Homelessness is a devastating experience for children and their families. Families, the majority of whose members are children, now comprise more than one-third of the overall US homeless population. Most of these children are less than six years old. Various assumptions have driven policy and the allocation of resources to programs serving these families. Although decades of research and field experience suggest strategies for preventing and reducing this problem, perspectives differ, hindering the development of effective solutions. In this article, we explore some of these assumptions, including () definitions of homelessness used to count the numbers of families and determine resource allocation, () the needs of children and responses to the impact of adverse childhood experiences, and () whether services matter and should be integrated with affordable housing. We conclude by suggesting various directions to ensure that these children are protected and have the opportunity to grow and thrive.


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Literature Cited

  1. 1. 
    Assoc. Play Ther 2019. Play therapy makes a difference. Association for Play Therapy https://www.a4pt.org/page/PTMakesADifference/Play-Therapy-Makes-a-Difference.htm
    [Google Scholar]
  2. 2. 
    Bassuk EL. 2010. Ending child homelessness in America. Am. J. Orthopsychiatr. 80:496–504
    [Google Scholar]
  3. 3. 
    Bassuk EL, Beardslee WR. 2014. Depression in homeless mothers: addressing an unrecognized public health issue. Am. J. Orthopsychiatr. 84:73–81
    [Google Scholar]
  4. 4. 
    Bassuk EL, DeCandia CJ, Beach CA, Berman F 2014. America's youngest outcasts: a report card on child homelessness Rep., Natl. Cent. Family Homelessness, Am. Inst. Res Waltham, MA: https://www.air.org/sites/default/files/downloads/report/Americas-Youngest-Outcasts-Child-Homelessness-Nov2014.pdf
  5. 5. 
    Bassuk EL, DeCandia CJ, Richard MK 2015. Services matter: how housing & services can end family homelessness Rep., Bassuk Cent Needham, MA: https://www.bassukcenter.org/wp-content/uploads/2015/11/Services-Matter.pdf
  6. 6. 
    Bassuk EL, DeCandia CJ, Tsertsvadze A, Richard MK 2014. The effectiveness of housing interventions and housing and service interventions on ending family homelessness: a systematic review. Am. J. Orthopsychiatr. 84:457–74
    [Google Scholar]
  7. 7. 
    Bassuk EL, Olivet J, DeCandia CJ 2015. Building on Strengths and Advocating Family Empowerment (BSAFE): an intervention to end family homelessness Rep., C4 Innov., Bassuk Cent Needham, MA: https://www.bassukcenter.org/wp-content/uploads/2016/10/BSAFE_2.pdf
  8. 8. 
    Bassuk EL, Richard MK, Tsertsvadze A 2015. The prevalence of mental illness in homeless children: a systematic review and meta-analysis. J. Am. Acad. Child Adolesc. Psychiatry 54:86–96
    [Google Scholar]
  9. 9. 
    Bassuk EL, Unick GJ, Paquette K, Richard MK 2017. Developing an instrument to measure organizational trauma-informed care in human services: the TICOMETER. Psychol. Violence 7:150–57
    [Google Scholar]
  10. 10. 
    Bassuk EL, Weinreb LF, Buckner JC, Browne A, Salomon A, Bassuk SS 1996. The characteristics and needs of sheltered homeless and low-income housed mothers. JAMA 276:640–46
    [Google Scholar]
  11. 11. 
    Bitler MP, Hoynes HW, Domina T 2014. Experimental evidence on distributional effects of Head Start NBER Work. Pap 20434
  12. 12. 
    Bloom SL. 1997. Creating Sanctuary: Toward the Evolution of Sane Societies New York: Routledge
  13. 13. 
    Bratton SC, Ray D, Rhine T, Jones L 2005. The efficacy of play therapy with children: a meta-analytic review of treatment outcomes. Prof. Psychol. Res. Pract. 36:376–90
    [Google Scholar]
  14. 14. 
    Burke NJ, Hellman JL, Scott BG, Weems CF, Carrion VG 2011. The impact of adverse childhood experiences on an urban pediatric population. Child Abuse Negl 35:408–13
    [Google Scholar]
  15. 15. 
    Campbell JA, Walker RJ, Egede LE 2016. Associations between adverse childhood experiences, high-risk behaviors, and morbidity in adulthood. Am. J. Prev. Med. 50:344–52
    [Google Scholar]
  16. 16. 
    Cent. Dev. Child 2019. Brain architecture. Center on the Developing Child, Harvard University https://developingchild.harvard.edu/science/key-concepts/brain-architecture/
    [Google Scholar]
  17. 17. 
    Cent. Dev. Child 2019. Learning through play. Center on the Developing Child, Harvard University https://developingchild.harvard.edu/innovation-application/innovation-in-action/learning-through-play/
    [Google Scholar]
  18. 18. 
    Chapman DP, Whitfield CL, Felitti VJ, Dube SR, Edwards VJ, Anda RF 2004. Adverse childhood experiences and the risk of depressive disorders in adulthood. J. Affect. Disord. 82:217–25
    [Google Scholar]
  19. 19. 
    Coohey C, Easton SD, Kong J, Bockenstedt JKW 2015. Sources of psychological pain and suicidal thoughts among homeless adults. Suicide Life Threat. Behav. 45:271–80
    [Google Scholar]
  20. 20. 
    DeCandia CJ, Guarino K. 2015. Trauma-informed care: an ecological response. J. Child Youth Care Work 25:7–32
    [Google Scholar]
  21. 21. 
    Domest. Violence Hous. Tech. Assist. Consort 2018. Point-in-time count fact sheet on identifying survivors of domestic violence Fact Sheet, Domest. Violence Hous. Tech. Assist. Consort Washington, DC: https://files.hudexchange.info/resources/documents/2019-PIT-Count-DV-Fact-Sheet.pdf
  22. 22. 
    Dong M, Giles WH, Felitti VH, Dube SR, Williams JE et al. 2004. Insights into causal pathways for ischemic heart disease: adverse childhood experiences study. Circulation 110:1761–66
    [Google Scholar]
  23. 23. 
    Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM et al. 1998. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study. Am. J. Prev. Med. 14:245–58
    [Google Scholar]
  24. 24. 
    Gewirtz AH, DeGarmo DS, Lee S, Morrell N, August GJ 2015. Two-year outcomes of the Early Risers prevention trial with formerly homeless families residing in supportive housing. J. Fam. Psychol. 29:242–52
    [Google Scholar]
  25. 25. 
    Gewirtz AH, Hart-Shegos E, Medhanie A 2008. Psychosocial status of homeless children and youth in family supportive housing. Am. Behav. Sci. 51:810–23
    [Google Scholar]
  26. 26. 
    Giovanelli A, Reynolds AJ, Mondi CF, Ou S-R 2016. Adverse childhood experiences and adult well-being in a low-income, urban cohort. Pediatrics 137:e20154016
    [Google Scholar]
  27. 27. 
    Goodman SH, Rouse MH, Connell AM, Broth MR, Hall CM, Heyward D 2011. Maternal depression and child psychopathology: a meta-analytic review. Clin. Child Fam. Psychol. Rev. 14:1–27
    [Google Scholar]
  28. 28. 
    Guarino K, Bassuk ENatl. Cent. Family Homelessness 2010. Working with families experiencing homelessness: understanding trauma and its impact. Zero Three 30:11–20
    [Google Scholar]
  29. 29. 
    Halfron N, Larson K, Son J, Lu M, Bethell C 2017. Income inequality and the differential effect of adverse childhood experiences in US children. Acad. Pediatr. 17:S70–78
    [Google Scholar]
  30. 30. 
    Hayes M, Zonneville M, Bassuk E 2013. The SHIFT Study final report: service and housing interventions for families in transition Rep., Natl. Cent. Family Homelessness Newton, MA: https://www.air.org/sites/default/files/SHIFT_Service_and_Housing_Interventions_for_Families_in_Transition_final_report.pdf
  31. 31. 
    Henry M, Mahathey A, Morrill T, Robinson A, Shivji A et al. 2018. The 2018 annual homeless assessment report (AHAR) to Congress. Part 1: point-in-time-estimates of homelessness Rep., U.S. Dep. Hous. Urban Dev Washington, DC: https://files.hudexchange.info/resources/documents/2018-AHAR-Part-1.pdf
  32. 32. 
    Herbers JE, Cutuli JJ, Monn AR, Narayan AJ, Masten AS 2014. Trauma, adversity, and parent-child relationships among young children experiencing homelessness. J. Abnorm. Child Psychol. 42:1167–74
    [Google Scholar]
  33. 33. 
    Holtrop K, Piehler TF, Gewirtz AH, August GJ 2017. Observed parenting in families exposed to homelessness: child and parent characteristics as predictors of response to the Early Risers intervention. Child and Family Well-Being and Homelessness: Integrating Research into Practice and Policy ME Haskett 27–48 Cham, Switz: Springer Int.
    [Google Scholar]
  34. 34. 
    Hopper EK, Bassuk EL, Olivet J 2009. Shelter from the storm: trauma-informed care in homelessness services settings. Open Health Serv. Policy J. 2:131–51
    [Google Scholar]
  35. 35. 
    Horizons for Homeless Children 2019. Playspace program. Horizons for Homeless Children http://horizonschildren.org/programs/playspace/
    [Google Scholar]
  36. 36. 
    Howard KS, Cartwright S, Barajas RG 2009. Examining the impact of parental risk on family functioning among homeless and housed families. Am. J. Orthopsychiatr. 79:326–35
    [Google Scholar]
  37. 37. 
    Hunt TKA, Slack KS, Berger LM 2017. Adverse childhood experiences and behavioral problems in middle childhood. Child Abuse Negl 67:391–402
    [Google Scholar]
  38. 38. 
    Huntington N, Buckner JC, Bassuk EL 2008. Adaptation in homeless children: an empirical examination using cluster analysis. Am. Behav. Sci. 51:737–55
    [Google Scholar]
  39. 39. 
    ICPH (Inst. Child. Poverty Homelessness) 2013. Rapidly rehousing homeless families: New York Citya case study Rep., ICPH New York: https://www.icphusa.org/reports/rapidly-rehousing-homeless-families/
    [Google Scholar]
  40. 40. 
    Khadduri J. 2008. Housing vouchers are critical for ending family homelessness Rep., Natl. Alliance End Homelessness Washington, DC:
  41. 41. 
    Knitzer J, Theberge S, Johnson K 2008. Reducing Maternal Depression and Its Impact on Young Children: Toward a Responsive Early Childhood Policy Framework Rep., Natl. Cent. Child. Poverty New York: http://www.nccp.org/publications/pub_791.html
  42. 42. 
    Kreatsoulas CE, Fleegler W, Subramanian SV 2014. Adverse childhood events increase the risk of behavioral and clinical cardiovascular risk factors. Can. J. Cardiol. 30:S77–78
    [Google Scholar]
  43. 43. 
    Mayberry LS, Shinn M, Benton JG, Wise J 2014. Families experiencing housing instability: the effects of housing programs on family routines and rituals. Am. J. Orthopsychiatr. 84:95–109
    [Google Scholar]
  44. 44. 
    McKelvey LM, Selif JP, Whiteside-Mansell L 2017. Foundations for screening adverse childhood experiences: exploring patterns of exposure through infancy and toddlerhood. Child Abuse Negl. 70:112–21
    [Google Scholar]
  45. 45. 
    Merrick MT, Ports KA, Ford DC, Afifi TO, Gershoff ET, Grogan-Kaylor A 2017. Unpacking the impact of adverse childhood experiences on adult mental health. Child Abuse Negl 69:10–19
    [Google Scholar]
  46. 46. 
    Mersky JP, Janczewski CE, Topitzes J 2017. Rethinking the measurement of adversity: moving toward second-generation research on adverse childhood experiences. Child Maltreat 22:58–68
    [Google Scholar]
  47. 47. 
    Mishel L. 2015. Causes of wage stagnation Brief, Econ. Policy Inst Washington, DC: https://www.epi.org/publication/causes-of-wage-stagnation/
  48. 48. 
    Morton MH, Dworsky A, Samuels GM 2017. Missed opportunities: youth homelessness in America. National estimates Brief, Chapin Hall, Univ Chicago: http://voicesofyouthcount.org/wp-content/uploads/2017/11/VoYC-National-Estimates-Brief-Chapin-Hall-2017.pdf
  49. 49. 
    Munns A, Watts R, Hegney D, Walker R 2016. Effectiveness and experiences of families and support workers participating in peer-led parenting support programs delivered as home visiting programs: a comprehensive systematic review. JBI Database Syst. Rev. Implement. Rep. 14:167–208
    [Google Scholar]
  50. 50. 
    NAEHCY (Natl. Assoc. Educ. Homeless Child. Youth) 2016. Summary of final Head Start regulations related to homelessness Summ., NAEHCY Minneapolis, MN: https://naehcy.org/wp-content/uploads/2018/02/Summary-of-Final-Head-Start-Regulations-Related-to-Homelessness-FINAL.pdf
  51. 51. 
    Natl. Cent. Homeless Educ 2019. Federal data summary: school years 201415 to 201617 Rep., Natl. Cent. Homeless Educ., Univ. N. C. Greensboro Browns Summit, NC: https://nche.ed.gov/wp-content/uploads/2019/02/Federal-Data-Summary-SY-14.15-to-16.17-Final-Published-2.12.19.pdf
    [Google Scholar]
  52. 52. 
    Natl. Coalit. Homeless 2009. Employment and homelessness Fact Sheet, Natl. Coalit. Homeless Washington, DC: https://www.nationalhomeless.org/factsheets/employment.html
  53. 53. 
    Natl. Law Cent. Homelessness Poverty 2017. Don't count on it: how the HUD point-in-time count underestimates the homelessness crisis in America Rep., Natl. Law Cent. Homelessness Poverty Washington, DC: https://nlchp.org/wp-content/uploads/2018/10/HUD-PIT-report2017.pdf
  54. 54. 
    Natl. Low Income Hous. Coalit 2019. The gap: a shortage of affordable rental homes Rep., Natl. Low Income Hous. Coalit Washington, DC: https://reports.nlihc.org/sites/default/files/gap/Gap-Report_2019.pdf
  55. 55. 
    Natl. Res. Counc., IOM (Inst. Med.) 2009. Preventing Mental, Emotional, and Behavioral Disorders Among Young People: Progress and Possibilities Washington, DC: Natl. Acad. Press
  56. 56. 
    Natl. Sci. Counc. Dev. Child 2009. Young children develop in an environment of relationships Work. Pap. 1, Cent. Dev. Child Cambridge, MA:
  57. 57. 
    Natl. Sci. Counc. Dev. Child 2014. Excessive stress disrupts the architecture of the developing brain Work. Pap. 3, Cent. Dev. Child Cambridge, MA:
  58. 58. 
    Off. ASPE (Assist. Secr. Plan. Eval.), Off. Hum. Serv. Policy, Adm. Child. Fam. Off. Plan. Res. Eval 2017. Head Start children and families experiencing homelessness: trends, characteristics, and program services ASPE Res. Brief., U.S. Dep. Health Hum. Serv Washington, DC: https://aspe.hhs.gov/system/files/pdf/258496/HeadStartHomelessFamilies.pdf
  59. 59. 
    Off. Community Plan. Dev 2008. A guide to counting unsheltered homeless people: second revision Rep., U.S. Dep. Hous. Urban Dev Washington, DC: https://files.hudexchange.info/resources/documents/counting_unsheltered.pdf
  60. 60. 
    Off. Community Plan. Dev 2012. A guide to counting sheltered homeless people: third revision Rep., U.S. Dep. Hous. Urban Dev Washington, DC: https://www.hudexchange.info/onecpd/assets/File/A-Guide-to-Counting-Sheltered.pdf
  61. 61. 
    Off. Head Start, Adm. Child. Fam 2019. Head start programs. Office of Head Start https://www.acf.hhs.gov/ohs/about/head-start
    [Google Scholar]
  62. 62. 
    Piehler TF, Bloomquist ML, August GJ, Gewirtz AH, Lee SS, Lee WS 2014. Executive functioning as a mediator of conduct problems prevention in children of homeless families residing in temporary supportive housing: a parallel process latent growth modeling approach. J. Abnorm. Child Psychol. 42:681–92
    [Google Scholar]
  63. 63. 
    Poleshuck EL, Cerrito B, Leshoure N, Finocan-Kaag G, Kearney MH 2013. Underserved women in women's health clinic describe their experiences of depressive symptoms and why they have low uptake of psychotherapy. Community Ment. Health J. 49:50–60
    [Google Scholar]
  64. 64. 
    Remigio-Baker RA, Hayes DK, Rayes-Salvail F 2015. Adverse childhood events are related to the prevalence of asthma and chronic obstructive pulmonary disorder among adult women in Hawaii. Lung 193:885–91
    [Google Scholar]
  65. 65. 
    Samuels J. 2010. Young Family Critical Time Intervention (CTI): successful transitions from homelessness to stability Rep., Strength. At Risk Homeless Young Mothers Child Newton Centre, MA: https://www.criticaltime.org/wp-content/uploads/2011/10/Samuels-Young-Families.pdf
  66. 66. 
    Schaefer CE, Peabody MA. 2016. Glossary of play therapy terms Gloss., Advocates Play Ther Clovis, CA: https://cdn.ymaws.com/a4pt.site-ym.com/resource/resmgr/Publications/Glossary_of_Play_Therapy_Ter.pdf
  67. 67. 
    SchoolHouse Connect 2019. Home at Head Start: new national campaign on homelessness News and Views, Feb. 5, SchoolHouse Connect Washington, DC: https://www.schoolhouseconnection.org/home-at-head-start-new-national-campaign-on-homelessness/
  68. 68. 
    SchoolHouse Connect 2019. The pitfalls of HUD's point-in-time count SCH Perspect., Jan. 11, SchoolHouse Connect Washington, DC: https://www.schoolhouseconnection.org/the-pitfalls-of-huds-point-in-time-count/
  69. 69. 
    Shinn M, Samuels J, Fischer SN, Thompkins A, Fowler PJ 2015. Longitudinal impact of a family critical time intervention on children in high-risk families experiencing homelessness: a randomized trial. Am. J. Community Psychol. 56:205–16
    [Google Scholar]
  70. 70. 
    Shonkoff JP, Garner AS, Siegel BS, Dobbins MI, Earls MF et al. 2012. The lifelong effects of early childhood adversity and toxic stress. Pediatrics 129:e232–46
    [Google Scholar]
  71. 71. 
    Simone J. 2015. Today's read: Low wages are leaving millions of workers behind. Coalit. Homeless Blog Sept. 17. https://www.coalitionforthehomeless.org/todays-read-low-wages-leaving-millions-workers-behind/
    [Google Scholar]
  72. 72. 
    Steffen BL, Fudge K, Martin M, Souza MT, Vandenbroucke DA et al. 2011. Worst case housing needs 2009: report to Congress Rep., U.S. Dep. Hous. Urban Dev Washington, DC: https://www.huduser.gov/portal/publications/worstcase_HsgNeeds09.pdf
  73. 73. 
    US DHHS (Dep. Health Hum. Serv.), ACF (Adm. Child. Fam.) 2010. Head Start impact study: final report Rep., U.S. DHHS Washington, DC: https://www.acf.hhs.gov/sites/default/files/opre/hs_impact_study_final.pdf
  74. 74. 
    US DHHS (Dep. Health Hum. Serv.), ACF (Adm. Child. Fam.), HRSA (Health Resour. Serv. Adm.) 2018. The Maternal, Infant, and Early Childhood Home Visiting program: partnering with parents to help children succeed Progr. Brief, U.S. HHS, ACF, HRSA Washington, DC: https://mchb.hrsa.gov/sites/default/files/mchb/MaternalChildHealthInitiatives/HomeVisiting/pdf/programbrief.pdf
  75. 75. 
    US HUD (Dep. Hous. Urban Dev.) 2016. Family options study: 3-year impacts of housing and services interventions for homeless families Summ. Rep., U.S. HUD Washington, DC: https://www.huduser.gov/portal/sites/default/files/pdf/Family-Options-Study-Full-Report.pdf
  76. 76. 
    US HUD (Dep. Hous. Urban Dev.) 2016. HUD releases 3-year study of strategies to end family homelessness: housing vouchers most effective intervention while rapid re-housing proves least costly News Release 16-160, Oct. 25. https://archives.hud.gov/news/2016/pr16-160.cfm
  77. 77. 
    USICH (U. S. Interag. Counc. Homelessness) 2016. Ending homelessness among families with children in 2020 Fact Sheet, USICH Washington, DC: https://www.usich.gov/resources/uploads/asset_library/Ending_Homelessness_Families_Fact_Sheet_052016.pdf
  78. 78. 
    Weinreb LF, Buckner JC, Williams V, Nicholson J 2006. A comparison of the health and mental health status of homeless mothers in Worcester, Mass: 1993 and 2003. Am. J. Public Health 96:81444–48
    [Google Scholar]
  79. 79. 
    Weissman MM, Pilowsky DJ, Wickramaratne PJ, Talati A, Wisniewski SR et al. 2006. Remissions in maternal depression and child psychopathology: a STAR*D-Child report. JAMA 295:1389–98
    [Google Scholar]
  80. 80. 
    Wilder Res 2019. Single night count of people experiencing homelessness: 2018 Minnesota homeless study fact sheet Fact Sheet, Wilder Res Saint Paul, MN: https://www.wilder.org/wilder-research/research-library/single-night-count-people-experiencing-homelessness-2018-minnesota
  81. 81. 
    Win Y-W, Bratton SC. 2015. A meta‐analytic review of child‐centered play therapy approaches. J. Couns. Dev. 9:45–58
    [Google Scholar]
  82. 82. 
    Zhai F, Brooks-Gunn J, Waldfogel J 2011. Head Start and urban children's school readiness: a birth cohort study in 18 cities. Dev. Psychol. 47:134–52
    [Google Scholar]
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