Background Caregivers of individuals with fetal alcohol spectrum disorder (FASD) experience unique challenges, stressors, and strengths, and there is growing understanding of the needs of these caregivers. However, less is known about how the broader caregiver context, including sociodemographic and ecological factors, may be associated with well-being. Methods Data for this study were collected between 2021 and 2025, gathered at baseline as part of an ongoing international longitudinal survey about caregiver experiences and perspectives of raising people with FASD (N = 234). Information on sociodemographic factors, family characteristics, and caregiver well-being was analyzed. Results Participants predominantly identified as women (95%) and had a mean age of 54 years (range 26-82); most (69%) were adoptive caregivers of children and adults with FASD and 67% were living in Canada. Family structure and composition varied across participants, and many caregivers reported financial challenges. Overall, caregivers reported high levels of stress and limited social support, along with strengths in their relationships with spouses/partners and relatives. Self-reported well-being was highest among parents who were retired, did not experience employment disruptions because of parenting responsibilities, cared for adults (as opposed to young children) with FASD, and had only one (as opposed to multiple) dependent(s) with FASD. Conclusions This study provides insight into broad contextual factors (i.e., employment status, life stage) that may influence well-being among caregivers of people with FASD. Understanding these factors can lead to more tailored and effective responses, interventions, and policies that support stability and thriving among caregivers, families, and communities of people with FASD.
Background Climate change is accelerating; however, effects on child health remain poorly understood. Countries need context-specific evidence to translate global knowledge into adaptation. Canada is warming faster than the global average and provides an informative case of paediatric climate risks. Methods We conducted a systematic review with narrative synthesis of the impacts of climate change on child health in Canada. Eligible studies explicitly attributed a change in a child health risk factor or exposure to climate change. Findings were narratively synthesised and study quality was appraised using design-appropriate tools. Results Of 3614 records identified, 54 original articles and 17 reviews were included. A Canada-specific framework linked rising temperatures, changes in precipitation, increased wildfires, alterations to ecosystems and the spread of vector-borne diseases with child health. These impacts appear to follow existing health inequities. Quality appraisal identified frequent concerns about representativeness and control of confounding in quantitative studies, while most reviews were judged at high risk of bias. Conclusions Evidence increasingly demonstrates climate change impacts on child health in Canada, but knowledge gaps remain. The findings demonstrate that children remain vulnerable even in a high-income country when climate hazards interact with developmental needs, inequity, infrastructure and relationships to land. The framework offers a transferable approach for countries to identify locally important hazards, vulnerable groups and intervention points. Strengthened efforts are urgently needed to implement these interventions in order to protect the health of current and future generations of Canadian children.
Healthy and stimulating early life environments are key for children to develop to their full potential. Household socioeconomic status (SES) is a strong predictor of early child development (ECD). This study used a rich new dataset from Andean Peru to examine the pathways through which household SES shapes ECD. Drawing on frameworks from multiple disciplines, we consider early life health, family well-being, and family investment as mediating pathways. Factors were assessed at two time points in a sample of 2702 parent-child dyads (49.7% children female). Measurements were conducted at infancy (M child age = 5.02 months) and toddlerhood (M child age = 29.62 months). We estimated two structural equation models to examine the direct and indirect pathways between SES and ECD. Results show that while SES predict children's health and environments in infancy and toddlerhood, the links between mediators and ECD differ by developmental stage. During infancy, the pathways between SES and ECD are explained in part by birth weight, maternal social support, stimulation activities, and learning materials. During toddlerhood the association is explained in part by child nutritional status (height-for-age) and learning materials. All three pathways explained some, but not all, of the SES-ECD gaps, with family investments emerging as the largest contributor. This highlights the complex and multidimensional nature of SES-ECD gaps, indicates that additional pathways must be integrated, and informs a nuanced understanding of the mechanisms that may explain how socioeconomic well-being influences early thriving in a low-resource Peruvian setting, with implications for similar Majority World contexts.
Following a long history of forced assimilation through family separation, American Indian and Alaska Native children continue to be separated from their families by state child welfare agencies at exceptionally high rates. This study provides insights into the geographies and institutional sites where inequalities emerge. We find that risks of child welfare system contact are highest for AIAN infants, and that risk is highly variable across states. These exceptionally high levels of risk indicate that the crisis of Indian family separation is ongoing. For AIAN children in states like Minnesota, Alaska, South Dakota, North Dakota, and Oklahoma, contact with the child welfare system is a routine part of growing up.
Frank Edwards, Theresa Rocha Beardall, Hannah M. Curtis
This study utilizes a quasi-experimental propensity score matching design to assess the causal impact on child welfare outcomes when parents facing an abuse or neglect case in the New York City Family Court were provided interdisciplinary law office representation as opposed to a standard panel attorney. The interdisciplinary law office approach includes social work staff and parent advocates for the parent, and salaried attorneys working in nonprofit organizations. Using administrative child welfare data, the study assesses the foster care and safety outcomes of 9582 families and their 18,288 children. The propensity score matched results do not indicate a preventive effect toward foster care entry nor any difference in children's likelihoods of experiencing a subsequent substantiated report of maltreatment. However, when children's parents received the interdisciplinary representation and those children did enter foster care, children spent 118 fewer days on average in foster care during the four years following the abuse or neglect case filing. Subsequent competing risk models show that children whose parents received the interdisciplinary law office model achieved overall permanency, reunification, and guardianship more quickly. These results provide evidence that interdisciplinary law office parental representation is an effective intervention to promote permanency for children in foster care.
This study addressed the adverse effects of cyberbullying on our young people, focusing particularly on immigrant youths. To minimize cyberbullying risks, while maximizing online opportunities, this study explored two types of uses for information and communication technologies (ICT): leisure and information as risk and protective factors. By including two types of ICT use as mediators in adopting a structural equation modeling (SEM) analysis, this study sought to explore the full mechanism governing the ways cyberbullying affects immigrant youths including its indirect paths via two types of ICT uses as well as its direct path. The results demonstrated the need to combat cyberbullying of immigrant youths, providing empirical evidence of its harmful influences on this vulnerable population. The harmful influences of cyberbullying were more pronounced among youths who frequently used ICT for leisure than among those who used it primarily for information. Interestingly, this study identified significant indirect paths for different ICT uses for immigrant students but no significant effects for nonimmigrant students, showing the importance of targeted approaches for immigrant students.
Advancements in the implementation of evidence-based family therapies have yielded successful reductions in child disruptive behavior. Unfortunately, effective interventions such as Parent-Child Interaction Therapy (PCIT) are plagued with high rates of attrition and low rates of homework completion in community clinics. To evaluate the use of low-cost incentives on attendance and homework adherence in PCIT in a community mental health center. Families referred for PCIT (N = 84; 63.1% Latinx) were randomly assigned to receive PCIT as usual or PCIT plus incentives. Families were able to earn incentives for attendance, homework completion, and therapeutic skill mastery. Attrition rates (59.5%) were reflective of other community-based intervention studies, with a significant reduction in no-show rates for families receiving incentives. No significant changes were found between groups on attainment of therapeutic skill mastery or number of sessions prior to termination. Families completed homework at low rates with no differences between groups. Low-cost incentives largely did not impact meaningful outcomes for attendance in parent training, although no-shows were less likely. These findings suggest that adherence is a complex phenomenon requiring multi-faceted solutions.
Lauren Borduin Quetsch, Emma I. Girard, Cheryl Bodiford McNeil
Permanency is a key child welfare system goal for the children they serve. This study addresses three key research questions: (1) How do older youth in foster care define their personal permanency goals? (2) How much progress have these youth made in achieving their personal permanency goals and other aspects of relational permanency, and how does this vary by gender, race, and age? and (3) What transition-related outcomes are associated with relational permanency achievement? Surveys were conducted with 97 youth between the ages of 14 and 20 currently in care. Over three-fourths of participants had an informal/relational permanency goal; however, only 6.7% had achieved their goal. Of eight additional conceptualizations of relational permanency assessed, the one associated with achievement of the highest number of key transition outcomes was Sense of Family Belonging. The transition outcomes with the most associations with permanency achievement were physical health and mental health. Relational permanency is a highly personal part of the transition process for youth in care, warranting personalized supports to ensure individual youths' goals are being addressed in transition planning. Permanency achievement may also provide a foundation for supporting youth in achieving other key transition outcomes.
Amy M. Salazar, Kevin R. Jones, Jamie L. Amemiya et al.
The current study examined the effects of implementing a new program model on the quality of relationships between direct care providers and residents in group care agencies. Children and Residential Experiences (CARE), an organization-wide program model that involves a range of structural change and staff-development activities, was implemented in 13 group care agencies in one Southeastern state. CARE implementation lasted three years and involved the application of six evidence-informed principles throughout the organization in order to create more therapeutic environments and improve the quality of care for children. We used a stepped-wedge design in which one cohort of agencies began CARE immediately and a second cohort waited 12 months before beginning, allowing them to serve as a comparison group during the waiting period. Children in each agency were surveyed annually about the perceived quality of their relationships with staff using a new instrument developed for this study. Results of a linear mixed model indicated that after accounting for clustering at the agency and cottage levels and controlling for several important covariates, child perceptions of relationship quality increased significantly in the three years after CARE implementation began. The strength of the CARE effect was stronger for residents with several previous placements, but did not differ by age, gender, race, length of stay, DSS referral, or problem behavior. Results provide evidence that supports the effectiveness of CARE as an intervention to help group care agencies improve the quality of children's daily interactions with caregiving staff, a critical aspect of their experience while living in care. The process requires a long-term commitment and an organization-wide focus on serving the best interests of children.
Charles V. Izzo, Elliott G. Smith, Deborah E. Sellers et al.
Child protective services (CPS) contact is consistently linked with poverty in the US, and empirical evidence is mounting to indicate that disparate exposure to income poverty explains a substantial portion of racial inequities in CPS involvement. Evidence about the different distributions of income poverty and material hardship also suggests that income poverty may not sufficiently capture economic wellbeing among families. This paper assessed whether differences in exposure to income poverty and/or material hardship explain racial inequities in CPS contact and further examined whether income poverty and material hardship predict CPS contact differently within racialized groups. We used data from the Fragile Families and Child Wellbeing Study (FFCWS), an urban cohort representative of births in large US cities in 1998–2000. The FFCWS data are ideal for this study in capturing each of the key constructs: racialized group membership, income, material hardship, and CPS contact. We measured income poverty and material hardship when children were age 1 and measured any CPS contact by age five. Our final sample included 3,517 families, including 1,848 Black, 614 white, and 1,055 Latinx families. We employed logistic regression to assess the associations between income poverty and material hardship, independently and jointly, and CPS contact. We conducted analyses in our full analytic sample and among subsamples of the Black, white, and Latinx families. We found that differences in income-to-poverty ratio account for differences in CPS contact between Black and white families. Differences in CPS contact between Black and Latinx families were not explained by economic wellbeing measures alone but were ameliorated when differences in income poverty, material hardship, and a full set of family characteristics were considered. Additionally, we found that material hardship was a consistent predictor of CPS contact in the full sample and within each of the Black, white, and Latinx subsamples, even accounting for differences in income and other family characteristics. The clear role of income poverty in explaining inequities in CPS contact between Black and white families and the consistent importance of material hardship in predicting CPS contact across all families underscore the critical importance of reducing income poverty and hardship and of distinguishing material need from maltreatment in the context of CPS. Our findings offer clear implications for policy intervention to reduce income poverty and material hardship. Such interventions might include extending the temporarily expanded Child Tax Credit and expanded food and housing assistance benefits, toward the ends of supporting child and family wellbeing and reducing economic and racial inequities in CPS contact.
