cloning. Second, it is sensitive. Activities canbe detected

cloning. Second, it is sensitive. Activities can
be detected in the purified GST-ORF pools
that simply cannot be detected in extracts or
cells, the starting point of both conventional
purification and expression cloning. Because
the GST-ORFs are individually expressed at
high levels and are largely free of extract
proteins after purification, activities can be
measured for hours without competing activ-
ities that destroy the substrate, the product, or
the enzymes.
In addition to the conventional use demon-
strated here, this array could be used in two
other ways: (i) to determine the range of poten-
tial substrate proteins for any protein-modifying
enzyme (such as a protein kinase) before genet-
ic or biochemical tests to establish authentic
substrates and (ii) to identify genes encoding
proteins that bind any particular macromole-
cule, ligand, or drug. Thus, one could rapidly
ascribe function to many presently unclassified
yeast proteins, complementing other genomic
approaches to deduce gene function from ex-
pression patterns, mutant phenotypes, localiza-
tion of gene products, and identification of in-
teracting partners.
References and Notes
1. H. Simonsen and H. F. Lodish, Trends Pharmacol. Sci.
15, 437 (1994).

2. Plasmid pYEX 4T-1 (Clontech, Palo Alto, CA) was
modified by the addition of a 140-nucleotide recom-
bination domain, 39 of its Eco RI site, linearized within
the recombination domain by restriction digestion,
and cotransformed with a genomic set of reamplified
ORFs that had the same ends as the linearized plas-
mid [ J. R. Hudson Jr. et al., Genome Res. 7, 1169
(1997)] into strain EJ 758 [MATa his3-D200, leu2-
3,112, ura3-52, pep4::URA3], a derivative of JHRY-
20-2Ca (5). Transformants obtained on synthetic
minimal (SD) 2 Ura drop-out plates [F. Sherman,
Methods Enzymol. 194, 3 (1991)] (.100 in all cases,
and more than five times the cut vector in 97% of the
cases) were eluted in batch and saved in 96-well
microtiter plates. The library contains 6080 ORF-
containing strains and 64 strains with vector only.
3. Cell patches were inoculated in SD 2 Ura liquid
medium, grown overnight, reinoculated, and grown
overnight in SD 2 Ura 2 Leu medium, and then
inoculated into 250 ml of SD 2 Ura 2 Leu medium,
grown to absorbance at 600 nm of 0.8, and induced
with 0.5 mM copper sulfate for 2 hours before har-
vest [I. G. Macreadie, O. Horaitis, A. J. Verkuylen,
K. W. Savin, Gene 104, 107 (1991)]. Cells were re-
suspended in 1 ml of buffer [50 mM tris-HCl (pH 7.5),
1 mM EDTA, 4 mM MgCl2, 5 mM dithiothreitol (DT T),
10% glycerol, and 1 M NaCl] containing leupeptin (2
mg/ml) and pepstatin (1 mg/ml), and extracts were
made with glass beads [S. M. McCraith and E. M.
Phizicky, Mol. Cell. Biol. 10, 1049 (1990)], followed
by supplementation with 1 mM phenylmethylsulfo-
nyl fluoride and centrifugation. GST-ORF fusion pro-
teins were purified by glutathione agarose chroma-
tography in buffer containing 0.5 M NaCl, essentially

as described [ J. R. Nelson, C. W. Lawrence, D. C.
Hinkle, Science 272, 1646 (1996)], followed by dial-
ysis in 20 mM tris-HCl, 2 mM EDTA, 4 mM MgCl2, 1
mM DT T, 55 mM NaCl, and 50% (v/v) glycerol and
storage at 220°C.
4. C. L. Greer, C. L. Peebles, P. Gegenheimer, J. Abelson,
Cell 32, 537 (1983); E. M. Phizicky, R. C. Schwartz, J.
Abelson J. Biol. Chem. 261, 2978 (1986); E. M.
Phizicky, S. A. Consaul, K. W. Nehrke, J. Abelson,
J. Biol. Chem. 267, 4577 (1992).
5. S. M. McCraith and E. M. Phizicky, J. Biol. Chem. 266,
11986 (1991); G. M. Culver, S. M. McCraith, S. A.
Consaul, D. R. Stanford, E. M. Phizicky, J. Biol. Chem.
272, 13203 (1997); S. L. Spinelli, S. A. Consaul, E. M.
Phizicky, RNA 3, 1388 (1997).
6. G. M. Culver, S. A. Consaul, K. T. Tycowski, W. Filip-
owicz, E. M. Phizicky, J. Biol. Chem. 269, 24928
(1994).
7. G. M. Culver et al., Science 261, 206 (1993).
8. R. J. DeLange, A. N. Glazer, E. L. Smith, J. Biol. Chem.
245, 3325 (1970).
9. Crude extract from 430 g of strain JHRY-20-2Ca (5)
was chromatographed successively on Blue Sepha-
rose, heparin agarose, hydroxyapatite, and Orange A
Sepharose to purify cyclic phosphodiesterase activity
4000-fold in relation to crude extract.
10. C. L. Peebles, P. Gegenheimer, J. Abelson, Cell 32, 525
(1983); C. R. Trotta et al., Cell 89, 849 (1996).

11. S. L. Spinelli, R. Kierzek, D. H. Turner, E. M. Phizicky,
J. Biol. Chem. 274, 2637 (1999).
12. H. H. Liao and F. Sherman, J. Bacteriol. 138, 853
(1979); H. Morino, T. Kawamoto, M. Miyake, Y. Kaki-
moto, J. Neurochem. 48, 1201 (1987).
13. We thank M. Dumont, M. Gorovsky, and L. Tabak for
comments and B. Pinsky for assistance. Supported by
the University of Rochester Medical School and the
Merck Genome Research Institute (grant 196 to
E.M.P. and E.J.G.), NIH (grant GM52347 to E.M.P.),
American Cancer Society (grant RPG-95-049-05-
MBC to E.J.G.), the National Center for Research
Resources (grant P41 RR11823 to S.F.), and the Merck
Genome Research Institute (to S.F.). S.F. is an inves-
tigator of the Howard Hughes Medical Institute.
26 July 1999; accepted 23 September 1999
Nongenomic Transmission Across
Generations of Maternal Behavior
and Stress Responses in the Rat
Darlene Francis, Josie Diorio, Dong Liu, Michael J. Meaney*
In the rat, variations in maternal care appear to influence the
development of
behavioral and endocrine responses to stress in the offspring.
The results of
cross-fostering studies reported here provide evidence for (i) a
causal rela-
tionship between maternal behavior and stress reactivity in the
offspring and
(ii) the transmission of such individual differences in maternal
behavior from

one generation of females to the next. Moreover, an
environmental manipu-
lation imposed during early development that alters maternal
behavior can then
affect the pattern of transmission in subsequent generations.
Taken together,
these findings indicate that variations in maternal care can serve
as the basis
for a nongenomic behavioral transmission of individual
differences in stress
reactivity across generations.
Individual differences in personality traits ap-
pear to be transmitted from parents to off-
spring. A critical question, however, concerns
the mode of inheritance. Concordance studies
with mono- and dizygotic twins have provid-
ed evidence for a genetic mechanism of trans-
mission even of complex traits (1). In addi-
tion, parental behavior influences the devel-
opment of the offspring (2) and could there-
fore serve as a mechanism for a nongenomic
behavioral mode of inheritance. In the Norway
rat (Rattus norvegicus), variations in maternal
care are associated with the development of
individual differences in behavioral and en-
docrine responses to stress in the offspring (3,
4 ). In the studies reported here we have
examined the possibility that such variations
in maternal care might be the mechanism for
a behavioral transmission of individual dif-
ferences across multiple generations.
Mother-pup contact in the rat occurs primar-
ily within the context of a nest bout that begins

when the mother approaches the litter, gathers
the pups under her, licks/grooms her pups, and
nurses her offspring while continuing to occa-
sionally lick/groom the pups, and terminates
when the mother leaves the nest (5). Naturally
occurring variations in maternal licking/groom-
ing and arched-back nursing (LG-ABN) have
been associated with the developme nt of indi-
vidual differences in hypothalamic-pituitary-
adrenal (HPA) and behavioral responses to
stress in the offspring (3, 4 ). As adults, the
offspring of high LG-ABN mothers are behav-
iorally less fearful and show more modest HPA
responses to stress than do the offspring of low
LG-ABN mothers. The variation in maternal
behavior may thus constitute a mechanism for
the nongenomic behavioral transmission of
fearfulness from parent to offspring. Alterna-
tively, of course, the differences in fearfulness
and those in maternal behavior may both be
associated with a common genotype so that the
observed continuity of individual differences
from mother to offspring is mediated by a
genomically based pattern of inheritance.
We found that the female offspring of high
LG-ABN mothers showed significantly in-
creased licking/grooming of pups in compari-
son with those of low LG-ABN mothers
(12.9 6 1.0 versus 6.9 6 1.1; P , 0.001) (6 ),
Developmental Neuroendocrinology Laboratory, Doug-
las Hospital Research Centre, Departments of Psychiatry
and of Neurology and Neurosurgery, McGill University,
Montreal, H4H 1R3, Canada.

*To whom correspondence should be addressed. E-
mail: [email protected]
R E P O R T S
www.sciencemag.org SCIENCE VOL 286 5 NOVEMBER 1999
1155
o
n
M
a
y 6
, 2
0
2
1
h
ttp
://scie
n
ce
.scie
n
ce
m
a
g
.o

rg
/
D
o
w
n
lo
a
d
e
d
fro
m
http://science.sciencemag.org/
which suggests that individual differences in
maternal behavior are transmitted across gener-
ations. To determine the mode of transmission
we performed a cross-fostering study with the
offspring of high and low LG-ABN mothers
(7 ). A primary concern here was that the
wholesale fostering of litters between mothers
is known to affect maternal behavior (8). To
avoid this problem and maintain the original
character of the host litter, no more than 2 of 12
pups were fostered into or from any one litter
(7 ). The control groups included (i) the off-
spring of low LG-ABN mothers fostered to
other low LG-ABN mothers as well as off-

spring of high LG-ABN mothers fostered to
other high LG-ABN mothers, (ii) sham-adop-
tion animals, which were simply removed from
the nest and fostered back to their biological
mothers, and (iii) unmanipulated pups of high
or low LG-ABN mothers. The limited cross-
fostering design did not affect group differences
in maternal behavior. The frequency of pup
licking/grooming (Fig. 1A) and arched-back
nursing across all groups of high LG-ABN
mothers was significantly greater than that
for any of the low LG-ABN dams, regardless
of litter composition.
The biological female offspring of low LG-
ABN dams reared by high LG-ABN mothers
were significantly less fearful under conditions
of novelty (9) than were any of the female
offspring reared by low LG-ABN mothers, in-
cluding the biological offspring of high LG-
ABN mothers (Fig. 1B). This was also ob-
served for male offspring (10). A separate
group of female offspring was then mated, al-
lowed to give birth, and observed for differenc-
es in maternal behavior (6 ). The effect on ma-
ternal behavior followed the same pattern as
that for differences in fearfulness. As adults, the
female offspring of low LG-ABN dams reared
by high LG-ABN mothers did not differ from
normal, high LG-ABN offspring in the frequen-
cy of pup licking/grooming (Fig. 1C) or arched-
back nursing (10). The frequency of licking/
grooming and arched-back nursing in animals
reared by high LG-ABN mothers was signif-
icantly higher than in any of the low LG-
ABN groups, including female pups original-

ly born to high LG-ABN mothers but reared
by low LG-ABN dams.
Postnatal handling of pups is known to in-
crease the frequency of maternal licking/
grooming and arched-back nursing (11) and to
decrease the response to stress in the offspring
(12). Postnatal handling should alter the pheno-
type of the low LG-ABN offspring, and the
behavioral transmission hypothesis would sug-
gest that these effects should then be transmit-
ted to the next generation. To see whether an
experimental manipulation that alters maternal
behavior would influence the transmission of
these individual differences in behavior in sub-
sequent generations, female offspring (F1) of
high or low LG-ABN mothers were mated (6 ),
and the pups (F2) in one-half of the litters in
each group were exposed daily to brief sessions
of handling (11). The female offspring of high
LG-ABN mothers showed significantly more
licking/grooming (Fig. 2A) and arched-back
nursing than did the offspring of low LG-ABN
mothers. Thus, as observed in our earlier study,
individual differences in maternal behavior
were transmitted across generations. The han-
dling of the pups significantly increased the
frequency of maternal licking/grooming and
arched-back nursing in the offspring of low
LG-ABN mothers but had no effect on the
offspring of high LG-ABN mothers (Fig.
2A). Thus, the effects of maternal behavior of
the low LG-ABN mothers with handled pups
was indistinguishable from that of the high
LG-ABN mothers. The maternal behavior of

the adult female offspring (F2) showed the
same pattern (Fig. 2A), and this result is
consistent with the transmission of individual
differences in maternal behavior across gen-
erations. As adults, the handled female off-
spring of low LG-ABN mothers did not differ
from the offspring of high LG-ABN dams in
the frequency of maternal licking/grooming
and arched-back nursing.
The next question concerned the effective
transmission of the individual differences in
behavioral responses to stress in the unmanipu-
lated offspring (F3) of these females (F2). The
level of fearfulness under conditions of novelty
in the male or female offspring of handled, low
LG-ABN mothers, which did not differ from
high LG-ABN mothers in measures of maternal
behavior, was comparable to that of the off-
spring of high LG-ABN mothers (Fig. 2B). The
postnatal handling results suggest that environ-
mental events that affect maternal behavior can
alter the pattern of transmission of individual
differences in stress reactivity and maternal be-
havior from one generation to the next.
The effects of variation in maternal care on
the development of stress reactivity are medi-
ated by changes in the levels of expression of
specific genes in brain regions that regulate
behavioral and endocrine responses to stress (3,
4, 13). In comparison to the offspring of low
LG-ABN mothers, the adult offspring of high
LG-ABN dams showed increased hippocam-

Fig. 1. (A) Mean 6 SEM percentage frequency
of licking/grooming in high LG-ABN and low
LG-ABN mothers (n 5 6 to 8 per group), col-
lapsed over the first 10 days postpartum in the
adoption study (6, 7). The biological offspring
of high LG-ABN or low LG-ABN mothers were
(i) left undisturbed with their mothers, high/
control (H/C) and low/control (L/C); (ii) cross-
fostered back onto their own mothers, high/w
(H/w) and low/w (L/w); (iii) cross-fostered to
mothers of the same group, high-high (H-H)
and low-low (L-L); and (iv) cross-fostered
across groups, high-low (H-L) and low-high (L-
H). No more than two pups were cross-fostered
from any one litter. The ANOVA revealed a
significant group effect (F 5 12.67; P ,
0.0001). Post-hoc analysis revealed that the
frequency of licking/grooming was significantly
higher in each of the high LG-ABN groups as
compared to any one of the low LG-ABN
groups (P , 0.05; differences are indicated by
a solid horizontal line). (B) Mean 6 SEM time in
seconds spent in the inner area of a novel open
field (exploration) (9) in the adult female off-
spring from the cross-fostering study (n 5 6 to
8 per group). The ANOVA revealed a significant
effect (F 5 3.37; P , 0.05) of the mother, a
significant effect of cross-fostering (F 5 11.88;
P , 0.0001) and a significant mother 3 cross-
fostering interaction effect (F 5 7.39; P , 0.001).
Post-hoc analysis revealed that the time spent
in inner area exploration was significantly (P ,
0.01) higher in the biological offspring of low
LG-ABN mothers reared by high LG-ABN moth-
ers (L-H) than in the offspring of high LG-ABN
mothers reared by low LG-ABN mothers (H-L).

Groups lying below the solid line differ signifi-
cantly from those above the line. (C) Mean 6 SEM percentage
frequency of licking/grooming,
collapsed over the first 10 days postpartum in the adult female
offspring from the cross-fostering
study (n 5 5 to 7 per group). The ANOVA revealed a significant
effect (F 5 26.28; P , 0.0001)
of the mother, a significant effect of cross-fostering (F 5 13.56;
P , 0.0001) and a significant
mother 3 cross-fostering interaction effect (F 5 8.13; P , 0.001).
Post-hoc analysis revealed
that the frequency of maternal licking/grooming was
significantly (P , 0.001; solid line) higher
in the biological offspring of low LG-ABN mothers reared by
high LG-ABN mothers (L-H) than in
offspring of high LG-ABN mothers reared by low LG-ABN
mothers (H-L).
R E P O R T S
5 NOVEMBER 1999 VOL 286 SCIENCE
www.sciencemag.org1156
o
n
M
a
y 6
, 2
0
2
1

h
ttp
://scie
n
ce
.scie
n
ce
m
a
g
.o
rg
/
D
o
w
n
lo
a
d
e
d
fro
m

pal glucocorticoid receptor (GR) mRNA ex-
pression, increased central benzodiazepine
(CBZ) receptor levels in the central and ba-
solateral nuclei of the amygdala, and de-
creased corticotropin-releasing factor (CRF)
mRNA in the paraventricular nucleus of the
hypothalamus (PVNh) (3, 4 ). As adults, the
offspring of handled, low LG-ABN mothers
showed hippocampal GR mRNA levels that
were comparable to those observed in the
offspring of either handled (H) or nonhandled
(NH) high LG-ABN mothers and were sig-
nificantly higher than those in the offspring
of NH/LG-ABN females (Fig. 2, C and D)
(14 ). Moreover, the offspring of the H/low
LG-ABN females showed significantly re-
duced CRF mRNA levels in the paraventricu-
lar nucleus of the hypothalamus in compari-
son to the offspring of the NH/low LG-ABN
mothers (Fig. 2, C and E) (14 ). CRF mRNA
levels in these animals were comparable to
those of the offspring of H or NH high LG-
ABN mothers. In previous studies, we also
found that the offspring of high LG-ABN
mothers show increased CBZ receptor bind-
ing in the amygdala in comparison with the
offspring of low LG-ABN mothers (3, 4 ). As
expected, the adult offspring of H/low LG-
ABN mothers showed CBZ receptor levels in
the central and basolateral nuclei of the
amygdala that were comparable to those ob-
served in the offspring of either H or NH high

LG-ABN mothers and were significantly
Maternal
origin
C
High-NH
Low-NH
High-H
Low-H
GR mRNA CRH mRNA
Fig. 2. (A) Mean 6 SEM frequency (as a percentage of total
observations) of licking/grooming, collapsed over
the first 10 days postpartum in high and low LG-ABN mothers
(F1), with handled (H) or nonhandled (NH) pups
(n 5 5 to 7 per group). The ANOVA revealed a significant group
3 pup treatment interaction effect (F 5 7.67;
df 5 1, 19; P , 0.01). Post-hoc analysis showed that low LG-
ABN mothers with nonhandled offspring showed
significantly (p, P , 0.01) less licking/grooming than any other
group, including low LG-ABN mothers with
handled offspring. The same group 3 pup treatment interaction
effect (F 5 9.78; df 5 1, 24; P , 0.001) in
pup licking/grooming was apparent in the lactating female
offspring (F2) of these mothers. Open bar, High-NH;
striped bar, High/H; black bar, Low/NH; gray bar, Low/H. (B)
Mean 6 SEM time in seconds spent in the inner
area of a novel open field (exploration) (9) in the
unmanipulated adult female offspring (F3) of H or NH, high
or low LG-ABN (F2) mothers (n 5 8 to 10 per group). The

ANOVA revealed a significant group effect (F 5 3.39;
df 5 3, 31; P , 0.05). Post-hoc analysis revealed that the time
spent in inner area exploration was significantly
lower in the offspring of the low LG-ABN/NH animals than in
any other group (p, P , 0.05). (C) A pseudocolor
image of representative sections showing relevant brain regions
from in situ hybridization studies examining GR
mRNA expression in the dorsal hippocampus and CRF mRNA
expression in the PVNh in the unmanipulated
adult female offspring (F3) of high LG-ABN/NH, high LG-
ABN/H, low LG-ABN/NH, and low LG-ABN/NH (F2) mothers
(n 5 4 per group). (D) Mean 6
SEM levels of GR mRNA (arbitrary optical density units using
[35S]-labeled standards) (14) in Ammon’s Horn (CA1) and the
dentate gyrus (DG) in the
unmanipulated adult female offspring (F3) of high LG-
ABN/NH, high LG-ABN/H, low LG-ABN/NH, and low LG-
ABN/NH (F2) mothers (n 5 4 per group).
The two-way ANOVA (group 3 region) revealed a significant
group effect (F 5 7.74; df 5 3, 12; P , 0.01). Post-hoc analysis
showed that for both
the DG (P , 0.05) and the CA1 (P , 0.002) regions, GR mRNA
levels were significantly lower (p) in the offspring of the low
LG-ABN/NH animals
than in any other group. Bar shading is the same as in (A). (E)
Mean 6 SEM levels of CRF mRNA (arbitrary optical density
units using [35S]-labeled
standards) (14) in the PVNh in the unmanipulated adult female
offspring (F3) of high LG-ABN/NH, high LG-ABN/H, low LG-
ABN/NH, and low
LG-ABN/NH (F2) mothers (n 5 4 to 5 per group). The ANOVA
revealed a significant group effect (F 5 4.11; df 5 3, 15; P ,
0.05). Post-hoc analysis
revealed that in both regions mRNA levels were significantly
highly in the offspring of the low LG-ABN/NH animals than in
any other group (p, P ,

0.05). (F) Mean 6 SEM levels of CBZ receptor binding
(femtomoles per milligram protein) (15) in the basolateral
nucleus (BLnA) and central nucleus
(CnA) regions of the amygdala and the ventromedial nucleus of
the hypothalamus ( VMH) of unmanipulated, adult female
offspring (F3) of high
LG-ABN/NH, high LG-ABN/H, low LG-ABN/NH, and low LG-
ABN/NH (F2) mothers (n 5 4 per group). The two-way ANOVA
(group 3 region) revealed
a marginal group effect (F 5 3.04; df 5 3, 12; P , 0.10) and,
more important, a significant group 3 region interactions effect
(F 5 3.18; df 5
6, 24; P , 0.02). Post-hoc analysis showed that for both the
basolateral (P , 0.05) and the central (P , 0.002) regions of the
amygdala, CBZ
receptor levels were significantly (p, P , 0.05) lower in the
offspring of the low LG-ABN/NH animals than in any other
group. Bar shading is the same
as in (A).
R E P O R T S
www.sciencemag.org SCIENCE VOL 286 5 NOVEMBER 1999
1157
o
n
M
a
y 6
, 2
0
2
1

h
ttp
://scie
n
ce
.scie
n
ce
m
a
g
.o
rg
/
D
o
w
n
lo
a
d
e
d
fro
m

higher than those in the offspring of NH/LG-
ABN females (Fig. 2F) (15).
These findings suggest that individual dif-
ferences in the expression of genes in brain
regions that regulate stress reactivity can be
transmitted from one generation to the next
through behavior. The studies of Denenberg
(16 ) in rodents suggested that individual dif-
ferences in behavioral fearfulness to novelty
could be transmitted from parent to offspring
through a nongenomic mechanism of inheri-
tance. The results of the present study support
this idea and suggest that the mechanism for
this pattern of inheritance involves differenc-
es in maternal care during the first week of
life. In humans, social, emotional, and eco-
nomic contexts influence the quality of the
relationship between parent and child (17 )
and can show continuity across generations
(18). Our findings in rats may thus be rele-
vant in understanding the importance of early
intervention programs in humans.
References and Notes
1. R. Plomin, J. C. De Fries, G. E. McClearn, M. Rutter,
Behavioral Genetics (Freeman, New York, ed. 3,
1997).
2. J. Bowlby, Maternal Care and Mental Health ( World
Health Organization, Geneva, 1951); H. F. Harlow,

Am. Psychol. 13, 673 (1958); S. J. Suomi, Br. Med.
Bull. 53, 170 (1997); M. Rutter, Am. Psychol. 52, 603
(1997); S. Levine and E. B. Thoman, in Postnatal
Development of Phenotype, S. Kazda and V. H.
Denenberg, Eds. (Academia, Prague, 1970).
3. D. Liu et al., Science 277, 1659 (1997).
4. C. Caldji et al., Proc. Natl. Acad. Sci. U.S.A. 95, 5335
(1998).
5. J. R. Alberts and C. P. Cramer, in Handbook of Behav-
ioral Neurobiology, vol. 9, E. M. Blass, Ed. (Plenum,
New York, 1989); J. S. Rosenblatt, Acta Paediatr.
Suppl. 397, 3 (1994); J. M. Stern, Dev. Psychobiol. 31,
19 (1997).
6. The animals were derived from Long-Evans hooded rats
obtained from Charles River Canada (St. Constant, Qué-
bec), mated with males drawn randomly from our col-
ony breeding stock, and maintained under previously
described conditions (3, 4). In cases where the offspring
of high or low LG-ABN mothers were used in studies, no
more than two animals per group were drawn from any
single mother. All procedures were performed according
to guidelines developed by the Canadian Council on
Animal Care and the protocol was approved by the
McGill University Animal Care Committee. Mothers and
their litters were housed in 46 cm by 18 cm by 30 cm
Plexiglas cages and maternal behavior was scored [M. M.
Myers, S. A. Brunelli, H. N. Shair, J. M. Squire, M. A. Hofer,
Dev. Psychobiol. 22, 55 (1989) and (3, 4)] for six 100-
min observation periods daily for the first 10 days
postpartum by individuals unaware of the origin of the
animals. The following behaviors were scored: mother
off pups; mother licking/grooming any pup; and mother

nursing pups in either an arched-back posture, a “blan-
ket” posture (in which the mother lies over the pups), or
a passive posture (in which the mother is lying either on
her back or side). The data were analyzed as the per-
centage of total observations (frequency per total ob-
servations 3 100) in which animals engaged in the
target behavior (3, 4). In order to define populations, we
observed the maternal behavior in a cohort of 32 moth-
ers and devised the group mean and standard deviation
for each behavior over the first 10 days of life. High
LG-ABN mothers were defined as females whose fre-
quency scores for both licking/grooming and arched-
back nursing were greater than 1 SD above the mean.
Low LG-ABN mothers were defined as females whose
frequency scores for both licking/grooming and arched-
back nursing were more than 1 SD below the mean. As
in our previous reports (3, 4), the frequency of licking/
grooming and arched-back nursing were highly corre-
lated (r . 10.90). The adult female offspring of high
and low LG-ABN dams were then mated and observed
for maternal behavior with the use of the same proce-
dures described above over the first 10 days postpar -
tum. As previously reported (3, 4), there were no dif-
ferences in the percentage of total observations in
which the offspring of high or low LG-ABN mothers
were observed to be in contact with their pups (53 6 5
versus 51 6 4%; NS). Variations in licking/grooming or
arched-back nursing were not related to differences in
time spent with pups.
7. R. McCarty and J. H. Lee, Physiol. Behav. 59, 71 (1996).
Female offspring of high or low LG-ABN dams were
mated and allowed to give birth. Within 12 hours of
birth, dams were removed from the home cage and two
animals per litter were cross-fostered. The cross-fos-

tered pups, along with two native pups, were labeled
with a permanent marker (Codman pens, Johnson &
Johnson) until day 10 of life and were identified by
individual differences in the pattern of pelage pigmen-
tation thereafter. All litters were culled to 12 pups.
Subsequent studies showed that marking the pups had
no effect on maternal licking/grooming; marked pups
are licked/groomed no more or less frequently than
unmarked pups (10). The dam was returned once the
foster pups were introduced into the new litter. The
entire procedure took less than 15 min. The data were
analyzed using a two-way analysis of variance
(ANOVA) (mother 3 cross-fostering condition).
8. S. Maccari et al., J. Neurosci. 15, 110 (1995).
9. Fearfulness under conditions of novelty was studied
by means of an open-field test of exploration as
previously described (4). Animals were placed one at
a time, in a novel, circular open field 1.6 m in diam-
eter for 5 min. The critical measure of exploration
was the time (s) spent in the inner area of the novel
arena (that is, entire body of the animal being .10
cm away from any wall (.10 cm) enclosing the open
field.
10. D. Francis and M. J. Meaney, unpublished data.
11. The handling procedure involved removing the moth-
er and then pups from their cage, placing the pups
together in a small container, and returning the an-
imals and their mothers to their cage 15 min later.
The manipulation was performed daily for the first 14
days of life, and the animals were tested as fully
mature adults. Nonhandled animals were left com-
pletely undisturbed until day 12 of life, at which time

normal cage maintenance was initiated. Mothers of
handled pups consistently showed an increased fre-
quency of maternal licking/grooming [M. H. S. Lee
and D. I. Williams, Anim. Behav. 22, 679 (1974); S. A.
Barnett and J. Burn, Nature 213, 150 (1967); S.
Levine, in Society, Stress and Disease, L. Levi, Ed.
(Oxford Univ. Press, London, 1975); W. P. Smother-
man and R. W. Bell, in Maternal Influences and Early
Behavior, R. W. Bell and W. P. Smotherman, Eds.
(Spectrum, New York, 1980); M. B. Hennessy, J. Vogt,
S. Levine, Physiol. Psychol. 10, 153 (1982); (3).
12. S. Levine, Science 135, 795 (1962); iiii, G. C.
Haltmeyer, G. G. Karas, V. H. Denenberg, Physiol.
Behav. 2, 55 (1967); J. L. Hess, V. H. Denenberg, M. X.
Zarrow, W. D. Pfeifer, Physiol. Behav. 4, 109 (1969);
M. X. Zarrow, P. S. Campbell, V. H. Denenberg, Proc.
Soc. Exp. Biol. Med. 356, 141 (1973); M. J. Meaney,
D. H. Aitken, Ch. Van Berkel, S. Bhatnagar, R. M.
Sapolsky, Science 239, 766 (1988); M. J. Meaney,
D. H. Aitken, S. Sharma, V. Viau, A. Sarrieau, Neu-
roendocrinology 5, 597 (1989); M. Vallée et al.,
J. Neurosci. 17, 2626 (1993); S. Bhatnagar, N. Shanks,
M. J. Meaney, J. Neuroendocrinol. 7, 107 (1995).
13. A. J. Dunn and C. W. Berridge, Brain Res. Rev. 15, 71
(1990); M. J. Owens and C. B. Nemeroff, Pharmacol.
Rev. 43, 425 (1991); P. M. Plotsky, J. Neuroendocri-
nol. 3, 1 (1991); M. F. Dallman et al., J. Neuroendo-
crinol. 4, 517 (1993); G. F. Koob, S. C. Heinrichs, F.
Menzaghi, E. M. Pich, K. T. Britton, Semin. Neurosci. 6,
221 (1994); S. L. Lightman and M. S. Harbuz, Ciba
Found. Symp. 172, 173 (1994); J. Schulkin, B. S.
McEwen, P. W. Gold, Neurosci. Biobehav. Rev. 18, 1
(1994); J. P. Herman and W. E. Cullinan, Trends.
Neurosci. 20, 78 (1997); J. A. Gray, The Psychology of

Fear and Stress, (Cambridge Univ. Press, Cambridge,
1987); A. L. Malizia et al., Eds., GABAA Receptors and
Anxiety: From Neurobiology to Treatment (Raven,
New York, 1995); P. Roy-Byrne, D. K. Wingerson, A.
Radant, D. J. Greenblatt, D. S. Cowley, Am. J. Psychi-
atry 153, 1444 (1996).
14. For all in situ hybridization studies, animals were
killed under resting-state conditions directly from the
home cage. After rapid decapitation, brains were
removed and quickly frozen in isopentane maintained
on dry ice. Brains were blocked, and 15-mm cryostat
sections were mounted onto poly-D-lysine–coated
slides, desiccated under vacuum, and stored at
280°C. CRF mRNA in situ hybridization was per-
formed with a [35S]ATP-labeled 48 – base pair (bp)
oligonucleotide sequence (CAG T T T CCT GT T GCT
GTG AGC T TG CTG AGC TAA CTG CTC TGC CCT
GGC) obtained from the Sheldon Biotechnology Cen-
ter (Montréal, Canada) as previously described (3).
Preparation and description of GR riboprobes as well
as the in situ hybridization procedure have been
described (3). The GR cRNA was transcribed from a
674-bp Pst I–Eco RI fragment of the rat GR cDNA
(steroid binding domain, R. Meisfield, University of
Arizona), linearized with Ava I, and transcribed with
T7 RNA polymerase. The hybridization signal within
the parvocellular subregion of the PVNh (CRF mRNA)
or the dorsal hippocampus (GR mRNA) was quanti-
fied by means of densitometry with an image anal-
ysis system (MCID, Imaging Research, Inc., St. Cathe-
rines, Ontario). The data are presented as arbitrary
optical density (absorbance) units after correction for
background. The anatomical level of analysis was
verified with the Paxinos and Watson rat brain atlas

(19) and Nissl-staining of sections after autoradiog-
raphy. The hippocampal GR mRNA data were ana-
lyzed with a two-way ANOVA (group 3 region). The
CRF mRNA data were analyzed with a one-way
ANOVA (group).
15. CBZ receptor binding was measured with in vitro
receptor autoradiography as previously described
[M. H. Bureau and R. W. Olsen, J. Neurochem. 61,
1479 (1993)]. Brain sections were prepared as de-
scribed above (14) and incubated with [3H]flunitraz-
epam (84.5 Ci/mmol, New England Nuclear, Boston,
MA), with or without 1 mM clonazepam. The sections
were left to dry overnight and were then apposed to
3H-sensitive Ultrafilm (Amersham Canada, Montréal,
Canada) along with 3H microscales for 14 days. Au-
toradiograms were analyzed by obtaining optical
densities (expressed as mean 6 SEM in femtomoles
per milligram of protein) that were determined with
computer-assisted densitometry using an MCID im-
age analysis system and low activity 3H standards of
(19). Autoradiographic data were analyzed with a
two-way ANOVA (group 3 region).
16. V. H. Denenberg and K. M. Rosenberg, Nature 216,
549 (1967); V. H. Denenberg, Psychol. Rev. 71, 335
(1964).
17. L. Eisenberg, in Mammalian Parenting: Biochemical,
Neurobiological, and Behavioral Determinants, N. A.
Krasnegor and R. S. Bridges, Eds. (Oxford Univ. Press,
New York, 1990); T. Field, Prev. Med. 27, 200 (1998);
A. S. Fleming, Psychoneuroendocrinology 13, 189
(1988).
18. M. H. Van Ijzendoorn, Dev. Rev. 12, 76 (1992); K. E.

Grossman and K. Grossman, in Attachment Across the
Life Cycle, C. M. Parkes, J. Stevenson-Hinde, P. Marris,
Eds. (Routledge, New York, 1993); R. J. Noone, Fam.
Sys. 2, 116 (1995); L. M. Fairbanks, Adv. Study Behav.
25, 579 (1996); L. Miller, R. Kramer, V. Warner, P.
Wickramaratne, M. Weissman, J. Am. Acad. Child
Adolesc. Psychiatry 36, 1134 (1997).
19. G. Paxinos and D. Watson, The Rat Brain in Stereo-
taxic Coordinates (Academic, New York, 1982).
20. Supported by grants from the Medical Research
Council of Canada (MRCC) and the National Institute
of Mental Health to M.J.M., as well as an MRCC
graduate fellowship (D.L.) and an MRCC Senior Sci-
entist award (M.J.M.). The authors thank B. S. Mc-
Ewen and M. Hofer for comments on an earlier draft
of this paper.
24 June 1999; accepted 23 September 1999
R E P O R T S
5 NOVEMBER 1999 VOL 286 SCIENCE
www.sciencemag.org1158
o
n
M
a
y 6
, 2
0
2

1
h
ttp
://scie
n
ce
.scie
n
ce
m
a
g
.o
rg
/
D
o
w
n
lo
a
d
e
d
fro
m

Rat
Nongenomic Transmission Across Generations of Maternal
Behavior and Stress Responses in the
Darlene Francis, Josie Diorio, Dong Liu and Michael J. Meaney
DOI: 10.1126/science.286.5442.1155
(5442), 1155-1158.286Science
ARTICLE TOOLS
http://science.sciencemag.org/content/286/5442/1155
REFERENCES
http://science.sciencemag.org/content/286/5442/1155#BIBL
This article cites 39 articles, 5 of which you can access for free
PERMISSIONS http://www.sciencemag.org/help/reprints-and-
permissions
Terms of ServiceUse of this article is subject to the
is a registered trademark of AAAS.ScienceScience, 1200 New
York Avenue NW, Washington, DC 20005. The title
(print ISSN 0036-8075; online ISSN 1095-9203) is published by
the American Association for the Advancement ofScience
No claim to original U.S. Government Works.
Copyright © 1999 The Authors, some rights reserved; exclusive
licensee American Association for the Advancement of Science.

o
n
M
a
y 6
, 2
0
2
1
h
ttp
://scie
n
ce
.scie
n
ce
m
a
g
.o
rg
/
D
o
w

n
lo
a
d
e
d
fro
m
http://science.sciencemag.org/content/286/5442/1155
http://science.sciencemag.org/content/286/5442/1155#BIBL
http://www.sciencemag.org/help/reprints-and-permissions
http://www.sciencemag.org/about/terms-service
Research Review: Independent living programmes: the
influence on youth ageing out of care (YAO)
Anna Yelick
Lecturer, College of Social Work, Florida State University,
Tallahassee, FL, USA
Correspondence:
Anna Yelick,
College of Social Work,
Florida State University,
296 Champions Way,
University Center Building C,
Tallahassee, FL 32306,
USA
E-mail: [email protected]

Keywords: educational attainment,
employment, independent living
programmes, life skills, productive
outcomes, youth ageing out of care
Accepted for publication: December
2014
A B S T R AC T
Independent living programmes (ILPs) aid in promoting
productive
outcomes for youth ageing out of care (YAO). This narrative
review
aimed to determine if sufficient evidence exists to substantiate
state-
ments regarding the effectiveness of ILPs based upon outcome
studies
published from January 2006 through December 2012. Are
current
ILPs effectively promoting independent living and productive
out-
comes among youth leaving foster care, relative to similar youth
who
do not participate in an ILP? Six studies published in English,
in the
USA and in peer-reviewed journals included non-experimental
design
(n = 1), quantitative designs (n = 2), mixed methods design (n =
2) and
randomized design (n = 1). Five outcomes addressing education,
employment, housing, mental health, and living skills emerged.
Weak
evidence that ILPs effectively aid YAO exists. Additionally,
inconsist-
encies exist in methodology. Finally, differences in important

compo-
nents in the ILPs exist, making comparisons difficult.
I N T R O D U C T I O N
Approximately 10% (23 396) of youth emancipated
from the care system in 2012 (Adoption and Foster
Care Analysis and Reporting System (AFCARS)
2011). These emancipated youth (youth who have
aged out of the system, usually when they reach 18
years old) typically face disadvantages in terms of
educational attainment and employment outcomes
compared to non-fostered youth (Unrau et al. 2011).
For example, 50% of foster youth obtain a high school
diploma or general educational development (GED)
degree compared to nearly 70% of non-fostered youth
(Sheehy et al. 2001; Wolanin 2005; Unrau et al.
2011). Post-secondary education is not encouraged
among the foster youth population as approximately
15% of foster youth enroll in college-preparatory
classes compared to 32% of non-fostered youth
(Unrau et al. 2011). Further, while nearly 79% of
foster youth express an interest in attending a post-
secondary education programme (Courtney et al.
2010), as few as 7–13% enroll in post-secondary edu-
cation programmes (Casey Family Programs 2010)
and fewer than 6% obtain post-secondary degrees
(Pecora et al. 2010).
Youth ageing out of care (YAO) also face challenges
in terms of housing and life skills. YAO are independ-
ent, and as such, must find housing, pay bills and find
employment shortly after leaving care.YAO often lack
social and familial support, which arguably leads to a
lack in life skills and resources to successful independ-
ent living (Lemon et al. 2005; Montgomery et al.

2006; Collins et al. 2008; Avery & Freundlich 2009;
Avery 2010; Harder et al. 2011). Additionally, YAO
tend to live independently at an earlier age compared
to non-fostered youth – many of whom return home
or have financial and emotional support well into their
20s (Lemon et al. 2005; Montgomery et al. 2006).
Independent living programmes (ILPs) were estab-
lished to aid YAO obtain productive positive out-
comes, such as educational attainment, employment
stability, housing and life skills (Montgomery et al.
2006; Petr 2006; Naccarato & DeLorenzo 2008;
Uzoebo et al. 2008; Mares 2010; Kroner & Mares
2011; Mares & Kroner 2011; Powers et al. 2012).
The Independent Living Initiative established ILPs,
which was an amendment to the Social Security Act
(Mares & Kroner 2011), and established aid for foster
youth to live independently, as well as enabled states
to develop life skills, academic achievement and
bs_bs_banner
doi:10.1111/cfs.12208
© 201 John Wiley & Sons LtdChild and Family Social Work
2017, 22, pp 515–526515 5
mailto:[email protected]
vocational training programmes to circumvent home-
lessness, dependence on public assistance and institu-
tionalization after emancipation (Hardin 1987). ILPs
were further develop with the enactment of the John
Chafee Foster Care Independence Program of 1999
and the Foster Care Independence Act of 1999, which

provided states with additional funding in response to
independent living research findings and child welfare
advocates calling for an amendment of the Social
Security Act (Allen & Bissell 2004). The Fostering
Connections to Success and Increasing Adoptions Act
of 2008 improved outcomes for children in foster care
by expanding the definition of child. This definition
included youth ages 18–20, enrolled in secondary
education, post-secondary education or vocational
training programmes; employed 80 hours a month or
more; or who are incapable of attending school or
work because of a medical condition (Mares & Kroner
2011).
Approximately two-thirds of eligible youth receive
independent living services (Courtney 2005; Avery
2010), indicating that ILPs are widely used by youth
exiting the foster care system. ILPs aim to promote
skills for independent living (Reilly 2003; Lemon et al.
2005; Montgomery et al. 2006; Geenen & Powers
2007), encouraging youth to become productive
members of society and attain positive productive out-
comes (independent living, education, employment
and increased life skills) despite lacks in social and
familial support (Montgomery et al. 2006; Mares &
Kroner 2011).
Effectiveness of ILPs
Two systematic reviews have been completed
(Montgomery et al. 2006; Naccarato & DeLorenzo
2008) assessing the efficacy of ILPs in accomplishing
the projected aims discussed earlier.The Montgomery
et al. (2006) review aimed to examine whether ILPs are
effective at providing youth with skills that enhance
their transition to independence.They included studies

conducted prior to January 2006, which examined
educational attainment, employment, housing, health
and life skills for youth leaving the care system. They
excluded any study that examined programmes specifi-
cally designed for special populations (i.e. special
needs, teen parenting, juvenile justice concerns).
The authors suggest evidence indicating that ILPs
improved educational, employment and housing out-
comes for YAO; however, the evidence was weakened
by evaluation methodology – specifically, a lack of
randomized control trials (RCTs), as non-randomized
studies are susceptible to bias. Confidence regarding
the effectiveness of the ILP was low because of the
inability to say with certainty that observed differences
are attributable solely to the ILP. Despite this limita-
tion, approximately 55% of the ILP group graduated
from high school. However, discrepancies between
YAO and the general population youth still exist.
Approximately 86% of the general population youth
graduated from high school, according to the US
National Center for Education Statistics (Greene
2002). In addition, the national rate for employment
differs between YAO and the general population
youth, indicating that ILPs have yet to bridge the gap
in positive productive outcomes for YAO compared to
the general population youth.
The second systematic review by Naccarato &
DeLorenzo (2008) aimed to examine studies regard-
ing the effectiveness of ILPs in youth transitioning out
of the care system from 1990 until 2006 in and
outside the USA. However, the review only included
studies in the USA and UK. The authors reviewed 19
articles, which met the four criteria: (i) the ILP aimed

to increase readiness for youth leaving the care system;
(ii) reported on education, employment, housing and
mental health; (iii) published in a peer-reviewed
journal and in English; and (iv) discussed transitional
services.
The authors suggested that the studies they
reviewed offered recommendations regarding improv-
ing services to YAO. Some of the recommendations
were to improve ILP practice, policy and research.
The authors also suggested that the studies varied
greatly in measurement of the ILP, specifically, in
sample size, demographics, placement histories,
support networks and outcome measures.The authors
recommended a national database with input from
researchers and practitioners in the field in order to
design a functional information system. Non-uniform
measurements make it difficult to determine the effec-
tiveness of ILPs, indicating service goals and quality
often vary among different ILPs (Courtney 2005;
Avery 2010), making it difficult to formulate general
assessments of ILPs and the effectiveness in aiding
YAO.
Purpose of paper
This paper aims to examine newer literature published
from January 2006 through December 2012 to deter-
mine if sufficient evidence exists to substantiate state-
ments made that ILPs effectively promote productive
outcomes (i.e. educational attainment, employment,
Research Review: Independent living programmes A Yelick
2017, 22, pp 515–52651 56

housing, mental health and life skills) for youth
leaving the care system. The paper includes only
studies conducted and published within the USA, in
English and in peer-reviewed journals.
Research question
Are current ILPs effectively promoting independent
living and productive outcomes among youth ageing
out of the care system relative to similar youth who do
not participate in an ILP?
M E T H O D S
Study selection
The present paper reviewed peer-reviewed studies
published in the USA and in English. The review
includes quasi-experimental and non-experimental
group outcome studies. The review included several
additional inclusionary and exclusionary criteria. The
inclusionary criteria were as follows: (i) the study
must contain information regarding an ILP; (ii) the
study must have measureable outcomes (educational
attainment, employment, housing, mental health/
special needs or life skills); and (iii) the study must
examine ILPs for foster youth or residential care
youth, or youth ageing out of the care system (YAO)
only. The exclusionary criteria were (i) if the study did
not examine ILPs; (ii) if the study was published prior
to January 2006; or (iii) if the study was conducted
outside the USA.

The electronic databases searched included the
Cochrane Central Register of Controlled Trials, The
Campbell Library, PsycINFO, Sociological Abstracts,
Applied Social Sciences Index and Abstracts (ASSIA)
and Web of Science. The keyword search terms were
(i) ab(Foster Care Youth) AND ab(Independent
Living); (ii) ab(Foster Youth) AND ab(Independent
Living Programs); (iii) ab(Independent Living) AND
ab(Evaluation) AND ab(Randomized Control Trials);
and (iv) ab(Foster Care) AND ab(Foster Care Youth)
AND ab([Independent Living Programs OR ILPs])
AND ab(Outcomes).This resulted in an initial pool of
135 citations. Of these, 32 abstracts were examined,
resulting in the inclusion of six primary studies (refer
to Table 1 and Fig. 1).
Search results
The six primary studies utilized qualitative methods
(one study), mix methods (two studies) and quantita-
tive methods (three studies) to assess the effectiveness
of ILPs from across the USA (Table 2 provides a
summary of each study). The study participants were
foster youth aged 16 and older preparing to leave the
care system, or in the case of the qualitative study – the
participants could include service providers. Out-
comes of interest include secondary education,
post-secondary education, employment, housing
attainment, mental health or other special needs, and
achieving life skills.
The study by Petr (2006) utilized a qualitative
approach to evaluate the Kansas Independent Living
Program in addition to five private contract agencies
to assess youths’ perspectives (n = 27) regarding the

quantity and quality of independent living services.
This study utilized a convenience sample and
included two groups: youth still in custody (n = 19)
and youth out of custody (n = 8). Only youth aged 16
and up were included in the study (mean age of 17.3).
Table 1 Database search
Databases search
Database Date Results
Cochrane Library Since 2000 0
Campbell Library Since 2000 1 – Systematic review completed
in 2006 –
restricted review to after 2006
Web of Science January 2006 through December 2012 51
PsycINFO January 2006 through December 2012 78 – These
four databases were searched
simultaneously in order to reduce duplications.
Another review was discovered; however, it also
examined ILPs prior to January 2006
Sociological Abstracts January 2006 through December 2012
Applied Social Science Index
and Abstracts (ASSIA)
January 2006 through December 2012
Social Services Abstracts January 2006 through December 2012
ILP, independent living programmes.

2017, 22, pp 515–52651 57
Fifty-one per cent (n = 14) of the total sample were
male (57% for in custody, 37.5% for out of custody).
Approximately 51% (n = 14) of the total sample were
Caucasian (42% for in custody and 87.5% for out of
custody), while 33% (n = 9) of the total sample were
African-American (47% for in custody). Of the eight
participants in the out of custody group, six had a high
school diploma (or GED equivalent) and two were in
college. There were five outcomes assessed in this
study: (i) education; (ii) mentors and support systems;
(iii) life skills training; (iv) vocational preparation; and
(v) knowledge of post-custody independent living
benefits.The interviews were transcribed and analysed
using Atlas ti, a qualitative software program. Petr
coded units of the interview text according to the
themes presented and then grouped the themes by
commonality.
The study by Uzoebo et al. (2008) examined a spe-
cific ILP, VISIONS, utilizing a mixed methods
approach. It has been included in the review based
upon the important perceptions discussed by youth
receiving services. The quantitative data were col-
lected using the Ansell Casey Life Skills Assessment
(ACLSA). There were both pre-test and post-test
assessments of the ACLSA for 89 participants. Quali-
tative data were gathered using the Life Skills Evalu-
ation Questionnaire for 24 participants. The average
age of the participants was 16 years, with 63% female
and 61% African-American. The average length of

stay in the programme was 17 months. The outcomes
of this study included determining perceptions of the
life skills received by the participants regarding the
benefits of the programme, barriers to skills acquisi -
tion and the role of the youth–mentor relationship in
promoting skills development.
The study by Mares (2010) utilized a mixed
methods approach using a focus group (n = 35) as well
as administrative data from Lucas County in Ohio.
The study included a sample of 108 youth who had
emancipated from an ILP from 2005 through 2007.
The information collected via the tracking data
included demographic characteristics, clinical charac-
teristics, foster home placements, outcomes at dis-
charge and receipt of post-emancipation services. Five
needs emerged during the focus groups: (i) higher
amount for clothing vouchers; (ii) assistance obtaining
a driver’s licence; (iii) provide home-based independ-
ent living life skills training; (iv) ensure confidentiality
of foster care placement packet; and (v) address the
perception of unfair/unequal treatment by the foster
parent(s) towards the foster youth. These themes
included the expressed views of the participants and
observations made by the research team. The modera-
tor, a social work student, and the author discussed
the observations during meetings. The transcriptions
provided illustrative quotations for each theme iden-
tified. In addition to the qualitative reports from the
youth participants, surveys were collected from 83
public and private service providers using an online
survey constructed by the author with input from the
research team. The survey included 22 items contain-
ing respondent information, programme information,

Potentially relevant studies
identified and screened for
retrieval (n=135)
Ineligible studies excluded based
on title, language or date. In
addition, studies using “grey”
literature have also been excluded
(n=103)
Abstracts of studies retrieved
(n=32)
Studies excluded if not looking at
independent living programmes/
transitions for foster youth (n=21)
Potentially appropriate studies for
review; studies evaluated using the
inclusion/ exclusion criteria
worksheet (n=11)
Studies excluded from the review
if there was no measurable
outcome related to an independent
living programme (n=5)
Primary studies with usable
information by outcome (n=6)
Figure 1 Flowchart of the primary
six studies included in this review.

2017, 22, pp 515–52651 58
Table 2 Summary of the six primary studies included in the
narrative review
Study Year Title Study population
Study
design Primary outcome
Kroner & Mares 2011 Living arrangements and
level of care among
clients discharged from a
scattered-site
housing-based
independent living
programme
Foster and former foster
youth mean age 17.86
XO
YO
OXO
Housing outcomes: Three-fourths of youth
were discharged to an independent level
of care, 28% living by self, 13% living with
friend, or 17% living with a relative. 55% of
sample attained a status of independent
living.
Mares & Kroner 2011 Lighthouse independent
living programme:
Predictors of client

outcomes at discharge.
youth mean age 17.9
OXO
OYO
Educational outcome: They indicated that
participants with mental-health problems
were less likely to complete high school
(0.60). In addition, participants who stayed in
the programme longer were more likely to
complete high school (0.96). Participants who
were older at admission were also more
likely to complete high school (1.55 and 2.35).
Employment outcome: Being 1 year older when
entering into the programme predicated high
rates of employment (1.55 to 2.35). Staying at
least 1 month longer before exiting the
programme also predicted high rates of paid
employment (1.10). Participant without
mental-health problems were also more
likely to have paid employment (0.460).
Housing outcome: Participants who were older
when entering the programme were more
likely to live independently (1.55 and 2.35) at
discharge. Participants who remained in the
programme at least 1 month longer were also
more likely to have independent housing
(1.10). Participants who reported being
parents also more likely to have independent
housing at discharge (2.0).

Mental health/special needs outcome: Youth
with mental-health problems are less likely
to complete high school (0.61), find
employment (0.64) or establish independent
housing (0.68).
Uzoebo
et al.
2008 Deconstructing youth
transition to adulthood
services: Lessons learned
from the VISIONS
programme
youth mean age 16.0
OXO
OYO
Life skills outcome: Participants reported
higher mastery of skills in areas of daily living
skills, work life, money management and
budgeting, and self-care. At follow-up,
participants demonstrated an increase in
skills acquisition from 52% to 55%.
Participants indicated receiving training in a
class room setting was less efficacious to
learning via a mentor or from ‘real-life’
experiences.
Petr 2006 Foster care independent
living services: youth
perspectives

Foster and Former Foster
Youth mean age 17.3
– Educational outcome: 26% behind in
educational progress and goals, one
participant enrolled in GED programme.
Increased number of placements often
indicates a decrease in educational
attainment.
Employment outcome: 10 participants were
working at paid jobs in the community. Two
participants in the out-of-custody group were
working part-time and attending college.
Life skills outcome: 26% of the youth indicated
that they had not received any life skills
training. Two of the youth indicated it was
offered but they refused. 63% of the youth
who received the life skills training indicated
they were in one of three settings: a class
room setting, mental-health agency, or group
home facility. These youth also indicated
receiving life skills training from foster
parents in a less formal, day-to-day basis.
2017, 22, pp 515–52651 59
Table 2 Continued
Study Year Title Study population

Study
design Primary outcome
Mares 2010 An assessment of
independent living needs
among emancipating
foster youth
youth
– Educational outcome: Secondary education
support was identified as one of the most
common services available. However,
financial support for college was among the
least common service available or offered
according to service providers.
Housing outcome: Housing assistance was
among the most helpful service identified for
youth aging out of care. However, affordable
housing and structured transitional housing
were identified as gaps for youth within ILPs.
Life skills outcome: Life skills training was
identified as being among the most helpful
for emancipating youth, however, hands-on
life skills training was identified as a gap in
service. This is also identified as one of the
greatest unmet needs within ILPs.
Powers et al. 2012 My life: Effects of a
longitudinal, randomized
study of
self-determination
enhancement on the

transition outcomes of
youth in foster care and
special education
youth mean age 16.8
OXO O
OYO O
Education outcome: 38% of the intervention
group and 28% of the comparison group
completed secondary education. At 1-year
follow-up, 72% for intervention and 50% for
comparison group completed secondary
education. Three youth were participating in
post-secondary education and 26% of youth
were participating in post-secondary
education at 1-year follow-up.
Employment outcome: 14% of the intervention
reported working paid jobs at baseline. At
post-intervention, 34% of the intervention
reported working paid jobs. At 1-year
follow-up, 45% of the intervention group and
28% of the comparison group had a paid job.
Housing outcome: At post-intervention, 63% of
participants were still in foster care, six
participants were adopted or reunited with
birth family, 14 participants were living with
friends or a partner in their own apartment,
one participant had housing provided
through Job Corps and two participants

identified as being homeless. At 1-year
follow-up, 57% of participants had exited
care, 15 participants reported being reunited
or adopted, 14 participants were living in
their own apartment, four participants were
residing in college dormitories, one
participant was in military housing and one
participant had housing through Job Corps.
60% of the comparison group reported
having a different placement from the year
before compared to 50% of the intervention
group, indicating a trend toward placement
stability.
Mental health/special needs outcome: 40% of
the sample had emotional/behavioural
problems, 10% of the sample had intellectual
disabilities, 16% had speech/language
problems, 26% had a learning disability, 5%
were considered to be on the autism
spectrum, and 26% developmental disabilities
services. The youth who received the
intervention fared better in high school
completion and fared better in employment
outcomes.
ILP, independent living programme; XO: indicates the research
design included only an intervention and post-test (no pre-test);
YO: indicates an
alternative design with only an intervention (or treatment as
usual) and post-test (no pre-test); OYO: indicates an alternative
design with a pre-test,
intervention (or treatment as usual), and post-test; OXO:
indicates a research design with a pre-test, intervention, and
post-test.

2017, 22, pp 515–5265 520
and views on helpful and needed independent living
services.The response rate for the survey was 28% (23
respondents).
The study by Kroner & Mares (2011) sampled
youth who admitted into and discharged from the
Lighthouse ILP from 2001 through 2006. The initial
number of youth was 455; however, the final sample
size included 367 participants because of the missing
data. This experimental study compared two groups –
youth with discharge living arrangements and youth
without discharge living arrangements. The authors
found no statistically significant differences between
these two groups at the initial assessments.There were
22 different living arrangement categories divided into
four levels of care from lowest (described as living in
the most independent and stable housing) to the
highest (described as living in the least independent
and most unstable housing). The authors used inde-
pendent samples t-test and chi-square tests in order to
compare youth with living arrangement data to those
without such data available. In addition, the use of an
analysis of variance (ANOVA) compared characteris-
tics of the youth entering the programme from the
youth being discharged from the programme.
The study by Mares & Kroner (2011) sampled 385
youth admitted into the Lighthouse ILP during 2001
through 2005. The authors utilized an experimental

study comparing youth with mental-health concerns
to those without such concerns. The youth had an
average age of 17.9 years, with a range from 16 to 20.
The length of stay averaged 9.9 months with a range
from 0 to 32 months. Sixty-nine per cent of the
sample received some life skills training prior to dis-
charge, including employment skills training (54%),
vocational training (16%), GED preparation (8%)
and violence prevention (8%). Originally, the authors
examined 22 dichotomous risk factors; however, the
six domains pertinent to the study only included 19
risk factors. The six domains included mental health
and substance abuse, socialization, delinquency, teen
parenting, cognitive impairment, and motivation and
health. There were four dichotomous outcomes meas-
ured: completing high school or GED, being
employed or completing a vocational training pro-
gramme, living independently (i.e. renting an apart-
ment or home, either alone or with someone else), and
completing high school, being employed, and living
independently. An exploratory factor analysis identi-
fied clinical risk factor groups using the principal
component method of extraction.The authors utilized
logistic regression to examine the association between
clinical risk factors and client outcomes, controlling
for socio-demographic characteristics, length of stay
and life skills training.
Finally, the study by Powers et al. (2012) examined
an ILP specifically designed for foster youth who
received special education services. While this sub-
population differs from the general foster care popu-
lation, this study was included because it fell within
this review’s inclusionary criteria. This study
employed a randomized methodology, comparing

Foster Care Independent Living Program (FCILP)
and TAKE CHARGE. There were four criteria for
inclusion, youth must (i) receive special education
services; (ii) be between 16.5 and 17.5 years of age;
(iii) be under the guardianship of Oregon DHS; and
(iv) attend a large school district. The approximate
length of stay in the TAKE CHARGE group was 12
months; youth in the FCILP received services as
normal. There were 69 participants at baseline (33 in
the intervention group and 36 in the comparison
group), enrolled over three study waves and randomly
assigned to either the treatment or comparison group.
There were several outcomes measured at baseline,
post-intervention and 1-year follow-up; however, for
the purposes of this review, only three will be exam-
ined; high school completion, employment and living
status. At post-intervention, 60 participants were
assessed (29 intervention and 31 comparison), and at
1-year follow-up, 61 participants were assessed (29
intervention and 32 comparison). The attrition rate
was 13% at post-intervention and 11% at 1-year
follow-up. At baseline, the mean age for the partici-
pants was 16.8 years, with 41% of the sample identi-
fied as female. Approximately 40% of the participants
attended an alternative school and approximately 26%
of the participants received developmental disability
services.
A R E V I E W O F T H E S I X
P R I M A R Y S T U D I E S
Participants’ characteristics
The average age of the participants, calculated using
reported mean ages across the six primary studies, was
17.1 years.The studies indicated that youth often have

mental-health problems (64% for Kroner & Mares
(2011); 47% for Mares & Kroner (2011); and 34% for
Mares (2010)) when ageing out of the system, which
likely influence post-secondary education, employ-
ment, life skills and housing. Five of the six studies
included race/ethnicity and gender characteristics of
the sample. Three out of the five studies that reported
2017, 22, pp 515–5265 521
race indicated that over 50% of the sample was
African-American or non-Caucasian (61% for
Uzoebo et al. (2008); 70% for Mares & Kroner
(2011); and 62% for Kroner & Mares (2011)). Petr
(2006) indicated that 55.5% of the sample identified
as Caucasian, while 33.3% identified as African-
American. Powers et al. (2012) also indicated a higher
percentage of Caucasian participants (50.8%) com-
pared to African-American participants (16.4%);
however, this sample included only participants that
used special education services, which influence the
race distribution of this study. The three studies that
indicated a higher percentage of African-American
participants also indicated a higher number of female
participants (63% for Uzoebo et al. (2008); 58% for
Mares & Kroner (2011); and 55% for Kroner &
Mares (2011)). Petr (2006) and Powers et al. (2012)
indicated that fewer than 50% of the sample identified
as being female (48.1% and 41%, respectively). Four
out of the six studies indicated an average length of
stay. Three of these four studies indicated that the

average length of stay was 12 months or less: 9.9
months (Mares & Kroner 2011), 10.2 months
(Kroner & Mares 2011) and 12 months (Powers et al.
2012). However, Uzoebo et al. (2008) indicated that
the average length of stay for this programme was 17
months. The differences in length of stay could result
from different requirements important to each of the
programmes.
Outcome measures
Educational attainment
Four out of six of the primary studies (Petr 2006;
Mares 2010; Mares & Kroner 2011; Powers et al.
2012) examined educational attainment. The most
common theme discussed is secondary education
completion (i.e. high school completion or obtaining a
GED).
Petr (2006) indicated that seven youth (26%)
reported being seriously behind in their educational
progress and goals, with only one participant currently
enrolled in a GED programme. Petr did not discuss
post-secondary education goals; however, in order to
complete post-secondary education, youth need to
finish high school or obtain a GED.This study utilized
focus groups, from which a theme of concern that an
increased number of placements often leads to a
decrease in educational attainment emerged. The
trend that youth not finishing high school would have
to re-take grade levels or enroll in a GED programme
surfaced during this study. The public school system
increased the likelihood of poor educational attain-
ment due to not offering credit for courses taken in

residential care, resulting in youth falling behind in
their educational pursuits.
Mares (2010) suggested that secondary education
support was among one of the most common services
available and offered to youth according to a group of
independent living service providers. Conversely,
however, financial support for college was among the
least common service available or offered according to
the same providers.
Mares & Kroner (2011) examined the differences in
outcomes based upon mental-health concerns. They
indicated that participants with mental-health prob-
lems were less likely to complete high school com-
pared to participants without mental-health concerns
(0.60 decreased odds). In addition, those participants
that stayed in the programme longer (even 1 month
longer) were more likely to have completed high
school (0.96 increased odds). In addition, students
who were older at admission into the programme were
more likely to complete high school (between 1.55
and 2.35 increased odds). The authors argued that
while having a mental-health problem is a risk factor
for not completing high school, spending more time in
the programme and being older before entering the
programme predicted a higher likelihood of finishing
high school despite the risk.
Powers et al. (2012) indicated that at post-
intervention, 38% of the intervention group and 28%
of the comparison group had completed their second-
ary education (via either a high school diploma or
equivalent). At 1-year follow-up, this number
increased to 72% for the intervention group and 50%
for the comparison group. Three youth (one compari-

son youth and two intervention youth) were partici-
pating in post-secondary education after the
intervention. This number increased, at 1-year follow-
up, to 26% (6 comparison youth and 10 intervention
youth) of youth attended post-secondary education
classes at least part-time.
Employment
Three of the six primary studies discussed employ-
ment outcomes: Petr (2006), Mares & Kroner (2011)
and Powers et al. (2012). Seven of the 19 youth in
custody (still in foster care; 37%) and 3 of the 9 out of
custody (emancipated; 38%) were working at paid
jobs in the community (Petr 2006). Of the three that
were out of custody, two were working part-time and
2017, 22, pp 515–5265 522
attending college. The youth in custody tended to
work part-time jobs in areas such as food services.
Similar to the education results, Mares & Kroner
(2011) indicated that being at least 1 year older
when entering into the programme predicted higher
rates of employment (between 1.55 and 2.35
increased odds). Additionally, staying at least 1
month longer before exiting the programme and not
having a mental-health problem predicted a higher
rate of paid employment (1.10 and 0.460 increased
odds, respectively).

The Powers et al. (2012) study reported that 14%
of the intervention group and 19% of the compari-
son group worked paid jobs at baseline. At post-
intervention, 34% of the intervention group
indicated that they had a job that paid a wage or
salary. In contrast, the rate of paid employment
decreased slightly for the comparison group from
19% to 16%. At 1-year follow-up, 45% of the inter-
vention group compared to 28% of the comparison
group had jobs that paid wages or salaries, working
at least part-time.
Housing
Four of the six primary studies – Mares (2010),
Kroner & Mares (2011), Mares & Kroner (2011), and
Powers et al. (2012) – discuss housing/living status
after completion of the ILP. According to the percep-
tions of the service providers, housing assistance was
among the most helpful service offered to emancipat-
ing youth (Mares 2010). Conversely, the service pro-
viders identified two gaps in housing: affordable
housing and structured transitional housing.
Kroner & Mares (2011) examined housing place-
ments after the ILP and determined that three-fourths
of youth went into an independent level of care: living
by self (28%), living with a friend (13%) or living with
a relative (17%). Additionally, just over half of the
participants (55%) attained a status of independent
living. Mares & Kroner (2011) indicated that partici-
pants who were older when entering into the pro-
gramme were more likely to live independently
(between 1.55 and 2.35 increased odds). Specifically,
female participants were more likely to have inde-

pendent housing at discharge as well as participants
who reported being parents (two times more likely).
Participants who remained in the programme at least
1 month longer were more likely to have independent
housing (1.10 increased odds).
The Powers et al. (2012) study indicated that at the
time of enrolment in the study, all participants were in
foster care. At post-intervention, 63% of the partici-
pants were still in foster care, 6 participants were
adopted or reunited with their birth family, 14 partici -
pants were living with friends or a partner in their own
apartment, 1 participant had housing provided
through Job Corps and 2 (both in the comparison
group) participants identified as being homeless. At
1-year follow-up, 57% of the all the participants had
exited care, 15 participants reported being reunited or
adopted, 14 participants were living in their own
apartment (either with a friend or partner), 4 partici -
pants were residing in college dormitories, 1 partici -
pant was in military housing and 1 participant had
housing through Job Corps. In addition, 60% of the
comparison group reported having a different place-
ment from the year before compared to 50% in the
intervention group.
Mental health/special needs
Mares & Kroner (2011) and Powers et al. (2012) are
the two primary studies that examine outcomes for
youth with mental-health problems or special educa-
tion needs. Mares & Kroner (2011) indicated that
youth with mental-health problems are less likely to
complete high school (0.61 decreased odds), find
employment (0.64 decreased odds) or establish inde-

pendent housing (0.68 decreased odds). Powers et al.
(2012) indicated that participants who received the
intervention fared better in high school completion
(38% compared to 26% at completion of pro-
gramme and 72% compared to 50% at 1-year
follow-up) compared to participants in the compari-
son group. In addition, participants in the interven-
tion group fared better in employment outcomes
(14% compared to 19% at baseline, 34% compared
to 16% at completion of the programme, and 45%
compared to 28% at 1-year follow-up) compared to
the comparison group.
Life skills
Three of the six primary studies – Petr (2006),
Uzoebo et al. (2008) and Mares (2010) – reported life
skills outcomes. Petr suggested that 26% (n = 7 out of
19) of youth indicated that they had not received
any life skills training, while 2 (10%) out of 19 par-
ticipants indicated it was offered, but they refused.
The participants that received life skills training
(63%) indicated that they were in one of three set-
tings: a regular school setting, a mental-health agency
or in a group home facility. In addition, participants
2017, 22, pp 515–5265 523
also indicated receiving life skills training from foster
parents in a less formal, day-to-day, basis. There were
inconsistent reviews of the formal training sessions;

some participants suggested they learned a great deal,
whereas others insisted that the classes were boring
and covered material already known.
Uzoebo et al. (2008) indicated that ILP partici-
pants reported higher mastery of skills in the areas of
daily living skills, work life, money management and
budgeting, and self-care. In addition, at follow-up,
participants demonstrated an increase in skills acqui-
sition (52.6% at intake to 55.2%). Participants indi-
cated that receiving training in a classroom setting
was less efficacious to learning via a mentor or from
‘real life experiences’. In addition, participants sug-
gested that modelling life skills was more productive
and significant compared to learning about life skills
in a classroom setting. Participants indicated a need
for a curriculum that was hands-on and age appro-
priate. In the Mares (2010) study, life skills training
was identified as being among the most helpful for
emancipating youth; however, hands-on independent
living life skills training was identified as being a gap
in services provided, viewed as both the most helpful
independent living service and among the greatest
unmet need.
D I S C U S S I O N
This review aimed to assess the effectiveness of ILPs
in yielding productive outcomes (i.e. educational
attainment, employment and housing) for YAO.
There is a lack of consistency in the types of services
provided by ILPs as well as no general standards
that all ILPs follow (Courtney 2005; Naccarato &
DeLorenzo 2008; Avery 2010). Therefore, some
ILPs focused on housing issues but overlooked edu-
cational attainment or employment, while other ILPs

focused solely on secondary educational attainment
but overlooked post-secondary educational services.
Only four out of six studies reported outcomes for
education, and each reported educational attainment
differently. For example, Petr (2006) reported infor-
mation regarding educational progress and goals as
well as participant likelihood to finish high school or
enroll in a GED programme. Mares (2010) reported
the information regarding ILP service providers in
the role of secondary education support and finan-
cial support for post-secondary education. Mares &
Kroner (2011) reported completion rates for high
school among participants hindered by mental-
health problems. Finally, Powers et al. (2012)
reported on completion rates for high school as well
as entrance rates for post-secondary education;
however, they focused only on youth with mental-
health concerns enrolled in special education
programmes.
In addition to the inconsistencies in reporting edu-
cational outcomes, inconsistencies in reported out-
comes of employment also existed; only half of the
primary studies discussed employment outcomes.
Petr (2006) and Powers et al. (2012) reported the
percentage of participants that worked jobs that paid
a salary; however, the Powers et al. (2012) study was
the only one to discuss follow-up rates. While the
studies reported outcomes similarly, only three
studies addressed this outcome measure, and
employment is important for YAO seeking independ-
ent living (Donkoh et al. 2006; Mares & Kroner
2011; Unrau et al. 2011). In addition, there was a
lack of information regarding the type of jobs the
youth receive, how long youth maintain or stay in

one job and the typical salary these youth receive.
These aspects of employment are important for
policy implications as well as help ascertain the pre-
paredness of youth leaving the ILP and succeeding
in independent living.
Independent living is an important outcome as four
out of the six primary studies addressed housing out-
comes. However, the housing outcomes were not
reported in a consistent manner across studies. For
example, two out of the four studies (Mares 2010;
Mares & Kroner 2011) reported this outcome in
terms of perception of the importance of housing
assistance and housing outcomes of participants with
mental-health problems compared to youth without
mental-health problems. The other two studies
(Kroner & Mares 2011; Powers et al. 2012) reported
percentage of participants’ actual housing situations.
Additionally, a lack of reporting the different aspects
of housing existed. For instance, only one of the
studies (Kroner & Mares 2011) indicated what type of
housing these youth received after the ILP (i.e. low
income, apartment, condominium, renting a house,
owning a house and living with a relative). Powers
et al. (2012) reported basic long-term follow-up of
housing; however, none of the other studies reported
follow-up results of housing (i.e. stability in housing,
stability of the environment, stability of the neigh-
bourhood).
Only two out of six studies addressed mental-health
concerns or special education needs (Mares & Kroner
2011; Powers et al. 2012).These studies examined how
having a mental-health concern or special education

2017, 22, pp 515–5265 524
need could influence other outcomes (i.e. educational
attainment, employment, housing and life skills). Lit-
erature suggests that foster youth fall behind in
education because of the pressure and instability of the
foster care system, which can lead to possible mental-
health concerns (Lemon et al. 2005; Montgomery
et al. 2006; Collins et al. 2008; Avery & Freundlich
2009; Avery 2010; Harder et al. 2011; Unrau et al.
2011). However, only two of the six primary studies
examined this outcome.
The final outcome examined in this review was life
skills. Again, only half of the primary studies reported
life skills outcomes. Many ILPs interpret and address
life skills and life skills training differently. Petr (2006)
and Uzoebo et al. (2008) reported percentage of par-
ticipants’ knowledge of life skills. Uzoebo et al. (2008)
discussed life skills in terms of daily living (i.e. work life,
money management and budgeting, and self-care). In
the Mares (2010) study, life skills were identified as
being important for youth exiting care; however, often
life skills are taught and discussed in a classroom or
controlled setting. This was a concern for Petr (2006)
and Uzoebo et al. (2008) as well, who indicated that
many participants preferred a less formal, hands-on
approach. In addition, the participants enrolled in the
Uzoebo et al. (2008) study indicated that the use of
mentors would benefit the participants, allowing the
mentors to model life skills in order for the participants
to learn from real-life experiences.

While these six studies are important, they bring up
some limitations that need addressing. For example,
not one of the studies used an RCT, which can better
determine the effectiveness of an intervention.
However, evaluating ILPs utilizing RCTs does not
commonly occur (Montgomery et al. 2006). Four of
the six primary studies utilized some comparison
group, which allows for an increased understanding as
well as a more confident assumption regarding the
effectiveness of particular ILPs (Uzoebo et al. 2008;
Kroner & Mares 2011; Mares & Kroner 2011; Powers
et al. 2012).Two of the studies utilized mixed methods
(using both qualitative and quantitative methodology;
Uzoebo et al. 2008; Mares 2010).The inclusion of one
study that utilized a non-experimental design and four
others that utilized quasi-experimental designs indi-
cates insufficient experimental outcome studies for
ILPs.
Limitations
While this review of ILPs calls attention to the lack in
consistency in ILPs for youth exiting the care system, it
only included published studies in peer-reviewed jour-
nals. Grey literature, studies published in a different
language and studies published prior to 2006 were not
included in the review. Although this is a limitation,
peer-reviewed studies are often highly regarded com-
pared to all other literature. In addition, while includ-
ing studies in different languages or in different
countries can be illuminating, US policy-makers would
most likely be interested in the studies published in the
USA.

Next steps
The present review determined that insufficient
outcome studies evaluating ILPs for YAO still exist.
Future studies evaluating the outcomes of ILPs need
to make use of stronger research designs, such as
RCTs and high-quality quasi-experimental designs.
While the RCT does not necessarily need to be inter-
vention vs. no intervention (e.g. the RCT could be
new ILP vs. standard ILP), the use of an RCT will
expand the understanding of which ILP works better
and potentially what types of interventions work
better. For example, YAO may need more housing
support and less employment support in order to have
a sustainable lifestyle. However, this assumption
cannot be made from the literature that currently
exists. The most that can be said about the effective-
ness of ILPs is that YAO who participate in ILPs
obtain some productive outcomes. Comparisons
about non-ILP youth cannot be made, comparison
between certain ILPs cannot be made, and claims that
ILPs effectively aid YAO to obtain productive out-
comes cannot be made.
YAO are at an increased risk in terms of educa-
tional attainment, employment, housing, mental
health and life skills, yet the ILPs, which are adver-
tised as aiding YAO in attaining productive out-
comes, have failed to use methodologies that can
adequately report on the outcomes. It is a disservice
to these youth to inflate desired outcomes with
documented, achieved results. Future studies also
need to focus on comparative studies, which examine
the effectiveness of different ILPs. It would also be
desirable to promote some common core outcome
measures to be used in evaluating ILP results, stand-

ardized ways of reporting educational, employment
and housing outcomes, for example. There are great
groundwork studies out there, some included in this
review; however, there needs to be a next step.
Future studies need to include RCTs and compari-
son studies in order to explicate the effectiveness of
2017, 22, pp 515–5265 525
ILPs. Only then can policies be modified and cor-
rected to fit the needs of the population.
R E F E R E N C E S
Adoption and Foster Care Analysis and Reporting System
(AFCARS). (2011) Preliminary FY 2011 Estimates as of July
2012. The AFCARS Report No. 19. Available at: http://
www.acf.hhs.gov/sites/default/files/cb/afcarsreport19.pdf
(accessed June 2013).
Allen, M. & Bissell, M. (2004) Safety and stability for foster
children: the policy context. The Future of Children, 14, 49–
73.
Avery, R.J. (2010) An examination of theory and promising

practice for achieving permanency for teens before they age
out of foster care. Children andYouth Services Review, 32,
399–
408.
Avery, R.J. & Freundlich, M. (2009) You’re all grown up now:
termination of foster care support at age 18. Journal of Adoles -
cence, 32, 247–257.
Casey Family Programs (2010) Supporting Success: Improving
Higher Education Outcomes for Students from Foster Care.
Casey
Family Programs, Seattle, WA.
Collins, M.E., Paris, R. & Ward, R.L. (2008) The permanence
of
family ties: implications for youth transitioning from foster
care. American Journal of Orthopsychiatry, 78, 54–62.
Courtney, M.E. (2005) Youth Aging Out of Foster Care:
Network on
Transitions to Adulthood Policy Brief.The Network of
Transitions
to Adulthood, Vol. 19. Available at: http://wispolitics.com/
1006/Chapin_Hall_Executive_Summary.pdf (accessed June
2013).

Courtney, M.E., Dworsky, A., Lee, J.S. & Raap, M. (2010)
Midwest Evaluation of the Functioning of Former Foster Youth:
Outcomes at Ages 23 and 24. Chapin Hall Center for Children
at the University of Chicago, Chicago, IL.
Donkoh, C., Underhill, K. & Montgomery, P. (2006) Independ-
ent living programmes for improving outcomes for young
people leaving the care system. Cochrane Database of
Systematic
Reviews, 3, 1–9. doi: 10.1002/14651858.CD005558.pub2.
Geenen, S. & Powers, L.E. (2007) Tomorrow is another
problem: the experiences of youth in foster care during their
transition into adulthood. Children and Youth Services Review,
29, 1085–1101.
Greene, J.P. (2002) High School Graduate Rates in the United
States. Available at: http://www.manhattan-institute.org/html/
cr_baeo.htsm#14 (accessed June 2013).
Harder, A.T., Kongeter, S., Zeller, M., Knorth, E.J. &
Knot-Dickscheit, J. (2011) Instruments for research on tran-
sition: applied methods and approaches for exploring the tran-
sition of young care leavers to adulthood. Children and Youth

Services Review, 33, 2431–2441.
Hardin, M. (1987) Legal Issues Related to the Federal
Independent
Living Initiative. American Bar Association, Washington,
DC.
*Kroner, M.J. & Mares, A.S. (2011) Living arrangements and
level of care among clients discharged from a scattered-site
housing-based independent living program. Children andYouth
Services Review, 33, 405–415.
Lemon, K., Hines, A.M. & Merdinger, J. (2005) From foster
care
to young adulthood: the role of independent living programs in
supporting successful transitions. Children and Youth Services
Review, 27, 251–270.
*Mares, A.S. (2010) An assessment of independent living needs
among emancipating foster youth. Child & Adolescent Social
Work Journal, 27, 79–96.
*Mares, A.S. & Kroner, M.J. (2011) Lighthouse independent
living program: predictors of client outcomes at discharge.
Children and Youth Services Review, 33, 1749–1758.
**Montgomery, P., Donkoh, C. & Underhill, K. (2006) Inde-

pendent living programs for young people leaving the care
system: the state of the evidence. Children and Youth Services
Review, 28, 1435–1448.
**Naccarato, T. & DeLorenzo, E. (2008) Transitional Youth
Services: practice implications from a systematic review. Child
& Adolescent Social Work Journal, 25, 287–308.
Pecora, P. J. (2010) Why current and former recipients of foster
care need high quality mental health services. Administration
and Policy in Mental Health and Mental Health Services
Research,
37, 185–190.
*Petr, C.G. (2006) Foster care independent living services:
youth
perspectives. Families in society. The Journal of Contemporary
Social Services, 89, 100–108.
*Powers, L.E., Geenen, S., Powers, J., Pommier-Satya, S.,
Turner, A., Dalton, L.D. et al. (2012) My life: effects of a
longitudinal, randomized study of self-determination enhance-
ment on the transition outcomes of youth in foster care and
special education. Children and Youth Services Review, 34,
2179–2187.
Reilly, T. (2003) Transition from care: status and outcomes of

youth who age out of foster care. Child Welfare League of
America, 82, 727–746.
Sheehy, A., Oldham, E., Zanghi, M., Ansell, D., Correia, P. &
Copeland, R. (2001) Promising Practices: Supporting the
Transi-
tion of Youth Served by the Foster Care System. Annie E.
Casey
Foundation, Baltimore, MD.
Unrau, Y.A., Font, S.A. & Rawls, G. (2011) Readiness for
college
engagement among students who have aged out of foster care.
Children and Youth Services Review, 34, 76–83.
*Uzoebo, V., Kioko, M. & Jones, R. (2008) Deconstructing
youth transition to adulthood services: lessons learned from
the VISIONS program. Vulnerable Children andYouth Studies,
3,
37–41.
Wolanin, T.R. (2005) Higher Education Opportunities for Foster
Youth: A Primer for Policymakers. Institute for Higher
Education
Policy, Washington, DC.
*Primary studies included in this review.

**Previous systematic review on this topic.
2017, 22, pp 515–5265 526
http://www.acf.hhs.gov/sites/default/files/cb/afcarsreport19.pdf
http://www.acf.hhs.gov/sites/default/files/cb/afcarsreport19.pdf
http://wispolitics.com/1006/Chapin_Hall_Executive_Sum mary.p
df
http://wispolitics.com/1006/Chapin_Hall_Executive_Summary.p
df
http://www.manhattan-institute.org/html/cr_baeo.htsm#14
http://www.manhattan-institute.org/html/cr_baeo.htsm#14
Copyright of Child & Family Social Work is the property of
Wiley-Blackwell and its content
may not be copied or emailed to multiple sites or posted to a
listserv without the copyright
holder's express written permission. However, users may print,
download, or email articles for
individual use.
The Impact of Victimization and Mental Health Symptoms on
Recidivism
for Early System-Involved Juvenile Offenders
Lindsey E. Wylie
University of Nebraska Omaha

Katrina A. Rufino
University of Houston–Downtown and The Menninger Clinic,
Baylor College of Medicine
Although research has linked mental health symptoms and prior
victimization to recidivism for youth on
probation or in detention, little attention has been given to these
risk factors for early system-involved
youth. We conducted a survival/hazard model to estimate the
impact of official records of abuse/neglect,
crime victimization, and mental health issues (mood, anxiety,
disruptive, and substance use disorders) on
recidivism in a sample of 2,792 youth in a large Midwestern
diversion program. Results indicated that
youth with official records of abuse/neglect, person crime
victimization, and property crime victimization
were more likely to recidivate sooner than those without these
victimization experiences (hazard ratio:
1.37, 1.42, and 1.52, respectively). Findings from the present
study also demonstrated that substance use
disorder was the only mental health cluster that predicted
quicker time to recidivism. As one of the
earliest points of entry into the juvenile justice system,
diversion programs are in a unique position to
address trauma from multiple types of victimization and adapt
diversion programming to be responsive
to each juvenile’s mental health needs.
Public Significance Statement
Early system-involved youth referred to juvenile diversion had
high levels of mental health symp-
toms and many had prior experiences with various types of
victimization that are based on official
law enforcement records. Prior victimization significantly
predicted whether a youth had future

contact with the juvenile or adult criminal justice system, even
while considering other factors, such
as risk level and youth characteristics.
Keywords: juvenile recidivism, juvenile diversion, mental
health, victimization
In 2016, there were approximately 856,130 juvenile arrests in
the
United States—many for nonviolent offenses such as larceny–
theft,
other assaults, drug abuse violations, liquor law violations,
vandalism,
disorderly conduct, and curfew/loitering (OJJDP, 2016). As
such, the
juvenile justice system is often tasked with how to address
youth who
commit less serious offenses. One approach is to divert them
away
from formal juvenile justice system involvement through
diversion
programs. As the gateway to the juvenile justice system,
diversion
programs are in a unique position to address the needs of early
system-involved youth, including needs related to victimization
and
mental health symptoms, to reduce future involvement in the
juvenile
or adult criminal justice system.
Developmental models of antisocial behavior propose that
“delin-
quency is marked by a reliable developmental sequence of
experi-
ences,” in which childhood experiences and social environment

put
children at risk for social maladjustment and criminal behavior
(Pat-
terson, Debaryshe, & Ramsey, 1989, p.263). Specifically,
studies find
that experiences with victimization, broadly defined as
maltreatment,
adverse childhood experiences, and general crime victimization,
are
related to mental health issues (e.g., Abram et al., 2004;
Kilpatrick et
al., 2000) and that both victimization and mental health issues
are
related to juvenile justice involvement (e.g., Barrett,
Katsiyannis,
Zhang, & Zhang, 2014; Fazel, Doll, & Långström, 2008).
Although
the association of victimization and mental health symptoms
within
juvenile justice populations are well-documented, especially
within
samples of serious juvenile offenders (e.g., adjudicated or
incarcer-
ated), fewer studies have examined these risk factors in a
sample of
early system-involved youth. The purpose of this study is to
examine
the relationship between prior victimization, as obtained from
official
law enforcement records, and mental health symptoms on time
to
recidivism in a sample of early system-involved youth in a
juvenile
diversion program.
Operationalizing Victimization

Researchers operationalize victimization using multiple defini -
tions. Most studies measure victimization as child maltreatment,
utilizing official data obtained from social service agencies or
This article was published Online First November 1, 2018.
Lindsey E. Wylie, School of Criminology and Criminal Justice,
Juvenile
Justice Institute, University of Nebraska Omaha; Katrina A.
Rufino, De-
partment of Social Sciences, University of Houston–Downtown
and The
Menninger Clinic, Baylor College of Medicine.
Correspondence concerning this article should be addressed to
Lindsey
E. Wylie, Juvenile Justice Institute, University of Nebraska
Omaha, 941 O
Street, Suite 706, Lincoln, NE 68508. E-mail: [email protected]
T
hi
s
do
cu
m
en
t
is
co
py

ri
gh
te
d
by
th
e
A
m
er
ic
an
P
sy
ch
ol
og
ic
al
A
ss
oc
ia
ti

on
or
on
e
of
it
s
al
li
ed
pu
bl
is
he
rs
.
T
hi
s
ar
ti
cl
e
is

in
te
nd
ed
so
le
ly
fo
r
th
e
pe
rs
on
al
us
e
of
th
e
in
di
vi
du

al
us
er
an
d
is
no
t
to
be
di
ss
em
in
at
ed
br
oa
dl
y.
Law and Human Behavior
© 2018 American Psychological Association 2018, Vol. 42, No.
6, 558 –569
0147-7307/18/$12.00 http://dx.doi.org/10.1037/lhb0000311

558
mailto:[email protected]
http://dx.doi.org/10.1037/lhb0000311
child protective services (e.g., Barrett et al., 2014; English, Wi -
dom, & Brandford, 2002; Smith, Ireland, & Thornberry, 2005),
or
self-report data obtained from caregivers or youth (e.g., Conrad,
Tolou-Shams, Rizzo, Placella, & Brown, 2014). Other studies
include broader definitions of victimization, usually measured
with
self-report data, including adverse childhood experiences
(ACEs),
such as abuse/neglect, parental divorce, and family violence
(e.g.,
Wolff, Baglivio, & Piquero, 2015; Kilpatrick et al., 2003) or
general crime victimization, such as theft or assault (e.g.,
Finkel-
hor, Ormrod, & Turner, 2009; Manasse & Ganem, 2009).
Research
employing these broader definitions of victimization typically
have not included data from official agency records.
As such, the current study expands previous research using a
broader definition of victimization, to include abuse/neglect,
sex-
ual assault, property crimes, and person crimes, utilizing
reported
incidents of victimization data obtained from official law
enforce-
ment records. Although official records are likely an
underestima-
tion of abuse/neglect (Swahn et al., 2006) or general crime
trends

(see Loftin & McDowall, 2010) because of failure to report or
other system-wide factors, using this definition has practical
im-
plications for programmatic interventions because this
information
may be readily available to diversion programs, and may
produce
different findings than studies using self-report data.
Victimization and Mental Health Symptoms
Research demonstrates that victimization as a child or adoles -
cent is associated with later mental health problems in both lon-
gitudinal studies with representative samples (e.g., Finkelhor et
al.,
2009; Kilpatrick et al., 2000; Manasse & Ganem, 2009) and
retrospective studies with justice-involved samples (e.g.,
Barrett et
al., 2014; Dierkhising et al., 2013; Ford, Grasso, Hawke, &
Chap-
man, 2013). For instance, in a national random sample of non-
justice-involved children ages 2 to 17, Finkelhor and colleagues
(2009) examined the Developmental Victimization Survey
(DVS)
to assess the range of childhood victimizations across five
victim-
ization types, including conventional crime (e.g., assaults and
property crimes), child maltreatment, peer and sibling
victimiza-
tion, sexual assault, and indirect victimization (e.g., witnessing
violence). Overall, 79.6% of the sample reported lifetime
victim-
ization and analysis revealed a strong association between
lifetime
poly victimization (the total number of different types of
victim-

cloning. Second, it is sensitive. Activities canbe detected

cloning. Second, it is sensitive. Activities canbe detected

Recommended

Recommended

More Related Content

Similar to cloning. Second, it is sensitive. Activities canbe detected

Similar to cloning. Second, it is sensitive. Activities canbe detected (20)

More from WilheminaRossi174

More from WilheminaRossi174 (20)

Recently uploaded

Recently uploaded (20)

cloning. Second, it is sensitive. Activities canbe detected