Have you ever dreamed about foster care discovering a breakthrough approach to making a huge difference in the lives of the kids they care for? I suspect if you are reading this article, the chances are that all signs point toward yes. Similar to many individuals focused on supporting foster children and parents, I have pondered for many years what we would need to better ensure the safety and wellbeing of foster kids. More specifically and recently, however, my curiosity has focused on how we can use numbers to better document and guide what’s working, and what’s not working, when it comes to the care provided to foster children.
To borrow a line from a not so altruistic fictitious “doctor”, “Allow myself to introduce myself.”
I’m a psychologist and a professor who researches kids. Over the years I have taught Organizational Communication, Child Development, Educational Psychology, Research Methods, and Quantitative Statistical Analysis. Yes, I am a numbers cruncher. Or as some of my more qualitative leaning research colleagues have called me a “psycho”-metrician or quantoid. Now I fully realize the mere mention of measurement or numbers, aka statistics, might produce the same effect as Nyquil for some folks, but the solution my friends and I have developed is what I would like to share with you today.
The premise I would like to begin with is this: if the goal is to make a measureable difference in Foster Care, wouldn’t it make sense to adopt a system that can actually comprehensively measure the care and support being provided in real-time as well as measure the success and failures of such efforts? Although those working in foster care already collect a large amount of data, I believe the possibility exists that we can do much better.
Where There’s a Will, There’s a Way
With the help of two of my closest research partners (Drs. Robert Foltz and Doug Grove), some of our amazing colleagues working in at-risk youth care, and the expert teams at Helix Business Solutions and Oracle, we have created a promising new approach called the Vital Child Platform. The Vital Child Platform is a case management solution complemented by an end-to-end Outcomes Monitoring System component developed for those working within Foster Care as well as other at-risk youth sectors. We call the outcomes monitoring component, which I directed the development of, the Multi-Dimensional Youth Assessment 360, or the MDYA360. And if you are interested how bringing a little science and modern IT to the foster care industry might help, please read on…
“An ‘outcomes monitoring system’ for Foster Care?
That sounds sadistically based, uh… I mean statistically based?”
Yes, you are correct my imaginary reader friend possibly suffering from a slight case of Numerophobia. I want to discuss how statistics (i.e. numbers), when collected strategically and reported in a fashion that even our most attention challenged stats weary coworkers can understand, can help guide the foster care sector’s improvement efforts. I recognize some might think a data system designed to assess and track the physical and mental wellbeing of youth, as well as the quality of care and support being provided to this population of vulnerable children, could have only been created by Dr. Evil himself. I mean, who wants to be held accountable by numbers, right?
Yet, I beg to differ. Rest assured that though I might play the role of frightening stats professor from time to time for my day job, “I AM NOT A MONSTER!” I think, however, or at least hope, you might be pleasantly surprised after reading what I have to share. Plus, we must remember that with forthcoming possible federal legislation such as the Family First Prevention Act, and with state level foster care reform laws such as California’s Continuum of Care Reform and SACWIS reform going into effect, the age of more stringent accountability has arrived whether one likes it or not. Keep in mind, the goal of this accountability is to improve the care to youth and families.
To be very transparent, the numbers I want to discuss might eventually serve as accountability measures in some needed instances. But these numbers are more focused on “Applicability” rather than just “Accountability.” In other words, we want to help collect data which can be highly applicable (aka actually relevant) to informing, guiding and improving the agency support provided within the systems of care we often find foster children and other at-risk youth.
So please, please (you see I really am begging), bear with me a moment as I provide you some back story and share details how a multi-dimensional approach, powered by Oracle Cloud Solutions, holds great promise to helping the admirable understaffed and resource challenged agencies across our country truly make and document a measureable difference in the lives of our 400,000+ foster kids. Kids who more than deserve a fighting chance to find a “forever” home, or a much more efficient and effective path back to living with their family in a more stable setting.
The Scary Headlines Behind Our Motivation
Is it just me, or is it not uncommon, on a daily basis, to stumble across a scary or depressing headline related to foster care? From New York City to California to Texas to (fill in tomorrow’s foster care or child welfare crisis here), it seems never-ending at times. Meanwhile, the stories that provide some good news seem so few and far between. Give credit where credit is due. The media has a knack for taking every opportunity to call out the under resourced individuals and agencies working in the at-risk youth sectors when a crisis or unfortunate incident takes place. Don’t get me wrong, the public needs to know when kids are sleeping in office buildings because not enough foster parents and homes are available, or news about child abuse, neglect or even worse a foster child’s death. But with so many sad stories seemingly at times to be the norm, and knowing full well there are for more heartwarming stories we could be reading every day, I came to the conclusion that I should stop sitting on the sidelines judging and take the step forward to get involved. Help is needed.
As a self-admitted news junkie and once former problem child, I have read more than my fair share of headlines and published research related to at-risk youth in Children Services, Foster Care, Juvenile Detention, Psychiatric Inpatient and Residential Treatment. I’ve read news stories and studies that made me angry, and far too many others, which brought tears of sadness to my eyes. These headlines, however, are what lead me back to my efforts to research and help at-risk youth.
For more than a decade I have focused on researching kids in schools and helping adults help kids live better lives academically and socially. In my earlier years, however, I taught within a Juvenile Detention Center, and also created a non-profit organization focused on building stronger communities to help kids overcome the challenges of life. With a soft spot in my heart for kids in Foster Care and Juvenile Detention, due to personal experiences we will save for sharing another day, I had been developing a method to apply our Multi-Dimensional Assessment approach (which school districts across the USA have utilized in since 2006) to the challenges the at-risk youth sectors are experiencing today. I was exploring ways to possibly adapt our K12 evaluation efforts to more specifically measure predictive dimensions related to success with at-risk youth, details to follow.
Then one weekend while presenting at a mental health focused conference held on the Michigan State University campus, I was introduced to a fellow presenter named Dr. Robert Foltz. Bob, as his friends call him, is one of the kindest and most insightful mental health clinicians you will meet in the field. He’s an Associate Professor of Clinical Psychology at the Chicago School of Professional Psychology, and his private practice specializes in working with youth who have experienced trauma. He has decades of experience working within clinical and managerial roles in Residential Treatment facilities serving youth. Well, a friend introduced the two of us, and low and behold it turned out we had a lot in common personally and professionally. And as fate would have it, Bob had been working on developing a similar data system to support Residential Treatment facilities.
As the next few months progressed, and after a series of conference calls, we came to the conclusion that our two systems we had in mind could be combined to create an end-to-end solution for those working within the systems of care serving our at-risk and more vulnerable youth.
Connecting the Dots
I probably should clarify that as we began to develop our outcomes monitoring system, we were fully aware that some assessment and diagnostic tools already existed. Tools, such as the Child Adolescent Needs and Strengths (CANS) assessment and the Juvenile Detention Alternative Initiative (JDAI) Risk Assessment, are being utilized broadly and helping some to reduce the length of stay and discover quicker solutions to placement and permanency. We also discovered, however, that most of the behavioral focused child welfare tools, as well as criteria found within the Diagnostic and Statistical Manual of Mental Disorders (DSM5), were lacking validity and also are often only focused on diagnosing what the child is experiencing or suffering from related to mental health or life challenges. We came to the conclusion that most tools used for data collection currently in the at-risk youth sectors provide a good explanation for the “What” (e.g., What issues or hypothesized mental disorders does the overloaded staff or clinician who just met the youth think are challenging the youth), but often fall short of providing enough insights to explain the “Why” (why youth are experiencing or displaying such issues or behaviors related to associated disorder symptoms).
This was similar to what my longtime research partner Dr. Doug Grove and I discovered while working with K12 schools nationwide on our numerous federally-funded grant efforts. For example, many schools we have worked with, due to accountability efforts, had a measurement in place to assess what is called School Climate. For some this meant they had a measurement that met the requirements of the accountability demands, and by administering that instrument, they could check that box off the accountability requirement list. But for most of these assessments, though they might provide a number supposedly representing the quality of school climate, most rarely provide a number (data aka answers), which explain why the school climate is being perceived as poor, average or good. This is why we created the first iteration of our measurement tool called the Multi-Dimensional Assessment (MDA). The MDA measures eight dimensions predictive of highly effective educational and child development efforts.
In developing the MDA, we determined that in order to more accurately measure variables such as School or Facility Climate, one also should measure variables which research has connected to the success or failure to build better educational, ethical, psychological and social environments or outcomes for youth. We decided early in our K12 research that variables such as bullying prevalence, parent engagement, student/staff/faculty relationships, safety and peer relations needed to be added to the climate assessments as a means to cast a wider net which could better document “why” the climate is being viewed as poor, average or good.
When we began conceptualizing the application of our measurement of climate to assess foster homes and related at-risk youth sector facilities, it made sense that this too should be accomplished via a collection of connected variable measurements organized strategically into a select number of predictive dimensions. In order to be similarly beneficial to helping adults improve services and build more positive foster home and support facility environments, they would need to know more.
The possibility exists that many behavioral and socialization issues for foster children could be related to the foster home climate they reside in. To know whether a child has a mental disorder (the “what”), and the foster home they reside in has a poor, average or good climate, is not enough. We also must know “why” the foster home is being perceived in such way and how it is impacting a youth’s progress or outcomes. Is it because of the foster parents, their birth children, other foster children, location, overcrowding …? The list goes on. But without enough foster parents and homes to go around, the system needs to help the foster care sector figure out why some homes are having success via a good climate, and use (apply) those findings to help other homes improve climate, care and support. At least this was our logic. Make sense to you?
Do You Love Me Now?
When I teach my research and stats courses, I always take the time early in the semester to discuss the reliability and validity of assessment tools, surveys, and/or scales that my students might use to measure the variables they wish to research. In my opinion, if we don’t know how consistent or accurately we are measuring the variables we are concerned about, then we probably will end up with little information to help us. So if you don’t mind, how about a quick Methods 101 refresher lesson?
Real quick, in laymen’s terms, reliability reflects how consistently an assessment measures the same thing over and over, and validity is focused on whether evidence establishes that the tool actually measures what it says it measures. For this discussion I have every semester in class, I use “love” as an example. I ask the students if they have ever had someone say, “I love you” to them, and yet they didn’t believe it. Most say yes, which might explain the massive success of online dating websites, yet I digress. Any who, I then ask them what they did next after being told they were loved.
Most of the nonbelievers of bequeathed love say they said something like “prove it,” or they asked multiple questions of their potential future longtime lover. Why do you love me? When did you first realize you love me? Would you jump in front of a car to save me… since you love me? The questions go on and on, and yes, the questions get fairly humorous and as a result it is a welcomed fun exercise to do in a not-always much fun stats class.
One point of this exercise is to establish that one question (e.g., “Do you love me?”, or for this article’s focus “Is the youth depressed?”) is not enough. Think about it. The assessments used currently in child welfare settings are often administered when a youth arrives that first day to children services or encounters a challenge while at a foster home. The odds are high that a youth entering foster care is going to show signs of depression. They are often being forced to leave their homes or recently have been abandoned.
But such signs of depression for these kids are most likely signs of life challenges and trauma, and not so much a sign of the hypothesized and fairly debunked chemically imbalanced brain theory used often to justify a diagnosis and a prescription to mask the pain. From our experience, and as more sad headlines have confirmed, the average foster child is already prescribed far too many medications. Our belief is what they need is to be asked more questions in order to be better understood and supported. I share this opine because I want you to understand our system is more holistic in nature and seeks to avoid the bio-model of care when possible.
But back to the “Love” exercise, this activity designed to turn sadistics (drum roll please, place bad stats joke punchline here)… into statistics also shares that by gathering a broader view of love and increasing questions asked in the assessment focused on building a scale for love, if you will, we are by default increasing the reliability of the Love measurement. Typically, the more questions we ask, more consistency of the respondent’s answers is required, thus leading ideally to better reliability.
The way I teach validity, is by listing all of their questions related to love on the board to see if we have identified a valid definition of love. Then I explain how I thought I found the most amazing love ever when I met my wife, and then several years later we had our first child. I share with them how in my sleep deprived stupor in the low lights of that small hospital delivery room, while my amazing wife finally was catching some much needed sleep after 24 hours of labor, I held my firstborn beautiful little daughter in my arms. I whispered to her how much I love her and how I would never let anything happen to her, and how I will hold her, and… well you get the picture. And then I share with my students how for approximately the next three years I wiped the poop from that young child’s buttocks, several times a day. I share with them how this love that sent a shiver down my backbone that wonderful evening, was so different for the love I had and still have for my wife.
I ask them if the collection of multiple questions they created to measure love with a higher level of reliability, reflects this father-daughter type love or ever included wiping one’s significant other’s butt for three years. I challenge them to go home and ask their significant other, to prove that if they love them, to wipe their butt. Easy now, I am kidding with them. And luckily most get this joke and we all have a good laugh.
The point is that no way in Hades would the average college student do this for their love. Heck, most adults wouldn’t do this for their love, “Hey Siri, find in-home nurse.” Do I love my wife? Yes, with all my heart! Do I love my daughter and son? Yes, ditto. Are they the same type of love. Not really. This is why using assessments that have established validity is important. When a child’s future and possible life is at stake, we must measure what we say we measure when we are trying to determine better measurements of issues which could be life threatening, or we might as well not ask. We also must establish evidence we have reliable instruments, which measure the same thing consistently 70% or more of the time. Because if we are using measurements which have no reliability documented, or only show 50-60% of the time they measure the same thing consistently, we might as well just flip a coin, go with 50/50 chance, and save the time and expense of administering nonscientific assessments.
The reason I share this short tutorial on reliability and validity is because we also learned from our K12 work that one question answered by an administrator or staff person strangely designed to measure a student’s perception of depression, social isolation, motivation, or the facility’s climate cannot provide a reliable and valid assessment of such mental or psychological constructs held by the youth. Unfortunately, currently in K12 and at-risk youth sectors we have too many one question measurements being answered by a limited sample of adults, as well as “home grown” assessments with no established reliability or validity being used to assess or document how the youth feel.
To measure most variables related to youth development and wellbeing, reliable and validated scales (comprised of multiple questions which provide a more comprehensive and accurate assessment of the variable’s nuances) are needed. Taking what we learned from a few decades of studying kids, and working in schools, juvenile detention centers, and residential treatment facilities with administrators, staff, educators, youth, parents, clinicians and counselors, and given many of these variables we have studied relate to a comprehensive collection of efforts in the at-risk youth sectors, we set out to adapt our Multi-Dimensional Assessment for use in at-risk youth settings. We call this assessment we have developed the Multi-Dimensional Youth Assessment (MDYA), and the MDYA is the foundational assessment tool of our Vital Child Platform and the MDYA360 Outcomes Monitoring System.
We decided, given the urgency and magnitude of risks currently associated with at-risk youth care, any evaluation or assessment taking place in the systems of care serving at-risk youth, needed to be more comprehensive. We needed to develop an outcomes monitoring system that assessed with more reliability and validity the diagnoses of what children are experiencing psychologically and socially. We also needed to assess, however, what has historically led to such challenges, what support had been attempted, what worked and what didn’t for each individual youth. Most of all, we needed to measure what was being provided currently to help improve potential success leading to finding a bypass to move beyond the challenges. This is what was needed to find the “Why,” but also to find or better determine the “What’s Next.”
During our research into the at-risk youth sector’s tools and assessments we also discovered, that similar to researchers in higher education, many of the tools and approaches were being utilized within silos. We learned that even though many kids who enter Foster Care also might have or eventually will pass through Juvenile Detention or Residential Treatment, most agencies were not collaborating enough or at the least not sharing data systems to collaborate when such incidents brought their efforts together (e.g., when a foster child was sent to Juvenile Detention and then made a stop in Residential Treatment before going back to Foster Care).
On top of these evaluation and assessment challenges, during our MDYA360 development efforts, we also discovered that many were still collecting such data via pencil and paper, and then once completed the forms or assessments were faxed or emailed to a county or state office where the info was entered manually into a database, which by the way very few had access to. The need for a new data collection and reporting system became very clear to us.
Therefore, beyond creating the needed assessment tools and case management forms to better measure the What, Why and What’s Next, we needed to create a system that allowed states to provide real time access to youth data collected by all in the at-risk youth sectors of care.
As my partner Dr. Foltz had learned during his work in Residential Treatment, and many other colleagues confirmed, too often when a child is received at a facility, care providers have little accessible information to determine the child’s personal and family history as well as possible stints and experiences within the at-risk youth sector’s systems of care. Most upon the intake of a youth, have little knowledge of past trauma and treatment provided. Often in the current system, care providers are forced to start anew and quickly diagnose the youth with little insights to their past history, despite the fact that the youth had been in the system previously. As a result, and given the assessment tools currently being used, many are left to make decisions for a youth based upon one clinician’s or case workers perspective with little input from parents, educators, and others who have cared for the youth in the past. Many of these assessments also do not even provide the youth an opportunity to give their personal opinion as to what is bothering them and what they feel is needed to help.
Our conclusion was that the systems of care connected to Children Services, Foster Care, Juvenile Detention, Psychiatric Inpatient and Residential Treatment, needed one system which provided a much more comprehensive approach to collecting diagnostic and evaluative information on the youth. The new system should also collect data capable of tracking and monitoring the outcomes of youth, while simultaneously evaluating and guiding the care and support being provided. And the system needed to be accessible in real time by all who play a part in a child’s placement as well as continued care, while preserving privacy. Additionally, this system needed the capabilities to produce a collection of robust reports that case managers, clinicians, magistrates, agencies and supervisors could readily use in real time (via a computer, tablet or smartphone) to make more informed decisions and possibly document unusual incidents or change of status decisions. The end result is the creation of what we call the MDYA360, and the MDYA360 is a major component of the Vital Child Platform (http://VitalChild.Solutions) developed by Helix and powered by Oracle Cloud.
How does the Vital Child Platform and the MDYA360 work?
If you work with foster children, imagine your computer monitor (tablet or smartphone) becoming a case management application to monitor all the children and foster homes you oversee. This dashboard-based daily organizer and documentation device also displays icons reflecting key aspects predictive of your agency and foster homes’ success, as well as your youths’ wellbeing. The Vital Child Platform and the MDYA360 simplify the collection of insights for the management forms and assessments you currently use. Then with the click of the mouse or the touch of the screen, in real-time, you access the first layer of automated multi-dimensional reports showing how well a youth, foster home, specific facility, or agency is performing. “Make it so, warp speed Number 1.” These reports provide an assortment of visual organizers, tables and charts clarifying the quality of climate, youth care, behavioral risk management, parental/guardian support and education being provided.
With another click, a 360 degree lens helps you to drill down to see how specific issues such as bullying, emotional wellbeing and overall program effectiveness are being perceived by the youth, parents, foster parents, guardians, and staff. The MDYA360 is designed to help caring adults working in at-risk youth sectors such as foster care discover how to become insight engineers, evidence-driven gurus if you will. The result is an easily integrated insight platform that collects and connects consistent information across agencies within the systems of care by using reliable and valid assessments.
The Vital Child Platform and the MDYA360 Outcomes Monitoring System allows care providers to house and administer many existing assessments needed to monitor the mental health and wellbeing of the youth under their care, but also combine these with a MDYA360’s many new standardized, reliable and more valid tools. By doing this, the MDYA360 helps staff and clinicians to adopt a more consistent system of assessment throughout the agencies in a county or state. Once data is collected and reports are generated, staff then have an insights-driven process to help better determine how the services and support being provided might be helping or hindering efforts to help individual kids as well as improve organizational services.
As the MDYA360 process chart illustrates, this continuous improvement system is based on three simple steps that can be applied to organizational efforts or the treatment of an individual youth. The system is designed to help the at-risk youth sector… first Assess, second Inform and then Improve the services provided. Let’s take a closer look at each step.
Step 1: Assess
The three-step process begins by administering the Multi-Dimensional Youth Assessment (MDYA) and the many other forms provided in the Vital Child Resource Library. The MDYA is the core assessment, the foundation, energizing the MDYA360 process. The MDYA measures many of the factors foster care is currently expected to monitor. The MDYA also was designed to complement existing efforts requiring integration of evidence driven practices, such as requests your state has put forth or other efforts such as SAMHSA’s Building Bridges program, the MacArthur Foundation’s Models for Change Initiative, and Annie E. Casey’s JDAI efforts. The MDYA also focuses on the variables and factors CCWIS and future legislation will require many to measure in order to retain state and federal funding.
But most importantly, the MDYA measures four dimensions which decades of research document to be essential to success with at-risk youth. These dimensions focus on assessing the climate and environment of the facilities and homes where your youth are residents, the youths’ wellbeing, behavioral risk factors, and the educational and parental or guardian support being provided.
Under each dimension is a collection of reliable and validated scales measuring variables often associated with the dimension. When these variables’ measurements are combined together, the scales create a “dimensional index” capable of illuminating with specificity the strengths and challenges reported by individual youth and the many stakeholders involved in such work. The measurements contained within and the information collected by the MDYA and Vital Child Resource Library tools also are programmed to provide emergency alert notifications for issues such a suicidal alert and unusual incidents.
Quick Overview of the MDYA Dimensions?
Dimension 1: Facility (or Foster Home) Climate & Environment
Achieving positive outcomes begins with having a clear understanding of the environment youth are being cared for within, the level of services provided, and for whom these services are most advantageous. But this information is most accurate and useful when collected from multiple perspectives. All of the dimensions of MDYA gather data from youth, caretakers, and staff, a 360 degree view. This dimension measure variables such as the treatment setting’s climate and environment, trust in staff or guardian(s), peer relationships, investment in care, and issues of bullying or coercion. Areas of strengths and challenges can quickly be identified to create a more robust treatment outcome, and satisfying collaborative work environment. Also, please note, each dimension provides an opportunity for the youth, parents and staff to provide written comments related to the dimension, qualitative feedback detailing any other concerns or ideas they have.
Dimension 2: Youth Wellbeing
Youth Wellbeing offers the opportunity to establish and track the overall health and life-satisfaction of the youth under care. Areas of inquiry include motivation, academic confidence, interpersonal relations and aspects of the personal healthiness or social wellbeing. A 360 degree view of this dimension provides a well-rounded understanding of the youth’s and organizational efforts, and can help guide interventions to optimize youth, family and organizational outcomes.
Dimension 3: Behavioral Risk Factors
The Behavioral Risk Factors dimension provides key indicators about the clinical presentation of youth under care. As an administrator or clinician working with multiple youth, data can be aggregated to observe trends in problematic behaviors and coping skills. This dimension enhances the understanding of the treatment population, and helps to monitor the progress of individual youth. As with all of the dimensions, the variables here also are evaluated from multiple perspectives, creating improved reliability and external validity for gauging the true progress in treatment outcomes. In addition, the MDYA360 Resource Library offers additional modules such as Clinical Rating Scales and Risk Assessment; providing a broader assortment of behavioral anchors as well as Level of Care indicators.
Dimension 4: Educational & Parent or Guardian Support
Tracking academic progress and family engagement (foster, familial, biological/birth parents when applicable) are critical to positive outcomes, regardless of the at-risk youth setting. Whether you are working with youth in outpatient, inpatient, juvenile detention, residential care, foster care, or some other service capacity, understanding and enhancing their success throughout their ecology is directly related to improved outcomes. The MDYA offers the ability to gather information about academic engagement, but also improve understanding of how the parents/caregivers are perceiving care, how they could be more effectively engaged, and ultimately, how to create a transition plan for the youth to less restrictive care that will result in success; because the needs of the youth and family have been identified and met.
By beginning the MDYA360 3-step process with administering the MDYA and the assorted Resource Library tools, this system is different from any other system ever offered within the at-risk youth sectors. It is different because the MDYA and Resource Library Tools are designed to collect and connect an assortment of variables, which in the past, were measured by numerous unconnected and inaccessible surveys and diagnostic tools; and in some cases not measured at all. Offering an additional advantage, the MDYA is completed by youth, parents/guardians, and staff; giving all a voice in and on the care being provided.
The MDYA provides a method for assessing the wellbeing of individual at-risk youth from multiple perspectives, while simultaneously also providing a 360 degree organizational assessment reflecting the quality and effectiveness of service and support being provided by teams caring for the youth. Staff also can use the MDYA whenever they feel additional data collection would be valuable. For example, when using the MDYA as a tool to track the program effectiveness, supervisors could have a random sample of youth, parents/guardians and staff in a facility or foster parents at specific homes (e.g., 10% of stakeholders) take the MDYA monthly or quarterly to keep a pulse on organizational or care facility’s progress.
When first adopting the MDYA as an outcomes monitoring system, one could also choose to have all facilities, foster homes and differing protective services complete the MDYA. This will provide a baseline measure of where their youth and organizational strengths and challenges currently exist. Some might then choose to wait 6 months or a year to follow up and have all stakeholders complete the MDYA again, providing a posttest measuring to what extent progress has or has not been made. Meanwhile, others might choose to have every new youth entering the system complete the MDYA upon in-take, and also have the new youth and those youth remaining in care take the MDYA periodically, such as bi-weekly, monthly or quarterly, or any time they might be moved to a different facility or home setting, or possibly discharged. This would allow agencies to better monitor the progress of individual youth.
Meanwhile, we also realize most staff have many other assessment and mental health related diagnostic needs. This is why we created and continue to build on the Vital Child Platform’s MDYA360 Resource Library. This resource library contains a collection of free tools which can be used by staff to standardize collection of Intakes, Change of Status, or Psychosocial, Risk and Trauma assessments, as well as Substance Use and other challenges.
The resource library also contains Clinical Rating Scales and CPS or Foster Home Safety Inspection forms. Recently we have started working with state agencies and adding additional management tools such as mechanisms to administer and organize Unusual Incident forms. In this first step we want to provide foster care agencies and others within the systems of care with everything they need to assess and guide all they do.
With the Helix Vital Child Platform and the MDYA360 powered by Oracle Cloud, agency and facility staff can choose to use all of the assessments, or select only the management forms, assessments, and MDYA scales and dimensions they want to utilize, over the course of providing services to youth and families. And if an assessment is missing from the collection, we are asking new clients to share it with us so that we might add it to the list of tools for them and possibly others to utilize.
Helix and Oracle has helped thousands of companies survey millions of people, and as a result, you will find the Helix Vital Child Platform and the MDYA360 powered by Oracle to be one the most user friendly approaches to personalizing, distributing and administering online surveys and management forms. We hope the streamlined system to distribute surveys through various communication lines, interface for survey completion via smartphones, tablets or computers, and then use this evidence in real-time via the Vital Child Platform dashboard driven monitoring and reporting technology will become a welcome addition to many in their more than sometimes chaotic worlds.
Caseworkers can use a laptop or tablet on location to administer the MDYA360 assessments, forms and diagnostic tools to kids in foster care or protective custody. Facility staff can administer the MDYA360 tools to one youth at a time on an as needed basis, or do administration with larger groups. Parents and staff can complete the surveys whenever via smartphones, tablets or computers. And with a little programming, the system can be set up to send out regular reminders and invites for stakeholders to complete forms and assessments at predetermined time.
STEP 2: Inform
Once the MDYA and the various MDYA360 Resource Library support tools have been administered via a client’s personalized online survey portal, using the Vital Child Platform’s dashboard controls, they now can begin to explore organizational results focused on their facilities or various home-based care settings. Please remember, the 360 degree assessments can be used to produce reports for monitoring facilities at the state or county level as well as guiding the facility or agency management staff in their continuous improvement efforts. Meanwhile, for those working with individual youth, the MDYA360 platform can be used to drill down further to reports documenting individual youth’s progress, strengths and challenges.
The Vital Child’s MDYA360 automated reports will provide a place to start in considering the many malleable factors and compounding variables contributing to or detracting from agencies’, foster homes’ or youths’ strengths or challenges. The MDYA360 report provides such statistical results in a visual way that are easy to understand, and document the status of the many parts of the system the kids are operating or being cared for within. The MDYA report results reflect an analysis utilizing four dimensional indexes reliant upon 16 scales we have tested and supported through research for reliability and validity.
The MDYA report provides an analysis of agencies’ or facilities’ multi-dimensional youth assessment data as a whole as well as breaks down the performance by the dimensional indexes and the variables (sub-dimensions) which fall under the dimensions. The MDYA360 report will not only provide descriptive statistics to assess how well or poorly an organization or foster home is doing on certain dimensions or variables, but also when complemented by the tools within the MDYA360 Resource Library will provide information, a systemic view if you will, that helps to determine more holistically and precisely why the overall organizational efforts are doing well or not so well.
This is where the Vital Child Platform’s MDYA360 probably is quite different from anything those in the field have ever used. Once the specific hurdles are revealed, and determined to be interfering with optimal outcomes for youth, their families or organizational efforts, one then can develop strategies to turn the concerns into strengths. Without such data, many are forced to guess on such issues. Our goal is to help those working within the at-risk youth systems of care know, not guess. We want to give solutions, not just statistics. Our goal is to inform the decision-making improvement process so others can document better outcomes, and give staff something to celebrate, results to be proud of. And who knows, with a little luck and proactive public relations efforts, maybe see some positive headlines published.
But once staffs have completed the initial review of the organizational level data, they can also use the dashboard-driven system to dig even deeper. Say, for instance, you would like to know if the perceptions of the stakeholders differ between male youth and female youth. Or maybe you would like to know how the perceptions differ between those who have been in the systems of care for a short time versus a longer duration. Or maybe you are worried about staff retention and want to know how your new employees are feeling.
With the MDYA360, all an agency’s selected systems manager needs to do is select and click which demographic variables and outcomes they would like more details on, and in real-time the system provides such details by dimension and scale. The results, charts and tables within the MDYA360 reports can be saved in fashion to share with others or utilize in a presentation, training session, or accountability report such as CCWIS. Currently, we are developing analyses which also will allow the system to utilize data collected to create predictive heuristics and optimal matching algorithms to help foster care agencies get a statistical answer as to what would be the most beneficial placement of foster youth.
As discussed previously, you also can use these mechanisms of the system to drill down to a youth’s individual MDYA report and also efficiently gather (connect) additional information on the youth via any of the MDYA360 Resource Library tools completed. In an instant, staff, magistrates, case workers… have a comprehensive picture, or portable portfolio if you will, of how well a youth is doing, or equally important be able to create systems to develop more strategic individual treatment plans and better track any youth who might need to be given an emergency or high risk designation.
Imagine if a magistrate and Children and Family Services staff could have such information at a court hearing. Imagine if case workers or psychologists could have this information instantly available in times of emergencies or life-threatening crises. Imagine how this system could improve the lives of the youth, allowing them and their families to feel understood and more effectively cared for. Imagine how this system might even save lives.
STEP 3: Improve
Improving outcomes related to mental health, behavioral modification or other improvement efforts may start with asking how a child is feeling or thinking. But as many years of practice and research confirms, such unidimensional approaches do not provide the comprehensive answers needed to answer why the youth are feeling or thinking a certain way or why treatment goals are not being achieved. As successful therapists discovered long ago, we cannot just focus on assessing or diagnosing the symptoms, we must look at the whole system contributing to, or perpetuating, the symptoms.
Evaluation must include consideration of the factors interfering with success. Only when those factors are identified and considered, can treatment efforts more effectively create compensatory strategies to bypass such hindrances. Moreover, certain strategies being used program-wide may only provide temporary gains, because all interventions will not work for all youth, or each facility for that matter, all the time. Indeed, it is essential to know how the child is feeling and what symptoms they are challenged by, and new strategies must be developed that are congruent with each youth’s range of competencies. And for the providers, we must understand what is holding us back from helping the youth to overcome such symptoms or troubling behaviors and thought patterns.
As the Vital Child Platform Guidebook and our other support and training resources share, all of these reports can be used to energize continuous improvement efforts. Basically the Vital Child Platform’s MDYA360 is not only an assessment system or software application, it is also an effective intervention, program if you will, which can provide insights needed to further and better implement other interventions and programs. By taking a more evidence-driven process to making decisions related to individual youth and organizational efforts, sustainable and meaningful change is more easily accomplished.
Are We Going to Make a Measureable Difference?
I sure hope so. My colleagues and I have spent years working on this system. For too many kids that the current system does not have enough resources to manage efficiently and often effectively, we think Vital Child can help greatly to more efficiently and effectively document what is being done well and provide evidence supporting the need for more resources to improve what is not going as well.
We have kids entering the at-risk youth sector with issues ranging from abnormal to absurd to extreme. From a statistical perspective, these kids are all outliers. Almost all need some sort of therapy, and an equally large number need help with education challenges. All need a safe and caring place to live hopefully temporarily, until the systems of care can fix the issues at hand or find a more permanent home environment. And for such successful outcomes to more often materialize, we need a better system to support the youth and those caring for the youth.
The Vital Child Platform’s MDYA360 is a collection of reliable and valid assessments and management tools we and others have used for quite some time. But the Vital Child’s complete case management system we have developed for utilizing such data insights is new and unlike anything ever used within the at-risk youth sectors. We believe the Vital Child Platform holds great promise for making a measureable difference in the daily lives of foster children.
Every day spent caring for at-risk youth by agencies monitored by the local, state and federal governments, is often a demanding, uncertain, and typically an expensive endeavor. Therefore, helping these dedicated staffs to use the Vital Child Platform insights to improve rates of successful treatment and transitions, and when possible shorten the stay of youth under care by weeks if not months, is a prioritized goal of our efforts. By accomplishing this goal, and hopefully making a measureable difference, valuable resources can be maximized and costs can be lowered.