Adult well-being of foster care alumni: Comparisons to other child welfare recipients and a non-child welfare sample in a high-risk, urban setting
Highlights
► Compared to a non-child welfare sample, foster children had poor adult outcomes. ► Recipients of in-home child welfare services also had poor adult outcomes. ► Likewise, non-maltreated children with a CPS history fared poorly in adulthood. ► The outcomes of foster care alumni did not differ from other child welfare groups. ► Results implicate risks prior to CPS involvement as predictors of long-term well-being.
Introduction
Beginning in the early 1980s the number of children living in out-of-home (i.e., foster) care in the U.S. climbed steadily for nearly two decades, reaching a peak level of 568,000 in 1999 (U.S. House of Representatives, 2000). Placements have since declined, but in 2010 alone more than 250,000 children were placed in foster care and over 400,000 children resided in foster care at year's end (U.S. Department of Health and Human Services, 2012). Although most children who receive child protective services are not removed from their homes, the $25 billion spent on foster care annually accounts for the majority of dedicated federal child welfare spending (DeVooght, Allen, & Geen, 2008). Considering its public costs and implications for the well-being of vulnerable children and families, the need to scrutinize foster care is evident.
With the passage of the 1997 Adoption and Safe Families Act (Public Law 105–89), child well-being became a statutory goal of foster care. Empirical evidence suggests that this objective remains largely unfulfilled, inasmuch as foster children fare poorly compared to their peers in the general population on most metrics of well-being (McDonald et al., 1996, Pinderhughes et al., 2007). It remains unclear, however, what effects foster care has on children, net of other related factors such as child abuse and neglect (i.e., CAN). Therefore, comparisons of foster children to non-maltreated children, even those exposed to high levels of ecological risk, may reveal more about the effects of CAN and its attendant risks than about the effects of foster care per se.
Below, we present hypothesized mechanisms through which foster care may influence the well-being of children for better and worse. We then review empirical research that has examined the effects of foster care across three outcome domains: educational attainment, economic welfare, and crime. Finally, we discuss methodological challenges to assessing the effects of foster care and describe how data from the Chicago Longitudinal Study will be used to address these challenges and contribute to the literature.
Placing children in foster care may promote their well-being in multiple ways, three of which seem most plausible. First, children who face an imminent risk of harm may benefit from an alternative residential setting where they are unlikely to experience abuse or neglect.1 Second, while providing a haven, substitute care providers are expected to provide a secure, nurturing environment that should enrich a child's development over time. Third, children may receive therapeutic services that support their adjustment to foster care and reduce social, emotional, and cognitive deficits that may have emerged prior to placement. Following out-of-home placement, services may also be initiated that catalyze change in the child's family of origin and hasten reunification.
Conversely, there are no less than three ways foster care might be harmful or at least fall short of its mandate to promote child well-being. First, being removed from home may disrupt family connections and attachments to caregivers (Stovall-McClough & Dozier, 2004). This is an acute concern for children in foster care, many of whom have previously experienced harsh, inattentive, or inconsistent caregiving. Second, a child's capacity to adapt to family separation may be undermined by placement disruptions in foster care, which occur frequently (Fong, Schwab, & Armour, 2006). Third, evidence-based interventions are implemented infrequently in child welfare settings (Chaffin and Friedrich, 2004, Horwitz et al., 2010), and the services available may be delivered inconsistently and ineffectively due to conditions that often afflict child welfare systems. For instance, worker retention is an ongoing challenge for many agencies (DePanfilis and Zlotnik, 2008, Mor Barak et al., 2001), as is maintaining a sufficient corps of foster care providers capable of meeting service demands (Baum, Crase, & Crase, 2001).
Although children in foster care often fall short of developmental and functional norms, they are also exposed to higher-than-average levels of ecological risk. Thus, comparing foster children to the child population at large offers limited insight into the actual impact of foster care. In the subsequent review we turn to research that has attempted to quantify the effects of foster care, including studies that have compared foster children to matched samples of similar children who were not placed in foster care.
Academic performance is a widely adopted indicator of well-being that forecasts psychological, social, and economic outcomes over the life course. An early synthesis of research by McDonald et al. (1996) revealed that foster care alumni are at risk of poor school performance and low educational attainment, findings that have been replicated by contemporary research (Courtney et al., 2010, Pecora et al., 2006). These results have prompted speculation that children's educational progress may be hindered by foster care, due partly to a lack of emphasis on academic performance and a failure to mitigate the disruptive influence of school transfers (Jackson and McParlin, 2006, Zetlin et al., 2004).
Such conclusions may be premature, however, because most research has compared foster children to the general population or to poorly matched samples. One exception, a seminal study by Runyan and Gould (1985), found that children in out-of-home care had higher rates of school attendance and lower rates of school failure compared to maltreated children who received in-home services. Using multivariate analysis to examine data from the National Survey of Child and Adolescent Well-being (NSCAW), Stahmer et al. (2009) also discovered that most children receiving child welfare services made cognitive gains over time, and rates of cognitive change were unrelated to placement status. In a separate analysis of NSCAW data, Berger, Bruch, Johnson, James, and Rubin (2009) used multiple estimation procedures, including propensity score matching, and found that out-of-home placement did not significantly alter subsequent cognitive performance. Berzin (2010) also used propensity score matching to assess the long-term outcomes of foster children using the National Longitudinal Survey of Youth National Longitudinal Survey of Youth 1997. Results showed that rates of educational attainment among foster care alumni and non-foster youth did not differ once the groups were appropriately matched. Further, a study by Smithgall, Jarpe-Ratner, and Walker (2010) revealed that most foster children who struggle academically follow a developmental trajectory that is established prior to placement in foster care.
Given the strong association between educational and economic attainments, it is expected that foster care will effectuate similar outcomes in both domains. Supporting this hypothesis, McDonald et al. (1996) concluded that foster care alumni were more likely than individuals who were never placed in foster care to receive public assistance. Current research has also shown that, compared to population averages, foster youth have poorer labor market outcomes, including higher rates of unemployment and poverty and lower rates of health insurance (Courtney et al., 2010, Dworsky, 2005, Macomber et al., 2008, Pecora et al., 2006).
Few studies have compared the economic attainments of foster children to children with a child welfare history who were not placed in foster care. One investigation of data from California, Illinois, and South Carolina found that youth who aged out of foster care earned less than other underprivileged youth or than foster youth who were reunified with their parents (Goerge et al., 2002). Another study by Doyle (2007) found no overall differences in employment or earnings between maltreated children who were placed in foster care and maltreated children who were never placed in care.2 Finally, Berzin (2010) discovered that rates of public assistance were higher among foster care alumni than among other NLSY sample members with similar demographic profiles. Like her findings for educational attainment, however, Berzin found no significant discrepancies between groups once propensity score matching was employed.
Foster children often exhibit mental health and behavioral problems, which are associated with later antisocial behavior and crime (e.g., Clausen et al., 1998, Halfon et al., 1992, Keil and Price, 2006). Some evidence suggests out-of-home care may exacerbate these problems (Maluccio and Fein, 1985, Minty, 1999), including a study by Lawrence, Carlson, and Egeland (2006) that showed young children manifested greater psychological and behavioral deficits upon exiting foster care than maltreated children who were never placed in foster care. Other well-designed studies have discovered that out-of-home placement is associated with long-term behavioral consequences, including juvenile delinquency (Doyle, 2007, Ryan and Testa, 2005) and adult crime (Courtney and Dworsky, 2006, English et al., 2002).
Yet a comparable body of research has shown that crime and its earlier behavioral correlates do not vary as a function of placement status. For example, three recent studies uncovered no proximal differences in behavior problems between children receiving in-home services and children placed in out-of-home care (Berger et al., 2009, Mennen et al., 2010, Stahmer et al., 2009). Other studies have also called into question whether out-of-home placement leads to distal consequences such as delinquency and crime (Berzin, 2010, DeGue and Spatz Widom, 2009, Runyan and Gould, 1985). Moreover, some evidence suggests that out-of-home placement actually reduces the risk of juvenile arrest or incarceration for racial and ethnic minority youth (Jonson-Reid & Barth, 2000; Lemmon, 2006, McMurtry and Lie, 1992).
Research to date has shown unequivocally that foster children fare poorly relative to their peers in the general population. Comparisons of foster children to well-matched samples of non-foster children have produced mixed results, however, due partially to the methodological inconsistencies and limitations of prior research (Berger et al., 2009, Pecora et al., 2006). Again, investigations that have controlled for the confounding influence of child maltreatment are in the minority. Many studies have also suffered from limited statistical power (Dworsky, 2005), and most research has focused on childhood outcomes of foster children or the proximate functioning youth who age out of foster care.
This investigation adds to the literature by addressing the above limitations. Using prospective panel data from the Chicago Longitudinal Study (CLS), we examine the effects of out-of-home placement on educational and economic attainments as well as crime—three salient manifestations of well-being. We use multiple group comparisons to estimate the effects of foster care. Specifically, we compare individuals with an indicated3 record of CAN who resided in foster care to other maltreated children who did not reside in foster care. We also compare the out-of-home and in-home service groups to: (a) children lacking an indicated CAN allegation despite being raised in a household with a Child Protective Services (CPS) record, and (b) children without an individual or household record of CPS involvement. We use statistical techniques, including multivariate analysis and propensity score matching, to maximize group equivalence, reduce unmeasured variance, and test the sensitivity of our estimates.
Section snippets
Sample and data
The CLS investigates a cohort of 1539 participants who attended full-day kindergarten programs in the Chicago Public Schools in 1985–1986. Using a quasi-experimental design, 989 children who attended Chicago Child–parent Center (CPC) preschools were matched to 550 children enrolled in public schools located in comparable neighborhoods without a CPC site. The CPCs offer educational, family-support, health and nutrition services through 3rd grade to children residing in high-poverty catchment
Descriptive statistics
Table 1 presents comparisons of the original CLS sample (N = 1539) to the composition of the samples analyzed in the present study. Participants were included in each effective sample if their CPS records and outcome data could be verified; recovery rates ranged from 79.6% to 90.1%. While the full CLS sample and respective study samples were largely comparable, there were some significant unadjusted differences. Participants in the educational attainment, public assistance, and income samples
Discussion
This study compared the adult well-being of three groups of individuals with distinct CPS histories to the adult well-being of a fourth group of individuals who, prior to reaching the age of majority, had no personal or household record of child welfare involvement. We also tested pairwise contrasts between the three CPS groups to distill the lasting effects of foster care and other forms of CPS involvement from endogenous factors such as childhood maltreatment.
Several design features
Acknowledgments
We would like to thank Arthur Reynolds for permitting our use of data from the Chicago Longitudinal Study. We also thank Dylan Robertson and Lonnie Berger for their contributions to this work.
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2018, Children and Youth Services ReviewCitation Excerpt :Data from the Midwest study, a longitudinal multisite study of youth aging out of out-of-home care, revealed that youth who have experienced out-of-home care are at greater risk of criminal involvement at age 21 (Courtney et al., 2007), ages 23–24 (Courtney et al., 2010), and age 26 (Courtney et al., 2011). Additionally, a study by Mersky and Janczewski (2013) showed that individuals with an indicated child abuse or neglect report who were placed in out-of-home care are at an increased risk for criminal offending as compared to the individuals with no Child Protection Services (CPS) record. Another study by Orsi, Lee, Winokur, and Pearson (2018) found that youth with a prior child welfare placement had higher odds of non-permanency (i.e., emancipation, involvement with the state's Division of Youth Corrections, or runaway) as compared to those without a prior placement.