Differential response (DR), also referred to as alternative response (AR), family assessment response (FAR), or multiple track response, was developed to incorporate family-centered, strengths-based practices into child protective services (CPS), primarily by diverting lower risk families into an assessment track rather than requiring the traditional CPS investigation. Since the program's inception, researchers have conducted several large evaluation studies of DR programs, and a large body of research and program literature has been published touting the success and benefits of DR. In response to significant concerns about the clarity and consistency of DR program models and the validity and generalizability of its associated research, the authors undertook a comprehensive, three-pronged evaluation to provide guidance in shaping the ongoing development of DR programs. This report summarizes the methodology, findings, conclusions, and recommendations from the review.

Integrating physical and behavioral health services has the potential to reduce health disparities and service inequities among persons most at risk. However, clinical social workers in integrated health settings must possess relevant knowledge and skills to provide quality care to diverse populations. The Social Worker Integrated Care Competency Scale (SWICCS), developed to complement the Integrated and Culturally Relevant Care (ICRC) field education curriculum, measures students' self-perceptions of knowledge and skills associated with providing behavioral health care. Three student cohorts (n=38) completed the SWICCS three times during an integrated care field practicum. Results indicated a statistically significant increase in student knowledge and skills at each time point, with a large effect size (r =-0.87). The SWICCS demonstrated utility in measuring and tracking social work student acquisition of knowledge and skills required for practice in integrated care environments.

Some women continue to use cocaine during pregnancy, placing their fetus at risk for developmental problems. While gross problems are not evident after controlling for experimental flaws, subtle effects continue to be found. Social interactions of cocaine-exposed and nonexposed toddlers and their caregivers were assessed during a Free Play test to determine if psychobehavioral deficits were clinically observable. Risk factors were evaluated to assess whether the child's socioemotional-behavioral behaviors were related to exposure and/or interactions with caregivers or the environment. Twenty-four-month-old cocaine-exposed and nonexposed toddlers were evaluated with the Child Behavior Check List while they played with their caregivers. Caregivers' vocalizations were scored as contingent pairs if they occurred within 3 seconds of the child's. The proportion of pairs was compared by group. Quality of caregivers' vocalizations was rated as positive or negative based on approval, encouragement, and criticism. General linear model analyses indicate that cocaine-exposed children showed more dysfunctional behaviors than noncocaine-exposed children. Deficits increased when income and number of dependents were included. Caregivers in the drug group emitted fewer vocalizations during play before receiving a toy, indicating fewer opportunities for learning. No effect 246 of quality of caregiver communication or gender by cocaine exposure interaction emerged. Cocaine exposure predicts poor developmental outcomes, but the toddler-caregiver relationship and reduced access to resources are additional risks that had previously been attributed to cocaine exposure. Early intervention services are needed to reduce the impact of low income, increase preschool readiness, and optimize functioning of these fragile families.

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