Hi Nick;

You are so right, this is a complex matter.  I am the State Director for the Children's Mental Health System of Care Expansion Implementation for Florida.  Before this position I was the State Cultural and Linguistic Competence Director for this SOC Implementation.  I would answer your question by stating that Cultural and Linguistic competence is very important.  Our evaluators actually conduct a CLC assessment of our provider agencies and help them to develop CLC plans.  Hope this helps.Qasimah

I've run studies similar to this using a variety of methods.  For some of our child welfare system research evaluation efforts, we have built evaluation into the clinical activities -- obtaining de-identified administrative and assessment data collected through the intervention process (e.g., clinicians or caseworkers administer clinically relevant measures at intake, discharge, or quarterly) and also track child welfare data (e.g., CPS outcomes, placements, etc.) in administrative data systems that can be shared for evaluation purposes.  For other studies, where direct participant enrollment is required for more extensive research protocols we have done direct consent with participants -- having intake workers secure releases to provide contact information to the study team so we can follow-up and do consent and interview as early as possible in the intervention process.  I've used the latter primarily with CPS-involved families, however -- as you indicate foster care involvement poses additional challenge re: consent and other ethical considerations.  There is variation across communities in who is legally able to provide consent for such circumstances, so it's critical to understand those jurisdicitonal issues and have consents that can be used with different circumstances.

As principal investigator in two studies of clinical interventions with foster children (1969, 1983) I got consent at an administrative level in the foster care system. The earlier one was in Westchester County, NY with 30 foster children admitted to a therapeutic preschool and studied with transfers among foster homes as one outcome measure (IQ change was another).  The later one was in NYC using a manualized guided activity method in which transfers among foster homes was the outcome measure.  The foster care systems acted in loco parentis for consent.  Foster parents regularly participated but were agents of the systems and were not asked for consent. Neither were the children asked.

Hi Nick. It's not my area of expertise and paper below is a bit old now, but I know Christine Oliver at Thomas Coram Research Unit UCL_IOE has worked at a strategic level in this area in the past, along with Janet Boddy (now in Sussex) https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/182165/DFE-RR072.pdf  good luck!

Hi Nick,

I am not an expert on child consent, but in general local laws and ethics guidance must be identified and followed.

As advised above, in general the consent parents or legal guardians/legal custodians should also be sought, and for the research component child assent should also be sought from all of the children capable of giving assent. Child refusals should be respected.

There was an interesting set of papers and commentaries on a vaguely related topic a few years ago - see

Commentary: Ethical considerations in international research collaboration: The Bucharest Early Intervention Project DOUGLAS R. WASSENAAR

Infant Mental Health Journal 11/2006; 27(6):577 - 580. DOI:10.1002/imhj.20108 · 0.61 Impact Factor

and related papers.

Hope this helps,

D

Hello Nick

Happy to share reflections on running a UK based Adoptive partenting RCT.

You may be aware of the following:

Rushton A. and Monck E. (2010) A ‘real-world’ evaluation of an adoptive parenting programme: Reflections after conducting a randomised trial. Clinical Child Psychology and Psychiatry special issue, 15,4. 543-554.

Rushton A. (2013) Enhancing adoptive parenting: From a trial of effectiveness to translation Chapter 4 in Mental Health Services for Children and Young People .(Eds. Michael Tarren-Sweeney & Arlene Vetere. Sage.

Alan Rushton

Dear Nick,

Although John's comments are helpful I guess this highlights the difference between collecting data as a programme evaluation (not for publication but for internal quality assurance purposes) or whether this is research for possible publication in the scientific/public domain. If the latter, then guardian consent and child assent seem applicable - certainly in our own context in South Africa.

Nick, see here - hope, that helps:

http://edoc.bbaw.de/volltexte/2014/2592/pdf/BBAW_Vulnerable_Populationen_PDFA1_b.pdf

Hi Nick! Our study is a RCT of foster care as an intervention for institutionalized children. We obtained approval from governmental agencies, consent from the legal representatives of the children, as well as verbal/written assent from the children depending on age. Ethical approval was also obtained from the IRBs of the universities. Incidental findings are reported to the IRBs and regular data safety monitoring board meetings take place. Hope this helps.

Thank you, everyone, for responses so far - incredibly helpful.

What is fascinating to me is the many differences, in terms of different countries, cultures and legal contexts, in how these issues are considered. The area we've found most complex (for children living with foster carers, but on a range of different types of care orders) is the issue of consent from biological parents - especially in situations where they may either be only minimally involved in the child's life (yet still sharing parental responsibility with the local authority) or else in conflict with social services (hence potentially 'hard to engage'). What is an appropriate level of consent to seek in those situations, where the child, foster carer and local authority all agree to participate? (Age of child may be another factor too). Any thoughts on this area greatly welcomed...!

In the BEIP we only seek to obtain consent from the biological parents if they are the legal representatives of the child. Age is not an issue for us as long as the child is still = 18 we obviously wouldn't need parental consent anymore. Hope this helps.

You have to consider the culture of the person as well. In some cultures not getting approval from the elders, (grandparents, seniors) of the family could be disastrous to your research. It goes a long way to ask the legal guardian if anyone else should be sought for approval within a family unit but also outside of the family. In aboriginal culture you may have to get consent from the head of the family clan and chief of the community.

I work for a foster care non profit organization in Miami Florida and the assigned case manager gets all the consent forms for all services once a need is identified. You can partner with the foster care agency and the Guardian Ad Litem program (which is court appointed) who focuses on the best interest of the children.