Research of Note for February 2002

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This month’s Research Watch has some good news about teen pregnancy and potentially good news about foster care. Unfortunately, there are worrisome findings about “father figures” in the home.

Does Foster Care Help Kids?

Foster Care Placement Improves Children’s Functioning
Sarah McCue Horwitz, Ph.D., Kathleen Balestracci, Ph.D., and Mark Simms, M.D., M.P.H.
Archives in Pediatrics and Adolescent Medicine, Vol. 155, Nov. 2001, pp. 1255-1260. Free from Horwitz at the Department of Epidemiology, Yale School of Medicine, 60 College St., New Haven, CT 06520-8034, or

Every once in a while, a research finding that should seem obvious seems surprising. In this case, a new study shows that placement in foster care is good for many kids.

This should not be surprising. After all, 547,000 U.S. children were in foster care in 1999. We wouldn’t spend billions of dollars to take kids from their homes and place them in foster care unless society thought it would do some good (although some critics claim that foster care is overused). Most children enter foster care with physical or mental health problems, or developmental and educational deficits.

Even as the number of kids in foster care has risen – with 35 percent more kids in foster care in 1999 compared to 1990 – bashing foster care has become a national pastime. This study suggests that even with its shortcomings, foster care can represent an improvement over a child’s home. But how persuasive are the findings?

The study was conducted on all the children entering foster care in one region in Connecticut during 18 months in 1992-93. The 120 children ranged in age from 11 months to 6 years and 4 months, evenly split between males and females.

Forty-three percent of the children had been neglected, 14 percent had been physically abused, 2 percent had been sexually abused, and the others were at high risk for abuse. Most (81 percent) were in their first foster home. Two-thirds had medical problems, one-third had poor language scores, and one out of four had serious behavior problems.

Two-thirds of the foster mothers had at least a high school education, and half were homemakers. One-third were new foster parents, and one-third had been foster parents for at least six years.

At the time they entered foster care, the children had an average score of 79.5 on the Vineland Adaptive Behavior Scale (VABS), which is below average. The VABS measures personal independence and social skills, as measured by the foster parent. After six months in foster care, their VABS scores had increased to 86.5, and by 12 months it had increased to 94.5, which was within “normal” range.

Which kids were most likely to improve while in foster care? African-Americans, girls and older kids were most likely to improve, as were those who had been placed because of abuse, those who spent a longer time in foster care, and those for whom there were fewer recommended services while in foster care.

Are these results credible? There is no reason to doubt that some kids improved more than others, but an evaluation made by foster parents could be biased, since it is human nature to see improvement when you’re the one in charge. This is a major flaw of the study.

Another flaw of the study is that it compared scores for the children when they first entered foster care to their scores six months and a year later. Since the first scores were based on their behavior when they had just been removed from their homes and placed with strangers, this could be an especially low point, and improvement would seem inevitable.

However, the children improved just as much in the second six months as they did during the first six months, which suggests that, overall, foster care provides an environment that helps children do better than they were doing in unhealthy homes.

Children also improved even if they changed foster homes, which suggests the improvement is real and not just the result of the foster parent’s biased evaluation. However, a better-designed study would have first evaluated the children while they were still at home, and the evaluations would have been done by an independent observer.

Since most of the children were in their first foster care placement, and most others in their second placement, the results are not relevant to the serial placements that some children experience. The researchers point out that some kids seem to benefit more than others.

These conclusions are reasonable, but this study is not designed well enough to provide enthusiastic support for foster care. It certainly points to the kind of research that is needed to determine which kids are likely to benefit the most.

Father Figures are the Answer, But What is the Question?

Are Father Surrogates a Risk Factor for Child Maltreatment?
Aruna Radhakrishna, Ingrid Bou-Saada, Wanda Hunter, Diane Catellier and Jonathan Koch
Child Maltreatment, Vol. 6, No. 4, Nov. 2001. Available free from Radhakrishna, Maternal and Child Health, CB# 7445 Rosenau Hall, University of North Carolina, Chapel Hill, NC 27599-7445, or

In fairy tales the stepmother is the enemy, but father surrogates are usually considered a great addition to a family. The conventional wisdom is that children of single mothers, especially boys, need a man in the home to provide a role model.

News stories, on the other hand, provide many examples where a stepfather or boyfriend is the villain. Unfortunately, a new report supports the latter stereotype: Children with a father surrogate living at home are twice as likely to be reported for maltreatment after the man’s entry into the home than are those with either a biological father at home or no father figure at all.

The study focused on North Carolina newborns from hospitals in 37 counties, most from families where the risk of abuse or neglect seemed high. Of the 644 mother-infant pairs recruited for the study, one-third (221) were reported for abuse or neglect during the next four years. This study is based on 70 of these families and 140 families matched for age, race, sex and income that were not reported.

Of the almost 200 children who were living with their biological mothers, approximately 15 percent reported abuse between the fourth and sixth years, and an additional 15 percent between the sixth and the eighth year. In any of these time periods, maltreatment was most likely in homes with a stepfather (20 percent between the fourth and sixth year and 27 percent between the sixth and eighth year). Maltreatment was lowest among children who lived with two biological parents, but the difference in maltreatment between kids living with both parents and kids living with only the biological mother was not statistically significant.

It is important to note that most of the father surrogates were not stepfathers; most were boyfriends rather than husbands. The researchers reported anecdotally that when a report was filed against the abusive man, he often disappeared from the child protective services system, while the mother was accused of neglect because she failed to protect her child.

The implications for youth workers, especially those within or working with the child protective services system, are clear: Programs and services are needed to reduce the risk that father substitutes will harm children, and children in homes with an unrelated adult male may need special attention to keep them safe.

Teen Birth Rates at All Time Low

Emerging Answers: Research Findings on Programs to Reduce Teen Pregnancy
Douglas Kirby, Ph.D.
National Campaign to Prevent Teen Pregnancy, May 2001. Summary (11 pages) available free at; $15 for the report online or by calling (202) 478-8500.

Teen pregnancy, abortion and birth rates have been declining every year since 1991, and teen birth rates are now at the lowest rate since they have been recorded, according to this new report from the National Campaign to Prevent Teen Pregnancy.

The report cites several reasons for this good news. One is that some sex and HIV education programs are working – in fact, there is evidence that they have sustained influence for as long as three years. According to this report, the programs that work best combine sexuality education and youth development.

Before we bring out the champagne, it’s important to note that the U.S. teen pregnancy rate is still high: Almost 10 percent of 15- to 19-year-old girls became pregnant in 1996 (the most recent year quoted in the report). The fact that the rate is at an “all-time low” since statistics have been compiled is good news, but statistics have been compiled for less than 30 years. (Teen birth rates are available going back more years, but that’s a different statistic than pregnancy).

There were about 880,000 teen pregnancies in the United States in 1996. That is almost twice as high as Canada, England and Wales, and more than four times as high as France. Also, almost 25,000 girls 14 or younger became pregnant that same year. Teen pregnancy rates for 15- to 19-year-old girls are highest for African-Americans (18 percent) and Hispanics (17 percent) and lowest among non-Hispanic whites (7 percent).

The report provides a great deal of information about research that has been conducted and programs that have been implemented, synthesizing research findings on programs that work. The report lists 10 characteristics of effective pregnancy prevention programs, and also describes them in a way that can be used by youth workers:

1. Focus narrowly on reducing one or more sexual behaviors that lead to unintended pregnancy or HIV/STD infection.

2. Base the program on theoretical approaches developed to treat other risky behaviors, such as cognitive behavioral theory, which rewards changes in thoughts and behavior.

3. Give a clear message about sexual activity and condom or contraceptive use and continually reinforce that message.

4. Provide basic, accurate information about risks and methods to avoid intercourse or pregnancy and STDs.

5. Include activities that teach kids to deal with social pressures, such as information that helps them refute frequently used lines like “everyone does it” or activities that generate peer support for withstanding social pressures.

6. Model and provide practice with negotiation and refusal skills, such as how to say no, how to insist on condoms or other contraception, and how to make sure body language supports the verbal message.

7. Use a variety of teaching methods to involve participants and personalize the information.

8. Incorporate behavioral goals, teaching methods and materials that are specific to the age, culture and sexual experience of the students.

9. Run the program over a sufficient period of time (at least 14 hours or in small group settings).

10. Train teachers, youth workers or peer leaders (generally for at least six hours) who believe in the program.

The report is an excellent resource because it clearly summarizes what research tells us about teens who have more sexual partners, have sex more frequently, use contraception or become pregnant. For example, teens who have more sexual partners are more likely to be male, have divorced parents, come from more affluent homes and are more likely to have been physically abused. Teens who have fewer sexual partners tend to communicate more with family members, are more closely supervised by their parents, are more concerned about sexually transmitted diseases, attend church more often, have a mentor in the community and have more social support in the community.

The campaign is a nonprofit organization that has brought together experts from a wide range of ideological perspectives to work together to decrease teen pregnancy. The report’s message from campaign Director Sarah Brown urges youth workers not to adopt “simplistic solutions with little chance of making a dent” and to “be encouraged by declining rates and new research showing that some programs are making a difference.”