Frontline For Children | January 2021

  1. Children and Youth with Special Health Care Needs in Foster Care (Child Trends)

“In this brief, Child Trends examines the prevalence of children and youth with special health care needs (CYSHCN) in the foster care system. CYSHCN have—or are at increased risk for—chronic physical, developmental, or behavioral/emotional conditions. This brief provides an overview of the literature on CYSHCN and their experiences in the foster care system, a detailed explanation of the methodology used for the current brief, an explanation of our findings, and a brief discussion of practice and policy implications.” A key finding of this research suggests that “children and youth’s reasons for entering foster care, their experiences while in care, and their reasons for leaving care vary depending on whether they have an SHCN.”

TexProtects Takeaway: 18% of children in Texas foster care have special health care needs with older youth and Black or Hispanic children having a higher likelihood of having an identified special health care need. These children come into foster care for different reasons than their peers and have different experiences and needs. More must be done to identify which placements and strategies are available and needed to best ensure their safety and success in care.

2. Trends in U.S. Emergency Department Visits Related to Suspected or Confirmed Child Abuse and Neglect Among Children and Adolescents Aged 18 Years Before and During the COVID-19 Pandemic — United States, January 2019–September 2020 (Swedo, E. et al.)

This feature of the MMWR features research on national child maltreatment reports during eight months of the global pandemic. Findings suggest that during COVID-19, “the total number of emergency department visits related to child abuse and neglect decreased, but the percentage of such visits resulting in hospitalization increased, compared with 2019. The pandemic has affected health care–seeking patterns for child abuse and neglect, raising concerns that victims might not have received care and that severity of injuries remained stable or worsened. Implementation of strategies to prevent child abuse and neglect is important, particularly during public health emergencies.”

3. The Neglected Ones: Time at Home During COVID-19 and Child Maltreatment (Bullinger, L., Raissian, K., Feely, M., & Schneider, W.)

“We combine early release child maltreatment reports in Indiana with unique and newly available mobile phone movement data to better understand the relationship between staying at home intensively during the COVID-19 pandemic and child maltreatment. Our findings indicate that the prolonged stays at home promoted by the public health response to COVID-19 resulted in reductions in child maltreatment reports overall and in substantiated reports of maltreatment. However, relative to areas that stayed home less, children in areas that stayed home more were more likely to be both reported for and a confirmed victim of maltreatment, particularly neglect. These areas have historically been socioeconomically advantaged and experienced lower rates of maltreatment. We only observe increases in confirmed child maltreatment in metropolitan counties, suggesting that the effects of staying home on child maltreatment may reflect both the differential risk of leaving home and access to services in metropolitan–rather than non-metropolitan–counties.”

TexProtects Takeaway: Despite the decreases in reports during the earlier months of COVID-19, research supports an assumption that the stresses of COVID-19 on families is likely increasing the risk of child maltreatment. TexProtects wrote a brief summarizing relevant research that points to the ways in which economic recessions, unemployment, increases in family violence, mental health, substance use, and parental stress have been correlated to increases in child abuse and neglect.

4. Child Well-Being Spotlight: Children Living in Kinship Care and Nonrelative Foster Care Are Unlikely to Receive Needed Early Intervention or Special Education Services (OPRE & RTI International)

“The purpose of the spotlight is to examine the degree to which early intervention and special education services are being received by children who may have developmental delays and/or compromised cognitive or academic functioning, and the difference in unmet needs between children in voluntary kinship care, formal kinship care, and nonrelative foster care.” Findings indicate that young children (ages 0-2) in nonrelative foster care are significantly likelier than those in formal kinship care or voluntary kinship care to have a developmental delay. Further, among children ages 3-17 in foster care, those in nonrelative foster care and formal kinship care are likelier to have developmental delays than those in voluntary kinship care. Authors state: “it is especially important to note that across all types of placements, most children involved with the CWS who potentially need these critical services do not receive them.”

TexProtects Takeaway: Kinship care can be a safer and more effective placement for children involved with the child protection system. TexProtects is a big proponent of putting policies in place to provide more support and access to resources to kinship caregivers, whether formal or voluntary, so that they may provide the best care for children. 

5. Supporting Social-Emotional and Mental Health Needs of Young Children Through Part C Early Intervention: Results of a 50-State Survey (National Center for Children in Poverty & Georgetown University Health Policy Institute, Center for Children and Families)

“This report examines features of states’ Part C Early Intervention programs that help them identify and serve infants and toddlers with social-emotional (SE) delays and mental health conditions. A 50-state survey conducted by the National Center for Children in Poverty and Georgetown University Center for Children and Families asked state Part C Coordinators about their programs’ policies and procedures related to screening, evaluation, eligibility, services, and financing that affect the program’s capacity to meet the SE needs of infants and toddlers. The survey results are shared in this report, along with information from follow-up interviews with state Part C Coordinators. Overall, the findings point to both critical gaps in the capacity of Part C programs to meet infant-toddler SE and mental health needs and promising strategies some states are using to support children in this domain.”

TexProtects Takeaway: Increasing access and quality in Early Childhood Intervention (ECI) is a policy agenda item for the Prenatal to Three Collaborative and an unexpected but effective part of a robust system to prevent child abuse and neglect. ECI providers in Texas face numerous obstacles and this session, the legislature must increase investments so that the rates per child are adequate to meet demand and deliver quality.

6. COVID-19 Job and Income Loss Jeopardize Child Well-Being: Income Support Policies Can Help (Gennetian, L., Gassman-Pines, A., & Society for Research in Child Development)

“The burdens of job loss and continued economic uncertainty are felt by a wide range of families, though they are especially elevated among lower-income households and families of color. COVID-19-driven increases in job loss, income instability, and resulting strains on housing and food security are impairing child and family wellbeing. Temporary policy supports – such as stimulus checks, expanded Unemployment Insurance (UI) benefits, rent moratoriums, and expanded food programs – helped stem these losses and protect children.” Given the demonstrated ability of income support policies to mitigate harm among children and families experiencing unemployment and insufficient access to basic needs during the global pandemic, these researchers recommend that policymakers renew and reinstate economic supports.

TexProtects Takeaway: A healthy child comes from a healthy family. Especially during this pandemic, children and their families need economic support to stay safe, nurtured, and resilient. Policymakers can ease one aspect of childhood adversity – income instability — by making sure families who are struggling get the support they need.

7. 50-State Comparison: Early Care and Education Governance (Education Commission of the States)

“This 50-State Comparison provides data on states’ early care and education governance systems, with a focus on the agencies that oversee these programs, the level of alignment of these programs and the advisory entities for early care and education in the state.” The individual profile for Texas can be found here.

TexProtects Takeaway: Texas has an increasingly fragmented system of care for young children and their families that includes the Texas Workforce Commission, Texas Education Agency, Department of Family and Protective Services, Head Start Collaboration Office, and Health and Human Services among others. which makes collaboration, strategy, and coordination critical elements. The Texas Early Learning Council and PN3 Collaborative are a few of the groups working on improving collaboration and alignment to better ensure access and effectiveness of early childhood supports and services.

8. How Racism Can Affect Child Development (Harvard University: Center On the Developing Child)

“Advances in science are presenting an increasingly clear picture of how significant adversity in the lives of young children can disrupt the development of the brain and other biological systems. These early disruptions can undermine young children’s opportunities to achieve their full potential. And, while they may be invisible to those who do not experience them, there is no doubt that both systemic racism and interpersonal discrimination can lead to chronic stress activation that imposes significant hardships on families raising young children.”

TexProtects Takeaway: Childhood adversity and racism are some of the greatest public health crises in the U.S. We are working hard this legislative session with policymakers to create a Texas framework to address and prevent childhood adversity in our state. Stay tuned for ways you can advocate for this framework by signing up for our advocacy alerts on our home page.  

9. Considerations for Scaling Evidence-Based Prevention Programs under the Family First Prevention Services Act

“The federal Family First Prevention Services Act of 2018 (Family First Act) seeks to keep children safely with their families through the provision of evidence-based services to prevent foster care entry… In this brief, we present two evidence-based models (EBMs), implemented in NYC, as case studies: Brief Strategic Family Therapy (BSFT) and Child Parent Psychotherapy (CPP). Drawing on interviews with the purveyors of the two EBMs, as well as community-based provider agencies, we identify four key factors that influence the scale-up of EBMs in child welfare.

In addition to the brief above, the authors developed a fact sheet on program purveyors. “Program purveyors, who disseminate their program models through activities such as training staff and providing technical assistance, play an essential role in successfully implementing evidence-based models and scaling services. This fact sheet provides an overview of the role of purveyors in implementation and identifies four factors that may impact purveyors’ capacity to scale services under the Family First Act.”

TexProtects Takeaway: It is important to continue assessing various strongly-backed evidence-based models that could be included under FFPSA as promising, supported, or well-supported. States must begin scaling up their use of these models under FFPSA to better serve vulnerable and at-risk children and families.

10. Using Operations Research & Analytics to Increase the Effectiveness of Service Allocation to Families with Infants Out of Home Care Due to Substance Abuse in the Texas Child Welfare System (Barrameda, C., Clemente, J., Conroy, J., & Calnan, M.)

“This project is an extension of a 2018-2019 academic year MQP that conducted an initial investigation improving service allocation in the United States child welfare system. Our team narrowed the scope of the project by improving service allocation to infants from urban areas of Texas who were placed into foster care as a result of parental substance abuse. Through predictive analytics, we determined the impact services and other factors had on a child’s length of stay in the system. Then using prescriptive analytics, we developed a mechanism that reallocates services to minimize a child’s length of stay in the system. Our results demonstrate an opportunity to improve service allocation by examining both a child’s case details and the environmental factors surrounding their case.”

TexProtects Takeaway: Child involvement with the child welfare system due to parental substance use is a subject that needs more attention. TexProtects advocates for these children to receive the best care possible, including minimizing their continued involvement in the system. Texas can take note from this study to better improve service allocation to these vulnerable children and families.

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