Chamberlain, P., Price, J., Leve, L.D., Laurent, H., Landsverck, J.A., & Reid, J.B. (2008). Prevention of behavior problems for children in foster care: Outcomes and mediation effects. Prevention Science 9(1), 17-27.
This was an evaluation of a foster parent training program designed to reduce child problem behaviors by strengthening foster parents' skills. The sample comprised 700 foster families (34% kinship, 66% non-relative) who received a new placement of a child aged 5-12 years in San Diego County between 1999 and 2004; "medically fragile" children were excluded. Families were randomized to either intervention or control (usual caseworker services) conditions.
Intervention groups (each 3-10 foster parents) received 16 weeks of training, supervision and support in behavior management methods from trained facilitators and co-facilitators. Focus was on the use of positive reinforcement and non-harsh discipline; methods included role plays and videotapes. Home practice assignments were related to the topics covered during sessions.
Variables used in the analysis were group, child age at baseline, and the following behavior scores at both baseline and termination:
- Child behavior, based on a standardized Parent Daily Report Checklist (PDR), administered over the telephone by trained interviewers.
- Proportion of positive reinforcement, the ratio of daily rates of positive reinforcement to discipline, computed from foster parent responses to standardized questions during a 2-hour interview.
Relationships between these six variables were presented in two path diagrams:1) for the full sample, and 2) showing separate paths for high-risk (>6 child behavior problems) and low-risk subsamples.
The training program was found to significantly reduce the numbers of child behavior problems. There was both a direct effect, and also a significant indirect effect through an improvement in parent behavior. The mediating effect of improved parenting practices was greatest for the group of high-risk children.
This was a well-conducted study. The program was well-designed and implemented in a meticulous manner. The facilitators and co-facilitators were paraprofessionals; they were chosen for interpersonal skills, motivation and knowledge of children, trained in a 5-day session, and supervised weekly, using videotapes of sessions. Strategies to maintain foster parent involvement included refreshments, travelling expenses and provision of child care. Parent attendance rates were high; 81% of the group completed at least 75% of the sessions, and, if a foster parent missed a session, the material was delivered during a home visit.
Evaluation methods were also rigorous. The sample was ethnically diverse-the only significant difference between the randomized groups was a higher proportion of Spanish-speaking children in the intervention group, and language was not found to be related to behavior outcomes. Data analysis involved the use of 1) multiple regression to examine the possible effects of demographic variables; only child age was found to be significant and retained for further analysis, and 2) use of LISREL to test the path models, These current findings, together with an earlier report of the positive effect of this same program on children's placement changes (Research Watch, July 24/08), make a strong case for the value of this program.