LITERATURE REVIEW

Long Term Placement Stability - Kin & Non-Relative Care

 

Shanna Alvarez, PhD

Child Psychologist  //  1624 Representative

 

In order to align with HB 1661’s mission to provide evidence based care and policies, foster families and caregivers are dedicating ourselves to collaborating with researchers and child welfare experts to understand up to date research findings and identify additional research needs. In a 2016 survey of 900 foster families in WA state, foster families stated that the number one barrier to retention are related to extended timelines for achieving permanency for children in care. This includes: (a) lack of voice regarding the well-being for children in their long-term care and (b) traumatic disruptions in long-term placements. Regardless of private agency or state license, families share the experience in feeling complicit in re-traumatizing a foster child when, if reunification fails, that child is moved to another placement after having been part of that family for years. This grief and doubt can cause them to leave the system and share their stories with other potential foster families. It is not their own grief, but the feeling of not acting in the best interest of the child that ruminates. Given the foster family retention crisis in WA state, foster care advocates are uniting behind this cause so that efforts are aligned around highest priority issues.

 

Our work groups are focusing on conducting a comprehensive literature review of long term placement stability and disruptions in kinship and nonrelative care. There is established research on permanency in kin and non-relative care.  Kin placements are increasingly appropriately utilized for children in care, though significant barriers to timely identification of kin are commonly discussed by CA providers. There is also well established research on the detriments of placement changes/instability. To date, there appears to be limited to no data on (a) the impact of placement changes for children that have been in a long-term foster placement, and (b) Washington’s current timelines for conducting kin searches for children in care. Despite the nuance in the research findings and the questions still unanswered--the state of research on these topics seems to be oversimplified and overgeneralized in our conversations in the foster care community. Our hope is that a nuanced understanding of data will unite all parties in supporting evidence-based policy focused on the child’s well being. Please join us in educated advocacy by reviewing the following peer-reviewed scientific literature (please note that wording has not been changed from original articles; these are direct excerpts from research findings).

 

  1. Font, Sarah A. (2014). Kinship and Non-relative Foster Care: The Effect of Placement Type on Child Well-Being. Child Development, 85(5), 2074-2090.
    1. This study uses a national sample of 1,215 children, ages 6-17, who spent some time in formal kinship or non-relative foster care to identify the effect of placement type on academic achievement, behavior, and health. Several identification strategies are used to reduce selection bias, including ordinary least squares, change score models, propensity score weighting, and instrumental variables regression.
    2. The results consistently estimate a negative effect of kin placements on reading scores, but kin placements appear to have no effect on child health, and findings on children's math and cognitive skills test scores and behavioral problems are mixed.
    3. Estimated declines in both academic achievement and behavioral problems are concentrated among children who are lower functioning at baseline.

 

  1. Font,S. (2015). Is higher placement stability in kinship foster care by virtue or design? Child Abuse & Neglect, 42, 99.
    1. Prior research has repeatedly documented higher placement stability for children who enter kinship care rather than non-relative foster care. However, little is known about why, and under what circumstances, kinship care is more stable. This study uses longitudinal state administrative data to explore possible explanations.
    2. Results suggest that, while children in non-relative foster care are indeed at higher risk of any placement move than their peers in kinship care, this appears to be partly driven by child selection factors and policy preferences for kinship care. That is, the gap is not explained primarily by different rates of caregiver-requested moves.
    3. However, the gap was sizably smaller among select high-risk subgroups of foster children, suggesting that higher stability in kinship care may be partly explained by differences in the characteristics of children entering kinship care (versus non-relative foster care).
    4. Moreover, a large portion of the gap is explained by children in non-relative care being moved into kinship care; a move that is likely the result of policy preferences for kinship care rather than a defect in the initial placement.
    5. In sum, these results suggest that kinship care provides only a limited stability advantage, and the reasons for that advantage are not well understood.

 

  1. Benedict, M., Zuravin, S., & Stallings, R. (1996). Adult functioning of children who lived in kin versus non-relative family foster homes. Child Welfare, 75(5), 529-49.
    1. The study reported here explored associations between the type of placement in out-of-home care (kinship versus non-relative) and selected outcomes in adulthood. Interviews were conducted with 214 children formerly in care (40% kinship placed), who reported on parameters of their current functioning, including education and employment, physical and mental health, stresses and supports, and risk-taking behaviors.
    2. Although the social services records reported significant differences in functioning during out-of-home care between children in kinship care and those in non-relative family foster care, few differences were found in adult functioning. Explanations for these findings are explored.

 

  1. Andersen, & Fallesen. (2015). Family matters? The effect of kinship care on foster care disruption rates. Child Abuse & Neglect,48, 68-79.
    1. Compared with other types of out-of-home care, kinship care is cheap, and offers the child a more familiar environment. However, little is known about the causal effect of kinship care on important outcomes.
    2. This study is the first to estimate causal effects of kinship care on placement stability, using full-sample administrative data (N=13,157) and instrumental variables methods.
    3. Results show that, in a sample of children of age 0–17 years, kinship care is as stable as other types of care, and only when the kin caregiver is particularly empathic and dutiful does this type of care prove more stable. Thus, in terms of stability, most children do not benefit additionally from being placed with kin.

 

  1. Vanschoonlandt, Vanderfaeillie, Van Holen, De Maeyer, & Andries. (2012). Kinship and non-kinship foster care: Differences in contact with parents and foster child's mental health problems. Children and Youth Services Review, 34(8), 1533-1539.
    1. Foster care placements, especially placements with kin, are the first option of choice when parents cannot maintain the care for their children. Therefore, an evaluation of this type of out-of-home-placement, with special attention for the differences between kinship and non-kinship placements, is necessary. In this study both types of foster placements (n=186) are compared for two important aspects: contact with/attitude of parents and mental health of foster children.
    2. Non-kinship foster placements fare better on different aspects of contact with/attitude of parents than kinship foster placements. Foster children in kinship foster placements have less behavioral problems than non-kinship foster children.
    3. However, not the type of foster placement but the number of previous out-of-home placements is the most important predictive factor for behavioral problems. Implications for practice and policy are discussed.
    4. Researchers highlighted findings:
      1. Mothers more positive towards non-kinship foster placement.
      2. Better cooperation between parents and foster parents in non-kinship foster care.
      3. Less behavioral problems in kinship foster children.
      4. The number of previous out-of-home placements explains differences in mental health.

 

  1. Farmer, E. (2009), How do placements in kinship care compare with those in non-kin foster care: placement patterns, progress and outcomes?. Child & Family Social Work, 14: 331–342. doi:10.1111/j.1365-2206.2008.00600.x
    1. As the use of kinship care is set to rise in England, it is important that policy and practice developments are based on firm evidence about kin placement outcomes and how these compare with those in stranger foster care. The research reported in this paper was based on case file reviews of 270 children, half in kin placements and half in stranger foster care, and on interviews with a sub-sample of 32 kin carers, social workers, children and parents.
    2. Kin carers were found to be significantly more disadvantaged than stranger foster carers: more kin carers were lone carers, with health problems, living in overcrowded conditions and had financial difficulties. The children, in contrast, were remarkably similar in the two kinds of placement. The main differences between the children in the two settings are examined in the paper.
    3.  The children's progress and outcomes in terms of placement quality and disruption were very similar in the two settings, but kin placements lasted longer, mainly because fewer were planned as interim placements.
    4. However, because kin carers persisted with very challenging children and yet received fewer services than stranger foster carers, they were more often under strain. The implications for policy and practice are examined.

 

  1. Marissa O'Neill, Christina Risley-Curtiss, Cecilia Ayón, Lela Rankin Williams, Placement stability in the context of child development, Children and Youth Services Review, Volume 34, Issue 7, 2012, Pages 1251-1258, ISSN 0190-7409, https://doi.org/10.1016/j.childyouth.2012.02.018.
    1. Placement stability is important for children to find permanent families, and for social, emotional and educational development of children. This study used the National Survey of Child and Adolescent Well-being (NSCAW, long term foster care general sample) data set to examine foster child and caregiver characteristics, and the caregiver–child relationship as a predictor of placement stability. Logistic regression was performed to predict the odds of achieving placement stability.
    2. As expected, in the early childhood group more caregiver than child characteristics affected placement stability.
    3. In the middle childhood group it was expected that more child than caregiver characteristics would predict placement stability, however, only child problem behaviors and caregiver experience and age affected placement stability.
    4. It was noteworthy that marital status, caregiver education, and income did not. Implications for social work research and practice are discussed.


  1. Mirjam Oosterman, Carlo Schuengel, N. Wim Slot, Ruud A.R. Bullens, Theo A.H. Doreleijers, Disruptions in foster care: A review and meta-analysis, Children and Youth Services Review, Volume 29, Issue 1, 2007, Pages 53-76, ISSN 0190-7409, https://doi.org/10.1016/j.childyouth.2006.07.003.
    1.  Kinship care In a review of outcomes in long-term foster care, Minty (1999) mentioned that one of the factors associated with reduced placement breakdown is placement with relatives. Six studies (n= 11,390 participants) examined comparisons between kinship and non-kinship care in relation to placement breakdown.
    2. To conclude, the combined effect size for the negative association between kinship care and placement breakdown was not significant.
    3.  One study suggested moderator effects of age (Webster et al., 2000), indicating that older children in kinship care were more likely to experience placement breakdown than younger children. However, it was not possible to perform moderator analyses for age across the studies, because only one study (James, 2004) included the mean age of the foster children.

 

  1. Mark F. Testa PhD. Kinship Care and Permanency. Journal of Social Service Research Vol. 28, Iss. 1, 2002.
    1. Should kinship care be favored as a form of permanency in and of itself or should it be avoided as a barrier to more binding forms of legal permanency? This question is examined using data from Cook County, Illinois. The study uses event history methods to analyze placement histories for 1992-95 cohorts of 23,685 children and a 1994 matched, cross-sectional sample of 1,910 children.
    2. It finds that kin placements are more stable than non-kin placements but that the advantage diminishes with lengthier durations of care.

 

  1.   Achieving Permanence in Foster Care for Young Children: A Comparison of Kinship and Non-Kinship Placements. Jennifer Pabustan-Claar PhD. Journal of Ethnic & Cultural Diversity in Social Work Vol. 16, Iss. 1-2, 2007.  
    1. A number of child welfare policies have reinforced the use of kinship care as the most preferred placement for foster children, reflecting the philosophy that maintaining children within their own extended family system contributes to their stability and well-being. Given the growing utilization and legislative emphasis on kinship care along with the push for an immediate implementation of permanency plans for children in foster care, this study examines how the permanency goal under the 1997 Adoption and Safe Families Act (ASFA) is being implemented and achieved. The reunification and permanency placement (adoption or legal guardianship) outcomes of children in relative and non-relative care are analyzed, focusing on the experiences of young children
    2. Based on public child welfare agency data from 2000 to 2003, child, case, and placement variables are explored to identify which set of factors best explains case outcomes.
    3. The present study identifies the total length of foster placement (kinship and non-kinship), the length of family maintenance services, and the number of placement changes as the most important variables in determining family reunification and permanent placement (legal guardianship and adoption) outcomes for young children.

 

  1.   The Benefits and Challenges of Kinship Care. Valerie O'Brien. Child Care in Practice Vol. 18, Iss. 2, 2012.
    1. The outcomes for children in kinship care are generally seen as positive in terms of identity formation, stability of placement, behavioral and mental health outcomes, enabling siblings to live together and child protection.
    2.  However, there is some disquiet about the length of time children stay with relatives; agencies are not sure about how best to position themselves in relation to the families, or how best to conduct home studies and license relative carers.
    3. There is evidence that relatives receive both less support and supervision from agencies than do traditional foster parents.
    4. This paper examines the benefits and challenges of relative care, whilst identifying current research limitations, and focuses on the gaps in respect to the intersection between research policy and practice. Through this examination, considerations are given to such issues as: What service delivery models are needed to optimize potential benefits through aligning law, policy and practice guidance? How, and to what extent, should relative care be financed? Where does relative care fit with the intersection of permanency adoption and guardianship?
    5. The ambiguity that exists towards this care option needs exploration, as does the question of how a worker's own “family experiences and values” may influence, or be influenced in, the course of the relative-care work.

 

  1. Permanency for Children in Foster Care. Thomas P. McDonald PhD, John Poertner DSW & Mary Ann Jennings PhD. Journal of Social Service Research Vol. 33, Iss. 4, 2007 
    1. Child welfare professionals daily face the competing risks of balancing the needs and safety of children with different permanency outcomes (i.e., reunification, adoption, guardianship). However, research on permanency has focused on a single outcome or grouped them together under the general label of permanency.
    2. The literature suggests that there are differences in time to a particular permanency outcome and also the factors predicting these permanency outcomes. After using approximately 25,000 records to support these conclusions, this research as well as practice indicates that permanency outcomes are more properly analyzed as competing risks. Recommendations for future research are suggested

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      13.   Kinship Guardianship, Adoption, and Foster Care: Outcomes from a U.S. National Sample. James A. Rosenthal & Rebecca L. Hegar. Journal of Public Child Welfare Vol. 10, Iss. 3, 2016.

a.    Using data from a national longitudinal survey of children referred to child protective services (NSCAW II), this article compares behavioral, child/caregiver relationship, and school performance outcomes for children residing in kinship and non-kinship settings. Up to three waves of data were gathered for each child. The analysis sample comprises 4,202 children and 10,881 observations.

b.    The regressions using dummy-coded variables evidenced, on balance, somewhat better outcomes for kinship settings than for non-kinship ones.

c.    Good outcomes in these regressions were found for kinship adoption.

d.    Results with the child-mean centered regressions were more equivocal, though perhaps still favored kinship settings. Smith, D. K., Stormshak, E., Chamberlain, P., & Bridges.

14. Liao, & White. (2014). Post-permanency service needs, service utilization, and placement discontinuity for kinship versus non-kinship families. Children and Youth Services Review, 44, 370-378.

a.    The number of children who exit the foster care system and achieve permanency through kinship adoption or guardianship has grown rapidly in the past two decades. However, few studies have compared service needs and service utilization for kinship versus non-kinship post-permanency families or examined long-term outcomes for children in permanent kinship homes.

b.    This study compared service needs, services sought, unmet needs, and placement discontinuity for kinship and non-kinship adoptive and guardianship families.

c.    Consistent with previous studies, results indicated substantive differences in socio-demographic characteristics for children and caregivers in kinship placements as compared to those in non-kinship placements.

d.    Kinship caregivers also reported fewer needs and sought fewer services than non-kinship caregivers. No relationship was found between kinship status and unmet service needs or discontinuity of placement, but several covariates were associated with placement failure, including child behavior problems, adoptive versus guardianship placement, and unmarried caregiver.

 

15. Gary S Cuddeback, Kinship family foster care: a methodological and substantive synthesis of research, Children and Youth Services Review, Volume 26, Issue 7, 2004, Pages 623-639, ISSN 0190-7409, https://doi.org/10.1016/j.childyouth.2004.01.014. (http://www.sciencedirect.com/science/article/pii/S0190740904000155)

  1. Over the last decade or longer, the number of children in kinship care has increased dramatically.
  2. There is evidence that kinship foster families have fewer resources and receive less training, services, and support, as well as concern that kinship families are less qualified to foster than their non-kinship counterparts. However, the kinship literature has methodological limitations and significant gaps that restrict our knowledge.
  3. In this context, it is important to synthesize substantive findings and methodological limitations in an attempt to evaluate what we know about kinship family foster care as a child welfare service, and such an evaluation can shape practice, policy, and research. Therefore, this article presents a methodological and substantive synthesis of kinship care research.

 

 Additional Research and Resources Continuing to be Explored:

●        Kim, H. K., Pears, K. C., & Fisher, P. A. (2012). The placement history chart: A tool for understanding the longitudinal pattern of foster children's placements. Children and Youth Services Review, 34(8), 1459-1464.

●        Fisher, P. A., Burraston, B., & Pears, K. C. (2006). Permanency in foster care: Conceptual and methodological issues. Child Maltreatment, 11, 92-94

●        Chamberlain, P., Price, J. M., Reid, J. B., Landsverk, J., Fisher, P. A., & Stoolmiller, M. (2006). Who disrupts from placement in foster and kinship care? Child Abuse and Neglect, 30, 409-424.

●        Chamberlain, P., & Lewis, K. (2010). Preventing placement disruptions in foster care: A research-based approach. In T. LaLiberte & E. Snyder (Eds.), Child Welfare 360°: Promoting placement stability. 19-20). St. Paul, MN: Center for

●        Legal perspective regarding long term foster care: Out of the Shadows and Into the Courtroom: An Analysis of Foster Parents’ Legal Rights Seth A. Grob, JD http://www.grobeirich.com/Articles/Out-of-the-Shadows-and-Into-the-Courtroom-An-Analysis-of-Foster-Parents-Legal-Rights.pdf

●        Improving the Well-Being of Washington State’s Children, Youth and Families Executive Summary:http://www.governor.wa.gov/sites/default/files/documents/BRCCF_FinalReport.pdf

●        Moving Children Out of Foster Care: The Legislative Role in Finding Permanent Homes for Children. http://www.ncsl.org/documents/cyf/movingchildrenoutofcare.pdf