The Cumulative Effect of Prior Maltreatment on Emotional and Physical Health of Children in Informal Kinship Care

Abstract

Objective: Millions of children cared for by their grandparents or other kin without a biological parent present are not part of the foster care system. Maltreatment may have precipitated out-of-home care arrangements, but most children in informal kinship care are not being tracked or receiving services. Importantly, the extent of previous child welfare involvement and its association with well-being among this population are not well known. Methods: Kinship caregivers known to social service and community agencies were recruited for this study. Caregivers who agreed to participate rated the physical and emotional health of children under their care. Maternal mental health and demographic data were collected, and matched records of children were retrieved from the state child welfare database. The nested structure of children within families was addressed using a generalized estimating equation model. Results: The sample included 365 children from 274 families. Only 25% of the children were in private kinship care with no known Child Protective Services (CPS) involvement. An average of 2.37 open CPS cases were observed for those in voluntary kinship care. One out of 4 children scored below the clinical level of emotional health. The number of CPS cases and kin caregiver's parenting stress were inversely associated with child's physical and emotional health. The presence of maternal mental health problem was significantly associated with poor child emotional well-being. Conclusion: Many children in informal kinship care experienced multiple episodes of maltreatment. This study's results add further evidence of the cumulative negative effects of child maltreatment on child well-being. Children in informal kinship care are in need of services to mitigate their traumatic experiences.

The Negative Effects of Adverse Childhood Experiences (ACEs) on Behavioral Problems of Children in Kinship Care: The Protective Role of Kinship Caregivers’ Mental Health

“…Third, we excluded a proportion of participants with missing data and results may not be generalizable to those kinship children and families. Fourth, this study only included kinship caregivers who were involved in the CWS, whereas the majority of kinship families informally take care of relatives’ children (Lee et al, 2020). Thus, these results may not be generalizable to all informal kinship caregivers.…”

“…Since the implementation of the federal Family First Prevention Services Act (2018), child welfare agencies have prioritized placing children in kinship care and continued providing services to support kinship families. Prior research shows that children in kinship care not only experience child maltreatment, but also have exposure to household dysfunctions, including parental substance abuse (Davis et al, 2020; Lee et al, 2020). The majority of previous research has primarily focused on maltreatment that kinship children suffer, often overlooking the complex trauma, including household dysfunctions, that kinship children experience (Winokur et al, 2014).…”

“…For example, a nationally representative study of children involved in CWS found that 42% of children experienced four or more ACEs, 27.08% experienced three ACEs, 17.23% experienced two ACEs, and 8.42% experienced only one ACE (Clarkson Freeman, 2014). For children involved in kinship care, Lee et al (2020) found that 28% of them experienced neglect, 26% parental substance abuse, and 11% physical abuse. As kinship children enter care for reasons not limited to child maltreatment, but also household dysfunctions, it is imperative that the full effects of ACEs on children in kinship care be examined.…”

Associations Between Family Resilience, Child Flourishing, and School Engagement Among Children in Kinship Care

“…Few studies explicitly examine flourishing among children in kinship care. A related body of literature notes children in kinship care generally experience elevated mental health symptoms compared with those in the care of their birth parents (Bramlett et al, 2017; Lee et al, 2020). These suboptimal outcomes are posited to arise from the experiences of maltreatment, parent–child separation, and trauma that often precede kinship care arrangements (Hernández & Berrick, 2019; Xu et al, 2023).…”

Lessons from conducting a participatory evaluation of a kinship navigator program

“…Approximately one in ten children globally live with kinship caregivers—relatives and family friends who step in to care for a child when parents are unable to do so [ 3 ]. Children in kinship care are more likely to have faced childhood trauma and to have more significant mental health needs than children living with a biological parent [ 4 , 5 ]. When families take on the role of informal kinship care—care of a child outside of the child welfare system—they often do so without financial support and assistance navigating the systems of support available to them [ 6 ].…”