October 2013 – September 2017
This project evaluates Wisconsinâs Family Foundations Home Visiting (FFHV) Program, which coordinates home visiting programs across 15 counties and 4 tribal regions. The study examines whether Wisconsinâs evidence-based home visiting services are associated with expected client and program outcomes in...
Youth with good mental health develop skills and capacities that become the basis for strong communities. Toxic levels of stress and trauma negatively impact the architecture of a youth’s developing brain, which has lasting effects into adulthood. Youth in foster care face these challenges and many others, which contribute with significantly...
July 2011 – June 2014
Parent-Child Interaction Therapy (PCIT) is an empirically validated treatment for externalizing behavior problems in young children. Foster children are at an especially high risk of developing externalizing problems, difficulties that their foster parents are not often trained to manage effectively.
PCIT...
October 2007 – September 2013
Wisconsinâs Western Region is the area of the state with the highest concentration of methamphetamine abuse, and on par with the state as a whole in its problems with alcohol. This project responded to those needs by forming an alliance among state, regional, and county/tribe-level partners who are committed...
Objective
Research indicates that foster parents often do not receive sufficient training and support to help them meet the demands of caring for foster children with emotional and behavioral disturbances. Parent-Child Interaction Therapy (PCIT) is a clinically efficacious intervention for child externalizing problems, and it also has been shown to mitigate parenting stress and enhance parenting attitudes and behaviors. However, PCIT is seldom available to foster families, and it rarely has been tested under intervention conditions that are generalizable to community-based child welfare service contexts. To address this gap, PCIT was adapted and implemented in a field experiment using two novel approaches â group-based training and telephone consultation â both of which have the potential to be integrated into usual care.
Method
This study analyzes 129 foster-parent-child dyads who were randomly assigned to one of three conditions: (a) waitlist control, (b) brief PCIT, and (c) extended PCIT. Self-report and observational data were gathered at multiple time points up to 14 weeks post baseline.
Results
Findings from mixed-model, repeated measures analyses indicated that the brief and extended PCIT interventions were associated with a significant decrease in self-reported parenting stress. Results from mixed-effects generalized linear models showed that the interventions also led to significant improvements in observed indicators of positive and negative parenting. The brief course of PCIT was as efficacious as the extended PCIT intervention.
Conclusion
The findings suggest that usual training and support services can be improved upon by introducing foster parents to experiential, interactive PCIT training.
Janczewski, C.E. (2015). The influence of differential response on decision-making in child protective service agencies. Child Abuse and Neglect.
Objective
Differential response (DR) profoundly changes the decision pathways of public child welfare systems, yet little is known about how DR shapes the experiences of children whose reports receive an investigation rather than an alternate response. Using data from the National Child Abuse and Neglect Data System (NCANDS), this study examined the relationship between DR implementation and decision outcomes in neglect cases, as measured by investigation, substantiation, and removal rates in 297 U.S. counties.
Method
Multivariate regression models included county-level measures of child poverty and proportions of African American children. Path analyses were also conducted to identify mediating effects of prior decision points and moderating effects of DR on poverty and raceâs influence on decision outcomes.
Results
Results indicate that compared to non-DR counties, those implementing DR have significantly lower investigation and substantiation rates within county populations but higher substantiation rates among investigated cases. Regression models showed significant reductions in removal rates associated with DR implementation, but these effects became insignificant in path models that accounted for mediation effects of previous decision points. Findings also suggest that DR implementation may reduce the positive association between child poverty rates and investigation rates, but additional studies with larger samples are needed to confirm this moderation effect. Two methods of calculating decision outcomes, population- and decision based enumeration, were used, and policy and research implications of each are discussed.
Conclusion
This study demonstrates that despite their inherit complexity, large administrative datasets such as NCANDS can be used to assess the impact of wide-scale system change across jurisdictions.
This article describes an implementation project in which parent-child interaction therapy was adapted for and tested within foster parent training services. The authors recount multiple steps involved in translating an evidence-based intervention to child welfare services: (a) specifying the child welfare context for implementation and testing purposes, choosing an intervention model that responded to child welfare service needs, and tailoring the model for the child welfare setting; (b) securing external funding and initiating sustainability plans; and (c) forging a university-community partnership. The article concludes with a discussion of promising preliminary study results, future implementation plans, and lessons learned.
Mersky, J.P., Topitzes, J., Grant-Savela, S., Brondino, M., McNeil, C. (2014). Adapting parent-child interaction therapy to foster care: Outcomes from a randomized trial. Research on Social Work Practice.
Objective
This study presents outcomes from a randomized trial of a novel Parent-Child Interaction Therapy (PCIT) model for foster families. Differential effects of two intervention doses on child externalizing and internalizing symptoms are examined.
Method
A sample of 102 foster children was assigned to one of three conditionsâbrief PCIT, extended PCIT, or wait-list control. The brief and extended groups received 2 days of PCIT training and 8 weeks of telephone consultation. The extended PCIT group received an additional booster training plus 6 more weeks of consultation. Wait-list controls received services as usual. Tests of change over time were estimated using mixed-model repeated measures analysis of covariance.
Results
Compared to controls, children in both PCIT groups exhibited a greater reduction in externalizing and internalizing scores over time. Pairwise contrasts of the two PCIT conditions yielded mixed results.
Conclusion
Results indicate that PCIT can be tailored efficaciously for foster families using alternative treatment modalities.
Mersky, J.P., Topitzes, J., Reynolds, A. (2013). Impacts of adverse childhood experiences on health, mental health, and substance use in early adulthood: A cohort study of an urban, minority sample in the U.S. Child Abuse and Neglect.
Objective
Research has shown that adverse childhood experiences (ACEs) increase the risk of poor health-related outcomes in later life. Less is known about the consequences of ACEs in early adulthood or among diverse samples. Therefore, we investigated the impacts of differential exposure to ACEs on an urban, minority sample of young adults.
Method
Health, mental health, and substance use outcomes were examined alone and in aggregate. Potential moderating effects of sex were also explored. Data were derived from the Chicago Longitudinal Study, a panel investigation of individuals who were born in 1979 or 1980. Main-effect analyses were conducted with multivariate logistic and OLS regression. Sex differences were explored with stratified analysis, followed by tests of interaction effects with the full sample.
Results
Results confirmed that there was a robust association between ACEs and poor outcomes in early adulthood. Greater levels of adversity were associated with poorer self-rated health and life satisfaction, as well as more frequent depressive symptoms, anxiety, tobacco use, alcohol use, and marijuana use. Cumulative adversity also was associated with cumulative effects across domains. For instance, compared to individuals without an ACE, individuals exposed to multiple ACEs were more likely to have three or more poor outcomes (OR range = 2.75â10.15) and four or more poor outcomes (OR range = 3.93â15.18). No significant differences between males and females were detected.
Conclusion
Given that the consequences of ACEs in early adulthood may lead to later morbidity and mortality, increased investment in programs and policies that prevent ACEs and ameliorate their impacts is warranted.
Topitzes, J., Mersky, J.P., Dezen, K., Reynolds, A. (2013). Adult resilience among maltreated children: A prospective investigation of main effect and mediating models. Children and Youth Services Review.
Objective
Studies examining resilience to child maltreatment reveal that maltreatment victims can achieve adaptive functioning in several areas of development; however, few of these individuals persistently demonstrate resilience across multiple domains. The majority of these investigations deďŹne adjustment with a limited number of outcomes measured proximal in time to the maltreatment experience. In contrast, this study measured adjustment across a diverse set of domains during early adulthood (ages 16â24), a number of years after the occurrence of childhood maltreatment (ages 0â11).
Method
Main effect and mediation analyses were conducted. Data were derived from the Chicago Longitudinal Study, an examination of 1539 minority individuals born in low-income Chicago-area neighborhoods in 1979 or 1980. Study participants were followed prospectively from birth through age 24. Maltreatment data originated from ofďŹcial court and child protective service records. Parent report, self report, and administrative sources informed covariate, mediator and outcome measures.
Results
Results from multivariate probit regression revealed that childhood maltreatment signiďŹcantly and negatively predicted adult resilience. Exploratory and conďŹrmatory mediation analyses showed that the following adolescent indicators helped explain the long-term association between childhood maltreatment and young adult adjustment: school moves and out-of-home placement, reading ability, acting out behavior, social skills, juvenile delinquency, commitment to school, and expectation to attend college.
Conclusion
Implications of results are explored.
Mersky, J.P., Janczewski, C.E. (2013). Adult well-being of foster care alumni: Comparisons to other child welfare recipients and a non-child welfare sample in a high-risk, urban setting. Children and Youth Services Review.
Objective
Research has shown that children placed in foster care fall below population norms on many indicators of well-being. Yet few studies have been designed to distill the effects of foster care from conditions that precede foster care. Based on the available evidence, it is also uncertain whether the purported effects of foster care are lasting. This study used data gathered prospectively from an economically disadvantaged, urban cohort to examine whether foster care is associated with decreased educational and economic attainments as well as increased criminality in adulthood.
Method
Individuals who were placed in foster care after an indicated allegation of maltreatment were compared to three naturally occurring groups: (a) maltreatment victims who did not reside in foster care, (b) individuals without an indicated maltreatment allegation who were raised in a household with a Child Protective Services (CPS) record, and (c) individuals without an individual or household record of CPS involvement.
Results
Using multiple estimation procedures, we found that all participants with a CPS record fared worse in adulthood than their peers without a CPS record. Despite their poor outcomes, foster children functioned as well as other CPS recipients who did not reside in foster care.
Conclusion
Our findings indicate that caution is warranted when attributing dysfunction observed in foster children to the effects of foster care. Implications for prevention and intervention within the context of child welfare are discussed.
Topitzes, J., Mersky, J.P., Reynolds, A. (2012). From child maltreatment to violent offending: An examination of mixed-gender and gender-specific models. Journal of Interpersonal Violence.
Objective
Research suggests that child maltreatment predicts juvenile violence, but it is uncertain whether the effects of victimization persist into adulthood or differ across gender. Furthermore, we know little about the mechanisms underlying the victimâperpetrator cycle for males and females. Consequently, this study analyzed associations between child maltreatment and a number of adult measures of violent offending within mixed-gender and gender-specific models. Along with main effects, the study directly tested the moderating effects of gender on the maltreatmentâviolence link and analyzed theory-informed gender-specific mediators.
Method
Data were derived from the Chicago Longitudinal Study, a panel investigation of 1,539 low-income minority participants born in 1979 or 1980. Child welfare, juvenile court, and criminal court records informed the studyâs explanatory and outcome measures. Prospectively collected covariate and mediator measures originated with parent, teacher, and self-reports along with several administrative sources.
Results
Results indicated that child maltreatment, ages 0 to 11, significantly predicted all study indicators of violence in the full sample and most study outcomes in the male and female subsamples. In no instance did gender moderate the maltreatmentâviolence association. Late childhood/early adolescence environmental instability, childhood externalizing behaviors, and adolescent peer social skills fully mediated the maltreatmentâviolence nexus among males. Adolescent externalizing behavior partially mediated the relationship of interest among females. Evidence also indicated that internalizing processes protected females who had been maltreated in childhood against perpetrating violence later in life.
Conclusion
Implications of results are discussed.
Mersky, J.P., Topitzes, J., Reynolds, A. (2011). Unsafe at any age: linking childhood and adolescent maltreatment to delinquency and crime. Journal of Research in Crime and Delinquency.
Objective
This study compares the effects of childhood maltreatment and adolescent maltreatment on delinquency and crime, including violent and nonviolent offending.
Method
Data were derived from the Chicago Longitudinal Study, a prospective investigation of 1,539 underprivileged, minority subjects.
Results
Results confirmed that rates of overall delinquency, along with violent, drug, and property offending specifically, were elevated among childhood and adolescent maltreatment victims compared to their nonmaltreated peers. Childhood maltreatment was associated with delinquency independent of adolescent maltreatment, and strong connections between adolescent maltreatment and delinquency were present independent of prior victimization. Childhood maltreatment was also significantly related to a panel of adult crime measures, while the effects of adolescent maltreatment on adult crime were less robust.
Conclusion
The study findings suggest that maltreatment at any age increases the risk of future offending, implying that investments in prevention and intervention strategies throughout childhood and adolescence may reduce delinquency and crime.
Mersky, J.P., Topitzes, J., Reynolds, A. (2011). Maltreatment prevention through early childhood intervention: A confirmatory evaluation of the Chicago child-parent center preschool program. Children and Youth Services Review.
Objective
Increased recognition of the consequences associated with child maltreatment has led to greater emphasis on its prevention. Promising maltreatment prevention strategies have been identified, but research continues to suffer from methodological limitations and a narrow focus on select prevention models. This investigation uses data from the Chicago Longitudinal Study to examine mediating mechanisms that link the Chicago Child-Parent Center preschool program to a reduction in overall child maltreatment and, more specifically, child neglect.
Method
We use structural equation modeling to test child, family, and school measures hypothesized to mediate the effects of CPC participation on maltreatment and neglect.
Results
Results indicate that a substantial proportion of the program’s impacts can be accounted for by family support processes, including increased parent involvement in school and maternal educational attainment as well as decreased family problems. The CPC program’s association with reduced school mobility and increased attendance in higher-quality schools also significantly mediated its effects on maltreatment and neglect. Further, a decrease in troublemaking behavior contributed modestly to mediating the program’s association with maltreatment but not neglect.
Conclusion
We discuss the implications of these results for the field of maltreatment prevention.
Topitzes, J., Mersky, J.P., Reynolds, A. (2011). Child maltreatment and offending behavior: Gender-specific effects and pathways. Criminal Justice and Behavior.
Objective
This study assessed the association between child maltreatment (ages 0â11) and offending behavior within gender-specific models.
Method
Prospectively collected data, including official measures of maltreatment and offending, were derived from the Chicago Longitudinal Study, a panel study of 1,539 low-income minority participants.
Results
Multivariate probit analyses revealed that maltreatment significantly predicted delinquency for males but not females yet forged a significant relation to adult crime for both genders. Exploratory, confirmatory, and comparative analyses suggested that mechanisms linking maltreat-ment to adult crime primarily differed across gender. For males, childhood-era externalizing behavior and school commitment along with adolescent-era socioemotional skills, delinquency, and educational attainment explained the maltreatment-crime nexus. For females, childhood-era parent factors along with adolescent indicators of externalizing behavior, cognitive performance, mobility, and educational attainment partially mediated the maltreatmentâcrime relation.
Conclusion
Implications of results were explored.
Mersky, J.P., Topitzes, J. (2010). Comparing early adult outcomes of maltreated and non-maltreated children: A prospective longitudinal investigation. Children and Youth Services Review.
Objective
Using prospective data from the Chicago Longitudinal Study, this investigation examined associations between child maltreatment and an array of outcomes in early adulthood.
Results
Findings from bivariate and multivariate analyses indicated that verified maltreatment victims fared significantly worse than participants without an indicated maltreatment report on indicators of educational and economic attainment, criminal offending, and behavioral and mental health. Results also revealed that, while many maltreated children appeared to function well on individual outcomes, a large majority did not achieve criteria for resilience when development was assessed across domains. For example, non-maltreated participants were more than twice as likely to attain five or more positive outcomes (38.2%) on an aggregate seven-item index as the maltreated group (15.7%).
Conclusion
These findings suggest that child maltreatment is associated with extensive and enduring impacts, reinforcing the need to develop and implement effective maltreatment prevention and intervention strategies.
Topitzes, J., Mersky, J.P., Reynolds, A. (2009). Child maltreatment and adult cigarette smoking: A long-term developmental model. Journal of Pediatric Psychology.
Objective
To examine: (a) child maltreatmentâs association with young adult daily cigarette smoking, (b) variations in this association by gender, and (c) mediators of this association.
Method
For all study participants (NÂź1,125, 94% African American), data from multiple sources (e.g., child welfare records) were collected prospectively at child, adolescent, and young adult time points. Authors enlisted multivariate probit regression for objectives a and b versus exploratory and confirmatory mediation strategies for objective c.
Results
Maltreatment was significantly associated with daily cigarette smoking. Although not moderated by gender, this relation was fully mediated by adolescent indicators of family support/stability, social adjustment, and cognitive/school performance along with young adult indicators of educational attainment, life satisfaction, substance abuse, and criminality.
Conclusion
Maltreatment places low-income, minority children at risk for daily cigarette smoking and other deleterious young adult health outcomes. Recommended treatment targets include family support/stability, emotion regulation, social skills, and cognitive/academic functioning.
Topitzes, J., Godes, O, Mersky, J.P., Ceglarek, S., Reynolds, A. (2009). Educational success and adult health: from the Chicago Longitudinal Study. Prevention Science: The Official Journal for the Society of Prevention Research.
Objective
Growing evidence indicates that education is associated with health, yet we lack knowledge about the specific educational experiences influencing health trajectories. This study examines the role school factors play in the emergence of poor young adult health outcomes for a low-income, minority sample. The following research questions are addressed. First, what are the education-based predictors of daily tobacco smoking, frequent substance use, depression, and no health insurance coverage? Second, do later-occurring school factors explain the association between earlier school measures and the outcomes and, if so, what pathways account for this mediation effect?
Method
Data were derived from the Chicago Longitudinal Study, an investigation of a cohort of 1,539 individuals, born around 1980, who attended kindergarten programs in the Chicago Public Schools. Participants were followed prospectively from early childhood through age 24, and study measures were created from various data sources and multiple assessment waves.
Results
Findings from probit hierarchical regressions with controls for early sociodemographic covariates indicated that elementary school socioemotional classroom adjustment and high school completion were significantly and negatively associated with all four study outcomes. Participation in the Chicago Child Parent Center preschool program predicted lower rates of both daily tobacco smoking and no health insurance coverage (p<.05). Middle school reading achievement was inversely related to depression (p<.Ol), while middle school frustration toler-ance was inversely associated with daily tobacco smoking and frequent drug use (p<.05). Also, negatively linked to frequent drug use was a high school measure of students’ expectation to attend college (p<.01). In nearly all cases, later-occurring school factors fully mediated significant associations between earlier ones and the outcomes.
Conclusion
Patterns of mediation were explored along with implications of results.
Mersky, J.P., Berger, L., Reynolds, A., Gromoske, A. (2009). Risk factors for child and adolescent maltreatment. Child Maltreatment.
Objective
This study investigates associations between individual, family, and extrafamilial factors and the likelihood of subsequent childhood and adolescent maltreatment.
Method
The authors analyzed 1,411 participants in the Chicago Longitudinal Study whose maltreatment records were verified from administrative data.
Results
Findings suggest that maternal age at the childâs birth was a robust predictor of maltreatment outcomes. Receipt of public assistance and single-parent family status were significantly associated with select outcomes. Among school-age indicators examined, parent participation in school was negatively associated with most maltreatment outcomes. Participation in the Chicago Child-Parent Center program was negatively associated with maltreatment, although effects varied by type and timing of maltreatment. In separate analyses, several factors were associated with neglect, but only maternal age at the childâs birth was associated with physical abuse.
Conclusion
Findings suggest that prevention programs may need to target select populations and specific mechanisms associated with different types of maltreatment to maximize effectiveness.
Mersky, J.P., Topitzes, J., & Reynolds, A. J. (2009). Chronic neglect: Prediction and prevention. Protecting Children, 24, 67-77.
In 2006, more than 60% of verified child maltreatment victims in the United States experienced child neglect, exceeding the official rates of all other maltreatment types combined (U.S. Department of Health and Human Services [USDHHS], 2008). Despite its relatively high incidence, neglect remains one of the least studied forms of child maltreatment (Behl, Conyngham, & May, 2003; Lounds, Borkowski, & Whitman, 2006).
This disparity is disturbing because neglect often poses serious and persistent threats to child well-being. Among all types of maltreatment, neglect is associated with the largest number of child fatalities annually. In addition, neglected children are at risk for poor outcomes in multiple domains, including neurobiological development, physical and mental health, cognitive and educational performance, and social-emotional and behavioral functioning (Cicchetti & Valentino, 2006; Hildyard & Wolfe, 2002; Kendall- Tackett & Eckenrode, 1996; Kotch et al., 2008; Tyler, Allison, & Winsler, 2006).
Emerging evidence also suggests that the effects of child neglect are cumulative, meaning that the risk of unwanted consequences may rise in response to increased exposure to neglect (Bolger, Patterson, & Kupersmidt, 1998; Hildyard & Wolfe, 2002).
This is especially concerning because neglect is more likely than other types of maltreatment to manifest as a chronic pattern (DePanfilis & Zuravin, 1999; Fluke, Yuan, & Edwards, 1999). However, research into the processes that distinguish recurring and transitory forms of neglect is limited.
Janczewski, C.E., Dutch, N., Wang, K. (2008). Crafting the Greenbook: Framers Reflect on the Vision, Process, and Lessons Learned. Journal of Interpersonal Violence.
Guided by research and the experiences of judges nationwide, the National Council of Juvenile and Family Court Judges made a commitment in 1998 to improve community response to families experiencing domestic violence and child maltreatment.
A year later, the councilâs work culminated in a set of recommendations commonly called the Greenbook, which summoned child welfare agencies, domestic violence service providers, and dependency courts to implement internal changes and collaborate to address co-occurring domestic violence and child maltreatment.
In 2000, the federal government funded six community-based demonstration programs to implement the Greenbook recommendations. As part of the evaluation of the Greenbook initiative, the evaluation team asked the national experts who helped frame the Greenbook to reflect on the processes used and the decisions that shaped the document. In addition, the experts were asked to describe their expectations for the systems and communities that implemented the recommendations, including anticipated challenges.
Mersky, J.P., Reynolds, A. (2007). Child maltreatment and violent delinquency: disentangling main effects and subgroup effects. Child Maltreatment.
Objective
This study employs data from the Chicago Longitudinal Study (CLS) to investigate the relation between child maltreatment and the incidence and frequency of violent delinquency. The authors also examine if effects vary between physically abused and neglected children and if select indicators (sex, cumulative risk, public aid receipt) moderate the connections between maltreatment and violent outcomes.
Method
The CLS follows a cohort of 1,539 low-income, minority children who attended public kindergarten programs in 1985-1986. The primary sample includes 1,404 participants for whom maltreatment and delinquency status were verified.
Results
Maltreatment is significantly associated with all violent outcomes investigated. Effects are comparable for physically abused and neglected children. Results indicate that public assistance, particularly persistent receipt, moderates the association between maltreatment and multiple outcomes.
Conclusion
Findings support the hypothesized connection between maltreatment and violent delinquency while highlighting certain subgroups that may be at elevated risk. Implications for research design and program development are discussed.
Mersky, J.P., Reynolds, A. (2007). Predictors of early childbearing: Evidence from the Chicago Longitudinal Study. Children and Youth Services Review.
Objective
Using prospective data from the Chicago Longitudinal Study (CLS), we investigated the effects of early childhood and school-age predictors on female childbearing, including participation in the Chicago Child-Parent Center (CPC) Program, and related family and school behaviors.
Method
The CLS follows the progress of a single cohort of 1539 low-income, minority children who attended the CPCs and other public early childhood programs in 1985â1986. Birth records were obtained for 706 females (92% of original sample) from survey data collected between ages 22â24 and supplemental public aid and school records.
Results
Results from regression and survival analyses indicated that the CPC program had a limited impact on childbearing patterns. There was no evidence that preschool participation was associated with lower rates of early childbearing. CPC school-age participation was linked to significantly lower rates of multiple births by age 20.
Conclusion
The most consistent predictor of a female’s childbearing status was her parent’s educational attainment. Parent involvement in elementary school, children’s enrollment in magnet schools, AFDC receipt, and teacher ratings of acting out behavior also were significant predictors of early childbearing. Implications for the tailoring of future interventions are discussed.