underdog DREAMS: Improving Long-Term Quality of Life Outcomes for Florida’s Foster Youth and Families

Children and youth in the foster care system face significant and continuing barriers to both physical and mental health, including lack of a medical home, disruptions in primary care providers, frequent moves to new homes, excessive caseloads for oversight providers, and at times continuing exposure to the risk factors that are considered Adverse Childhood Experiences (ACEs). The underdog DREAMS project sought to alter the course of the foster youth experience via a tri-part model that focused on clinical, research, and advocacy interventions for foster youth and the development of the workforce that supports them through training on the impacts of trauma and poverty.

Investigation of Sensory Modulation Dysfunction in Children in Congregate Foster Care

Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. Youth who reside in congregate-care foster homes are at greater risk of developing physical, emotional, and behavioral problems. Many of these children could benefit from OT services but are not yet identified because of a lack of assessment. Data from this study suggest sensory modulation challenges are common in this population and may contribute to observed behavior problems. Critical information is provided to advocate for OT services in the foster care system. Primary Author and Speaker: Amy Armstrong-Heimsoth Additional Authors and Speakers: Sarah A. Schoen Contributing Authors: Tessa Burt

The Myth of Resilience

This poem discusses resilience as an adaption to circumstances children cannot control. It comes from the viewpoint that resilience assumes that there is something to which one can bounce back. However, children who are placed in the foster care system and/or adopted, especially from birth, are born into spaces to which there is no return, yet they are labeled resilient. Children who experience these traumatic circumstances are not resilient, they are adaptable and learn how to thrive and move forward. 

Calculating the Souls of Black Folk

In 1995, there were nearly 50,000 children removed from their families into the New York City Administration for Children’s Services’ (ACS) foster care system.1 The NYC ACS’ forcible transfer of children from a protected group into another group may amount to genocide under Article 2(e) of the Genocide Convention if formal review can demonstrate an “intent to destroy” the group “as such” or at least “in part.” Rather than pursuing a citizen’s tribunal, or truth and reconciliation committee to assess the historic transfer of Black children to other groups during this period by the child welfare system, ACS has focused on collecting data from currently targeted populations in order to “predict who needs prevention” services. This paper examines the Family First Prevention Act’s legislative mandate to calculate the “souls of Black folks” and the geographies of predictive analytics developed to serve this aim. Using an abolitionist lens grounded in the epistemology offered by W. E. B. Du Bois’ Souls of Black Folks, this argument moves beyond the Fairness, Accountability and Transparency (FAT) framework to propose strategies for dismantling the “new modes of surveillance and social control” manifested in NYC ACS’ preventive turn. I propose a Get Out mathematics drawing from Katherine McKittrick’s proposal to “count it out different” as the fugitive’s alternative to state sanctioned datafication.

Perceived Effectiveness of Parent Representation Social Workers by Legal Professionals Involved with Indigent Defendants

The total number of children in the U.S. foster care system exceeds 428,000. Previous research indicates that when social workers and legal professionals work together, children and their families benefit significantly. Parents who effectively engage in the child welfare system are more likely to benefit from services and reunify with their children. The present study employed a phenomenological approach to explore how a parent representation pilot, which paired social workers with public defenders to better represent the needs of families in the child welfare system, was experienced by legal professionals. Judges and family court attorneys (n = 9) found the program to be helpful in reunifying families. Public defenders were able to leverage the social worker’s skills and experience to facilitate more positive outcomes, while reducing case burden. Challenges were also identified and included a lack of interdisciplinary training, potential overlap in ethical responsibilities, and role confusion. Structured intervention programs that encourage collaboration between social workers and legal professionals may improve case outcomes for indigent families involved in the child welfare system. It is advised that social work undertake a formal multidisciplinary approach in support of public defenders, which may serve to encourage positive case outcomes.

Iron Status, Development, and Behavior in Young Children in the Pennsylvania Foster Care System, an Exploratory Retrospective Medicaid Chart Review

Objectives To 1) quantify the prevalence of iron deficiency (ID), iron deficiency anemia (IDA), and/or anemia in children in the Pennsylvania (PA) Foster Care System and 2) examine if a child's iron status is associated with the frequency of certain developmental and behavioral diagnoses. Methods Retrospective cohort Medicaid chart review of children, from 6 mos to 10 yrs of age, in the PA Foster Care System using the most recently available data (2010–2015), extracted from the Medicaid Analytic eXtract database. Data from ICD-9 and ICD-10 codes which capture iron status and anemia, along with 16 relevant behavioral and 10 relevant developmental diagnoses were extracted. ICD codes for ID, IDA, and anemia cannot be differentiated; therefore, we used ID/anemia as a group label. The prevalence of ID/anemia was calculated and the prevalence of developmental delays and behavioral impairments among those diagnosed with ID/anemia was compared to those who were not diagnosed with ID/anemia. Group differences were determined using Pearson's chi-squared tests. Results From 2010–2015, there were 50,311 children, ages 6 mos to 10 yrs, in the PA Foster Care System. Of these, 1,365 (2.7%) were diagnosed with ID/anemia. Specific delays in development (a category with several sub-diagnoses) were reported in 48% of children with ID/anemia and 19% of children without diagnosed ID/anemia (χ2 = 679.42, p < 0.001). Moderate, severe, and profound intellectual disability (IQ < 49) were each reported in 0.5% of children with ID/anemia, and in children without diagnosed ID/anemia, in 0.16% (χ2 = 9.84, p = 0.002), 0.1% (χ2 = 19.79, p < 0.001), and 0.08% (χ2 = 26.44, p < 0.001), respectively. Adjustment disorder with depressive mood was reported in 1% of children with diagnosed ID/anemia and 0.6% of children without (χ2 = 4.10, p < 0.05). Irritability was different between groups (χ2 = 59.91, p < 0.001; 0.9% of children with ID/anemia and 0.1% of children without). Conclusions In 2010–2015, 2.7% of children in PA Foster Care (6 mos-10 yrs old) were diagnosed as ID, IDA, and/or anemic. Frequency of developmental and behavioral diagnoses were generally greater in children with ID, IDA, or anemia, emphasizing the need for follow up of these children. Funding Sources The John L. Beard Endowment and the CHHD Limited Endowment Funds, The Pennsylvania State University.

Sexual and Gender Minority Youth in Foster Care: An Evidence-Based Theoretical Conceptual Model of Disproportionality and Psychological Comorbidities

Sexual and gender minority youth (SGMY) are overrepresented in the foster care system and experience greater foster-care-related stressors than their non-SGM peers. These factors may further elevate their risk of anxiety/depressive, post-traumatic stress disorder, self-harm, and suicidality. The system currently produces unequal and disproportionate adverse mental health outcomes for SGMY and needs points of intervention to disrupt this status quo. This article provides an empirically grounded conceptual–theoretical model of disproportionate representation and burden of psychological comorbidities experienced by SGMY in the foster care system. We apply findings from an integrated literature review of empirical research on factors related to overrepresentation and mental health burden among SGMY to minority stress theory to explicate how and why the foster care system exacerbates mental health comorbidities for SGMY. Searches were conducted in June 2020 in PubMed using MeSH terms and title/abstract terms for foster care, sexual or gender minorities, and psychological comorbidities. Inclusion criteria are studies conducted in the United States, published in English, focused on mental illness, and published between June 2010 and 2020. Developmental/intellectual and eating disorders were excluded. The initial search returned 490 results. After applying inclusion criteria, 229 results remained and are utilized to build our conceptual–theoretical model. We assert that the phenomenon of disproportionate psychological comorbidities for SGMY in foster care is best represented as a complex and dynamic system with multiple feedback loops. Extant empirical and theoretical literature identifies three critical areas for intervention: family acceptance, community belonging and queer chosen/constructed family, and affirming and nondiscriminatory child welfare policy.

FAMILY FOSTER CARE DILEMMAS DURING THE COVID-19 PANDEMIC – A QUALITATIVE ANALYSIS

The article is focused on the issues of family foster care functioning during the Covid-19 pandemic. The pandemic caused many significant changes and restrictions in social, institutional and family functioning and had an impact on the organization and functioning of the foster care system. The results of the qualitative research presented in this article describe the challenges and difficulties that foster care providers, organizers of foster care and supporting non-governmental organizations had to face. Conclusions were formulated, including proposals for actions to improve the functioning of family foster care during subsequent health crises and postulates for changes in educational practice and social policy.

Responding to COVID-19’s impact on supervised family time: The supportive virtual family time model

COVID-19 has put child wellbeing at risk, perhaps especially, for children and youth involved in the foster care system. For these children and youth, any stability they may have experienced since entering care has been disrupted and their contact with parents limited. A sudden shift to virtual only contact meant both parents and caregivers were in need of support to navigate these changes. This study reports on the rapid development and implementation of an eLearning and structured practice guide for visitation supervisors to help them facilitate virtual visits that promote parent-caregiver collaboration in support of the child. Over a four month period, April to August 2020, 140 people registered for the Supportive Virtual Family Time training. Of these participants, 101 (72%) completed a post-training survey which included an evaluation of the eLearning and assessment of the feasibility of implementing the model. Overall, participants were satisfied with the training content and delivery, agreed the training helped them develop new skills for interacting with parents and caregivers, and planned to start using the model right away. Given the ongoing and dynamic nature of the pandemic, there is likely continued need for virtual family time and training and support for supervisors who facilitate these interactions. It is critical these supports are timely, easily accessible, and include practice guidelines and resources that help practitioners facilitate and maintain youths’ critical attachments to their families. Given the potential benefits of supporting parent-caregiver collaboration, the model and accompanying materials address an overarching need in the field and remain relevant even after a return to in-person visitation.