effect sizes at postassessment than at follow-up, and proactive interventions, which had larger effect sizes at follow-up than at postassessment. These differences could be attributable to variations in the risks in the populations served or in the ages of the children at the time of the intervention.

Supported Foster Care

Children and adolescents removed from their parents’ homes are at high risk for MEB disorders. Recent research at the Oregon Social Learning Center has shown that significantly improved outcomes can be achieved through substantial training, support, and backup of parents, coupled with direct training of young people placed in foster care.

Early Intervention Foster Care (EIFC) is built on research that defined a set of critical parenting skills and methods for teaching them to parents and other caregivers (e.g., Forgatch and Martinez, 1999). The program involves a team approach to training and supporting foster parents through daily telephone contacts, weekly support group meetings for foster parents, and a 24-hour hotline. Children also participate in weekly therapeutic play group sessions. In a randomized controlled trial, Fisher, Burraston, and Pears (2005) found that children in the EIFC condition who had experienced failed attempts at permanent foster home placement were more likely to have a successful placement than similar children in regular foster care. One reason may be that EIFC children had significantly greater psychological attachment to their foster parents than those in regular foster care. The impact of EIFC was also shown by measures of diurnal variation in cortisol level, which is lowered when young children experience maternal deprivation, including foster care placement (Fisher, Gunnar, et al., 2000). Compared with children in regular foster care, those who received the EIFC intervention had increased diurnal variation in cortisol over the course of the intervention that became similar to the pattern for children who had not been maltreated (Fisher, Stoolmiller, et al., 2007).

Price, Chamberlain, and colleagues (2008) randomized 700 foster families to receive a version of a foster family care program or usual care. The study included a multiethnic and racially diverse sample of children between the ages of 5 and 12. Children who received the foster family care program were significantly more likely to be returned to their biological parents or other relatives and had reduced behavior problems. The intervention reduced the likelihood of a failed placement among those with many prior placements, primarily because of improvements in parenting practices (Chamberlain, Price, et al., 2008).

A quasi-experimental trial of another enhanced foster care program, the Casey Family Program, showed positive effects (Kessler, Heeringa, et al., 2008). Case workers in the program had higher educations and sala-

The National Academies | 500 Fifth St. N.W. | Washington, D.C. 20001
Copyright © National Academy of Sciences. All rights reserved.
Terms of Use and Privacy Statement