Barbara Needell - Academia.edu (original) (raw)
Papers by Barbara Needell
Scandal has once again brought attention to the nation's child welfare system. In response to the... more Scandal has once again brought attention to the nation's child welfare system. In response to the news that Florida's child welfare bureaucracy could not account for hundreds of children supposedly in its care (2002), investigative journalists have found evidence of similar problems in other states. Ironically, the news that some states cannot even locate children comes at a time when the federal government is in the midst of trying, for the first time, to hold states accountable for achieving quantifiable outcomes for children involved with the child welfare system. These outcomes focus on the safety, permanency and stability of living arrangements, and well-being of children. The juxtaposition of high hopes for improving state accountability for foster children and the continuing legacy of poor performance by child welfare bureaucracies calls for a sober assessment of current federal efforts to help states improve outcomes. This paper critiques the national standards used in the new Child and Family Service Reviews being conducted by the federal government and suggest new directions. First, a historical perspective is provided on current federal policy and a description of the new performance measurement system. The paper then points out the conceptual limitations of the current national standards and uses empirical evidence to illustrate some of these limitations. The paper concludes with recommendations for new standards and additional efforts that will be necessary to ensure that state performance can improve.
Journal of Drug Issues, 1997
An analysis of how violence affects the lives of pregnant, low-income women was undertaken, drawi... more An analysis of how violence affects the lives of pregnant, low-income women was undertaken, drawing from needs assessment data from two diverse California counties. Self-report screening was used to determine risk for heavier or problem substance use. Of 1,147 women, 401 met the screening threshold. The 401 at-risk respondents report significantly higher levels of substance-related violence when compared to the other 746 respondents. Among all respondents, neighborhood substance-related problems, being United States-born, meeting the screening threshold, and being a woman of color were associated with reported substance-related violence among acquaintances. Among the substance-involved sample, neighborhood drug problems, being a woman of color, and being hurt, beaten or taken advantage of due to drugs were associated with violence reports. The implications are that substance-related violence prevention strategies need to focus on the community as well as on the individual and the fa...
PURPOSE: Female youth in foster care often face considerable challenges as they transition to adu... more PURPOSE: Female youth in foster care often face considerable challenges as they transition to adulthood, including homelessness, limited educational and vocational prospects, delinquency, and high rates of substance use and mental heath difficulties. Prior research indicates that early parenting is also more common among current and former foster youth than among non-foster youth, but no studies to date have utilized population-based vital birth record data to measure the incidence of childbearing among girls in foster care. This presentation will describe the prevalence of first births among female foster youth (ages 12-18) in California between 2006 and 2010 and identify demographic characteristics and foster care experiences that impact the risk of giving birth while in out of home care. METHODS: This analysis is based on a unique dataset constructed by probabilistically matching California child protection records for all female youth in foster care between 2006 and 2010 to mate...
ABSTRACT PURPOSE: Pregnancy during adolescence is associated with later adversities for both moth... more ABSTRACT PURPOSE: Pregnancy during adolescence is associated with later adversities for both mother and child, including low birth weight.Although the mechanisms remain unclear, low birth weight among infants born to teenage mothers may be attributable to health behaviors,access to reproductive health services, or unmeasured maternal selection effects. Pregnant teens with a history of maltreatment may have an acute vulnerability to poor birth outcomes. This presentation explores maternal maltreatment history as an independent predictor of low birth weight among infants born to teenage mothers. METHODS: This study uses vital birth records probabilistically matched to administrative child protective service (CPS) records for the state of California. The records of all singleton infants born between 2007 and 2009 to mothers aged 12–19 years were extracted from vital birth files. These records were linked to CPS data to identify teenage mothers for whom an allegation of maltreatment victimization had been substantiated after age 10 and before birth. Low birth weight was based on a gestational weight threshold of 2,500 grams. To isolate the potential effect of maternal maltreatment, a number of potential confounders were included: maternal age; birth order; maternal race/ethnicity; cigarette smoking during pregnancy; birth payment method; prenatal care initiation; Women, Infant, Children (WIC) utilization; and infant gender. Descriptive statistics were computed and χ2 tests used to compare the distribution of maternal maltreatment and other sociodemographic characteristics stratified by infant birth weight. To examine the effect of maternal maltreatment, a log Poisson regression model with a robust variance estimation was specified. RESULTS: Of the 153,762 singleton births to teenage mothers in California between January 1, 2007 and December 31, 2009, 7.1% (n = 10,886) were low birth weight. Among teenage mothers, 13.6% had been substantiated as a victim of maltreatment after age 10 and before giving birth. Maternal maltreatment history was associated with a 10% increased risk of low birth weight (RR: 1.10; 95% CI: 1.04-1.16). Maternal smoking, prenatal care, and other confounders modestly attenuated the association between maternal victimization and infant birth weight, yet after adjusting for these other factors, the risk of low birth weight was still 6% greater among infants born to adolescent mothers with a maltreatment history (RR: 1.06; 95% CI: 1.01-1.12). Bivariate associations observed for covariates continued to emerge in the multivariable model, with the largest relative differences in birth weight associated with race/ethnicity, smoking, and WIC utilization. CONCLUSIONS AND IMPLICATIONS: This study identified the maltreatment history of adolescent mothers as a significant and independent hazard associated with low birth weight. This finding aligns with research which suggests that maltreatment and other adversities negatively affect health and well-being throughout the life course. The association between a history of maltreatment victimization and infant birth weight may reflect physiological changes or chronic maternal stress responses. Regardless of the mechanism and despite the modest effect relative to other risk factors, these findings are provocative in that they suggest that maltreatment not only impacts the health and emotional well-being of individual victims, but may also contribute to intergenerational health disparities.
Maternal and Child Health Journal, 2014
We followed Latino infants prospectively through age 1 to determine whether maternal foreign-born... more We followed Latino infants prospectively through age 1 to determine whether maternal foreign-born status conferred a protective advantage against reported and substantiated maltreatment across Hispanic-origin groups, and whether the likelihood an infant was reported or substantiated for maltreatment varied by Hispanic origin. We drew data for all Latino infants born in California between 2000 and 2006 (N = 1,909,155) from populationbased birth records linked to child protective services data. We used v 2 tests to assess distributional differences in covariates and utilized generalized linear models to estimate the adjusted relative risk of report and substantiation in models stratified by nativity. We observed significant health advantages in reported and substantiated maltreatment for infants of foreign-born mothers within every Hispanic-origin group. Risks of report and substantiation among infants of Mexican and Central/South American mothers were consistently lower than Puerto Rican and Cuban mothers despite socioeconomic disadvantage. The presence of disparities among Hispanic-origin groups in child maltreatment report and substantiation during infancy has implications for the health of Latinos across the life course. Further research is warranted to unravel the complex processes underlying observed relationships. Keywords Latino health paradox Á Latino infant health Á Child maltreatment Á Hispanic health paradox
Funding for this evaluation was provided by California Department of Social Services with additio... more Funding for this evaluation was provided by California Department of Social Services with additional support provided by the Stuart Foundation. 3 4 5 Num ber of Placem ent Moves Percent of Total Kin Non-Kin Although children in kinship care are less likely than children in nonrelated foster care to be reunified with their biological parent within the first 6 months of removal, they are almost as likely to be reunified within 2 years (45% v. 51%) and 3 years (53% v. 57%) and tend to be less likely to reenter care once they have reunified (Needell et al., 2003; Westat & Chapin Hall Center for Children, 2001). Despite the tangible benefits of kinship care and a set of identified service needs (see below), services for both formal and informal kinship caregivers have been slow to materialize. In 1996, a Kinship Care Policy Summit sponsored by CDSS, CWDA and the California Partnership for Children, attended by state foster care administrators, county child welfare leaders, university-based analysts, and child advocates was convened and resulted in an action plan for the State of California. As a result of this collaborative process, legislation was passed in 1997 (Shelley, Chapter 794, Statutes of 1997; amended WIC Section 16605) establishing the Kinship Support Services Program (KSSP). This grants-in-aid program allowed eligible counties to facilitate the creation of community-based kinship support programs designed to provide services to relatives caring for abused and neglected children and those at risk of entering foster care (Appendix I-KSSP Fact Sheet). Although an evaluation component was not originally part of the KSSP legislation, in July 2001 CDSS asked the Center for Social Services Research at UC Berkeley to conduct an outcome evaluation as an addendum to its ongoing contract (California Children's Services Archive) with CDSS. This report presents findings from the beginning of
Journal of Substance Abuse Treatment, 2009
The effect of mothers' participation in substance abuse treatment on reunification with their chi... more The effect of mothers' participation in substance abuse treatment on reunification with their children who are in out-of-home care is an important policy issue. This article examines the predictors of child reunification among mothers who participated in a statewide treatment outcome study. Data were integrated from multiple sources to determine the contributions of characteristics of mothers (n = 1,115), their children (n = 2,299), and treatment programs (n = 43) on reunification outcomes. Hierarchical linear modeling was used to determine the fixed and random effects of mother, child, and program characteristics. Mothers with more employment and psychiatric problems were less likely to be reunified with their children; completion of 90 or more days in treatment approximately doubled their likelihood of reunification. Mothers who were treated in programs providing a "high" level of family-related or education/employment services were approximately twice as likely to reunify with their children as those who were treated in programs with "low" levels of these services.
Journal of Adolescent Health, 2013
This analysis used linked birth and child protective service records to develop the first populat... more This analysis used linked birth and child protective service records to develop the first population-level estimates of maternal maltreatment victimization among adolescent mothers. Findings document that a significant share of adolescent mothers have had contact with child protective services as alleged or substantiated victims of abuse or neglect. These data underscore the importance of better understanding the impact of childhood and adolescent maltreatment on both early childbearing risk and subsequent parenting capacity.
Children and Youth Services Review, 2011
Children and Youth Services Review, 1998
Findings from a four-year study of over 700 adoptions by non-foster parents indicate that opennes... more Findings from a four-year study of over 700 adoptions by non-foster parents indicate that openness has decreased or ceased among a large proportion of adoptions, primarily among those adoptive families who chose openness at the recommendation or insistence of the adoption agency or agent. For all families in the fourth year of their adoption, satisfaction levels and other indicators of adjustment are very positive, with openness bearing little relation to adjustment at this point. Adoption practice in the United States has undergone a dramatic evolution in the past thirty years. Postponed child bearing among two-career couples, changes in the labor force participation of women, birth control and abortion practices, societal acceptance of single motherhood, and an increased push to establish permanent homes for foster children have each contributed to a decreasing availability of infants for adoption and an increased number of adoptable older children with histories of maltreatment (Bachrach, Adams, Sambrano, & London, 1990). These changes in the At the time of the study Marianne Berry and Richard P.
Children and Youth Services Review, 2002
Children and Youth Services Review, 1999
Probability matching software was employed to link AFDC histories for children with birth records... more Probability matching software was employed to link AFDC histories for children with birth records, child abuse reporting data, and foster care data. A total of 63,768 children entering AFDC between 1990 and 1995 in 10 California counties were followed to determine subsequent child welfare involvement. Within 5 years of AFDC entry, 27% of children had child abuse referrals, 22% had child abuse investigations, 8% had child welfare cases opened, and 3% were placed in foster care. Although relatively few children transition from welfare to foster care, AFDC child entrants who later experience child welfare events and their mothers are more likely than others to have certain characteristics such as single parent family structure, larger family size, low birthweight, and late or no prenatal care. Total time on aid and the number of spells on aid are positively associated with child welfare events. It will be important to monitor these findings as welfare reform progresses. Administrative data analysis can suggest ways to effectively target services when fiscal limitations prohibit universal support. A growing series of authors have reflected on the possible impacts of welfare reform on child well-being in general and child maltreatment in par
Children and Youth Services Review, 2011
... 2002 birth cohort Children and Youth Services Review, Volume 33, Issue 8, August 2011, Pages ... more ... 2002 birth cohort Children and Youth Services Review, Volume 33, Issue 8, August 2011, Pages 1337-1344, Emily Putnam-Hornstein, Barbara ... was used to create a rough proxy for family socioeconomic status based on a dichotomous coding of Medi-Cal coverage, California's ...
Children and Youth Services Review, 2003
Children and Youth Services Review, 2004
Scandal has once again brought attention to the nation's child welfare system. In response to the... more Scandal has once again brought attention to the nation's child welfare system. In response to the news that Florida's child welfare bureaucracy could not account for hundreds of children supposedly in its care (2002), investigative journalists have found evidence of similar problems in other states. Ironically, the news that some states cannot even locate children comes at a time when the federal government is in the midst of trying, for the first time, to hold states accountable for achieving quantifiable outcomes for children involved with the child welfare system. These outcomes focus on the safety, permanency and stability of living arrangements, and well-being of children. The juxtaposition of high hopes for improving state accountability for foster children and the continuing legacy of poor performance by child welfare bureaucracies calls for a sober assessment of current federal efforts to help states improve outcomes. This paper critiques the national standards used in the new Child and Family Service Reviews being conducted by the federal government and suggest new directions. First, a historical perspective is provided on current federal policy and a description of the new performance measurement system. The paper then points out the conceptual limitations of the current national standards and uses empirical evidence to illustrate some of these limitations. The paper concludes with recommendations for new standards and additional efforts that will be necessary to ensure that state performance can improve.
Journal of Drug Issues, 1997
An analysis of how violence affects the lives of pregnant, low-income women was undertaken, drawi... more An analysis of how violence affects the lives of pregnant, low-income women was undertaken, drawing from needs assessment data from two diverse California counties. Self-report screening was used to determine risk for heavier or problem substance use. Of 1,147 women, 401 met the screening threshold. The 401 at-risk respondents report significantly higher levels of substance-related violence when compared to the other 746 respondents. Among all respondents, neighborhood substance-related problems, being United States-born, meeting the screening threshold, and being a woman of color were associated with reported substance-related violence among acquaintances. Among the substance-involved sample, neighborhood drug problems, being a woman of color, and being hurt, beaten or taken advantage of due to drugs were associated with violence reports. The implications are that substance-related violence prevention strategies need to focus on the community as well as on the individual and the fa...
PURPOSE: Female youth in foster care often face considerable challenges as they transition to adu... more PURPOSE: Female youth in foster care often face considerable challenges as they transition to adulthood, including homelessness, limited educational and vocational prospects, delinquency, and high rates of substance use and mental heath difficulties. Prior research indicates that early parenting is also more common among current and former foster youth than among non-foster youth, but no studies to date have utilized population-based vital birth record data to measure the incidence of childbearing among girls in foster care. This presentation will describe the prevalence of first births among female foster youth (ages 12-18) in California between 2006 and 2010 and identify demographic characteristics and foster care experiences that impact the risk of giving birth while in out of home care. METHODS: This analysis is based on a unique dataset constructed by probabilistically matching California child protection records for all female youth in foster care between 2006 and 2010 to mate...
ABSTRACT PURPOSE: Pregnancy during adolescence is associated with later adversities for both moth... more ABSTRACT PURPOSE: Pregnancy during adolescence is associated with later adversities for both mother and child, including low birth weight.Although the mechanisms remain unclear, low birth weight among infants born to teenage mothers may be attributable to health behaviors,access to reproductive health services, or unmeasured maternal selection effects. Pregnant teens with a history of maltreatment may have an acute vulnerability to poor birth outcomes. This presentation explores maternal maltreatment history as an independent predictor of low birth weight among infants born to teenage mothers. METHODS: This study uses vital birth records probabilistically matched to administrative child protective service (CPS) records for the state of California. The records of all singleton infants born between 2007 and 2009 to mothers aged 12–19 years were extracted from vital birth files. These records were linked to CPS data to identify teenage mothers for whom an allegation of maltreatment victimization had been substantiated after age 10 and before birth. Low birth weight was based on a gestational weight threshold of 2,500 grams. To isolate the potential effect of maternal maltreatment, a number of potential confounders were included: maternal age; birth order; maternal race/ethnicity; cigarette smoking during pregnancy; birth payment method; prenatal care initiation; Women, Infant, Children (WIC) utilization; and infant gender. Descriptive statistics were computed and χ2 tests used to compare the distribution of maternal maltreatment and other sociodemographic characteristics stratified by infant birth weight. To examine the effect of maternal maltreatment, a log Poisson regression model with a robust variance estimation was specified. RESULTS: Of the 153,762 singleton births to teenage mothers in California between January 1, 2007 and December 31, 2009, 7.1% (n = 10,886) were low birth weight. Among teenage mothers, 13.6% had been substantiated as a victim of maltreatment after age 10 and before giving birth. Maternal maltreatment history was associated with a 10% increased risk of low birth weight (RR: 1.10; 95% CI: 1.04-1.16). Maternal smoking, prenatal care, and other confounders modestly attenuated the association between maternal victimization and infant birth weight, yet after adjusting for these other factors, the risk of low birth weight was still 6% greater among infants born to adolescent mothers with a maltreatment history (RR: 1.06; 95% CI: 1.01-1.12). Bivariate associations observed for covariates continued to emerge in the multivariable model, with the largest relative differences in birth weight associated with race/ethnicity, smoking, and WIC utilization. CONCLUSIONS AND IMPLICATIONS: This study identified the maltreatment history of adolescent mothers as a significant and independent hazard associated with low birth weight. This finding aligns with research which suggests that maltreatment and other adversities negatively affect health and well-being throughout the life course. The association between a history of maltreatment victimization and infant birth weight may reflect physiological changes or chronic maternal stress responses. Regardless of the mechanism and despite the modest effect relative to other risk factors, these findings are provocative in that they suggest that maltreatment not only impacts the health and emotional well-being of individual victims, but may also contribute to intergenerational health disparities.
Maternal and Child Health Journal, 2014
We followed Latino infants prospectively through age 1 to determine whether maternal foreign-born... more We followed Latino infants prospectively through age 1 to determine whether maternal foreign-born status conferred a protective advantage against reported and substantiated maltreatment across Hispanic-origin groups, and whether the likelihood an infant was reported or substantiated for maltreatment varied by Hispanic origin. We drew data for all Latino infants born in California between 2000 and 2006 (N = 1,909,155) from populationbased birth records linked to child protective services data. We used v 2 tests to assess distributional differences in covariates and utilized generalized linear models to estimate the adjusted relative risk of report and substantiation in models stratified by nativity. We observed significant health advantages in reported and substantiated maltreatment for infants of foreign-born mothers within every Hispanic-origin group. Risks of report and substantiation among infants of Mexican and Central/South American mothers were consistently lower than Puerto Rican and Cuban mothers despite socioeconomic disadvantage. The presence of disparities among Hispanic-origin groups in child maltreatment report and substantiation during infancy has implications for the health of Latinos across the life course. Further research is warranted to unravel the complex processes underlying observed relationships. Keywords Latino health paradox Á Latino infant health Á Child maltreatment Á Hispanic health paradox
Funding for this evaluation was provided by California Department of Social Services with additio... more Funding for this evaluation was provided by California Department of Social Services with additional support provided by the Stuart Foundation. 3 4 5 Num ber of Placem ent Moves Percent of Total Kin Non-Kin Although children in kinship care are less likely than children in nonrelated foster care to be reunified with their biological parent within the first 6 months of removal, they are almost as likely to be reunified within 2 years (45% v. 51%) and 3 years (53% v. 57%) and tend to be less likely to reenter care once they have reunified (Needell et al., 2003; Westat & Chapin Hall Center for Children, 2001). Despite the tangible benefits of kinship care and a set of identified service needs (see below), services for both formal and informal kinship caregivers have been slow to materialize. In 1996, a Kinship Care Policy Summit sponsored by CDSS, CWDA and the California Partnership for Children, attended by state foster care administrators, county child welfare leaders, university-based analysts, and child advocates was convened and resulted in an action plan for the State of California. As a result of this collaborative process, legislation was passed in 1997 (Shelley, Chapter 794, Statutes of 1997; amended WIC Section 16605) establishing the Kinship Support Services Program (KSSP). This grants-in-aid program allowed eligible counties to facilitate the creation of community-based kinship support programs designed to provide services to relatives caring for abused and neglected children and those at risk of entering foster care (Appendix I-KSSP Fact Sheet). Although an evaluation component was not originally part of the KSSP legislation, in July 2001 CDSS asked the Center for Social Services Research at UC Berkeley to conduct an outcome evaluation as an addendum to its ongoing contract (California Children's Services Archive) with CDSS. This report presents findings from the beginning of
Journal of Substance Abuse Treatment, 2009
The effect of mothers' participation in substance abuse treatment on reunification with their chi... more The effect of mothers' participation in substance abuse treatment on reunification with their children who are in out-of-home care is an important policy issue. This article examines the predictors of child reunification among mothers who participated in a statewide treatment outcome study. Data were integrated from multiple sources to determine the contributions of characteristics of mothers (n = 1,115), their children (n = 2,299), and treatment programs (n = 43) on reunification outcomes. Hierarchical linear modeling was used to determine the fixed and random effects of mother, child, and program characteristics. Mothers with more employment and psychiatric problems were less likely to be reunified with their children; completion of 90 or more days in treatment approximately doubled their likelihood of reunification. Mothers who were treated in programs providing a "high" level of family-related or education/employment services were approximately twice as likely to reunify with their children as those who were treated in programs with "low" levels of these services.
Journal of Adolescent Health, 2013
This analysis used linked birth and child protective service records to develop the first populat... more This analysis used linked birth and child protective service records to develop the first population-level estimates of maternal maltreatment victimization among adolescent mothers. Findings document that a significant share of adolescent mothers have had contact with child protective services as alleged or substantiated victims of abuse or neglect. These data underscore the importance of better understanding the impact of childhood and adolescent maltreatment on both early childbearing risk and subsequent parenting capacity.
Children and Youth Services Review, 2011
Children and Youth Services Review, 1998
Findings from a four-year study of over 700 adoptions by non-foster parents indicate that opennes... more Findings from a four-year study of over 700 adoptions by non-foster parents indicate that openness has decreased or ceased among a large proportion of adoptions, primarily among those adoptive families who chose openness at the recommendation or insistence of the adoption agency or agent. For all families in the fourth year of their adoption, satisfaction levels and other indicators of adjustment are very positive, with openness bearing little relation to adjustment at this point. Adoption practice in the United States has undergone a dramatic evolution in the past thirty years. Postponed child bearing among two-career couples, changes in the labor force participation of women, birth control and abortion practices, societal acceptance of single motherhood, and an increased push to establish permanent homes for foster children have each contributed to a decreasing availability of infants for adoption and an increased number of adoptable older children with histories of maltreatment (Bachrach, Adams, Sambrano, & London, 1990). These changes in the At the time of the study Marianne Berry and Richard P.
Children and Youth Services Review, 2002
Children and Youth Services Review, 1999
Probability matching software was employed to link AFDC histories for children with birth records... more Probability matching software was employed to link AFDC histories for children with birth records, child abuse reporting data, and foster care data. A total of 63,768 children entering AFDC between 1990 and 1995 in 10 California counties were followed to determine subsequent child welfare involvement. Within 5 years of AFDC entry, 27% of children had child abuse referrals, 22% had child abuse investigations, 8% had child welfare cases opened, and 3% were placed in foster care. Although relatively few children transition from welfare to foster care, AFDC child entrants who later experience child welfare events and their mothers are more likely than others to have certain characteristics such as single parent family structure, larger family size, low birthweight, and late or no prenatal care. Total time on aid and the number of spells on aid are positively associated with child welfare events. It will be important to monitor these findings as welfare reform progresses. Administrative data analysis can suggest ways to effectively target services when fiscal limitations prohibit universal support. A growing series of authors have reflected on the possible impacts of welfare reform on child well-being in general and child maltreatment in par
Children and Youth Services Review, 2011
... 2002 birth cohort Children and Youth Services Review, Volume 33, Issue 8, August 2011, Pages ... more ... 2002 birth cohort Children and Youth Services Review, Volume 33, Issue 8, August 2011, Pages 1337-1344, Emily Putnam-Hornstein, Barbara ... was used to create a rough proxy for family socioeconomic status based on a dichotomous coding of Medi-Cal coverage, California's ...
Children and Youth Services Review, 2003
Children and Youth Services Review, 2004