title: Assessing change in the behavior of children and adolescents in youth welfare institutions using goal attainment scaling.
abstract: BACKGROUND
  Evaluating youth welfare services is vital, both because of the considerable influence they have on the development of children and adolescents, as well as owing to the extensive financial costs involved, especially for child residential care. In this naturalistic study we have undertaken to evaluate changes in various behaviors of young people who are in youth welfare institutions, not only by using standardized questionnaires, but also specifically modified goal attainment scales (GAS). These scales were meant to represent the pedagogical objectives of youth welfare professionals as well as the individual goals of the young people in care.
  
  
  METHODS
  Goal attainment scales were used to ascertain behavioral changes in 433 children and adolescents (age 6 to 18 years) in 25 youth welfare institutions (day care and residential care) in Germany. Social and individual goals were rated by young people and caregivers together on at least two occasions. In addition, to examine potential problems of children and adolescents, quality of life as well as mental health and behavior problems were identified by the caregiver and also by the youth using a self-report inventory.
  
  
  RESULTS
  Many of the children and adolescents had experienced critical life events, problems in school, impaired quality of life, along with mental health and behavior problems (range: 41-87%). During their stay in day care or residential care institutions, children and adolescents showed some improvement in social goals (Cohen's d = 0.14-0.44), especially those young people with deficits at the beginning, and with regard to mental health and problem behavior (d = 0.10-0.31). For individual goals, progress was even more pronounced (d = 0.75). Improvements to social goals were more pronounced if mental health and behavior problems decreased. This link to changes in behavioral and emotional problems was only ascertained to a limited extent for individual goals.
  
  
  CONCLUSIONS
  Young people residing in youth welfare institutions achieved individual and social goals and improved with regard to behavior problems. The applied goal attainment scales are well suited for measuring individual change in children and adolescents and constitute a relevant addition to established instruments. Furthermore, their advantages include cooperative goal setting, the assessment of goals by caregivers and young people, and congruence with the pedagogical objectives of professionals.
authors.affiliation: Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Ulm, Steinhoevelstr 5, 89075 Ulm, Germany. rita.kleinrahm@uniklinik-ulm.de.
authors.forename: Rita
authors.initials: R
authors.lastname: Kleinrahm
authors.forename: Ferdinand
authors.initials: F
authors.lastname: Keller
authors.forename: Kerstin
authors.initials: K
authors.lastname: Lutz
authors.forename: Michael
authors.initials: M
authors.lastname: Kölch
authors.forename: Jörg M
authors.initials: JM
authors.lastname: Fegert
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