Children who experience maltreatment are at increased risk of revictimization across the life span. In childhood, this risk often manifests as peer victimization. Understanding the nature of this... Show moreChildren who experience maltreatment are at increased risk of revictimization across the life span. In childhood, this risk often manifests as peer victimization. Understanding the nature of this risk, and its impact on mental health, is critical if we are to provide effective support for those children who are most vulnerable. A systematic scoping review was conducted using Google Scholar and PsycINFO. Studies on adults, psychiatric, and/or inpatient populations were excluded. Included studies concerned all forms of child maltreatment and peer victimization. We found 28 studies about the association between maltreatment experience and peer victimization as well as peer rejection. We review the evidence documenting the relation between these adverse childhood experiences and mental health. The evidence suggests that maltreatment and peer victimization have additive effects on mental health outcomes. A number of theoretical developmental frameworks that delineate putative mechanisms that might account for an association are considered. Building on prior research, we then discuss the role of recent neurocognitive findings in providing a multilevel framework for conceptualizing mental health vulnerability following maltreatment. In addition, we consider how altered neurocognitive functioning following maltreatment may shed light on why affected children are more likely to be victimized by their peers. Specifically, we consider the threat, reward, and autobiographical memory systems and their role in relation to stress generation, stress susceptibility, and social thinning. Such a mechanistic understanding is necessary if we are to reduce the likelihood of peer victimization in children exposed to maltreatment, and move to a preventative model of mental health care. Show less
The present review sought to address the following questions: What evidence is there that long-term, family-based out-of-home care (OOHC) has a general, population-wide effect on children’s mental... Show moreThe present review sought to address the following questions: What evidence is there that long-term, family-based out-of-home care (OOHC) has a general, population-wide effect on children’s mental health such that it is generally reparative or generally harmful? Does entry into long-term OOHC affect children’s mental health, as evidenced by prospective changes over the first years in care? And, is the reparative potential of long-term, family-based OOHC moderated by children’s age at entry into care? Fourteen studies were identified for review. We found no consistent evidence that family-based OOHC exerts a general, population-wide effect on the mental health of children in care; or that entry into care has an initial effect on children’s mental health; or that children’s age at entry into care moderates their subsequent mental health trajectories. Instead, several longitudinal studies have found that sizable proportions of children in care manifest meaningful improvement in their mental health over both short- and long-term time frames and that similarly sizable proportions experience meaningful deterioration in their mental health. Rather than asking whether long-term, family-based care is generally reparative or harmful for the development of previously maltreated children, future investigations should instead focus on identifying the systemic and interpersonal characteristics of care that promote and sustain children’s psychological development throughout childhood—and those characteristics that are developmentally harmful (i.e., for which children is the experience of care beneficial, and for which children is it not?). The review concludes with recommendations for the design of improved cohort studies that can address these questions. Show less
Foster and adoptive parents often face challenges while taking care of children who, due to their adverse early life experiences, are at risk of developing insecure attachment relationships,... Show moreFoster and adoptive parents often face challenges while taking care of children who, due to their adverse early life experiences, are at risk of developing insecure attachment relationships, behavior problems, and stress dysregulation. Several intervention programs have been developed to help foster and adoptive parents to overcome these challenges. In the current study, a series of eight meta-analyses were performed to examine the effectiveness of these intervention programs on four parent outcomes (sensitive parenting, k = 11, N = 684; dysfunctional discipline, k = 4, N = 239; parenting knowledge and attitudes, k = 7, N = 535; parenting stress, k = 18, N = 1,306), three child outcomes (attachment security, k = 6, N = 395; behavior problems, k = 33, N = 2,661; diurnal cortisol levels, k = 3, N = 261), and placement disruption (k = 7, N = 1,100). Results show positive effects for the four parent outcomes and child behavior problems, but not for attachment security, child diurnal cortisol levels, or placement disruption. Indirect effects on child outcomes may be delayed, and therefore long-term follow-up studies are needed to examine the effects of parenting interventions on children. Show less
Tarren-Sweeney, M.; Goemans, A.; Hahne, A.S.; Gieve, M. 2019
Although children residing in statutory out-of-home care and those adopted from care are more likely than not to have mental health difficulties requiring clinical intervention or support, their... Show moreAlthough children residing in statutory out-of-home care and those adopted from care are more likely than not to have mental health difficulties requiring clinical intervention or support, their difficulties often remain undetected. Children’s agencies have a duty of care to identify those child clients who require therapeutic and other support services, without regard to the availability of such services. The present article proposes a first-stage mental health screening procedure (calibrated for high sensitivity) for children and adolescents (ages 4–17) in alternative care, which children’s agencies can implement without clinical oversight using the Strengths and Difficulties Questionnaire (SDQ) and Brief Assessment Checklists (BAC). The screening procedure was derived from analyses of BAC, SDQ, and “proxy SDQ” scores obtained in three national studies of children and adolescents residing in alternative care (Australia, the Netherlands, and England). The SDQ and BAC demonstrated moderate to high screening accuracy across a range of clinical case criteria—the SDQ being slightly better at predicting general mental health problems and the BAC slightly better at predicting attachment- and trauma-related problems. Accurate first-stage screening is achieved using either the SDQ or the BAC alone, with recommended cut points of 10 (i.e., positive screen is 10 or higher) for the SDQ and 7 for the BAC. Greater accuracy is gained from using the SDQ and BAC in parallel, with positive screens defined by an SDQ score of 11 or higher or a BAC score of 8 or higher. Agencies and post-adoption support services should refer positive screens for comprehensive mental health assessment by clinical services. Show less
This study aimed to review and analyze the pathways from care to education and employment, using meta-analysis. Ten meta-analyses were conducted, five to examine the association of placement... Show moreThis study aimed to review and analyze the pathways from care to education and employment, using meta-analysis. Ten meta-analyses were conducted, five to examine the association of placement stability, race, mentoring, gender and education with employment outcomes; and five to examine the association of placement stability, race, mentoring, gender and maltreatment with education outcomes. A systematic literature search in five data bases (PubMed, PsycINFO, ProQuest and Web of Science) identified 12 publications with employment outcomes for youth out of care (N = 9392) and 12 publications with education outcomes (N = 6781). Being a girl and having a high school diploma were found to be related to higher odds of employment. However, no significant overall effects for employment outcomes were found for placement stability, race and mentoring. As regards to education outcomes, meta-analytic results indicated that placement stability is linked with a higher probability of having a high school diploma. The other meta-analyses pointed out the nonexistence of significant differences of educational level considering the variables race, gender, mentoring and type of maltreatment. This study indicated that placement instability in might be where the problem of achieving improvements in care leavers' education and employability actually lies. Limitations, such as sample size and a bias regarding the origin of the studies included, should be considered in interpreting results. Research on factors influencing the trajectories of young people leaving care is still limited, therefore, it is important that more effective studies will be conducted to draw valid conclusions for different child welfare contexts and countries. Show less
Geel, M. van; Goemans, A.; Zwaanswijk, W.; Gini, G.; Vedder, P. 2018
In the current study two meta-analyses are performed on longitudinal studies on peer victimization and self-esteem. The goal of these meta-analyses was to analyze whether a low self-esteem predicts... Show moreIn the current study two meta-analyses are performed on longitudinal studies on peer victimization and self-esteem. The goal of these meta-analyses was to analyze whether a low self-esteem predicts future peer victimization, or whether peer victimization predicts future low self-esteem. The databases PsycINFO, MEDLINE, and ERIC were searched for relevant literature. Two authors independently went through the retrieved articles and found four doctoral dissertations and 14 peer reviewed articles eligible for inclusion in the meta-analysis. Articles were independently coded by two authors, with good interrater agreement. A total of 16,230 youth were included in the meta-analysis on peer victimization and self-esteem, and a total of 16,394 youth were included in the meta-analysis on self-esteem and peer victimization. Significant prospective pathways were found from peer victimization to self-esteem, and from self-esteem to peer victimization, which suggests that peer victimization and self-esteem are related in a transactional manner. Analyses suggested a negligible role of publication bias in the obtained results. Moderator analyses revealed that effect sizes were smaller for studies that used peer reports, and for studies that considered longer time-spans. The results of the current study suggest that peer victimization could have long lasting negative effects on self-esteem, but also point out that children may become victims because of low self-esteem. Show less
Goemans, A.; Geel, M. van; Wilderjans, T.F.; Ginkel, J.R. van; Vedder, P. 2018
Children in foster care are often characterized by low academic outcomes which negatively impact their later lives. School engagement may be a key element to promote their academic and educational... Show moreChildren in foster care are often characterized by low academic outcomes which negatively impact their later lives. School engagement may be a key element to promote their academic and educational outcomes. However, little is known about the development of school engagement in foster children and longitudinal studies are lacking. The current study reports the findings of a three-wave longitudinal study wherein we examined the development of school engagement and analyzed which factors were predictive of school engagement in a sample of 363 Dutch foster children (age range 5–18 years, 46.6% girls). Multilevel analyses showed that characteristics related to demographics, school functioning, foster children, and foster families predicted levels of school engagement of children in foster care. Foster children's behavioral functioning and foster parents’ positive parenting appeared to be characteristics important to consider in screening and interventions. Based on the findings we suggest that teachers and foster care professionals should collaborate to ensure that school engagement and consequently school functioning becomes part of foster children's personal development plans. Show less
The goal of this three-wave longitudinal study was to analyze foster parent stress and foster children’s internalizing and externalizing behaviors in a transactional framework. Participants in this... Show moreThe goal of this three-wave longitudinal study was to analyze foster parent stress and foster children’s internalizing and externalizing behaviors in a transactional framework. Participants in this study were 237 children in foster care in the Netherlands with, mostly, long placement durations (M = 56.86 months, SD = 49.10 months). We examined concurrent, prospective unidirectional and bidirectional relations between foster children’s behavior and foster parent stress by using cross-lagged structural equation modeling and examined whether the results were stable across different subgroups of foster children. In contrast to our hypothesis, we found no bidirectional relations. There were unidirectional prospective pathways from foster children’s internalizing and externalizing problems to foster parent stress, but no significant prospective pathways from foster parent stress to foster children’s internalizing and externalizing problems. The results were fairly stable across different subgroups of foster children. The lack of bidirectional relations was unexpected given the presence of transactional relations in biological parent-child dyads. Foster parents seem not to influence their foster children when it comes to regulating problem behavior. Therefore, the question is whether foster parents can, in more general terms, help their foster children benefit from their improved home environment. Show less
This article focuses on the variability in developmental outcomes of foster children and the implications for foster care research and practice. We first provide a brief overview of our previous... Show moreThis article focuses on the variability in developmental outcomes of foster children and the implications for foster care research and practice. We first provide a brief overview of our previous work, where we have shown by means of meta-analysis and a longitudinal study that foster children greatly vary with respect to their developmental functioning. We then discuss that it is both the heterogeneity of developmental trajectories and the lack of an accurate model for predicting foster children's development that make the screening and monitoring of foster children's development important. We provide suggestions for screening and monitoring, and discuss the Brief Assessment Checklist as an example of a specific instrument available for screening and monitoring of vulnerable children exposed to severe social adversity. We conclude our article with directions to improve foster care and research on foster care, including a discussion of the effectiveness of and foster children's susceptibility to interventions, support for foster parents and the potential of large national and international studies. Show less
Family foster care is the option of choice for children in need of out‐of‐home care in Flanders and the Netherlands. Foster care is however a vulnerable intervention, and questions can be raised as... Show moreFamily foster care is the option of choice for children in need of out‐of‐home care in Flanders and the Netherlands. Foster care is however a vulnerable intervention, and questions can be raised as to its efficacy. Although the literature on placement breakdown has made significant progress during the last years, empirical knowledge regarding breakdown in Flanders and the Netherlands remains scant. Consequently, this study aimed at investigating prevalence and precursors of breakdowns in long‐term foster care, the duration of placement before breakdown, and the association of child and placement characteristics with breakdown. Case files of 271 Dutch and 309 Flemish foster children were analysed with a coding scheme designed for this study. After 6 years, 398 placements had terminated: 169 placements broke down and 229 placements ended positively. Placements broke down mainly because of behavioural problems of the foster child, foster parents' parenting problems, and conflicts between birth and foster parents. Foster children with behavioural problems, older foster children, foster children denied treatment, and foster children in care because of sexual abuse were more at risk of breakdown. Assessing these factors is important when evaluating the appropriateness of a family foster care placement. Show less
This dissertation focuses on the development of children in family foster care and examines which characteristics related to the foster child, the foster family, and the foster placement are... Show moreThis dissertation focuses on the development of children in family foster care and examines which characteristics related to the foster child, the foster family, and the foster placement are associated with foster children’s development. We used meta-analysis and longitudinal research to provide a better insight in foster children’s development. In sum, this dissertation clarifies that foster children vary greatly with respect to their developmental functioning. We found several characteristics related to foster children’s development. Although these characteristics partly explain foster children’s development and thereby provide useful insights, they cannot explain the total variance in foster children’s development. It is both this lack of an accurate model for foster children’s development and the heterogeneity of developmental trajectories that lend significance to screening and monitoring of foster children’s development. We advise foster care agencies to systematically implement screening and monitoring measures in order to capture foster children’s developmental diversity. This enables timely identification of those foster children who experience developmental difficulties and are therefore at risk for negative developmental trajectories and breakdown. Researchers and foster care professionals should establish collaborations in order to improve the validity as well as the feasibility of screening and monitoring children in foster care. Show less
Goemans, A.; Tarren-Sweeney, M.; Geel, M. van; Vedder, P. 2017
Children in foster care experience higher levels and rates of psychosocial difficulties than children from the general population. Governments and child welfare services have a responsibility to... Show moreChildren in foster care experience higher levels and rates of psychosocial difficulties than children from the general population. Governments and child welfare services have a responsibility to identify those children in care who have need for therapeutic services. This can be achieved through systematic screening and monitoring of psychosocial difficulties among all children in foster care. However, general screening and assessment measures such as the Strengths and Difficulties Questionnaire (SDQ) and Child Behavior Checklist (CBCL) might not adequately screen for the range of difficulties experienced by foster children. The Brief Assessment Checklists for Children (BAC-C) and Brief Assessment Checklists for Adolescents (BAC-A) are measures designed to screen for and monitor attachment- and trauma-related difficulties among child welfare populations. This article reports psychometric properties of the BAC-C and BAC-A, estimated in a population study of 219 Dutch foster children. The results suggest the BAC-C and BAC-A perform both screening and monitoring functions well. Their screening accuracy, internal reliability and concurrent validity are comparable to those estimated for the SDQ within the same child and adolescent sample. Future research is needed to assess the value of the Brief Assessment Checklists (BAC) compared to other measures and to validate cut-points for the BAC. This study further establishes the BAC-A and BAC-C as valid and useful mental health screening and monitoring measures for use with children and adolescents in foster care. Show less
