Changes in Placement among Children in Foster Care: A Longitudinal Study of Child and Case Influences

Abstract

Using Cox regression modeling, this longitudinal study examines child and case characteristics associated with changes in placement among 5,909 Rhode Island children in foster care. Results suggest that half of all children experience at least one placement change while in care. Infants change placements least, and risk increases with child age. Emergency shelter settings have the highest risk of placement change, followed by nonrelative settings, group home settings, and relative foster care. The reasons for removal from the home and the history of previous placements also predict placement changes, as do the interactions between foster care setting and some child characteristics.Numerous accounts document the often-deleterious psychological and health consequences of frequent changes in placement for foster care children. Placement changes are associated with compromised developmental trajectories and poor adult outcomes (Fanshel and Shinn 1978;Pardeck 1984;Newton, Litrownik, and Landsverk 2000;Rutter 2000;Wulczyn, Kogan, and Harden 2003). Accounts of such negative consequences have prompted the public and legislators to call for action. As a result, laws were enacted that, among other things, emphasize shorter lengths of stay and more stable placements for children in foster care such as the Adoption Assistance and Child Welfare Act of 1980 [U.S. Public Law 96-272] and the Adoption and Safe Families Act of 1997 [ASFA; U.S. Public Law 105-89]. As a result of concerns voiced in ASFA legislation with levels of placement stability, placement stability also is incorporated as an indicator of child welfare system functioning in the ongoing federal Child and Family Services Review (CFSR) process. Research shows a relation between multiple placement changes and negative developmental outcomes for children. Children who experience multiple placement changes are more likely to exhibit attachment difficulties (Palmer 1996), externalizing behavior problems (Pardeck 1984;Fanshel, Finch, and Grundy 1989;Palmer 1996;Fernandez 1999;Barber, Delfabbro, and Cooper 2001), and internalizing behavior problems (Newton et al. 2000). Placement changes are associated with disruption in educational settings and decreased academic performance (Zima et al. 2000). Multiple placement changes are linked to increased levels of physical and mental health service use, as well as to the economic cost associated with such patterns of service use (Rubin et al. 2004). Finally, placement instability is associated with increases in rates of juvenile delinquency among male foster youth (Ryan and Testa 2005). NIH Public AccessMultiple changes in placement also result in delayed permanency outcomes, such as reunification, adoption, and guardianship (Proch and Taber 1985). A history of repeated placements is linked to subsequent placement instability (Fernandez 1999;Webster, Barth, and Needell 2000), a reduced likelihood of reunification and exiting from care (Pardeck 1984;Goerge 1990;Fernandez 1999), an increased likelihood of returning to care...

Children in nonparental care: health and social risks

“…As is the case with poverty, disruptions in caregiving are also known to be associated with poorer health outcomes (34)(35)(36). The majority of studies describing stability of nonparental care arrangements has been among children in foster care and suggests that more than half of children in foster care experience at least one placement change and more than one-third experience two or more placement changes while in foster care (37)(38)(39). Annual rates of placement change across children in foster care are estimated to be between 0.55 and 0.62, with some children changing placements multiple times per year (40,41).…”

Correlates of Multiple Placements in Foster Care: A Study of Placement Instability in Five States

“…Another manifestation of this relationship is found between the current age of the child and the likelihood of the placement disrupting. Older children were significantly more likely to have their placements disrupt (Smith, Stormshak, Chamberlain, & Whaley, 2001) and had a significantly higher placement change rate (Connell et al, 2006). Significant positive coefficients have also been found between the child's current age and a retrospective measure of past placements (Pardeck, 1984).…”

Placement Stability for Children Adjudicated as Dependent: A Survival Analysis of a State Database

“…In the event history analysis by Connell et al (2006) with a Rhode Island sample, the risk of placement change for children in nonrelative care was 3.18 times that of children in relative care. In a recent study that matched children by age, gender, ethnicity, and geographic area, children placed with relatives or kin experienced, on average, 1.62 placements compared with 2.27 placements for those placed with nonrelatives, a statistically significant difference (Winokur et al, 2008).…”

“…Many studies have found that children placed with relatives or kin experienced fewer placements than those in family foster care with nonrelatives (Connell et al, 2006;Koh, 2008;Koh & Testa, 2008;Rubin et al, 2008;Winokur, Crawford, Longobardi, & Valentine, 2008;Wulczyn, Kogan, & Jones Harden, 2003). In the event history analysis by Connell et al (2006) with a Rhode Island sample, the risk of placement change for children in nonrelative care was 3.18 times that of children in relative care.…”