Children removed from their homes after reports of maltreatment have significantly fewer behavior problems three years after placement with relatives than if they are put into foster care, according to new research at The Children's Hospital of Philadelphia.
The study, which looked at a national sample of 1,309 U.S. children removed from their home between October 1999 and December 2000 following reports of maltreatment, is published in the June issue of the Archives of Pediatrics & Adolescent Medicine. The results of the study provide compelling evidence to support efforts in recent years to identify what is sometimes referred to as "kinship care" as an alternative for placing children into non-relative foster care and to maximize the supports and services that will help children achieve permanency in these settings.
"For a long time people have debated the value of kin in providing both stability and permanency to children in foster care," said David M. Rubin, M.D., M.S.C.E., a pediatric researcher at The Children's Hospital of Philadelphia and lead author of the study. "Our results suggest for the first time, in a national population group, that family care may offer protective value in terms of well-being and stability for children in out-of-home care."
"In the past, what has been difficult to reconcile is whether the benefit of a connection to family exceeds potential risks that children may face because kin caregivers tend to be single, older, of poorer health, of lower economic status, or--some may argue--more likely to share the same issues as those of the birth parents that may have harmed the children," said Rubin. "This debate often has stalled important benefits that would insure prompt access of family caregivers to children, as well as provide the guardianship benefits to help successfully transition them from the child welfare system."
Researchers analyzed data collected from the National Survey of Child and Adolescent Well-Being study mandated by Congress in 1996. Interviews for this study were conducted with children, caregivers, birth parents, child welfare workers, and teachers at the time the child was removed from the home, and at 18 months and 36 months after enrollment. The interviewers measured behavioral well-being with a standardized survey tool, the Child Behavior Checklist.
Three years after placement, nearly two-thirds of the children in kinship care were in long-lasting settings with family that were established quickly after they entered care, compared with only a third of children in foster care who achieved similar stability. , The researchers also found that even after controlling for the children's baseline problems and the extra stability in kinship settings three years after placement, those children placed in early kinship care had only a 32 percent risk of behavioral problems, compared to a risk of 46 percent in children assigned to foster care. Many of these problems were disruptive behaviors and oppositional defiance, in addition to anxiety or depression.
The authors caution that while children cared for by family members fared better than those in foster care, the entire group of children removed from their home showed higher rates of behavioral problems than the general population. The number of children living with relative caregivers has also been increasing in recent years, and so the needs in this population may be growing. More than 2.5 million children lived with family members other than a birth parent in 2005, a 55 percent increase from 1990, according to U.S. Census data.
The study findings could strengthen the policy rationale for pending federal legislation that supports expanded assistance and guardianship benefits for family members within or outside of the child welfare system. Although more than 90% of children raised by relatives outside the supervision of the child welfare system, their relationship to the system may be fluid, particularly if services are not provided to support permanent guardianship, and if additional assistance is not provided for the behavioral health needs of these children.
The authors also caution that kinship care is not always a realistic option for children removed from the home because of the lack of extended family options that would provide safe alternatives to foster care. For these children, the study demonstrated that preventing placement changes improved behavioral outcomes regardless of the caregiver's relationship to the child. The authors suggest that directing children toward appropriate kinship settings can only alleviate a shortage of quality foster care families best able to provide such stability to those children without viable kinship alternatives.
"There is something innate about the family that provides some sense of stability to the child," said Rubin, adding that the magnitude of the effect should be reassuring to child welfare specialists aware of the growing trend toward kinship placements in recent years. "We understand it is not a simple fix and that's why we need to support these families as much as we would a foster care family. The data speaks to the value of kin in providing permanent homes for children; such value needs to be nurtured by our public programs."
- David M. Rubin, MD, MSCE; Kevin J. Downes, MD; Amanda L. R. O'Reilly, MPH; Robin Mekonnen, MSW; Xianqun Luan, MS; Russell Localio, PhD. Impact of Kinship Care on Behavioral Well-being for Children in Out-of-Home Care. Arch Pediatr Adolesc Med, 2008;162(6) DOI: 10.1001/archpedi.162.6.550
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