Homelessness in the child welfare system: A randomized controlled trial to assess the impact of housing subsidies on foster care placements and costs

Inadequate housing and homelessness among families represent a substantial challenge for child and adolescent well-being. Child welfare services confront housing that threatens placement into foster care with little resources and evidence to guide practice. The present study provides the first rigorous test of the Family Unification Program (FUP) – a federal program that offers housing subsidies for inadequately housed families under investigation for child maltreatment. A randomized controlled trial assesses program impact on foster care placement and costs.The experiment referred intact child welfare-involved families whose inadequate housing threatened foster placement in Chicago, IL to FUP plus housing advocacy (n = 89 families with 257 children) or housing advocacy alone (n = 89 families with 257 children). Families were referred from 2011 to 2013, and administrative data recorded dates and costs of foster placements over a 3-year follow-up. Intent-to-treat analyses suggested families randomly assigned for FUP exhibited slower increases in rates of foster placement following housing intervention compared with families referred for housing advocacy alone. The program generates average savings of nearly $500 per family per year to the foster care system. Housing subsidies provide the foster care system small but significant benefits for keeping homeless families together. Findings inform the design of a coordinated child welfare response to housing insecurity.     

Child strengths and placement stability among racial/ethnic minority youth in the child welfare system

While all children deserve a stable living environment, national data illustrate that many states struggle to achieve placement stability for youth in the child welfare system as a significant number of children in foster care continue to experience multiple placements while in state custody. Prior research has not considered the impact of youth protective factors or strengths on the frequency of placement changes that youth experience while in the child welfare system. This study examined the association between strengths measured at multiple levels (i.e., individual, family, and community) and placement stability among 4022 minority youth (aged 10–18) using administrative and clinical data from the Illinois child welfare system. Negative binomial regressions at the family level revealed that youth with at least one loving and supportive family member experienced 16% fewer placement changes than youth without family strengths. At the community level, youth attending schools that work to create an environment that meets its students’ needs experienced 13% fewer placement changes than youth without educational supports. These findings can inform the quality of treatment and services provided to minority youth in the child welfare system.     

Variables associated with disrupted placement in a select sample of abused and neglected children

The purpose of this study was to examine the placement history of 172 abused and/or neglected children who had been placed in a residential home for maltreated children. Data were collected on the child's placement history (i.e., number of placements, time in transition, and placement rate) and also on child and family characteristics. Pearson correlation coefficients were run between child and family variables and each of the three placement history variables. In addition, t-tests were also used as a method of analysis. Results indicated that children with the following characteristics or life circumstances experienced the more disruptive experience while in foster care: children having severe behavior problems; children who were very young when first removed from their natural home; and children having drug addicted and/or alcoholic parents. Implications of these findings indicate social workers and judges need to be alert to the potential for system abuse of children in foster placement, responsible long-term planning for any child in foster care is critical, and those involved in therapeutic treatment for abused/neglected children should be attentive to the child's placement history.     

Children leaving foster care: Outcomes of permanency planning

Foster care, created to overcome some of the disadvantages and abuses of institutional care of children, can present its own problems. One problem is overt abuse, but there are other, more subtle, deficiencies and concerns about foster care. In response, the concept of permanency planning has been introduced as a philosophy, a policy, and a technique. It is designed to return every child who enters care to the stability of a family as quickly as possible. This paper presents findings of a longitudinal study of the outcomes of permanency planning. Results show that over half the children returned to their biological parents, that adoptions were more common for Caucasian than black children, that 78% of the children were still in their permanent placements 12-16 months later, that most children were functioning well, and that there was a marked need for services for the families. In addition to the results of the study, the discussion focuses on implications for foster care practice and child welfare policy, including the importance of relatives, the impact of foster care placements, the needs of biological families, and the provision of services and supports for reunified families.     

Child welfare services involvement among the children of young parents in foster care

Despite the high rate of early parenthood among youth in foster care as well as the increased risk of child maltreatment among children whose adolescent parents have been neglected or abused, very little is known about child welfare services involvement among children whose parents were in foster care when they were born. This study uses administrative data from the Illinois Department of Children and Family Services (DCFS) to examine the occurrence of child abuse and neglect investigations, indicated reports and out of home care placements among the children of youth in foster. Thirty-nine percent of the children were the subject of at least one CPS investigation, 17 percent had at least one indicated report and 11 percent were placed in out of home care at least once before their 5th birthday. Cox proportional hazard models are also estimated to identify characteristics of parenting foster youth and their placement histories associated with the risk of child welfare services involvement. Implications of the findings for policy and practice are discussed.     

Are sexual minority youth overrepresented in foster care,child welfare,and out-of-home placement? Findings from nationally representative data

BackgroundPreliminary evidence suggests that sexual minority (e.g. lesbian, gay, bisexual, and same-sex attracted) youth are overrepresented in child welfare services. Yet, no study to date has been able to test this hypothesis with national data.ObjectiveUsing a two-study design, we test whether sexual minority youth are overrepresented in child welfare, foster care, and out-of-home placement using nationally representative data from the United States.Participants and settingStudy 1 data are from the National Longitudinal Study of Adolescent to Adult Health (n = 14,154; Mean age = 15.4). Study 2 data are from wave three of the National Survey of Child and Adolescent Well-Being II (n = 1309; Mean age = 15.0).MethodsFor Study 1, we use adjusted logistic regression models to test differences in lifetime foster care involvement between sexual minority and heterosexual youth. In Study 2, we calculate a Disproportionality Representation Index (DRI) – a ratio of sample prevalence relative to the general population – to estimate whether sexual minority youth were overrepresented in child welfare and out-of-home care.ResultsStudy 1 results indicate that sexual minority youth are nearly 2.5 times as likely as heterosexual youth to experience foster care placement (aOR = 2.43, 95% CI 1.40, 4.21, p = .002). Results from Study 2 show that sexual minority youth were largely overrepresented in child welfare services (DRI = 1.95–2.48) and out-of-home placement (DRI = 3.69–4.68).ConclusionsFindings are the first to demonstrate sexual minority youth’s overrepresentation in child welfare, foster care, and out-of-home placement using nationally representative data and emphasizes the need for focused research on sexual minority youth involved in the child welfare system.     

From maltreatment report to juvenile incarceration: the role of child welfare services

OBJECTIVE: This study examined whether children who received child welfare services (e.g., in-home or out-of-home placement) were more or less likely to become incarcerated as serious and violent youthful offenders than those children who were investigated as victims of abuse and neglect but received no further child welfare intervention. METHOD: Administrative data on child abuse reporting, foster care, birth records, and juvenile corrections (CYA) were linked to prospectively examine the risk of incarceration as an adolescent following an investigation of abuse or neglect after age 6. The 10 county California sample included 159,549 school-aged children reported for abuse and neglect after 1990. RESULTS: About 8 per 1,000 children in the sample were later incarcerated in CYA. African American and Hispanic children who received in-home or foster care services after the index investigation event had a lower risk of incarceration than those whose cases were closed after the investigation. Among females, the rate of incarceration was highest for those who experienced foster or group care placements. Children initially reported for neglect were more likely to be incarcerated than those reported for physical or sexual abuse. CONCLUSIONS: Public child welfare services have rarely been assessed in terms of future negative child outcomes. This study finds that one serious negative outcome, CYA involvement, can only be understood when a number of factors are considered. The importance of understanding the differences between how different subpopulations respond to services is highlighted. Specifically, our findings suggest that more attention should be focused on children who are now receiving no services after an investigated child abuse and neglect report, on females, and on victims of child neglect.     

Professionals' decision-making about out-of-home placements following instances of child abuse

OBJECTIVE: The goal of this research was to study how different groups of child welfare professionals prioritize and use information to make placement decisions following instances of child abuse. METHOD: A total of 90 juvenile court judges and guardians ad litem, Court Appointed Special Advocates (CASA), social workers, and mental health professionals responded to a detailed questionnaire describing four case studies of child physical abuse in which a parent was the perpetrator, the child was either 2 years or 6 years of age, and the abuse was either first time or chronic. Participants rated the impact of specific pieces of information regarding child, family, and system-level characteristics on their decision-making process. RESULTS: Analyses of reactions to these vignettes demonstrate that professional groups use different kinds of information when making decisions about foster care placements. Social workers and mental health providers rely on information about the severity and pattern of abuse and on information about services offered in the past and parental responses to those services. Judges and guardians ad litem rely more heavily on information about the likelihood of a reoccurrence of abuse and the child's ability to recount the abuse, whereas CASA volunteers rely on information about the stability of the family. CONCLUSIONS: Professional group membership, rather than factors such as age or ethnicity of the child or chronicity of abuse, accounts for different patterns of prioritizing and using information when making decisions about whether a child should remain in the home or be placed in foster care. The implications for community-based training and intervention efforts are discussed.     

Improving outcomes for babies and toddlers in child welfare: A model for infant mental health intervention and collaboration

Children under three comprise a sizable and growing proportion of foster care placements. Very young children who enter the child welfare system experience disruptions of critical attachments that are essential to this formative stage of brain development, as well as other traumatic events, leaving them at great risk for lifelong impairments. To reverse these concerning outcomes, babies who have been removed from their homes require intensive, relationship-based interventions that promote secure attachment to a primary caregiver and holistic attention the child's developmental needs. Child welfare decision-makers must be informed of infant brain development and knowledgeable about the particular needs and circumstances of each child. This article describes a model with these features that has been developed and tested in the Bronx, New York, one of the nation's poorest urban counties with high rates of foster care. The Project utilizes evidence-based Child-Parent Psychotherapy (CPP) as its core intervention, and emphasizes collaboration and information sharing– driven by the CPP clinician– with judges, child welfare workers, attorneys and other social service and mental health providers, thereby encouraging developmentally and relationally informed case planning and permanency decisions. The model is evaluated using pre and post treatment psychosocial measures and program outcome data. Results indicate improvement in parenting interactions, positive child welfare outcomes (including increased rates of reunification, fewer returns to foster care), and improved safety and wellbeing. Results highlight the need for child welfare practices to be more closely aligned with the current science of infant brain development, and to incorporate a specialized approach to address the unique needs of infants.     

Factors associated with caregiver stability in permanent placements: a classification tree approach

Objective

Identify individual and environmental variables associated with caregiver stability and instability for children in diverse permanent placement types (i.e., reunification, adoption, and long-term foster care/guardianship with relatives or non-relatives), following 5 or more months in out-of-home care prior to age 4 due to substantiated maltreatment.

Methods

Participants were 285 children from the Southwestern site of Longitudinal Studies of Child Abuse and Neglect (LONGSCAN). Caregiver instability was defined as a change in primary caregiver between ages 6 and 8 years. Classification and regression tree (CART) analysis was used to identify the strongest predictors of instability from multiple variables assessed at age 6 with caregiver and child reports within the domains of neighborhood/community characteristics, caregiving environment, caregiver characteristics, and child characteristics.

Results

One out of 7, or 14% of the 285 children experienced caregiver instability in their permanent placement between ages 6 and 8. The strongest predictor of stability was whether the child had been placed in adoptive care. However, for children who were not adopted, a number of contextual factors (e.g., father involvement, expressiveness within the family) and child characteristics (e.g., intellectual functioning, externalizing problem behaviors) predicted stability and instability of permanent placements.

Conclusions

Current findings suggest that a number of factors should be considered, in addition to placement type, if we are to understand what predicts caregiver stability and find stable permanent placements for children who have entered foster care. These factors include involvement of a father figure, family functioning, and child functioning.

Practice implications

Adoption was supported as a desired permanent placement in terms of stability, but results suggest that other placement types can also lead to stability. In fact, with attention to providing biological parents, relative, and non-relative caregivers with support and resources (e.g., emotional, financial, and optimizing father involvement or providing a stable adult figure) the likelihood that a child will have a stable caregiver may be increased.     

Determinants of foster care placement for the maltreated child

This study examined the records of the North Carolina Central Registry of Child Abuse and Neglect to determine which social, family, and child characteristics were most influential in the decision to place a child in foster care. These records contained all theoretically relevant factors as well as demographic data. Analysis included the computation of odds ratios for foster care for each of 250 variables. A maximum likelihood logistic regression model was constructed to obtain the independent and cumulative contribution of each factor. Some expected variables such as parental stress factors (substance abuse) and types of abuse (burns and scalds) placed a child at a significant risk for placement in foster care (p < 0.01). However, less obvious factors such as referral source (law enforcement agencies) or geographic area also placed children at risk. Overall, the model explained little of the variance of these decisions (R² = 0.168) and poorly predicted placement (sensitivity 66.3 per cent, specificity 74.6 per cent). Using existing data. we were unable to adequately describe the decision process in selecting foster care.     

Predicting re-involvement for children adopted out of a public child welfare system

Some of the approximately 400,000 children currently placed out-of-home in a public child welfare system will not reunify with their family of origin. They may instead be adopted into a new family. Adoption placements can be characterized by poor adjustment for children; some such placements even result in disruption or dissolution. We conducted a stratified Cox regression of 4,016 children from the Colorado public child welfare system. All of the children had a finalized adoption during the years 2002 through 2006. The two outcomes analyzed were new child protection and youth-in-conflict referrals and assessments for these previously adopted children. New child welfare referrals and assessments may be early indicators of poor adjustment for adopted children within the adoptive family. Study results indicate that older children and Hispanic children had higher rates of referral and assessment. Children with a pre-adoption history including longer time out-of-home or a larger number of out-of-home placements also experienced higher referral and assessment rates. Additional factors which predicted subsequent system re-involvement included presence of paid adoption assistance, adoption by a non-relative foster parent and younger adoptive parent age. Several study results were moderated by the presence or absence of an ethnic match between the child and the adoptive parents. We provide an overview of the statistical model used for analysis and we discuss implications of the study results for child welfare practice.     

Predictors of placement for children who initially remained in their homes after an investigation for abuse or neglect

Objective

To examine the frequency and predictors of out-of-home placement in a 30-month follow-up for a nationally representative sample of children investigated for a report of maltreatment who remained in their homes following the index child welfare report.

Methods

Data came from the National Survey of Child and Adolescent Well-being (NSCAW), a 3-year longitudinal study of 5,501 youth 0-14 years old referred to child welfare agencies for potential maltreatment between 10/1999 and 12/2000. These analyses focused on the children who had not been placed out-of-home at the baseline interview and examined child, family and case characteristics as predictors of subsequent out-of-home placement. Weighted logistic regression models were used to determine which baseline characteristics were related to out-of-home placement in the follow-up.

Results

For the total study sample, predictors of placement in the 30-month follow-up period included elevated Conflict Tactics Scale scores, prior history of child welfare involvement, high family risk scores and caseworkers’ assessment of likelihood of re-report without receipt of services. Higher family income was protective. For children without any prior child welfare history (incident cases), younger children, low family income and a high family risk score were strongly related to subsequent placement but receipt of services and case workers’ assessments were not.

Conclusions/practice implications

Family risk variables are strongly related to out-of-home placement in a 30-month follow-up, but receipt of child welfare services is not related to further placements. Considering family risk factors and income, 25% of the children who lived in poor families, with high family risk scores, were subsequently placed out-of-home, even among children in families who received child welfare services. Given that relevant evidence-based interventions are available for these families, more widespread tests of their use should be explored to understand whether their use could make a substantial difference in the lives of vulnerable children.     

Family Policy, Welfare, and Single Motherhood in the United States and Denmark: A Cross-National Analysis of Discourse and Practice

Family and child care policies in the United States and Denmark are discussed. Key issues in the article address the contrasting discourses that frame policies about the poor, about women and welfare, about single motherhood, and about the role and responsibility of government in providing for the welfare of children. The dismantling of entitlements and the shredding of the safety net in the United States is critically analyzed and contrasted with the Danish discourse of universalism and social citizenship rights.     

Family Policy,Welfare, and Single Motherhood in the United States and Denmark: A Cross-National Analysis of Discourse and Practice

Family and child care policies in the United States and Denmark are discussed. Key issues in the article address the contrasting discourses that frame policies about the poor, about women and welfare, about single motherhood, and about the role and responsibility of government in providing for the welfare of children. The dismantling of entitlements and the shredding of the safety net in the United States is critically analyzed and contrasted with the Danish discourse of universalism and social citizenship rights.     

Age-specific risk factors associated with placement instability among foster children

Placement instability places foster children at an increased risk of negative developmental outcomes. Previous research has yielded inconsistent results on risk factors for placement instability. Therefore, we investigated two research questions: (1) Which child attributes and case histories are associated with placement disruptions (moves indicative of child, agency or caregiver dissatisfaction with the existing placement)?; and (2) How do associations of child attributes and case histories with placement disruptions vary by developmental stage --early childhood (0–5 years), middle childhood (6–12 years), and adolescence (13 years or older)? Using a complete entry cohort of 23,765 foster children in Texas, our results demonstrated that the effects of different risk factors varied by placement end reason and across developmental stages. Of note, kinship placement, compared to non-relative foster care, and placement with all siblings were each associated with an increased risk of substandard care disruptions. Placements with females or Hispanic children were at an increased risk of child-initiated disruption, whereas placements with Black children were more likely to end due to placement mismatch or substandard care reasons. Finally, the adolescence age group was always associated with the greatest increase in risk regardless of disruption reason. These findings provide researchers, caseworkers, and policymakers important information on the risk factors for placement instability among children in foster care.     

The relative safety of paternal,maternal, and traditional foster care placements

When children are placed into foster care the caseworker must give preference to an adult relative, many of whom are grandparents, over an unrelated caregiver. This kinship preference is based in evolutionary biology, which suggests that the imperative to care for a child should be greater for kin versus non-kin. However, not all kin are related to a child in the same way, and level of paternity uncertainty may influence level of care provided. For instance, maternal grandparents can be assured that they share genetic material with their grandchild, while paternal grandparents may not have the same level of certainty. Owing to the possibility of paternity uncertainty, we hypothesize that out-of-home placements with paternal grandparents will be at a greater risk of subsequent investigations than placements with maternal grandparents or with foster parents. We secured data on placements n = 560 of children ages 1.5 to 17 following a maltreatment investigation from a merger of the National Survey of Child and Adolescent Well-Being NSCAW II and the National Child Abuse and Neglect Data System NCANDS. Kaplan-Meier and multivariate Cox regression were used to examine the difference in time to the first new investigation by type of out-of-home placement while controlling for covariates. Consistent with our hypothesis, placements with paternal grandparents were at a higher risk of a subsequent investigations than placements with maternal grandparents or non-kin foster parents. Results suggest a need for further considerations of child safety in foster care based on genetic relatedness of caregivers.     

Who disrupts from placement in foster and kinship care?

OBJECTIVE: To identify reliable, inexpensive predictors of foster care placement disruption that could be used to assess risk of placement failure. METHODS: Using the Parent Daily Report Checklist (PDR), foster or kinship parents of 246 children (5-12 years old) in California were interviewed three times about whether or not their foster child engaged in any of the 30 problem behaviors during the previous 24 h. PDR was conducted during telephone contacts (5-10 min each) that occurred from 1 to 3 days apart at baseline. Disruptions were tracked for the subsequent 12 months. Other potential predictors of disruption were examined, including the child's age, gender, and ethnicity, the foster parent's ethnicity, the number of other children in the foster home, and the type of placement (kin or non-kin). RESULTS: Foster/kin parents reported an average of 5.77 child problems per day on the PDR checklist. The number of problem behaviors was linearly related to the child's risk of placement disruption during the subsequent year. The threshold for the number of problem behaviors per day that foster and kinship parents tolerated without increased risk of placement disruption for these latency-aged children was 6 or fewer. Children in non-kin placements were more likely to disrupt than those in kinship placements. There was a trend for increased risk of disruption as the number of children in the home increased. CONCLUSIONS: The PDR Checklist may be useful in predicting which placements are at most risk of future disruption, allowing for targeted services and supports.     

How does family drug treatment court participation affect child welfare outcomes?

Parental substance use is a risk factor for child maltreatment. Family drug treatment courts (FDTCs) have emerged in the United States as a policy option to treat the underlying condition and promote family preservation. This study examines the effectiveness of FDTCs in North Carolina on child welfare outcomes. Data come from North Carolina records from child protection services, court system, and birth records. Three types of parental participation in a FDTC are considered: referral, enrolling, and completing an FDTC. The sample includes 566 children who were placed into foster care and whose parents participated in a FDTC program. Findings indicate that children of parents who were referred but did not enroll or who enrolled but did not complete had longer stays in foster care than children of completers. Reunification rates for children of completers were also higher. Outcomes for children in the referred and enrolled groups did not differ in the multivariate analyses. While effective substance use treatment services for parents may help preserve families, future research should examine factors for improving participation and completion rates as well as factors involved in scaling programs so that more families are served.