Children and Youth Services Review 33 (2011) 1930–1938

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Children and Youth Services Review

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Assessment of the needs of youth in residential care: Development and validation ofan instrument

Maria Manuela Calheiros a,⁎, Diniz Lopes a,b, Joana Nunes Patrício c

a Lisbon University Institute (ISCTE-IUL), CIS-IUL, Lisboa, Portugalb Université Paris Descartes, Francec CIS-IUL, Lisboa, Portugal

⁎ Corresponding author.E-mail address: maria.calheiros@iscte.pt (M.M. Calh

0190-7409/$ – see front matter © 2011 Elsevier Ltd. Aldoi:10.1016/j.childyouth.2011.05.020

a b s t r a c t

a r t i c l e i n f o

Article history:Received 2 February 2011Received in revised form 9 May 2011Accepted 10 May 2011Available online 14 May 2011

Keywords:Needs assessmentResidential careDevelopment of a measuring instrument

This article presents the development of a Residential Care Youth Needs Assessment (RCYNA) instrument. Intwo studies, initial evidence regarding the RCYNA psychometric properties was obtained using a sample ofyouth in residential care. Results show adequate levels of content and face validity, reliability and concurrentvalidity.

eiros).

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© 2011 Elsevier Ltd. All rights reserved.

1. Introduction

In the realm of psychosocial work with risk groups, the importanceof creating specific services based on user needs has been discussed inorder to increase the effectiveness of the response provided (e.g.Bullock, Little, & Millham, 1993).

One of the services where this issue has been addressed isresidential care for children and youth at risk. Various studies haveshown that the services provided are, above all, determined by theiravailability (i.e., supply), and not so much by the needs of their users(i.e., demand), and thus do not effectively satisfy them (Aldgate &Statham, 2001). In fact, the literature on residential care cites severallimitations of this response method, suggesting: a) the lack of carecentered on the specific needs of youth and children (Bullock et al.,1993; Casas, 1993; Valle, 1998); and b) residential care's inability toefficiently promote skill building so that, consequently, most youthleave institutions without the psychosocial resources needed for self-sufficiency (Colca & Colca, 1996).

A change, therefore, seems essential from services defined asbroad and categorical to specific services – called needs-led orcommunity-based services (Calheiros, Seabra, & Fornelos, 1993;Taylor, 2005) – so that care becomes more personalized (Axford &Little, 2004), specific, flexible, multifaceted and differentiated(McCoy, McMillen, & Spitznagel, 2008). This may increase thelikelihood that these services will be more effective (Axford, Little,Morpeth, &Weyts, 2005), since they are more oriented toward results

and based on empirical evidence involving the characteristics, needsand development phases of their users (Axford & Little, 2004).

In this context, the assessment of needs is seen as a key aspect forthe progress of social services for children and youth at risk (Bullocket al., 1993; Calheiros, Garrido, & Rodrigues, 2009), and entails theexistence of specific instruments to assess the needs of youth inresidential care. However, to our knowledge, no instrument has beenspecifically developed and published tomeasure the needs of youth inresidential care. Specific measures are of outmost importance sincedevelopmental approaches to the study of youth in residential careemphasize these environments as complex systems with specificstructural and functional characteristics (e.g., high young/caregiverratios, rotating staff and institutional structures and routines) inwhich youth experience accumulated institutional practices (Daining& DePanfilis, 2007; Raymond & Heseltine, 2008). Furthermore, theseyouth are in a period where significant developmental changes occurand have specific developmental needs not usually assessed bygeneric measures.

Therefore, in this article, we present the Residential Care YouthNeeds Assessment (RCYNA) instrument that aims at evaluating youthneeds and has practical implications at the level of guideline planningand program design for this age group (Calheiros, 2008). Also, thisarticle aims at presenting initial psychometric evidence regarding theRCYNA.

2. Definition and assessment of needs

Contemporary perspectives defining the concept of needs tend tosustain that they are indeed universal, but what is required to satisfythese needs (i.e., satisfiers) maybe universal or relative and culturally

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variable (Gough, 2003). These perspectives can be tied to thedevelopment context of children and youth at risk, and constitutethe viewpoint adopted in this article. In this sense, needs are definedas the result of accumulated risk and protective factors in thedevelopment of children and youth in various areas of life (Little,Axford, & Morpeth, 2004). By a risk factor we mean a “factor in theindividual or in the environment which predispose individuals tospecified social or psychological problems” (Little & Mount, 1999,p. 49); risk factors are therefore defined as correlative to weak ornegative results in development and well-being (Nettles & Pleck,1994).

On the other hand, protective factors are long lasting or passingconditions or attributes that moderate the negative effect of riskfactors (Cicchetti & Rizley, 1981), protecting the development andwell-being of individuals. Generally, these explain why some in-dividuals are more resistant to a set of risk factors than others (e.g.Werner & Smith, 1982), and thus should be identified and understood.

According to these perspectives, individuals with more risk andless protective factors will be in a situation of greater need. Thus, in acontext of needs assessment, it is important to understand what mayact as a protective or as a risk factor (Department of Health, 2000a). Asa consequence, in the realm of services for children and youth at risk,the need to create structured models sustaining the assessment ofneeds is crucial.

The instrument that we propose to develop (the RCYNA) is basedon a specific needs assessment model: the Framework for theAssessment of Children in Need and their Families (FACNF; Depart-ment of Health, 2000b). The purpose of the FACNF is to provide acommon language to the various entities and professionals working inthe area of children and youth at risk. It is based on what children andyouth need to achieve for successful development, and the factors thatmay positively or negatively affect their development (Ward & Rose,2002). This model asserts that at least three domains must beconsidered in assessing child and youth needs: development needs;parents' or caregivers' ability to provide an appropriate response; andenvironmental and family factors. Within these domains, variousdimensions or areas of life can be considered in which the risk andprotective factors interact. In this way, the FACNF takes psychologicaland social dimensions of child and youth into account, along withdiverse contextual variables, incorporating a developmental, ecolog-ical and systemic perspective (Bronfenbrenner, 1979) where differentecological systems impact varyingly according to their proximity tothe individual (Swenson & Swenson, 2002).

Thus, in the development of a specific instrument to measure theneeds of youth in residential care it is essential to highlight thiscontext as a primary area of assessment and to assess risk andprotective factors in areas of life comprised in the three domains ofthe Needs Assessment System (Department of Health, 2000b).

Moreover, while assessing the needs of youth in residential carethe involvement of practitioners is essential, since their perceptionswill influence how they work with them. However, the participationof youth is now being viewed as equally important, since their needs'perceptions can trigger specific types of behavior and decisions (Littleet al., 2004), and support a more effective response to youth problemsthrough planned change and action.

3. Overview and objectives

In this article, we present two studies involving the developmentand validation of a Residential Care Youth Needs Assessment (RCYNA)instrument. In Study 1, we describe the development of thisinstrument based on different information sources, and presentcontent and face validity evidence regarding the RCYNA. In Study 2,we determine some of its initial psychometric qualities with a sampleof 101 youth in residential care, namely its reliability and predictivevalidity (in its variant of concurrent validity).

4. Study 1

In this studywe present the different stages of building the RCYNA.The aims of this study are: a) to identify dimensions of needsassessment based on existing methodologies in social work withchildren and youth at risk; b) to identify dimensions and variablesrelevant to youth in assessing their needs, using focus groups. Thesefocus groups were conducted in order to incorporate in the RCYNAitems that would derive from the specific characteristics of thecontext and population that this instrument aims to assess; c) todevelop the RCYNA, taking into account the dimensions and variablesidentified by youth, instruments for assessing needs in social services,Portugal's Education Guardian Law (LTE—Official Gazette [Diário daRepública], Law 166/99 of 14 September), content validation providedby researchers in the area of youth studies, and the opinions gatheredin discussion groups with practitioners in this area.

4.1. Methodologies of assessing needs and identifying conceptualdimensions for operationalization

With a view to improving the effectiveness of services for childrenand youth, the assessment of needs requires a systematic approachusing a conceptual map or system for gathering and analyzinginformation on the child and his/her family, and that effectivelydiscriminates between different types and levels of needs (Depart-ment of Health, 2000b). Various conceptual and methodologicalapproaches have been developed within the scope of services forchildren and youth at risk, with at least four approaches of this typeidentified in the literature: a) LAC—Looking After Children (Depart-ment of Health, 1995); b) CLA—Common Language Approach(Dartington Social Research Unit, 1998); c) FACNF—Framework forthe Assessment of Children in Need and their Families (Department ofHealth, 2000b); d) ICS—Integrated Children's System (Department ofHealth, 2002). These approaches are part of an ecological perspectivewith a holistic vision of the child, taking the interaction and influenceof various areas of his/her life and the various systems in which he/sheis integrated into account. All of them underscore the importance ofassessing needs in terms of risk and protective factors, in order to planand implement care programs, thereby ensuring their effectiveness.However, these approaches have not been adapted to assessing theneeds of youth in residential care. In fact, the existing tools haveclinical assessment purposes, focusing on children and youth out-comes (e.g., Assessment and Action Records—LAC) or do not assessspecifically the youth in residential care (e.g., Aggregated Data Form—

CLA), which leads to some gaps in the assessment of key aspects tothis population (e.g., evaluation of the youth–practitioners relation-ship and of the residence living situation).

In this article, we focus on the Aggregate Data Form (ADF),belonging to the CLA methodology, and on the Core AssessmentRecord (CAR) of the FACNF methodology, since they representquantitative assessment methodologies that analyze needs takingrisk and protective factors into account.

The ADF, developed by the Dartington Social Research Unit (Little& Mount, 2003), identifies groups of youth with similar needs basedon information gathered on risk and protective factors in the fiveareas of life included under the methodology to which it belongs(CLA), together with the risk thresholds of children (Little, Axford, &Morpeth, 2002). It is comprised of 312 variables, nearly all of themwith a dichotomous response scale, and is completed by thetechnical–educational team to make its content more objective andreliable.

The CAR (Department of Health, 2000b) was developed tooperationalize the FACNF methodology, assessing all of its areasthrough 298 items. The response scale is generally dichotomous, andis completed by practitioners together with the child/young personand his/her family members.

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In addition to these two instruments, we also considered othermeasurements used to assess the effects of different residences of careon youth (Green & Ellis, 2007; Lemon, Hines, & Merdinger, 2005).Green and Ellis measure evaluates the satisfaction and productivity ofstructural (e.g., home appearance) and process (e.g., relationshipsbetween staff and residents) aspects of service. For the RCYNA, wefocused mainly on the process aspects linked to the interactionbetween staff and residents. Lemon et al. measure covers areas such aseducational history, employment history and social support, history offoster care system, skills training, and current life satisfaction, amongothers. We considered mostly the area of skills training, namelypsycho-emotional/social skills.

In selecting the dimensions to be included in this study, ourprincipal criteria included the fact that they were common to thedifferent needs assessment methodologies, and covered most di-mensions of the Framework for the Assessment of Children in Needand their Families (Department of Health, 2000b), thereby makingthem consensual and integrating dimensions. Five dimensions werethus identified: 1) living situation; 2) social and family relationships;3) social and antisocial behavior and skills; 4) physical andpsychological health; and 5) education and employment.

“Living situation” refers to the functional, relational, structural andphysical conditions of the place of residence and neighborhood inaddition to the household. It also refers to the economic conditions,stability and atmosphere experienced in these contexts.

“Social and family relationships” refers to the quality of the youngperson's relationship with his/her family and non-family members.This dimension also portrays family history and function, such asabuse and domestic violence, the relationships with caregivers/adultsin terms of emotions and education, and also refers to the stability ofthe relationship, guidance and limits in upbringing.

The dimension of “social and antisocial behavior and skills” refersto an assessment of behavior of the young person and his/her familymembers, the relationship with peers and practitioners, the youngperson's practical skills (e.g. cleaning his/her room) and cognitiveskills (e.g. goal setting and decision making), and institutional aspectssuch as the young person's involvement in different institutionalissues.

The dimension of “physical and psychological health” refers to thephysical and psychological state of health of the young person and his/her family members, risk behaviors and emotional problems. It alsorefers to health services, the young person and adults' ability to copewith problems, the youth's ability to adapt and his/her identity.

Finally, the dimension of “education and employment” refers notonly to the status of youth and family members in terms of educationand employment, but also illustrates the young person's status interms of his/her relationship with colleagues and teachers/employers,issues of satisfaction, motivation and conflicts and disciplinaryproblems in these contexts. It also refers to educational needs,stability and the young person's interests and skills.

These dimensions are assessed, in general, by reference tocommunity social contexts and the family. Within the scope of thisstudy, they have been incorporated into the context of residential careand used in the script that guides the focus groups.

4.2. Identification of dimensions relevant to youth

4.2.1. Method

4.2.1.1. Participants. In this study, four focus groups were heldincluding a total of 21 participants, all of them in residential care.These youth were aged 15–18 years (M=16; SD=1.07); 52% werefemale.

The participants came from 20 residences of care in the Lisbonmetropolitan area. To ensure the heterogeneity of the sample and agreater representativity of the data (Krippendorff, 1980), the

participants were chosen according to the following criteria: a)minimum age of 15 years; b) participants of male and female gender;c) participants with and without recorded behavioral problems; andd) at least three years of care.

4.2.1.2. Procedure. The youth who took part in this study werecontacted directly and asked about their availability. The focus groupswere conducted by three individuals from outside the institutions,two with the role of moderators and the other with the role of outsideobserver. The focus groups lasted from one to two hours, with thenumber of participants in each session ranging from four to six. In allof the sessions, the same introductory instructions were given, andthe questions were asked in the same order, thereby preventing anybiases. In addition, the participants were ensured that all datafurnished would be kept confidential and anonymous. The partici-pants were also asked for their consent to record the focus groups,which were then transcribed and analyzed.

4.2.1.3. Focus group script. The script used in the focus group includesthe five dimensions described above, including topics involving theliving situation (e.g. “Tell us a bit about your living conditions”), socialand family relationships (e.g. “What is your relationship like with theresidential care practitioners?”), physical and psychological health(e.g. “What do you think is important to ensure your physicalhealth?”), behavior and skills (e.g. “Tell us about your independence…Describe your characteristics in this area…”), and education andemployment (e.g. “We would like to know how you feel aboutschool”). The script also included several topics on the young persons'living situation: capacity, privacy, physical space, stability, functioning(rules and services) and neighborhood (community resources); topicsinvolving their social and family relationships: peer group, practi-tioners and the family or other relationships outside of the institution;and topics involving their behavior and skills: independence, support,etc.

It should also be noted that the language used in formulating thequestions was adjusted to the participants' age, and the focus groupswere conducted so as to identify positive and negative aspects toallow an assessment of the dimensions examined in terms of risk andprotective factors.

4.3. Results

The data resulting from the focus groups were content analyzed.The first step in this analysis was to select 834 enumeration andsemantic register units of analysis; the second step was to define amixed system of categories, i.e. with categories defined a priori and aposteriori (Bardin, 2007). In this regard, we defined a system with 7dimensions of needs, 25 macro-categories, 56 categories and 24 sub-categories; the 7 dimensions of needs were determined a priori by thedimensions common to the different needs assessment methodolo-gies referred to in the script, while with regard to the macro-categories and categories comprising them only 9 macro-categoriesand 6 categories were defined a priori. The third stepwas to verify thiscategorization system's reliability by determining inter-rater agree-ment at two levels: sequential attribution of the system's lower levelsto those immediately above (Cohen's kappa=0.968; pb0.000) andattribution of one fourth of the units of analysis of each focus group(241 units) to the lower level of the categories system (Cohen'skappa=0.814; pb0.000).

The fourth and last step entailed a structural and occurrenceanalysis of the categories system. Of the seven dimensions of needsidentified, the most often recurring were “living situation” (residenceof care; 48.6%) and “social and family relationships” (25.9%). Afterthis, came “education” (10.6%), “behavior and skills” (6.9%), “psycho-logical health factors” (3.4%), “employment” (2.6%), and, finally,“physical health factors” (2%).

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The dimension of “living situation” is comprised of seven macro-categories, including the perception of the institution (41.2%), thephysical space (22.5%) and the services of the residence of care(12.3%). Less important were the rules at the residence of care (8.6%),the atmosphere of safety at the residence of care (6.7%), the history ofcare (change of residence) (5%) and the desire to leave the residenceof care (3.7%).

In terms of the dimension of “social and family relationships”, themost recurring macro-categories are educators (48.2%) and peergroup (37.5%), followed by practitioners1 (8.3%) and family (6%).

Three macro-categories were identified in the dimension of“education”: adaptation/difficulties at school (56.8%), followed byacademic learning (21.6%), and finally change of school (frequency)(21.6%).

The dimension of “behavior and skills” includes three macro-categories: independence (84.5%), behavioral problems (8.6%) andsearch for/acceptance of support (6.9%).

Two macro-categories were identified in the dimension of“psychological health factors”: one regarding factors of the institution(53.6%) and another regarding factors of the youth (46.4%) withinfluence on psychological health.

The dimension of “employment” has four macro-categories,including personal development at work (50%), followed by amacro-category referring to work as a positive experience (22.8%),another referring to the functional aspects of work (13.6%) and,finally, a macro-category pointing to difficulties at work (13.6%).

Finally, the dimension of “physical health factors” includes twomacro-categories: healthy practices (70.6%) and health services(29.4%).

In summary, the results of this content analysis underscore thehigh frequency of references to the living situation at the residence ofcare, and social relationships with practitioners and peers. Thisreinforces the importance of the subsystems closest to the youth'secology as having the greatest potential to impact their life, and beingthe areas that should be prioritized for the specific instrument to bedeveloped.

4.4. Development of the Residential Care Youth Needs Assessment(RCYNA) instrument

The purpose of the RCYNA is to assess the needs of youth in fiveareas of their life, namely living situation, social and family relation-ships, social and antisocial behavior and skills, physical andpsychological health and education and employment. In fact, interms of the focus groups as well as the different needs assessmentmethodologies, these areas are consensual and capable of integratingdifferent dimensions of the Framework for the Assessment of Childrenin Need and their Families.

In developing the RCYNA, in addition to the data gathered in thefocus groups, the Aggregate Data Form (ADF; Little et al., 2002) andthe Core Assessment Record (CAR; Gray, 2000) were used as referenceinstruments in adapting items. Other sources for the operationaliza-tion of items included the Education Guardian Law (LTE—OfficialGazette [Diário da República], Law 166/99 of 14 September),instruments used in assessment studies on residences of care(Green & Ellis, 2007; Lemon et al., 2005), literature on the subject(Bullock et al., 1993; Casas, 1993; Department of Health, 2000b; Valle,1998) and the results of the discussion groupwith practitioners in thisarea, i.e. the operationalization of items that they considered relevant.

Table 1 summarizes the origin of the RCYNA's items, according tothe different information sources. The majority of the items originatefrom the focus groups with youth. 110 items resulted from the 68macro-categories and categories identified. Secondly, the instruments

1 In this context, youth and professionals tend to refer to practitioners aspsychologists and social workers, distinguishing them from educators.

analyzed contributed with 95 items. The contributions of theEducation Guardian Law and of practitioners (5 items) had the leastweight.

However, it should be emphasized that some of the variablesoriginating from the focus groups are shared by the other informationsources. Of the 110 items operationalized from the focus groups, 59are similar to the ADF, 11 are similar to the CAR and 6 are referred to inthe Education Guardian Law, in other instruments or by thepractitioners. In this way, it can be concluded that 34 items originateexclusively from the focus groups, essentially including the di-mensions of living situation and social and family relationships,which were the most often cited by the youth.

4.4.1. Content and face validity of an initial version of the RCYNAIn view of the goal to assess needs considering the presence of risk

and protective factors in the five dimensions mentioned, a contentassessment of the RCYNA was conducted by a group of researchers inthis area. In all, 109 risk items, 68 protective items and 33 neutralitems were classified (see Table 2).

The results of this assessment clearly show a greater preponder-ance of items involving risk factors compared to items involvingprotective factors, namely in the dimension of living situation (e.g.,“family is dependent on benefits”) and in the dimension of physicaland psychological health (e.g., “child pleasant to spend time with”).Items involving protective factors appear to be essentially tied to thedimension of behavior and skills. Finally, the dimension of educationand employment includes the highest number of items considered asneutral.

In order to ensure face validity, the instrument's practicality, thepertinence of the items and the instrument's suitability to the context,the RCYNA was also discussed with a group of practitioners withdifferent occupations (psychologists, social workers and educators)and performing different duties (direct work with young person orcoordination and direction). The majority of practitioners expressed ahigh degree of comprehension of the RCYNA items and its adaptabilityto the context of residential care. Nevertheless, practitioners proposedsome changes to the makeup of the original items, and these weretaken into consideration in the final version of the instrument. Inaddition, the instrument was pre-testedwith a sample of practitionersfrom social/educational teams and care units evaluating 20 youth inresidential care. The results of this pre-testing allow arguing for theRCYNA's suitability for assessing the needs of youth in this context.

In its final version, the RCYNA should be completed by thetechnical/educational team responsible for the young person, not onlyto minimize potential errors with regard to the assessment'ssubjectivity, but above all because youth are assessed in areasentailing specific areas of care by practitioners with differentfunctions, which may result in a unique and specialized contributionin filling in the instrument.

4.4.2. Description of the final version of the RCYNAThe RCYNA is comprised of two parts: one in reference to the

socio-demographic description of the young person, and another inreference to the assessment of his/her needs. As regards the socio-demographic description, in addition to age, ethnic group and gender,information is gathered on the young person's duration of care, thereason for admission to the institution and who reported the youngperson.

The RCYNA's needs assessment component is comprised of 211items: 210 items refer to risk and protective factors, and aredistributed among the five dimensions mentioned above, and oneitem (adapted from the ADF) refers to risk thresholds to measure thegravity or seriousness of the young person's problem (“Is theimpairment significant or is it likely to be significant if the situationpersists?”).

Table 2Number and type of items per dimension of the RCYNA (risk and protecting factors).

Dimensions Factors

Risk Protective Neutral

Living situation 23 9 6Social and family relationships 15 12 6Behavior and skills 20 26 5Physical and psychological health 37 12 0Education and employment 14 9 16Total 109 68 33

Table 1Origins of the different items composing the different dimensions of the RCYNA.

Source Number of items per dimension Total

Living situation Social and family relationships Behavior and skills Physical and psychological health Education and employment

Focus groups 15 16 34 31 14 110FDA 21 15 8 15 23 82CAR 0 0 0 2 0 2Other instruments 2 2 5 1 1 11LTE and technicians 0 0 4 0 1 5

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The first dimension, “living situation”, comprised of 38 items,provides an assessment of the family's household and the residence ofcare in terms of residents, physical and economic conditions, location,stability, atmosphere and functioning, among other aspects (e.g. “Theresidence of care's schedule is very strict”; “The residence of carefunctions much like a family environment”; “Overall, the institutionsatisfactorily addresses the young person's living needs”).

The dimension of “social and family relationships” considers theyoung person's relationship with family members and other signif-icant people in his/her life, the family's functioning and history, therelationship with the technical/educational team, stability, the abilityof the family and the young person to cope with problems, and otheraspects. This dimension is comprised of 33 items (e.g. “There isturnover in the technical/educational teams responsible for the youngperson”; “Young person recently ill-treated”; and “Overall, theinstitution promotes positive relationships between the young personand his/her family”).

The dimension of “social and antisocial behavior and skills”assesses the young person's relationshipwith peers and professionals,and the existence of behavioral problems of the young person and his/her family members. It also includes a number of personal skills, fromcognitive to practical/functional, and aspects of the residence of care,such as participation. This dimension incorporates 51 items (e.g. “Hasmoney beyond the monthly allowance”; “Is capable of making his/herown decisions”; “Makes requests, complaints and/or claims”).

The dimension of “physical and psychological health” incorporates49 items, and assesses, for the young person as well as adults, theexistence of physical or mental illnesses, risk and health behaviorsand psychological or emotional problems. It also considers overallwell-being, identity and several skills of the young person, amongother factors (e.g. “Tries to adapt or is adapted to his/her situation ofcare”; “Is capable of managing his/her emotions”; “Overall, theinstitution satisfactorily addresses the physical and psychologicalhealth needs of the young person”).

Finally, the dimension of “education and employment” describesthe academic and professional situation of the young person and ofadults, special education needs, absenteeism, integration problemsand conflicts, relationships with teachers and colleagues, the family'sinvolvement in education, the young person's motivation andabilities, etc. This dimension is comprised of 39 items (e.g. “Isolatedat school or at work”; “Involved in extracurricular activities”; and“Overall, the institution satisfactorily addresses the young person'seducation and employment needs”).

By applying this instrument, a score can be obtained for eachdimension assessed, involving the overall sum of the number of riskfactors and the overall sum of protective factors present in thedimension. Total risk and protective scores can also be calculated,resulting from the sum of these factors in all of the dimensions.

The scores obtained with this instrument can identify areas withgreater urgency of care, thereby providing a comparison of theseriousness of different groups. Moreover, risk and protective factorsmay be analyzed independently to ascertain and implement youthcare. This analysis may be undertaken by combining data and

identifying needs profiles, as determined by the existence andabsence of risk and protective factors.

5. Study 2

The purpose of this second study was to determine severalpsychometric qualities of the RCYNA, namely reliability, face validityand concurrent validity. The correlations between the dimensionscomprising this instrument were also analyzed. To this end, theinstrument was applied to teams of practitioners using a samplegroup of youth in residential care as a reference.

Is should be noted that a specific analysis testing the factorialstructure of the RCYNA was not performed. In fact, and due to thedichotomous nature of the RCYNA items, a latent class analysis shouldhave been run (McCutcheon, 1987). Nevertheless, sample specificitiesand especially sample size prevented us from presenting this kind ofevidence (it is known that small samples cause great instability tosolutions provided by conventional latent class analysis; Yang, 2006).We are thus basing our assumptions regarding the RCYNA structureon the content analysis presented in Study 1, and we are furtherreinforcing the internal consistency of its dimensions through thecalculation of internal consistency indexes (presented further down).Moreover, and as it can be seen from the evidence presented in Study1, the dimensions underlying the RCYNA do not depart much fromother instruments widely used in this area of study (e.g., ADF andCAR).

5.1. Method

5.1.1. Participants101 youth from 22 residential units, aged 14–23 years and with an

average age of 16 years (SD=1.8) were evaluated via the RCYNA.43.7% were female. The majority of these youth were of Portuguesedescent (69.9%), and the remaining of Portuguese African descent.These youth had lived in their respective residences of care for anaverage of eight years (SD=3.56).

These youth were assessed by a group of 47 practitioners, mostlyfemale (70.2%), aged 28–53 years, andwith an average age of 37 years(SD=7.94). With regard to the occupations of these practitioners,more than half were educators (55.3%), followed by social workers(23.4%) and psychologists (19.1%). In terms of their academic

2 The RCYNA is available upon request to the first author of this article.

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background, 74.5% of the practitioners were degree holders, and 14.9%completed secondary education. It is important to note that thesepractitioners had worked at the institutions for an average of9.51 years (SD=6.90). Each young person was assessed by a teamof practitioners ranging in size from 2 to 3 team members.

5.1.2. Instrument

5.1.2.1. Residential Care Youth Needs Assessment (RCYNA) instrument.In addition to the RCYNA, comprised of its two main parts (socio-demographic description and needs assessment), a third part wasintroduced to determine its concurrent validity. This third part iscomprised of 32 items involving the services provided to the youngperson (12 items; e.g., “youth mental health”, and “special educa-tion”) and to his/her family (20 items; e.g., “adult medication” and“financial support”). Two scores were calculated for these items: onefor the services provided to the family, and another for the servicesprovided to youth. Both stemmed from the total number of servicesprovided, thereby ranging from 0 to 20, and 0–12, respectively.

Finally, an item was introduced to assess the consistency/agreement of the technical/education team while filling in theRCYNA – “How often did the team that completed the form disagreewith the responses?” – with a response scale ranging from never (0times) to frequently (more than 20 times).

The items identified by the group of researchers as neutral (seeStudy 1) were not taken into consideration in the final version of theRCYNA. Indeed, the aim of this instrument is to measure youth needsby identifying risk and protective factors. In this sense, neutral itemsdo not directly contribute to the operationalization of these types offactors underlying the main dimensions of the RCYNA, and aretherefore negligible. For this reason, the RCYNA instrument analyzedin the present study comprises 177 items, instead of its original 210items.

5.1.3. ProcedureSince the questionnaire is completed by practitioners instructions

were given on how to fill out the RCYNA. Next, the questionnaireswere handed out to the practitioners in charge of the residential careunits to be subsequently distributed to, and completed by, the youngpersons' technical/education teams. To ensure the confidentiality andanonymity of the data, instructions were given not to disclose theyoung persons' and practitioners' identities. All the questionnaireswere put into a sealed envelope, whichwas then collected, obtaining areturn of 100% of the questionnaires.

5.2. Results

5.2.1. Analysis of the psychometric qualities of the RCYNA

5.2.1.1. Reliability. The reliability of the RCYNA was assessed todemonstrate the internal consistency of risk and protective factorswithin each needs dimension assessed by calculating Cronbach'salpha coefficients. These analyses resulted in the removal of someitems, since these contributed to the dimensions' inconsistency. In thedimension “living situation” (protective factor variant), 3 items wereremoved (e.g., “the residence of care functions much like a familyenvironment” and “youth profits from the available communityresources”); in the dimension “social and family relationships”(protective factor variant), 2 items were removed (“youth under-stands family's problems”, “members of family have skills to deal withthe problems faced by the youth”); and in the dimension “physicaland psychological health” (protective factor variant), 1 item wasremoved (“youth perceives the institution is worried with his/herwell-being”); and finally, in the dimension “education and employ-ment” (risk factor variant), 3 items were removed (e.g., “permanentlyexcluded from school” and “not serious special education needs”). In

this way, the final version of the RCYNA included 168 items, whichrepresents a difference of around 5% in relation to all items in theinitial version resulting from Study 1.2

In the end, risk and protective factors were obtained withacceptable to high internal consistency: living situation (risk factor,α=0.71; protective factor, α=0.66); social and family relationships(risk factor,α=0.70; protective factor,α=0.63); behaviors and skills(risk factor, α=0.71; protective factor, α=0.75); physical andpsychological health (risk factor, α=0.72; protective factor,α=0.66); education and employment (risk factor, α=0.60; protec-tive factor, α=0.75).

5.2.1.2. Face validity. In order to demonstrate the RCYNA's facevalidity, we analyzed the item measuring the disagreement amongpractitioners at the time of filling out this instrument. By analyzing allof the points of this item's underlying scale, we can see that in 11.7% ofthe cases there was no disagreement, in 52.4% of the casesdisagreement was rare (1–5 times), in 31.1% of the cases it wasoccasional (6–10 times), in 1 case it was sporadic (11–15 times), andat no time was it regular (16–20 times) or frequent (more than 20times). We can therefore conclude that the completion of this itemraised little disagreement among the evaluators, thereby demonstrat-ing its comprehensibility, clarity and ease of completion.

5.2.1.3. Descriptive analysis of dimensions of the RCYNA. Havingestablished the internal consistency of the dimensions of theRCYNA, along with its face validity, indicators were created for eachof these dimensions. These indicators resulted from the total sum ofparticipants' individual scores in the items comprising each of thesedimensions. The range of these scores can be seen in Table 3. Note thathigher risk factor values and lower protective factor values indicatesituations of greater need.

An analysis of the scores obtained in the RCYNA (see Table 3) interms of risk and protection reveals that, on average, these youth havehigher scores in protective factors (M=9.35), and lower scores in riskfactors (M=4.56), F (1,71)=160.41, pb0.000, η

2=0.69. We can also

see that, in a general sense, the participants' scores in the variousdimensions differ significantly, F (4284)=391.92, pb0.000, η

2=0.85.

We also analyzed the factors in terms of their distributions (seeTable 3). Looking at the skewness and kurtosis values for eachdimension, and the ratio between these and the respective errors, wecan see that the majority of the dimensions (whether risk orprotective factors) have negative symmetry values, i.e. with distribu-tions slightly biased to the right. The dimensions of “behavior andskills” and “physical and psychological health” (variant of risk factors)deviate from this pattern with positive symmetry values, i.e. withscores slightly biased to the left. In addition to this, when we look atthe ratios between symmetry and the respective standard error, wecan see that some of these dimensions deviate slightly from normality.In fact, the dimensions of “living situation” and “social and familyrelationships” (variant of protective factors), and the dimension of“education and employment” (variant of risk factor) show high ratiosthat bear out this fact. In the latter dimension we can also see thatmean responses value come close to its standard deviation, whichmay be a sign of deviation from normality.

When we analyze the values obtained for the kurtosis, we can seethat the majority of the dimensions are slightly platykurtic, i.e. withnegative kurtosis values. The dimensions of “living situation” and“family relationships” (variant of protective factors), as well as thedimension “education and employment” (variant of risk factor), showpositive kurtosis values, i.e. their distributions are slightly leptokurtic.

Table 3Descriptive measures of the RCYNA (risk and protective factors).

Dimensions Living situation Social and familyrelationships

Behavior andskills

Physical andpsychologicalhealth

Education andemployment

Totalrisk

Totalprotective

Factors RF PF RF PF RF PF RF PF RF PF

Mean 5.90 5.01 6.68 8.35 3.10 21.03 5.99 7.32 1.13 5.04 22.79 46.75Standard-deviation 3.24 1.26 2.85 1.63 2.67 3.39 3.89 2.00 1.28 2.15 9.32 8.28Minimum 0.00 2.00 0.00 3.00 0.00 13.00 0.00 3.00 0.00 0.00 4.00 25.00Maximum 14.00 6.00 12.00 10.00 11.00 26.00 15.00 11.00 5.00 8.00 42.00 59.00Symmetry −0.14 −1.15 −0.36 −1.09 0.74 −0.52 0.43 −0.14 1.26 −0.50 0.05 −0.69Ratio symmetry/standard error −0.50 −4.07 −1.29 −3.84 2.60 −1.82 1.51 −0.49 4.47 −1.77 0.18 −2.45Kurtosis −0.61 0.22 −0.53 0.93 −0.16 −0.62 −0.51 −0.42 1.15 −0.55 −0.49 −0.35Ratio kurtosis/standard error −1.10 0.39 −0.94 1.67 −0.29 −1.12 −0.92 −0.76 2.06 −0.99 −0.88 −0.62

Note: RF = Risk factors; PF = Protective factors.

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Overall, the distribution behavior of the RCYNA's dimensions, inthe areas of risk factors and protective factors alike, was acceptablewith regard to deviations from normality, with their associateddescriptive statistics falling within expected values.

5.2.1.4. Correlations between risk factors and protective factors indimensions of the RCYNA.With regard to inter-dimension correlations,as shown in Table 4, the risk factors have moderate to highcorrelations, with an identical pattern seen in correlations betweenprotective factors. However, and in the domain of risk factors, theassociations between “living situation”, “education and employment”and “social and family relationships”, together with associationsbetween this last factor and the dimension of “education andemployment”, were not significant.

As expected, the associations between risk and protective factors,overall, were negative, i.e. the greater the presence of certain types ofrisk factors, the lower the presence of protective factors.

In general, we can claim that these correlations attest to thesolidity of this instrument's underlying construct, together with itsability to discriminate with regard to risk factors and protectivefactors.

Finally, as shown in Table 5, when we analyze the correlationsbetween each dimension (variants of risk or protective factors) withthe total risk or protection score. We can see, as expected, that riskfactors correlate in a high and positive manner with total risk score,and that protective factors correlate positively with the totalprotection score. Conversely, we can see negative correlationsbetween risk factors and the total score in terms of protection, andbetween protective factors and the total risk score. In addition to theirdirect interpretation, these correlations also bear out the solidity ofthe operationalization of the needs construct, showing that this

Table 4Correlation matrix of the dimensions of the RCYNA (risk and protective factors).

Risk factors

Risk factors: LS SFR BS PPH

Living situation (LS) – 0.11 0.28⁎ 0.36⁎⁎

Social and family relationships (SFR) – – 0.39⁎⁎ 0.25⁎

Behavior and skills (BS) – – – 0.43⁎⁎⁎

Physical and psychological health (PPH) – – – –

Education and employment (EE) – – – –

Protective factors:Living situation (LS) – – – –

Social and family relationships (SFR) – – – –

Behavior and skills (BS) – – – –

Physical and psychological health (PPH) – – – –

Education and employment (EE) – – – –

⁎ pb0.05.⁎⁎ pb0.01.⁎⁎⁎ pb0.000.

instrument has sufficient sensitivity to differentiate scores obtained interms of risk factors versus protective factors, and to reconcile factorsthat share the same conceptual base.

5.2.1.5. Concurrent validity. The criterion-related validity of the RCYNA(in its variant of concurrent validity) was analysed through therelationship between the intensity of risk factors present in the youngperson's life (total risk factor score) and the number of servicesprovided to the young person (total sum of scores obtained for itemsinvolving the number of services used by the young person), since,theoretically, it can be expected that youth with more risk factors willbe subject to more care. According to this hypothesis, we can see thatthe variable involving total risk factors has a positive and moderatecorrelation with the total services provided to the young person,r=0.38, p=0.000. In this way, high risk factor scores in the RCYNAallow us to predict that youth will likely use a higher number of careservices.

6. Discussion

The purpose of this work was to build a Residential Care YouthNeeds Assessment (RCYNA) instrument containing the key dimen-sions for assessing needs, reflecting the methodological approachesalready laid out in the literature and, above all, including theviewpoint of youth to tailor the instrument to this context and to itstarget of assessment. In addition, efforts were made toward the initialassessment of the RCYNA by analyzing some of its psychometriccharacteristics.

Although the instrument has been developed based on differentconceptual and operational sources, as demonstrated in Study 1, themajority of the items comprising the RCYNA originated in the focus

Protective factors

EE LS SFR BS PPH EE

0.07 −0.20 −0.01 −0.22 −0.05 −0.24⁎

0.22 −0.43⁎⁎⁎ −0.33⁎⁎ −0.22 −0.23⁎ −0.34⁎⁎

0.47⁎⁎⁎ −0.43⁎⁎⁎ −0.46⁎⁎⁎ −0.52⁎⁎⁎ −0.43⁎⁎⁎ −0.60⁎⁎⁎

0.27⁎ −0.39⁎⁎ −0.40⁎⁎⁎ −0.52⁎⁎⁎ −0.52⁎⁎⁎ −0.48⁎⁎⁎

– −0.30⁎⁎ −0.26⁎ −0.28⁎ −0.30⁎⁎ −0.38⁎⁎

– – 0.57⁎⁎⁎ 0.52⁎⁎⁎ 0.26⁎ 0.41⁎⁎⁎

– – – 0.60⁎⁎⁎ 0.49⁎⁎⁎ 0.53⁎⁎⁎

– – – – 0.57⁎⁎⁎ 0.52⁎⁎⁎

– – – – – 0.60⁎⁎⁎

– – – – – –

Table 5Correlation matrix of the dimensions of the RCYNA and the total scoring on risk and protective factors.

Total risk factors Total protective factors

Risk factorsLiving situation (LS) 0.62⁎⁎ −0.19Social and family relationships (SFR) 0.59⁎⁎ −0.36⁎

Behaviour and skills (BS) 0.75⁎⁎ −0.63⁎⁎

Physical and psychological health (PPH) 0.78⁎⁎ −0.60⁎⁎

Education and employment (EE) 0.47⁎⁎ −0.37⁎⁎

Protective factorsLiving situation (LS) −0.53⁎⁎ 0.65⁎⁎

Social and family relationships (SFR) −0.44⁎⁎ 0.78⁎⁎

Behaviour and skills (BS) −0.55⁎⁎ 0.88⁎⁎

Physical and psychological health (PPH) −0.47⁎⁎ 0.77⁎⁎

Education and employment (EE) −0.61⁎⁎ 0.78⁎⁎

⁎⁎ p b 0.000.⁎ p b 0.01.

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groups with youth in residential care, which underscores theimportance of gathering information from the assessment's targets.This methodology allowed variables to be identified, giving greaterspecificity and singularity to the instrument, and making it suitable tothe interests of those it assesses. In fact, despite the existence ofseveral instruments that may be applied to these types of youth (e.g.CAR), none were specifically developed for this type of population,thus not assessing particular aspects of youth in care, such as thoseinvolving the residences of care or the youths' relationships withpractitioners.

In Study 2, we analyzed the psychometric qualities of the RCYNA.The results show suitable levels of reliability, face validity, constructvalidity and concurrent validity. With regard to reliability, we wereable to show that the internal consistency of risk and protectivefactors in the various dimensions of needs was high, despite theremoval of some items to obtain internally consistent factors. Indeed,this procedure generated some item mortality vis-à-vis the initialversion, although quite small and therefore negligible.

Moreover, a descriptive analysis of these dimensions showed thatthey follow a normal (or near normal) distribution. The exceptions tothis were the dimensions of “living situation” and “social and familyrelationships” (variant of protective factors) and the dimension of“education and employment” (variant of risk factor), which showedslightly asymmetrical distributions. In a future application of thisscale, it would be useful to review the items that comprise it in orderto surpass this situation.

In addition, the majority of the distributions show a negativeskewness, indicating quite high risk and protective factor averages alike.Nonetheless, and as we noted, the youth who took part in the secondstudy showhigher average scores in protective factors than in risk factors.The averages of most of these dimensions (variants of risk and protectivefactors) also differ between themselves, which shows this scale'ssensitivity to measure different facets of the needs of these youth.

With regard to the inter-dimension correlations, in general, weobserved positive associations among the risk factors and negativeassociations between the risk and protective factors. As we expected,these correlation standards show that youth with more risk factors ina dimension are more likely to have more risk factors and lessprotective factors in the other dimensions. These results are in linewith that indicated in the literature (e.g. Little et al., 2004), in that it isnot only a risk factor, but the interaction between various risk factorsthat affects the development of children and youth, via dynamicprocesses and chains of direct and indirect effects, while protectivefactors generally reduce or eliminate the negative effect of risk factors,thereby with the expectation of a negative relationship betweenthese. Ultimately, the correlation patterns that we found follow thetheoretical postulates involving the needs of youth, thereby ensuring

the validity of the underlying constructs of the different dimensions ofthe RCYNA.

The RCYNA's concurrent validity was shown via the positivecorrelation between the total number of risk factors present in theyouth's life and the amount of care to which the youth is subjected.This indicates that when youth are affected by more risk factors, theyare subject to more care, or given more support services. Thisrelationship proves the instrument's ability to predict situations offuture care, in addition to assessing the seriousness of the youth'ssituation considering his/her needs in terms of the presence/absenceof risk and protective factors.

Despite the merit and practical pertinence we have given to thiswork, we must still consider some of its limitations and make severalrecommendations for future research with this instrument.

In general terms, it should be emphasized that, although theinstrument incorporates aspects that youth consider important inassessing their needs, its completion by practitioners does not allowus to assess the youths' perspective. Therefore, one recommendationarising from this work will be to develop a version of the RCYNA to becompleted by youth. The development of such a version will provideinsights into their perspectives, and will allow a comparison betweenself-assessments and technician assessments to gauge the congruencebetween both perspectives. However, it is important to note that thisparticipation may occur after the assessment of needs, in terms ofestablishing specific goals for the design and development ofprograms, as it has proven essential for it to achieve change moreeffectively (Kirby, Lanyon, Cronin, & Sinclair, 2003). Furthermore,various studies have stated that children/youth generally have apositive view of the opportunity to take part and discuss the variousissues involving them (Cashmore, 2006).

Second, it is important to note that the response to the items isdichotomous, which may lead to some constraints in terms ofanalyzing and interpreting data (namely in conducting a more in-depth test of this instrument's factorial structure and subsequentconfirmation), and in forming profiles. It would also be advisable tocondense the number of items in the instrument (to lessen thepotential effects of fatigue in completing it), as well as useful to ensurethat the various dimensions of needs are assembled using the samenumber of risk and protective factors (to facilitate comparison).

Finally, we stress the importance of obtaining more evidenceconcerning its predictive value, since it is important for thisinstrument to provide a basis for developing services for youth inresidential care, both in terms of care, prevention, and planning. Infact, RCYNA criterion-related validity should be tested against criteriasuch as evaluation of outcomes in different areas of youth life andwell-being or the assessment of youth success in educational,professional, and social integration areas.

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References

Aldgate, J., & Statham, J. (2001). The children act now: Messages from research. London:The Stationery Office.

Axford, N., & Little, M. (2004).Meeting needs or protecting rights: Which way for childrenservices? Totnes: Dartington Social Research Unit.

Axford, N., Little, M., Morpeth, L., & Weyts, A. (2005). Evaluating children's services:Recent conceptual andmethodological developments. British Journal of Social Work,35, 73–88.

Bardin, L. (2007). L'analyse de contenu [Content analysis]. Paris: Presses Universitaires deFrance.

Bronfenbrenner, U. (1979). The ecology of human development: Experiments by natureand design. Cambridge: Havard University Press.

Bullock, R., Little, M., & Millham, S. (1993). Residential care for children: A review ofresearch. London: HMSO.

Calheiros, M. M. (2008). Program design and evaluation for at-risk children and youth:Preventing developmental impairment. In C. Canali, T. Vecchiato, & J. K. Whittaker(Eds.), Assessing the evidence-based of intervention for vulnerable children and theirfamilies (pp. 538–540). Padova: Fondazione Zancan.

Calheiros, M., Garrido, M., & Rodrigues, L. (2009). Percorsi di autonomia: Una ricerca-intervento portoghese [A route to autonomy: A Portuguese research-intervention].In S. Premoli (Ed.), Verso l'autonomia: Percorsi di sostegno all'integrazione sociale digiovani [Towards autonomy: Pathways to support the social integration of youth](pp. 96–126). Milano: Franco Angeli.

Calheiros, M. M., Seabra, D., & Fornelos, M. (1993). The nature and research ofresidential and foster care provision in Portugal. In M. Colton, &W. Hellinckx (Eds.),Child care in countries of the European community (pp. 177–195). Avebury: GowerPublishing Group.

Casas, F. (1993). Changing paradigms in child residential care. Paper presented at theThird European Scientific Congress on Residential and Foster Care. Lüneburg,Germany.

Cashmore, J. (2006). Ethical issues concerning consent in obtaining children's reportson their experience of violence. Child Abuse & Neglect, 30, 969–977.

Cicchetti, D., & Rizley, R. (1981). Developmental perspectives on the etiology,intergenerational transmissions, and sequelae of child maltreatment. New Di-rections for Child Development, 11, 31–55.

Colca, L., & Colca, C. (1996). Transitional independent living foster homes: A steptowards independence. Children Today, 24, 7–11.

Daining, C., & DePanfilis, D. (2007). Resilience of youth in transition from out-of homecare to adulthood. Children & Youth Services Review, 29, 1158–1178.

Dartington Social Research Unit (1998). Towards a common language. Totnes:Dartington Social Research Unit.

Department of Health (1995). Looking after children: Assessment and action records,essential information records, care plans, placement plans and review forms. London:HMSO.

Department of Health (2000a). Assessing children in need and their families: Practiceguidance. London: The Stationery Office Ltd..

Department of Health (2000b). Framework for the assessment of children in need andtheir families. London: The Stationery Office Ltd..

Department of Health (2002). Integrated children's system working with children in needand their families. London: Consultation Document.

Diário da República – I Série A. Lei Tutelar Educativa - Lei 166/99, de 14 de Setembro.Gough, I. (2003). Lists and thresholds: Comparing the Doyal-Gough theory of human need

withNussbaum's capabilities approach.WeDWorkingPaper#1. UK:University of Bath.Gray, J. (2000). Core assessment record. London: The Stationery Office Books.Green, R., & Ellis, P. (2007). Linking structure, process, and outcome to improve group

home services for foster youth in California. Evaluation and Program Planning, 30,307–317.

Kirby, P., Lanyon, C., Cronin, K., & Sinclair, R. (2003). Building a culture of participation:Involving children and young people in policy, service planning, delivery andevaluation. Nottingham: Department for Education and Skills Publications.

Krippendorff, K. (1980). Content analysis: An introduction to its methodology. BeverlyHills, CA: Sage.

Lemon, K., Hines, A., & Merdinger, J. (2005). From foster care to young adulthood: Therole of independent living programs in supporting successful transitions. Childrenand Youth Services Review, 27, 251–270.

Little, M., Axford, N., & Morpeth, L. (2002). Aggregating data: Better managementinformation and planning in children's services. Totnes: Warren House Press.

Little, M., Axford, N., &Morpeth, L. (2004). Risk and protection in the context of servicesfor children in need. Child and Family Social Work, 9, 105–118.

Little, M., & Mount, K. (1999). Prevention and early intervention with children in need.Aldershot: Ashgate Pub Ltd..

Little, M., & Mount, K. (2003). Paperwork: The clinical assessment of children in need.Totnes: Warren House Press.

McCoy, H., McMillen, J., & Spitznagel, E. (2008). Older youth leaving the foster caresystem:Who, what, when, where, and why? Children and Youth Services Review, 30,735–745.

McCutcheon, A. C. (1987). Latent class analysis. Beverly Hills: Sage.Nettles, S., & Pleck, J. (1994). Risk, resilience, and development: The multiple ecologies of

black adolescents in the United States. In R. J. Haggerty, L. R. Sherrod, N. Garmezy, & M.Rutter (Eds.), Stress, risk, and resilience in children and adolescents: Processes, mechanisms,and interventions (pp. 147–181). Cambridge, NY: Cambridge University Press.

Raymond, I., & Heseltine, K. (2008). What does it mean to be an adult? Perceptions ofyoung men in residential care. Child and Youth Care Forum, 37, 197–208.

Swenson, M., & Swenson, C. (2002). Panorâmica da investigação em terapia multissistémica[An overview on multisystemic therapy research]. In A. Castro Fonseca (Ed.), Simpósiointernacional comportamento anti-social: Escola e famíliaInternational symposium on anti-social behaviour: School and family. Coimbra, Portugal: Universidade de Coimbra.

Taylor, K. (2005). Understanding communities today: Using matching needs andservices to assess community needs and design community-based services. ChildWelfare League of America, 84, 251–264.

Valle, J. (1998). Manual de programation y evaluación para los centros de protección a lainfancia [Handbook of programming and evaluation of child care centers]. Salamanca:Junta de Castilla y León.

Ward, H., & Rose, W. (2002). Approaches to needs assessments in children's services.London: Jessica Kingsley Publishers.

Werner, E., & Smith, R. (1982). Vulnerable but invincible: A longitudinal study of resilientchildren and youth. New York: McGraw-Hill.

Yang, C. (2006). Evaluating latent class analysis models in quantitative phenotypeidentification. Computational Statistics & Data Analysis, 50, 1090–1104.