Characteristics and Dynamics of Homeless Families with Children

Appendix A:

Impact of Homelessness on Children:
An Analytic Review of the Literature

[ Main Page of Report | Contents of Report ]

By:
John C. Buckner, Ph.D.
Children's Hospital-Boston
Harvard Medical School

Printer Friendly Version in PDF format (38 pages)

Contents

• Part I: Literature Review
  • Mental Health and Problem Behaviors
  • Developmental Status
  • Health Outcomes
  • Education-Related Outcomes
• Part II: Why Studies of Homeless Children Have Produced Inconsistent Findings
  • Methodological Differences
  • Historical Factors
  • Contextual and Policy-related Factors
  • Homelessness is Not a Homogenous Experience
  • Shelter as an Intervention
  • Similarities Between Homeless and Low-income Housed Children
• Part III: Future Directions for Research
  • Topics for Further Inquiry
  • Overlapping Issues of At-Risk Groups
  • Typology Efforts
  • Conclusion

References
Endnotes

This paper reviews published research conducted in the United States pertaining to the effects of homelessness on the mental health, behavior, health, and academic performance of children who are homeless with their families. This has been the central aim of most of the studies involving homeless children that have been conducted to date. A primary intent of the chapter is to describe what has been learned as well as to discuss some of the issues that may have led to inconsistent study findings over the years. In addition, the paper identifies gaps in the understanding of homeless children, one of which is the lack of information on different subgroups of homeless children based on varying constellations of problems or needs.

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Part I: Literature Review

Using data from the National Survey of Homelessness Assistance Providers conducted in 1996, The Urban Institute (2000) estimated that families with children account for about 39 percent of the homeless population in this country on any given night.^[1] Based on this survey, researchers at The Urban Institute estimated that somewhere between 874,000 and 1,360,000 children experienced a homeless episode^[2] at some point in 1996. This implies that about 9 percent of poor children in the United States had a spell of homelessness that year. In most cases, a homeless family is comprised of a single mother with one or two young children in tow. This is particularly true in the Northeast, where, for instance, in Massachusetts about 95 percent of homeless families are single parent female headed (Bassuk et al., 1996). In some parts of the country it is more common to also encounter two-parent (or couple) families or families headed by a single father (U.S. Conference of Mayors, 2001).

Table 1-1.
Summary of published homelessness studies 1987-2004 by domain

Mental health/behavior problems

Health-related problems

The notion of a continuum of risk is a useful in describing how results tend to fall out when comparing homeless to low-income housed children as well as children in the general population. That is, compared to children in the general population, low-income housed children appear to be doing worse on most outcome measures with homeless children looking the most problematic. (In the next section a range of different factors are discussed that might account for the lack of dependable findings in studies that have compared homeless to housed children.) In addition to the table, Figure 1-1 provides a means by which to summarize both the intentions and the findings of the studies discussed in this section. It is intended as an explanatory device: The figure does not portray actual findings from any particular study and the quantitative values suggested by the lines on the y axis should not be taken literally. The figure portrays the continuum-of-risk concept mentioned by Masten et al. (1993), which is a consistent pattern of results across studies involving homeless and low-income housed children. In the figure, an “average degree of problem severity” is assigned to each of three different grouping of children: children in the general population, housed children living in poverty, and homeless children. Each group’s level of “problem severity” is apportioned to up to three different sources or risk. Children in the general population have just one source of risk (“normative stressors”), those who are from low-income families living in housing have two sources of risk (normative stressors plus “non-homeless, poverty-related” stressors) and homeless children have three sources (normative, poverty-related, and “homelessness-specific” stressors).

Figure 1-1:
Continuum-of-Risk Concept

To interpret this graph, assume that the y axis refers to values indicative of a problem of some sort, with higher values indicating greater severity. The graph illustrated a finding that is typical across the studies reviewed earlier, namely that the degree of problem severity is highest for homeless children, followed by low-income housed children, with children in the general population (based on test norms) scoring lowest. The continuum-of-risk notion posits that those with exposure to greater risk have heightened problems, with homeless children experiencing the most risk, hence more severe problems followed by poor housed children, followed by children in the general population. An implicit assumption is that all three groups of children share some common risk factors that are not related to poverty. These are labeled problems attributable to “normative risk factors” and assigned equal values in all three groups. Children in the low-income housed and homeless groups share in common a set of “poverty-related” risk factors. These would be mostly environmental and family variables that children from more advantaged backgrounds are rarely or never exposed to. Furthermore, these poverty-related risk factors are not related to homelessness. Equal values are assigned to both the low-income housed children and homeless children, but no value to children in the general population. Lastly, a value of risk exposure is assigned to the group of homeless children that represents their exposure to risks that are “homelessness-related.” Of course, only children in the homeless group receive such exposure.

Some of the studies reviewed earlier reveal a pattern of results that match up nicely to this figure. For instance, those studies listed in Table 1-1, in which the finding “Homeless Group > Housed > General Population” seems to fit a pattern of findings consistent with the continuum-of-risk notion.^[13] As described earlier, a goal of many of the studies, especially those involving both homeless and housed children and multivariate statistics, was to determine whether homeless children had heightened problems; and, if so, whether these could be attributed to homelessness or if it were simply the case that homeless children got a higher dose of poverty-related risk exposure than the low-income housed group. So, for example, Buckner et al. (1999) found that homeless school-age children had more internalizing mental health problems than their low-income housed counterparts. Furthermore, through the measurement and statistical control of other risk factors (such as negative events, chronic strains, abuse history, mother’s mental health), the study determined that homelessness, per se, seemed to be playing a role in these elevated internalizing problems. Put another way, it was unlikely that this was a spurious association between housing status and internalizing problems brought about by homeless children having been exposed to more poverty-related (non-homeless) risks than the low-income housed group. This is one of the few studies that has found both an elevated problem severity in homeless children and has been able to convincingly demonstrate that this heightened degree of problem severity is likely the result of homelessness-related stressors and not non-homeless poverty-related factors.

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Part II: Why Studies of Homeless Children Have Produced Inconsistent Findings

The previous section reviewed many of the published empirical articles that address the potential impact of homelessness on children. The continuum-of-risk figure (Figure 1-1) is helpful in summarizing various study findings. A rather consistent result across studies is noting elevated problems among homeless and low-income housed children compared to children in the general population. In essence, most studies have documented an apparent negative effect caused by exposure to a common set of “poverty-related” risks. What is less consistent across studies is whether an additional elevation in problems among homeless children as compared to low-income housed children is also found. Moreover, when differences are detected, limitations in methodology (such as not adequately measuring additional risk factors and/or not using multivariate analyses to control for them) call into question whether homelessness, per se, is behind the heightened severity of problems. In other words, it is hard to demarcate where poverty-related sources of risk end and homelessness-specific risks begin.

While the overall pattern of findings across studies does suggest that, more often than not, children’s exposure to homelessness increases their risk of adverse outcomes, it is difficult to make strong and definitive assertions about the impact of homelessness on children due to inconsistent study results. Rather, the effect that homelessness appears to have on children would seem to be dependent on a range of contextual factors and “effect modifiers.” Put simply, whether homelessness has an impact on children may depend. On the other hand, studies are much more consistent in discerning a negative impact of poverty on children (i.e., both low-income housed and homeless) across outcome domains and among different age groups within domains.

The remainder of this section offers some explanations as to why various studies involving homeless children have not been able to reliably produce findings suggestive of a negative impact of homelessness above and beyond the effects of broader poverty-related risks.

Methodological Differences

Studies of homeless children have differed in terms of the assessment instruments employed, the degree of statistical power afforded by sample size, selection of comparison groups, enrollment procedures, and other factors. While there are methodological shortcomings in some studies, this probably is not a major reason for the inconsistencies in study findings. For one, some of the more methodologically rigorous studies are internally inconsistent. For example, in the Worcester study, differences were found between homeless and housed children on behavior problems (but only for internalizing problems in school-age children and externalizing problems for preschool children). Infants and toddlers in both groups appeared equivalent and no differences were found on measures of academic achievement among the older children. The Rescorla et al. (1991) study in Philadelphia made the questionable choice of having children in a health clinic serve as the housed comparison group. Yet, the magnitude of problems they assessed in their sample of homeless children was very high and they were likely to have found statistically significant differences between this group and whichever comparison group they might have selected.

Pointing out methodological differences between studies (or problems within studies) yields an uncompelling argument for why studies of homeless children paint such a confusing picture as to the impact of homelessness on children. Rather, inconsistencies across these studies may have more to do with the fact that these investigations have involved different study groups in different communities at different points in time during the fast changing history of family homelessness in America. These other factors, which are largely outside the realm of what is described in an article’s methodology section, are discussed in the pages to follow.

Historical Factors

The early studies of homeless children took place in contexts in which the problem of family homelessness had recently emerged and where communities had not had sufficient time nor had marshaled adequate resources to address the needs of this new homeless subgroup. While difficult to document, it is likely that shelter conditions for families have improved in most cities between the mid-1980s and mid-1990s. What a typical child who was homeless in Washington, DC, in 1985 experienced versus what a child who was homeless in Worcester, Massachusetts, encountered in 1995 are very likely quite different. The contrast to 1985 is probably even greater now. The Stewart B. McKinney Act, which was passed in the late 1980s, has funneled hundreds of millions of dollars each year to communities to use in improving housing options and services available to homeless single adults, families, and unaccompanied youths. Legal changes and funding to reduce educational obstacles for homeless children could have made a difference in some communities as evidenced by findings in Worcester (Buckner et al., 2001) and more broadly (Anderson et al., 1995). It is safe to say that, were it not for Federal, state, and local funding to address the needs of homeless individuals and families, their plight would clearly be much worse.

One can make a bit more sense out of the inconsistencies across studies of homeless children by recognizing that the time span between some of these investigations was long enough that what investigators were observing in the later studies entailed a much greater societal response to the issue of homelessness that what the earliest studies had witnessed. For instance, it is probable that the “null” findings regarding school and education-related outcomes for homeless children in Worcester in the mid-1990s (Buckner et al., 2001) would not have emerged had the same investigation in the same city been conducted a decade earlier, before implementation of the McKinney Act and other responses, which began to rectify difficulties that homeless children were having in attending school.

Contextual and Policy-related Factors

Across communities at any given moment, the extent of structural imbalance between the supply of affordable housing and its demand will vary with some areas having greater disequilibrium between the supply of housing and demand than others. Likewise, within any given community over time, the degree of structural imbalance is not static but in a state of flux. For instance, Massachusetts, like many other regions of the United States, has had a shortage of affordable housing for many years and this structural imbalance between supply and demand has worsened over the past 10 years. Evidence of this has been increased length of time on waiting lists for eligible households to receive Section 8 housing assistance and longer average duration of shelter stays before families can secure permanent housing (U.S. Conference of Mayors, 2001). Interestingly, it is quite possible that changes in this structural imbalance, for better or for worse, may have ramifications for what researchers uncover at the individual-level among homeless individuals and families. How could this be so?

In understanding the root causes of homelessness, it is important to differentiate between a structural imbalance in the supply and demand for housing, which is the fundamental cause of homelessness, from individual-level vulnerability factors. As a structural imbalance emerges within a locale, such that there is a shortage of affordable housing, it is those who are least able to “compete” who are first to become homeless. Such persons may have multiple vulnerability factors so that, compared to a broader group of persons at risk, they are the least competitive (Buckner, 1991; Buckner, Bassuk, and Zima, 1993; Shinn, 1992). For instance, among families, where caring for children in and of itself leaves adults more vulnerable to homelessness, this could include having health, mental health, or substance use problems as additional risk factors. As the structural imbalance progresses, those who become homeless next will have fewer vulnerabilities than the earliest victims. In other words, when a community begins to encounter a lack of affordable housing appropriate for families, it will be the most vulnerable families who become homeless first. If the problem worsens over time, those families who become homeless thereafter will increasingly look less susceptible compared to the first entrants into homelessness.

The implication this has for homelessness research is that, all other things being equal, in a gradually worsening housing market, early studies may reveal greater problems among shelter residents (adults and children) than do later studies. The rationale being that a gradually tightening housing market “selects” out those families first with the most vulnerabilities (i.e., least ability to compete successfully for housing) followed by families with fewer vulnerabilities. Over time, early disparities between homeless and low-income housed families would tend to lessen. Hence, a comparative study conducted shortly after a structural imbalance in the supply and demand for housing emerges may end up seeing starker differences between the homeless and housed group (e.g., more ADM disorders with the mother). However, these may be factors that entered into the selection process for which families became homeless. If these factors also have a role in influencing a children’s mental health (or other aspect of child functioning) then it may appear as though housing status is the reason for heightened problems among children, when in fact the association is not a causal one. For this reason, it is important to measure other factors that can influence a child’s mental health (or other relevant outcome) so as to make a clearer determination about the specific contribution of housing status (i.e., homelessness) to such outcomes.

Housing assistance policy is another area that could change the complexion of sheltered homeless families over time. If housing policy is such that being homeless reduces a family’s wait for a Section 8 housing certificate/voucher or some other form of housing assistance, then some families may decide it is worth it in the long run to seek admittance to a family shelter. A situation then arises where homelessness is not something that is avoided by all. Should a modest proportion of families in shelter be there as a matter of “choice” rather than necessity, a comparison of homeless to low-income housed families would most likely reveal fewer differences than if all families in shelter were in shelter unwillingly.^[14]

Conceivably, some of these contextual and/or housing policy-related factors could have played a role in accounting for different results between Ellen Bassuk’s and colleagues study of homeless and housed families in Boston during the 1980s (Bassuk and Rosenberg, 1988; Bassuk and Rosenberg, 1990) and a similar but more comprehensive investigation of homeless and housed mothers in Worcester that she led 8 or so years later (Bassuk, Weinreb, Buckner, Browne, Salomon, and Bassuk, 1996; Bassuk, Buckner, Weinreb, Dawson, Browne, and Perloff, 1997; Bassuk, Buckner, Bassuk, and Perloff, 1998). In the earlier study, homeless mothers had greater difficulties than a comparison group of low-income mothers on a range of factors, including history of abuse in childhood and adulthood, greater psychiatric problems, and less supportive social networks (Bassuk and Rosenberg, 1998). In contrast, in the Worcester study, the two groups were quite similar across many different measures, including abuse histories, alcohol, drug, and mental health problems, health conditions, and social networks. In fact, the two groups were similar enough on so many different dimensions, especially histories of violent victimization and mental health problems, that it was almost as if they had been sampled from the same population. Conceivably, this contrast in study findings between Boston in the 1980s and Worcester in the 1990s is partly explained by a gradual worsening of the housing market in Massachusetts. Or perhaps housing policy shifted appreciably such that more low-income families were entering shelter to accelerate receiving housing assistance. Either way, what was observed in mothers in each of the two studies likely related to what was assessed in their children. In other words, the greater differences between homeless and housed children in the Boston study as reported by Bassuk and Rosenberg (1990) as compared to the Worcester study (Bassuk et al., 1997; Buckner and Bassuk, 1997; Garcia Coll et al., 1998; Buckner et al., 1997) could have partly been a function of there being more troubled families in the Boston homeless sample than the Worcester homeless sample.

While the above discussion is somewhat speculative, there are compelling reasons to warrant researchers taking a step back and evaluating possible contextual and/or policy-related factors that may play a role in study findings of homeless individuals and families. This is not to argue that differences in contextual or policy factors explain all the inconsistencies seen across the different investigations of homeless children (and families), but that they could account for some portion of the variability in results.

Homelessness is Not a Homogenous Experience

It is important to recognize that people experience homelessness in many different ways. For example, if one were to examine the residential histories of those children (or adults) who are homeless across the United States on any given night, one would find that a number of different circumstances have led to their present situation. Likewise, the ultimate pathways they shall take out of homelessness will vary as well. While homeless, these children will experience different durations of shelter stay, the conditions of shelters will vary both within and across cities, and shelter rules will be quite different. For instance, a few shelters require a family to leave during the daytime while others do not force such a requirement (U.S. Conference of Mayors, 2001). As such, homelessness is not a homogenous experience for children and it can be challenging to make generalized statements about the impact of “homelessness” on children because “homelessness” is not the same thing for all those who experience it. This can be the case as well for other stressful events, but there may be an especially high degree of variation in what homeless children encounter, both within and across locales and time periods.

Shelter conditions are probably an especially important factor in moderating the impact of homelessness for a child. Yet, previous investigations involving homeless children have not sought to measure attributes of a shelter or ecological indices to see if they relate to child outcome. No doubt this would be a challenging task and most studies have not had enough contrast in shelters from which families were enrolled to examine such issues. Nonetheless, it stands to reason that there are important qualities to shelters that may worsen or buffer a child’s experience while living there. These could include the amount of privacy accorded to families, the crowdedness of the facility, the extent to which rules are strictly enforced, the warmth of shelter staff, the size of the facility, its location, and whether families are asked to leave during the day or can remain on the premises.

Shelter as an Intervention

On the surface, a shelter stay may seem like a negative experience for a child in a low-income, but as Bassuk and Rosenberg (1990) remarked, “for some children, their stays in a neighborhood-based family shelter have been the most stable and predictable experiences of their young lives (p.261).” In fact, a stay in a family shelter (especially if it is neighborhood based and not a barrack-like shelter or a motel) accords some families the opportunity to receive assistance from case management staff in applying for assistance programs for which they may be eligible as well as referrals to professionals for treatment of one sort or another. As a general rule, the staffs of family shelters have good intentions and, over time, shelter staffs aim to improve their programs and be more responsive to their guests. Hence, some shelters may be providing useful assistance to families, thereby ameliorating other factors that can have a negative impact. In contrast, low-income families who have never been homeless can sometimes be quite isolated and far removed from a range of services and treatment programs that may be beneficial. The implication for research on the impact of homelessness on children is that a shelter stay is not always a negative event for a child. Were it the case in studies that homeless children had been literally without shelter (e.g., living in a car or in campgrounds), than the contrast in living conditions would be much more striking than is sometimes the case. In reality, studies that compare sheltered homeless versus low-income housed children are dealing with a much more complex underlying set of residential circumstances in the lives of each group of children than is generally appreciated. Said differently, the living conditions of children living in shelter are not always as bad as they might seem while the conditions of children in low-income housed settings can be much worse than imagined.

Similarities Between Homeless and Low-income Housed Children

As stated at the beginning of this section, it seems easier to discern a poverty-related effect in studies of homeless and low-income children than a homelessness-specific effect. A simple explanation is that both groups tend to differ far more from children in the general population, in terms of exposure to risk factors detrimental to various measures of outcomes than they do to one another. Despite differences in current housing status, homeless children and low-income housed children have more similarities than differences in what they have been exposed to. Even on housing status, it is important to note that homelessness is a temporary state through which people pass, not a permanent trait emanating from individual deficits (Shinn, 1997).^[15] Also, the living conditions of housed low-income children can be quite decrepit thereby attenuating the contrast between them and children who are living in shelter.

Children from low-income families, whether homeless or housed, face an array of chronic strains and acute negative life events that stem from the broader conditions of poverty.^[16] These adversities may loom large over the specific detrimental effects that homelessness can have on a child (especially when looked at over the long term). In other words, problems attributable to poverty-related stressors may be much greater than those that are homelessness specific. When viewed in the context of a much broader range of adversities, it is apparent that homelessness is but one of many stressors that children living in poverty all too frequently encounter. For most children, homelessness as a stressful event, may rank somewhere in the moderate range in terms of severity. It has the potential to be more stressful than many experiences, but not to the degree that some events hold, such as witnessing or being the victim of abuse or violence; events that are not uniquely experienced by children when homeless.

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Part III: Future Directions for Research

Research conducted to date on homeless children has illuminated the knowledge on current needs and the impact of homelessness. Additional studies of homeless and housed children along the lines of previous investigations may do little to clarify the inconsistencies in findings. If future research is conducted that specifically addresses the question of how and to what degree homelessness impacts children, it should address some of the issues brought up earlier. However, this is no small task because it would be impossible to control on historical factors that may have affected past results and it would be very difficult to account for contextual factors, such as the extent of a housing shortage in a community or shelter conditions, without conducting a large multisite study. Clearly there are variables that moderate the relationships between housing status and important indices of children’s well-being, but many of these variables may be at levels of analysis higher than the individual (e.g., shelter, community, etc.) and are difficult to investigate. Nonetheless, to advance this area of research to be more practical for policymakers and service providers, it would be helpful to understand some of the contextual, moderating influences raised here.

Topics for Further Inquiry

There is sparse data concerning some issues on homeless and low-income children. One issue is to better understand homelessness in the context of other adversities that children living in poverty frequently encounter. As mentioned previously, in comparing homelessness to other stressors that children living in poverty may encounter, homelessness is a moderate stressor, not as problematic as exposure to violence but capable of causing mental health and educational problems in children under certain circumstances (Buckner et al., 2004). Future studies to clarify the negative life events and chronic strains that are the most problematic for children would be helpful in targeting treatment resources and preventive efforts to those children living in poverty who are the most in need.

It is also useful to understand factors both internal and external to a child that lead to positive outcomes despite the adversities of poverty. Such findings lend themselves to more strengths-based interventions, which attempt to promote positive factors as opposed to only trying to eliminate risk factors. Two characteristics of children were identified in the Worcester research that were quite useful in distinguishing those who were resilient from those who were not doing as well on multiple indicators of mental health and adaptive functioning (Buckner, Mezzacappa, and Beardslee, 2003). One of these factors, which is external to a child, was parental monitoring. A child whose parent(s) engaged in active awareness of where and with whom there child was on a daily basis tended to exhibit more resilience. Another, even more important, factor distinguishing resilient from nonresilient children was an internal set of cognitive and emotion regulation skills that researchers refer to as “self-regulation.” Self-regulation comprises a set of skills that are invoked in order to accomplish goals, whether they are fairly proximal or distal in nature. In the Worcester study, children high in self-regulation looked much better on measures of mental health, behavior, adaptive functioning, and academic achievement than children low in self-regulation (Buckner, Mezzacappa, and Beardslee, paper in review). Furthermore, those high in self-regulation appeared to be better able to cope with stressors in their lives. Variables such as parental monitoring and self-regulation may offer promising leads for positive or strengths-based interventions to promote resilience in homeless children and other children living in poverty.

An additional area of importance to homeless children for which relatively little is known concerns the issue of children who are separated from their parent(s) due in part to a homeless episode. Such separation is sometimes the choice made by a parent, usually the mother, in deciding the best interests of a child or can be a decision forced upon her by the child welfare system, shelter staff, or relatives (Cowal, Shinn, Weitzman, Stojanovic, and Labay, 2002; Park, Metraux, Brodbar, and Culhane, 2004). Cowal et al. (2002) conducted the most involved investigation to date on this issue. Their study, which took place in New York City during the early 1990s involved 543 poor families, 251 of whom had experienced homelessness at some point in the 5 prior years. They found that 44 percent of the homeless families had had a child separation compared to only 8 percent of low-income never homeless families. Even when accounting for histories of mental health and substance abuse problems as well as domestic violence (directed at the mother), homelessness was strongly associated with a family experiencing such a separation (Cowal et al., 2002). The reasons why the risk of parent-child separation increases when a family becomes homeless is not entirely clear but it is likely there are multiple factors at work. The “fishbowl hypothesis” (Park et al., 2004) posits that shelters scrutinize the parenting practices of adult family members much more so than what they would experience if living in housing, and this poses a risk for child welfare placement. Alternatively, in some cases, a soon-to-be homeless mother will ask that relatives care for a child of hers so that the child can continue attending the same school. In other instances, shelters may not allow adolescents, especially males, to stay in their shelter, thereby forcing a family-child separation.

Looking at this matter of parent-child separation within the parameters of families living in homeless shelters masks an even larger issue because residents of family shelters must include at least one parent and at least one child. What about parents who are separated from their only child or all of their children? They would not be welcomed at a family shelter and instead would be placed in a shelter for “single” adults. Hence, the residents of shelters intended for single adults can and do include some individuals who would otherwise be in a family shelter if they were presently caring for their child(ren). This is borne out in a study conducted in Alameda County, California by Zlotnick, Robertson, and Wright (1999), who interviewed 171 homeless women drawn from a countywide probability sample. Of these women, 84 percent were mothers and 61.5 percent of these homeless mothers had a child under the age of 18 living either in foster care or some other out-of-home placement.

Another topic for future inquiry involves the issue of residential instability as a predictor of adverse outcomes in low-income children. Moving from place to place is certainly a common event for homeless children in the months before and sometimes after a shelter stay, but such residential instability can also be experienced among children who remain in permanent housing and do not ever spend time living in a homeless shelter. The impact that residential instability has on child outcomes is not presently well understood.

Overlapping Issues of At-risk Groups

Homeless children, because of their impoverished circumstances and residential instability share commonalities with another at-risk group of children, namely dependents of migrant farm workers. Mostly Latino of Mexican and Central American heritage, migrant farm workers provide a low-cost source of labor for American farmers who seasonally require large numbers of temporary workers to harvest their crops. About one-third of such workers lead a transient lifestyle as they travel from one state to another in the course of a year, laboring to harvest the different types of produce grown in each region. They are paid low-wages, usually with no or minimal benefits and must live in crowded makeshift abodes. It is estimated that about 42 percent of the 2 million farm workers in the United States are migrant workers. The National Commission on Migrant Education (1992) estimated that about 600,000 children belong to migrant farm worker families. Older children sometimes work alongside adults in the fields while younger children are loosely supervised during working hours. Studies of children of migrant farm workers have observed problems of a similar nature to that of homeless children, including higher rates of health and mental health problems compared to children in the general population, elevated rates of physical abuse, and academic problems (Kupersmidt and Martin, 1997; Larson, Doris, and Alvarez, 1987; Research Triangle Institute, 1992; Slesinger, Christenson, and Cautley, 1986). While the residential instability of migrant workers is somewhat more elective and predictable than for homeless families, it nonetheless can lead to similar problems, particularly difficulties in attending school and graduating (National Commission on Migrant Education, 1992).

Typology Efforts

As previously characterized, the emphasis on research to date involving homeless children has been to discern the nature and extent of impact that homelessness can have on children. Referring back to Figure 1-1, studies have tried to identify and quantify, to some extent, a homelessness-specific effect on children above and beyond a poverty-related impact. Because of this focus, much less is understood about homeless children themselves in terms of having different constellations of needs. For instance, studies of homeless children typically use measures of central tendency when summarizing results rather than focusing on a range (or extremes) in outcomes. There is work to be done on better understanding the needs of subgroups of homeless children who have significant problems in one realm and/or across different dimensions of functioning. For instance, it could be the case that a subgroup of homeless children with demonstrable needs require much more in the way of services than they are presently receiving while in shelter; whereas other homeless children, those with fewer problems, do not stand to benefit from the services than they presently getting. A better understanding of this issue would help in allocating preventive and treatment services for homeless children in the most sensible manner possible.

The studies that have been conducted to date on homeless children can be characterized as having predominantly taken a variable-centered approach to analyses. In other words, variables in specific domains (e.g., CBCL scores as indices of mental health and problem behaviors; academic achievement scores; indices of developmental status) are highlighted. In such analyses, little if any attention is paid to how, for instance, there may be subgroups of children with quite different patterns in the type and severity of their problems or needs. In contrast, a person-centered approach to data analysis (e.g., cluster analysis) would be needed to empirically identify different subgroups of children based on a range of outcome measures.^[17] Fortunately, the data sets of many existing studies of homeless children could be reexamined to better understand these different clusterings, but it would require a person-centered approach to data analyses. Little, if any, work in this area has been done to date, for the simple reason that it has not been a question that researchers have been trying to address (at least in the published literature), although it could have been examined. Nonetheless, those data sets from studies of homeless children that have a range of relevant outcome measures could be analyzed using cluster analytic and other person-centered procedures to rather readily identify subgroups based on problems or needs.

What are some of the things that might be found by looking at how problems in homeless children cluster together? Internalizing and externalizing mental health problems co-occur as can be seen in the high correlations (r = .40 - .50) between CBCL indices as well as in children who come to an outpatient clinic presenting with disruptive behavior problems and with internalizing issues (e.g., a child who is acting out but also manifests symptoms of depression and anxiety). In terms of how school-age children present with problems, it is common to see co-occurring difficulties in the realms of mental health and academic functioning, although it is difficult to discern if one is the cause of the other (e.g., is a child doing poorly in school because she is depressed or is her low self-esteem and dysphoric mood the result of poor academic performance?). Most of the time, mental health issues and academic performance influence each other in a reciprocal manner.

Conclusion

In summary, the literature on homeless children conducted over the past 18 years has focused on trying to understand if, how, and to what extent homelessness has an impact on children. Studies involving both homeless and low-income housed children have consistently found evidence for a poverty-related impact on children; that is finding that both groups have more problems on measures compared to children from nonpoverty backgrounds. Discerning an additional, homelessness-specific, impact in different realms of child functioning has been more difficult; although, not surprisingly, the preponderance of the evidence does suggest that homelessness is detrimental to the well-being of children across various realms of functioning. Yet, enough studies having the methodological capability of finding effects of homelessness (above and beyond poverty) on children have not done so, making it seem that a range of potential effect modifiers and contextual variables are operating, such that homelessness-specific effects are sometimes, but not always, detected by researchers. Additional areas in which further research is needed include trying to better understand parent-child separations that can occur because of a homeless episode and the effects this has on family members. Also, very little attention has been given to understanding whether there are distinct subgroups of homeless children based on different constellations of problems or needs.

As studies have indicated, homeless families are not a static and isolated group. Homeless families emerge from a broader population of low-income families living in housing and eventually return to this larger group. Because homelessness is but one of many stressors that children living in poverty must encounter, it is wise to always be mindful of the broader context of poverty in terms of understanding the needs and issues of homeless children. Many of their problems and needs will be quite similar to housed children who are living in poverty. That said, it is also vitally important to appreciate the specific problems that children encounter when homeless and attempt to rectify them.

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Endnotes

[1] This estimate is children who are part of families and does not include unaccompanied adolescents.

[2] This is a period (e.g., 12-month) prevalence estimate for a homelessness episode of any duration. A point prevalence estimate (e.g., the number of children homeless on any given night) would be a substantially smaller number.

[3] There is some minor variation in syndrome scales for the two age groups, but the composite internalizing and externalizing global scores can be calculated for each version thereby providing a useful means for aggregating data across the two age ranges.

[4] Children are considered in the clinical range of the instrument, suggesting the need for further assessment and possibly treatment by a mental health care provider, with T-scores of 64 or greater. T-scores from 60 to 63 are considered to be in the “borderline-clinical” range.

[5] The association between mothers’ psychological distress and CBCL ratings of their children’s problem behavior is a consistent finding in the literature. However, the nature of the link is unclear. One possibility is that a mother’s mental health influences her child’s behavior but the reverse could also be true. Furthermore, a mother who views the world in negativistic terms may report herself as having more distress as well rate her child’s behavior as more problematic.

[6] This is consistent with anecdotal reports and conjecture that older children experience more distress as a result of being homeless as compared to younger children. Possible reasons include older children’s increased awareness of their external surroundings and the greater likelihood of encountering stigmatization from peers.

[7] These CDI scores are nearly identical to those found by Bassuk and Rosenberg (1990) about 8 years earlier in Boston.

[8] Children ages 6 to 8 years who were included in the Buckner et al. (1999) report were not part of this paper because they were too young to be directly administered the DISC.

[9] A possible explanation is that the CBCL is better at picking up the effects of recent events than is the DISC, although both assessments use the same 6-month retrospective time frame. Also, diagnostic criteria for mental disorders versus behavior problem checklists do not correspond exactly, so the instruments may be assessing somewhat different things. The discrepancy could also be due to the source of the information (the CBCL is based on parent report, whereas the information taken to arrive at diagnoses for children regarding internalizing disorders came from the youth him or herself).

[10] The DDST was not administered to housed children in this study.

[11] In contrast, one could speculate that the results of Rubin et al. (1996) and that of Rafferty et al. (2004) (both which were conducted in New York city at about the same time), which each found higher school absences and lower academic achievement among homeless children, suggest that the EHCY program in this city was not as successfully implemented as compared to in Worcester 5 years later.

[12] As shown in Table 1-1, the “Ho > Hou > GP” abbreviation can be interpreted to mean that the “homeless group had more problems on the outcome measure(s) than the low-income housed comparison group, which in turn had more problems than children in the general population/normative data.”

[13] However, only some studies collected assessments of a range of adversities that children living in poverty experience, so it is not always possible to document how much risk children in the homeless and housed groups were exposed to.

[14] In Massachusetts, the Department of Transitional Assistance (DTA), which is in charge of the emergency shelter system (as well as other assistance programs for persons with low-income), refers to this as “rendering oneself homeless.” This term is an acknowledgement of the reality that some families decide a temporary stay in a family shelter may be worth it if it speeds up the process of securing permanent housing; especially if the alternative is to continue living in crowded, “doubled-up” quarters with relatives or friends. In general, DTA disapproves of rendering oneself or family homeless.

[15] As illustration of this, in the Worcester study when families in both groups were re-interviewed a year after the initial baseline interview, 92 percent of the initially homeless families were now in permanent housing and 8 percent were still homeless. By the same token, 92 percent of the housed families were still in permanent housing but 8 percent were now homeless. In other words, one year after enrollment, exactly the same proportion of “homeless” and “housed” families in our longitudinal study were living in permanent housing.

[16] Chronic strains include such things as feeling hungry, being cold in the winter, worrying about the safety of one’s relatives, feeling a lack of privacy. These are circumstances that can be experienced on a regular basis, and children were asked if they had experienced a strain, how frequently, and how much they were worried or bothered by it. Life events are more acute in nature and tend to have an onset and endpoint. They can include extreme events, such as witnessing violence, having a relative die, having a parent be arrested, and more normative events, such as changing schools or having a new sibling born into one’s family.

[17] A primary goal of cluster analysis is to take a group of variables (e.g., indices of mental health and other outcome measures) and try to identify subgroups where members are similar to one another but different from other subgroups. A goal is to minimize within-group variation on the values of variables used in the clustering, but maximize differences between groups. This yields an empirical typology.

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