Elsevier

Child Abuse & Neglect

Volume 30, Issue 4, April 2006, Pages 409-424
Child Abuse & Neglect

Who disrupts from placement in foster and kinship care?

https://doi.org/10.1016/j.chiabu.2005.11.004Get rights and content

Abstract

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.

Résumé

Objectif

Identifier des facteurs fiables et peu chers qui pourraient prédire la perturbation dans les placements en foyer d’accueil et ainsi servir à évaluer le risque que le placement échoue.

Méthode

Au moyen du Parent Daily Report Checklist, les parents nourriciers (ayant un lien de parenté ou non) de 246 enfants âgés de 5 à 12 ans en Californie ont été interviewés trois fois à savoir si leur enfant avait manifesté l’un ou plusieurs parmi 30 problèmes de comportement dans les 24 heures précédentes. L’interview a eu lieu au cours de conversations téléphoniques de 5 à 10 min chacune, à intervalles de 1 à 3 jours. Les perturbations ont été documentées durant les 12 mois qui ont suivi. On a noté d’autres facteurs pouvant possiblement influencer les perturbations, y compris l’âge de l’enfant, le sexe, son ethnie et celle des parents, le nombre d’enfants dans le foyer d’accueil et le type de placement (parenté ou non).

Résultats

Les parents nourriciers ont rapporté en moyenne 5.77 problèmes de comportement par jour. Le nombre de comportements s’associe directement aux incidents de perturbations durant le placement dans l’année qui suivit. Le seuil de tolérance aux problèmes de comportement, après quoi le risque de perturbations accélérait, était de 6 incidents ou moins. Les enfants placés dans des foyers sans lien de parenté étaient plus aptes à la perturbation. On a détecté une tendance à savoir que, plus il y a d’enfants dans le foyer, plus les perturbations augmentent.

Conclusions

L’instrument Parent Daily Report Checklist pourrait servir à prédire quels placements sont les plus à risque de perturbations futures, nonobstant les services et les appuis disponibles.

Resumen

Objetivo

Identificar predictores fiables y sencillos de alteraciones en el acogimiento familiar que pudieran ser utilizados para evaluar el riesgo de fracaso del acogimiento.

Métodos

Utilizando el Inventario de Notificaciones Parentales Diarias (PDR) se entrevistó tres veces a padres de acogida (ajena y extensa) de 246 niños (5 a 12 años) de California acerca de si el niño había tenido alguno de una serie de 30 problemas de conducta durante las 24 horas previas. El PDR se aplicó durante contactos telefónicos (5–10 minutos cada uno) llevados a cabo durante tres días consecutivos. Las alteraciones en el acogimiento fueron estudiadas a lo largo de los 12 meses posteriores. Se examinaron otros predictores potenciales de las alteraciones del acogimiento, incluyendo la edad del niño, el género, la etnia del niño y de los padres de acogida, el número de niños no acogidos presentes en el hogar y el tipo de acogimiento (ajena o extensa).

Resultados

: Los padres de acogida notificaron una media de 5.77 problemas de conducta por día en el PDR. El número de problemas de conducta estaba linealmente relacionado con el riesgo de alteraciones en el acogimiento durante el año posterior. El umbral para el número de problemas de conducta por día que los padres acogedores toleraron sin aumentar el riesgo de alteración del acogimiento en estos niños era de 6 o más. Los niños acogidos en familia ajena tenían más posibilidades de alteración en el acogimiento que los niños acogidos en familia extensa. Se observó una tendencia a que aumente el riesgo de alteración del acogimiento a medida que hay un mayor número de niños en el hogar.

Conclusiones

El PDR puede ser útil para predecir qué acogimientos están en un mayor riesgo de fracaso en el futuro, de manera que se les puedan proporcionar apoyos y recursos.

Introduction

Children in foster care are at high risk of behavioral and emotional problems (Garland et al., 2001; Landsverk, Garland, & Leslie, 2002; Pears & Fisher, 2004). These problems undoubtedly contribute to the challenges faced by foster parents and child welfare caseworkers in trying to provide foster children with nurturing and supportive home environments. Improving placement stability is a key component of adequate care that has received recent attention in Federal Guidelines (2001). During any 12-month period, up to 50% of children in foster care disrupt from their placements and have to be moved to another home or to a more restrictive setting (reviewed by Smith, Stormshak, Chamberlain, & Bridges Whaley, 2001). The aim of this study was to determine if it was possible to identify reliable, inexpensive predictors of placement disruption from foster and kinship care in an ethnically diverse sample of elementary school-aged children. Identification of such predictors could be helpful in focusing limited resources on the children at highest risk of disruption.

Disruption from foster or kinship placement is highly undesirable for a number of reasons. Foster placement disruptions are associated with an increased likelihood of failed permanent placements (i.e., reunifications and adoptions). For example, using administrative records for 6831 children discharged from foster care in California, Courtney (1995) found that greater instability in a child's placements was positively associated with risk of reentry into foster care. Similarly, Wells and Guo (1999) examined records for 2616 children in foster care in Ohio and noted a positive association between the number of transitions during the first period in foster care and the likelihood of foster care reentry. Farmer (1996) reviewed records for 321 children in foster care in the United Kingdom and reported that first attempts at reunification were significantly more successful than subsequent attempts.

In addition to the increased risk of permanent placement failures, foster care disruptions carry with them financial costs for the child welfare system (CWS). We found no published analyses of the financial costs associated with foster placement disruptions. However, in a series of focus group sessions with caseworker supervisors and child welfare agency line staff in San Diego County, CA, USA, it was estimated that each placement disruption required an average of over 25 h of casework and support staff time to remediate the problem (including time spent in identifying and placing a child in a new setting, court reports, staff meetings related to placement decisions, and paperwork documenting need and processes; Price, 2005).

Significant emotional costs are associated with placement changes for both foster children and foster parents (Fanshel, Finch, & Grundy, 1990; van der Kolk, 1987). Newton, Litrownik, and Landsverk (2000) found that changes in foster placements were associated with increases in both externalizing and internalizing child behavior problems. In their study of over 400 children who had entered care at an average age of 6.6 years (SD = 3.9 years), externalizing problems was the strongest predictor of placement change. Importantly, children who initially scored within the normal range on the Child Behavior Checklist (CBCL) were particularly vulnerable to the negative effects of placement disruptions. That is, placement changes for these children were followed by increases in both internalizing and externalizing scale scores on the CBCL 18 months later, strongly suggesting that placement changes contribute to the onset and development of child emotional and behavioral difficulties in the CWS. Ryan and Testa (2005) found that placement instability increased the risk for delinquency in males over and above being involved in the CWS and being placed in substitute care.

Despite the fact that placement disruptions in the CWS are clearly harmful, there has been relatively little recent research aimed at identifying predictors of disruption (James, 2004). Three exceptions are as follows: (a) Farmer, Lipscome, and Moyers (2005) found that stressful events experienced by foster parents in the 6 months prior to placement, the presence of child conduct problems, and inaccessibility to caseworkers related to higher disruption rates for adolescents; (b) Sinclair and Wilson (2003) found that child characteristics, such as attractiveness and wanting to be fostered, and foster parent characteristics, such as warmth and child-centeredness related to low disruption rates; and (c) James (2004) found that boys, older youth, and those with externalizing and internalizing behavior problems were at an increased risk of disruption.

Externalizing behavior has been shown in other work to relate to disruptions for teenagers (Sallnas, Vinnerljung, & Weestermark, 2004). Being placed in kinship care has been found to decrease the risk of disruption (James, 2004). Other research has found discrepancies in the definition of what constitutes a disruption, making it difficult to conduct systematic research on the occurrence and prevention of this problem (Smith et al., 2001).

We used a brief telephone interview (Parent Daily Report Checklist; PDR) with foster parents to measure the occurrence of child behavioral problems in the home during the 24-h period immediately preceding the call. The PDR Checklist takes 5–10 min to complete and is typically repeated on three to five separate occasions to get a stable estimate of a child's problem behavior as experienced by the caregiver. The PDR was originally developed as an observation-based outcome measure that could be administered to parents in their homes to help verify behavioral observations by trained coders and to increase the accuracy with which low base rate events could be counted (Chamberlain, 1990). The purpose of the PDR is to obtain reliable measures of the child's problem behaviors that minimize the biases associated with retrospective reports that attempt to summarize information over longer periods of time (Tourangeau, 2000). The PDR data provide the opportunity to examine typical levels of parent-reported child problems, how much variation in those levels is observed within a given sample, and whether such variation is a meaningful predictor of future outcomes.

In the current study, the PDR was used to predict placement disruption in a 12-month timeframe for a sample of children (ages 5–12 years) in foster care in San Diego County. In addition to the PDR, we evaluated the utility of several other potential predictors of placement disruption that could be obtained easily and inexpensively (child's age, child's gender, child's ethnicity, number of other children in the home, foster parent's ethnicity, and placement type, i.e., kin or non-kin).

Section snippets

Participants

Participants were 246 children (ages 5–12 years) in foster care, including 131 boys and 115 girls, placed in non-kinship foster (n = 158) or kinship (n = 88) care who participated in a foster care “as usual” control condition in a larger study. That study tested the effectiveness of an intervention aimed at strengthening the parenting skills of foster and kinship parents in state foster homes in San Diego, CA, USA. All children in San Diego County between the ages of 5 and 12 years who were placed

Results

The mean number of problem behaviors reported on the PDR was 5.77 (4.06). Table 2 shows the Cox hazard regression results for the PDR and for each of the other potential predictors. The baseline PDR score and placement in a non-kin home had significant predictive linear effects. Baseline PDR increased the hazard of disruption by 17% for every child problem behavior reported. In addition, placement in a non-kin foster home increased the risk of placement disruption by a factor of just over 3. In

Discussion

PDR scores at baseline were predictive of placement disruptions during the subsequent 12-month period. Children with PDR scores at or below the sample mean of 6 problem behaviors per day were at low risk of subsequent disruption.

In placements where 7 or more problem behaviors occurred per day, each behavior over 6 increased the odds of disruption by an additional 25% per additional behavior. In addition, there was a trend for the number of other children in the foster home to increase even

Acknowledgements

The authors wish to thank the San Diego County Department of Health and Human Services, Courtenay Paulic (OSLC), and Jan Price (CASRC) for their assistance with recruitment, data collection, and management.

References (46)

  • W. Barr

    Receiver operating characteristic curve analysis of Wechsler Memory Scale, revised scores in epilepsy surgery candidates

    Psychological Assessment

    (1997)
  • W.C. Becker et al.

    The contingent use of teacher attention and praise in reducing classroom behavior problems

    Journal of Special Education

    (1967)
  • G.H. Bower

    Mood and memory

    American Psychologist

    (1981)
  • P. Chamberlain

    Comparative evaluation of specialized foster care for seriously delinquent youths: A first step

    Community Alternatives: International Journal of Family Care

    (1990)
  • P. Chamberlain et al.

    Enhanced services and stipends for foster parents: Effects on retention rates and outcomes for children

    Child Welfare

    (1992)
  • P. Chamberlain et al.

    Parent observation and report of child symptoms

    Behavioral Assessment

    (1987)
  • P. Chamberlain et al.

    Using a specialized foster care community treatment model for children and adolescents leaving the state mental hospital

    Journal of Community Psychology

    (1991)
  • M.E. Courtney

    Reentry to foster care of children returned to their families

    Social Service Review

    (1995)
  • D. Fanshel et al.

    Foster children in a life course perspective

    (1990)
  • E. Farmer et al.

    Foster carer strain and its impact on parenting and placement outcomes for adolescents

    British Journal of Social Work

    (2005)
  • Federal Guidelines

    Child and family service reviews, administered by the Children's Bureau. Administration for Children and Families

    (2001)
  • M.S. Forgatch et al.

    Parenting through change: An effective prevention program for single mothers

    Journal of Consulting and Clinical Psychology

    (1999)
  • M.S. Forgatch et al.

    A cost-effective parent training program for use with normal preschool children

    Journal of Pediatric Psychology

    (1979)
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    Support for this research was provided by Grants from NIMH, U.S. PHS (MH60195), from NIMH and ORMH, U.S. PHS (MH46690), and from NIDA, U.S. PHS (DA17592).

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