; OR 2.47, CI 1.82, 3.37 for ages 12-17, compared to ages 2-5) were more likely to have visited the dentist, as were children of more educated caregivers (OR 1.68; CI 1.20, 2.36 for high school, OR 2.45; CI 1.71, 3.52 for more than high school). Children without a usual source of care (OR 0.50; CI 0.27, 0.94) and those living with non-biological parents had lower odds of a recent visit (OR 0.64; CI 0.43, 0.97). Children with dental problems were twice as likely to have a recent visit (OR 2.02; CI 1.21, 3.38), while children with unmet needs who could not afford care had lower odds of utilizing services (OR 0.28; CI 0.16, 0.46). Conclusions for Practice Many children in the CWS, especially younger children (ages 2-5), did not have a reported dental visit in the past year. Cost was a barrier, and caregiver status was associated with the likelihood of obtaining dental care. Health and social service providers should refer these children for dental care., Author(s): Tracy L. Finlayson [sup.1] , Emmeline Chuang [sup.2] , Jong-Deuk Baek [sup.1] , Robert Seidman [sup.1] Author Affiliations: (Aff1) 0000 0001 0790 1491, grid.263081.e, Health Management & Policy, Graduate [...]

Objectives To examine retention of Medicaid coverage over time for children in the child welfare system. Methods We linked a national survey of children with histories of abuse and neglect to their Medicaid claims files from 36 states, and followed these children over a 4 year period. We estimated a Cox proportional hazards model on time to first disenrollment from Medicaid. Results Half of our sample (50 %) retained Medicaid coverage across 4 years of follow up. Most disenrollments occurred in year 4. Being 3-5 years of age and rural residence were associated with increased hazard of insurance loss. Fee-for-service Medicaid and other non-managed insurance arrangements were associated with a lower hazard of insurance loss. Conclusions for Practice A considerable number of children entering child environments seem to retain Medicaid coverage over multiple years. Finding ways to promote entry of child welfare-involved children into health insurance coverage will be critical to assure services for this highly vulnerable population., Author(s): Ramesh Raghavan[sup.1] , Benjamin T. Allaire[sup.2] , Derek S. Brown[sup.3] , Raven E. Ross[sup.3] Author Affiliations: (1) School of Social Work, Rutgers, The State University of New Jersey, 536 [...]

Amental health therapist calls in a report to Child Protective Services (CPS). During a counseling session, a boy who has been placed in a safety home alleges that his 'emergency [...]

B. Violating Separation of Powers Is Particularly Harmful in Juvenile Court Placing juvenile officers in the judiciary and rendering them subject to judges' supervisory control is particularly harmful in the [...]

Little is known about effective strategic planning for public and private child welfare agencies working together to serve families. During a professionally facilitated, strategic planning event, public and private child welfare administrators from five states explored partnership challenges and strengths with a goal of improving collaborative interactions in order to improve outcomes for children and families. Summarizing thematic results of session notes from the planning event, this article describes effective strategies for facilitation of such processes as well as factors that challenge or promote group processes. Implications for conducting strategic planning in jurisdictions seeking to improve public/private partnerships are discussed., As the complexity of child welfare service delivery has increased over time, the need for collaboration between the public and private sectors has grown. In all state child welfare systems, [...]

In an effort to expand professional development offerings for child welfare leaders in the state, Wisconsin's Department of Children and Families integrated Organizational Effectiveness (OE) into its Program Improvement Plan [...]

Abstract A common theme running through child protection and safeguarding publications concerns the problems and consequences of ineffective communication between agencies. This article looks at why communication may, at times, [...]

'It takes a village to raise a child' (African proverb) 'Only those who do not work do not make mistakes' (Romanian proverb) The value of nonparental childcare is a widely [...]

Children in foster care comprise a population of students at great risk for school failure. The child welfare agency, schools, and home must all work together to provide the services and supports required to achieve better results. The purpose of this study was to conduct focus groups with participants from each sector to discuss their views on the educational problems and needs of students in foster care and their recommendations for what is needed to improve the academic prospects of foster students. The article provides details of the distinct themes identified by caregivers, school liaisons, and agency advocates and reveals how each group--while recognizing that foster students face substantial school problems--operates independent of each other and lacks a shared view on what is needed. The article concludes with recommendations for designing a model program that involves all the sectors and provides an arena for strategically addressing barriers to school success. KEY WORDS: caregivers; child welfare; educational barriers; foster youth; liaisons, There are half a million children in our nation who live away from their families and communities because of abuse or neglect at home. A third of the children who [...]

This study examined the effectiveness of a culturally adapted Strengthening Families Program (SFP) for Latinos to reduce risks for alcohol and drug use in children. Latino families, predominantly Puerto Rican, with a 9- to 12-year-old child and a parent(s) with a substance abuse problem participated in the study. Pre- and post-tests were conducted with each family. Parental stress, parent-child dysfunctional relations, and child behavior problems were reduced in the families receiving the intervention; family hardiness and family attachment were improved. Findings contribute to the validation of the SFP with Latinos, and can be used to inform social work practice with Puerto Rican families. KEYWORDS Latinos, family, children, prevention, alcohol, drugs DOI: 10.1080/15313200903531982

Summary The aim of this phenomenological study was to investigate the lived experiences of primary caregivers of children with intellectual disabilities who access specialist early intervention (EI) services in Ireland. [...]

Summary The number of parents with a learning disability is increasing, so it is important that the roles of professionals in supporting them are identified. The community learning disability nurse [...]

The 2008 Sichuan Province earthquake and 2005 Pakistan earthquake are examples of natural disasters that took an unimaginable toll on children. In such disaster management contexts, family members as well as health care and school personnel are the first-line responders and are natural sources of continued social support as children recover. Although psychologists have increasingly sophisticated understandings of post-disaster reactions and strategies for helping children and adolescents cope with trauma, models for responding to mass catastrophes are limited, particularly in geographically remote communities and in regions in which mental health services are stigmatizing. With children's well-being subsequent to earthquakes inextricably linked to family and community, psychologists can make important contributions in 3 spheres: (a) coordinating and activating collaborations within children's existing social contexts to develop post-earthquake interventions; (b) designing prevention and preparedness programs focused on the emotional needs of children in earthquake-prone communities; and (c) conducting research on interventions and recovery with particular attention to developmental stage, sociocultural-economic contexts, and the similarities versus differences across various types of disasters. Keywords: children, earthquakes, disasters, mass trauma, family and community interventions DOI: 10.1037/a0018103

Parents of children with long-term emotional or behavioral conditions often struggle to access and afford mental health services for their children. This article examines the parent-reported reasons for unmet mental health needs in children using the National Survey of Children with Special Health Care Needs, specifically investigating whether insurance status (insured versus uninsured) and insurance type (private versus public) influences why a child has an unmet mental health need. The sample included children whose parents reported a need for mental health care or counseling in the previous 12 months, focusing on children with long-term emotional/behavioral problems rather than children experiencing episodic events that might only require short-term mental health services. Findings indicate that being uninsured increases the likelihood of parents reporting costs too much as the reason for their child having unmet mental health needs, whereas being insured by public health insurance decreases the likelihood of reporting costs too much as the reason. Policy implications include the need for expansion of health insurance coverage for all children and the need to achieve parity for mental health benefits in private health insurance. KEY WORDS: children; health policy; mental health; unmet need, Parents of children with long-term emotional and behavioral problems often struggle to access mental health services for their children. When a child has extensive treatment needs, even parents with high [...]

Analysis of the data from 500 youths in the child welfare system with out-of-home placements shows that behavior problems significantly predicted placement changes for three path coefficients. It is suggested that screening for behavioral problems be done for youths entering or transitioning in the child welfare system.

Child abduction is a serious problem; therefore, it is essential that researchers evaluate the efficacy of commercially available abduction-prevention programs. A multiple baseline design across participants (ages 6 to 8 years) was used to evaluate the effects of a training program, The Safe Side. Experimenters assessed safety responses in situ in two different situations (knock on the door and interaction by a stranger in public). Results revealed that participants did not demonstrate the safety skills following Safe Side training. All participants subsequently received in situ training (IST) implemented by the parent. Additional assessments and IST were conducted until each participant performed the skills to criterion. All participants demonstrated criterion performance following IST and maintained the skills over time. DESCRIPTORS: abduction, in situ assessment, in situ training, prevention, safety skills doi: 10.1901/jaba.2009.42-761

This study describes the behaviours of four educational assistants in regular primary classrooms where children with autism spectrum disorders (ASD) are integrated. Five categories of behaviours are described: a) social [...]

Evidence-based management is emerging in the helping professions in response to heightened demands for public accountability and organizational performance. This paper defines evidence-based management and reviews its origins in the health care and business sectors and its recent incorporation into the social work profession. A case study describes the efforts of one social service agency to use evidence-based management to improve the performance of its child welfare and mental health programs. Consideration is given to the similarities between the dominant models of evidence-based management and evidence-based practice, the challenges facing administrators seeking to incorporate evidence-based management processes into social service agencies, and the implications of evidence-based management for social service agency practice and social work management. KEYWORDS evidence-based management, evidence-based practice, decision making, organizational performance, public accountability

Objectives. This article explores ways in which population aging in the United States between 2010 and 2030 might impact the well-being of children, with a distinction made between advantaged and disadvantaged children. Methods. A variety of economic and demographic statistics are used to describe the changing age structure of the population and changing public spending on older people and children. Data from the 1985 General Social Survey and Wave 2 of the National Survey of Families and Households are also used to examine connections between older people and children. Results. In recent decades, there has been a graying of the federal budget, and programs for children have received a declining proportion of domestic spending. These trends will be exaggerated between 2010 and 2030 unless structural changes occur. Grandparents may provide increasing resources for their grandchildren. Age segregation results in relatively few older people being directly involved with children not related to them by kinship. Conclusions. The implications of population aging for children are relevant primarily for disadvantaged children. Disadvantaged children have grandparents with fewest resources and are most in need of public spending. As costs of supporting the older population increase, intentional social changes will be needed to prevent growing inequality among children. Key Words: Age segregation--Child well-being--Grandparents--Population aging Welfare state.

The outcomes for children in public care are generally considered to be poor. This has contributed to a focus on reducing the number of children in care: a goal that is made explicit in the provisions of the current Children and Young Persons Bill. Yet while children in care do less well than most children on a range of measures, such comparisons do not disentangle the extent to which these difficulties pre-dated care and the specific impact of care on child welfare. This article explores the specific impact of care through a review of British research since 1991 that provides data on changes in child welfare over time for children in care. Only 12 studies were identified, indicating a lack of research in this important area. The studies consistelrtly found that children entering care tended to have serious problems but that in general their welfare improved over time. This finding is consistent with the international literature. It has important policy implications. Most significantly it suggests that attempts to reduce the use of public care are misguided, and may place more children at risk of serious harm. Instead, it is argued that England and Wales should move toward a Scandinavian system of public care, in which care is seen as a form of family support and is provided for more rather than fewer children and families.

Summary A project to deliver effective mandatory training on safeguarding children to a team of nurses in an acute psychiatric inpatient unit has delivered benefits. Safeguarding children practice on the [...]

Abstract As a result of recent legislation that removes from the Crimes Act the statutory defence of "reasonable force" to correct a child, professionals have an increasingly important role in [...]