New TXICFW study published on caregivers’ adverse childhood experiences and their impact on children’s social-emotional challenges

In their most recent published article, TXICFW’s Dr. Tina Adkins, Ph.D., Swetha Nulu, MPH, and Kaitlyn Doerge, MSSW, examined foster parents and ACEs. The article explored foster parents’ history of Adverse Childhood Experiences (ACEs), and their impact in providing optimal care to youth.

You can read the full article here. If you’re pressed for time but would like to learn more about this publication’s findings, read on for a brief synopsis.

What’s the problem?

Foster children who come from a background of child abuse and neglect are more likely to have a higher number of ACEs than other children. As the study cites, ACEs have been extensively studied and shown to be an important risk factor that contributes to adult physical and mental health behaviors and outcomes (Felitti et al., 1998). Although there is ample research in examining ACEs for youth in foster care, there is a gap in what we know about how caregivers’ own ACEs may impact their parenting and/or caregiving style when providing support to youth. When looking at ACEs and how trauma can unintentionally impact an adult’s life, it can not only lead to health risk behaviors, but a history of trauma also negatively effects mental health. Given this, when working with foster parents, it is essential these caregivers feel supported when facing potential challenges and uncertainty in trying to develop healthy relationships with their foster children.

What makes this study different?

This is the first peer-reviewed study that examines the possible link between foster parents and foster children’s social-emotional and behavioral challenges. Foster parents are key to supporting foster children, yet there is limited research on their ACE history in how it effects their relationships with their foster children and their behavior.

How was this subject studied?

The researchers conducted a randomized controlled trial (RCT) intervention study, researchers surveyed 89 foster parents within the Central Texas area. Each foster parent was required to be licensed and currently have at least 1 foster child in their home in order to participate in the study. Participants were asked to fill out an ACE questionnaire that contained ten yes/no answers to questions. Questions asked about different types of abuse and neglect they experienced as a child, as well as dynamics between relationships in participants’ homes growing up, such as household dysfunction, abuse, or domestic violence.

When conducting this study to identify foster parents’ history of ACEs and their reports of foster children’s emotional and behavioral difficulties, researchers aimed to answer three key questions:

  1. What are the ACE totals in this sample of foster parents and how do percentages of ACEs compare with the original CDC-Kaiser study by Felitti et al. (1998)?
  2. Does foster parents’ ACE exposure relate to social-emotional and behavioral challenges in their foster children?
  3. Is the connection between foster parents’ ACEs and foster children’s social-emotional and behavioral challenges different based on the specific ACE reported?

When comparing this study to the CDC-Kaiser Permanente ACE study, 20% of foster parents reported having 4 or more adverse childhood experiences, whereas the CDC-Kaiser study only had a 12.5% rate. Results showed that foster parents’ ACEs were directly related to foster children’s social-emotional difficulties. Foster parents who reported more ACEs also reported that their foster children showed more behavioral difficulties. The top three ACEs reported by foster parents were history of emotional abuse, domestic violence, and parental divorce. These three ACEs corresponded with significant increases in children’s social-emotional total difficulties reported by caregivers. Researchers explained how these past experiences may impact adults and foster parents’ parenting practices, whether intentional or unintentional. These ACEs and behaviors can prove to be a significant risk factor when determining a caregivers’ mental health and emotional support capacity.

How can this study be applied to your work with children and families?

Findings from this study indicate that there is a pattern when connecting the past trauma and experiences of foster parents and how that can impact not only their relationships with their foster children, but also impact their foster children’s social-emotional behaviors and responses. When translating this research to practice, results from this study can further inform social workers and other professionals involved in the screening process for potential foster parents.

Although further research may be needed to understand what common ACEs are found among foster parents in a larger group, this study’s data provides more emphasis on why identifying risk factors related to past trauma experiences is essential when screening and supporting caregivers. As social workers, there is an ethical obligation to ensure that the best practices and tools are utilized when working to support the wellbeing of children in foster care.

The researchers in this study further explain how although there may be ACEs found in foster parents and their experiences can have negative effects on youth in care, further studies should examine the positive childhood experiences (PCEs) of foster parents in order to gather a more complete profile when determining eligibility of adults in the foster parent screening process. By combining analysis of potential strengths and weaknesses for foster parents, there will a greater sense of empowerment when developing interventions and support programs to assist foster parents, children, and families in the proper development and relationships they deserve.

Adkins, T., Reisze, S., Doerge, K., & Nulu, S. (2020). Adverse Childhood Experience histories in foster parents:Connections to foster children’s emotional and behavioral difficulties. Child Abuse & Neglect, 104.