Functioning patterns among older adolescents in foster care: Results from a cluster analysis

Highlights

• This study examines patterns of functioning among older adolescents in foster care using a two-step cluster analysis.

• Five clusters were identified: resilience; substance abuse; multiple problems; incarceration only; and homelessness.

• Cluster differed in reasons for the most recent entry into foster care, as well as placement type and stability.

• Findings call for better design and targeting of child welfare services as appropriate to the needs of specific subgroups.

Abstract

Older adolescents in foster care represent a heterogeneous population, though such heterogeneity is often underemphasized in research and practice. This study employed a cluster analysis to identify subpopulations in a large, national sample of 17-year-old youth based on the following indicators: educational attainment, connection to a supportive adult, adolescent parenthood, homelessness, substance abuse referral and incarceration. Data from the National Youth in Transition Database (NYTD) and Adoption and Foster Care Analysis and Reporting System (AFCARS) were used in the analysis. Results revealed five subpopulations defined by specific strengths, vulnerabilities and child welfare experiences. The largest group identified (39%) functioned successfully in all domains, whereas an additional group (15%) exhibited consistent maladaptation. The remaining groups evidenced variable adaptation patterns, with strengths in some domains and challenges in others. Entry to foster care for reasons other than child's problem behaviors, and placement in stable, family-based settings were associated with belonging to the most adaptive group. Findings emphasize heterogeneity among older adolescents in foster care, and call for better design and targeting of child welfare services and programs as appropriate to the needs of specific subgroups.

Introduction

Every year, about 25,000 youth emancipate from foster care in the United States after reaching the age of maturity (U.S. Department of Health and Human Services, 2014). This period comes with the expectation that the youth are able to negotiate adult responsibilities and become self-sufficient (Keller, Cusick, & Courtney, 2007). Mastering such tasks, however, may be challenging for adolescents who abruptly transition out of foster care and into young adulthood (Lemon, Hines, & Merdinger, 2005). Unlike counterparts in the general population, foster youth must negotiate this transition suddenly and with limited or no support from family members (Collins et al., 2010, Keller et al., 2007, Stott, 2013). In addition, many are underprepared for assuming adult roles in terms of educational completion, job readiness and basic skills needed for independent living (Courtney, 2009, Keller et al., 2007, Stott, 2013).

Given such disadvantage, it is not surprising that foster youth tend to struggle as they transition to independence (Courtney, 2009, Stott, 2013). Nearly 50% fail to obtain a high school diploma by the age of 18, only 30% enroll in higher education institutions and less than 10% complete a four-year degree (Brandford and English, 2004, Stott and Gustavsson, 2010, Yates and Grey, 2012). Many experience unemployment, underemployment and homelessness, and receive need-based government assistance (Courtney, 2009, Dworsky and Courtney, 2009, Hughes et al., 2008, Naccarato et al., 2010, Stott and Gustavsson, 2010). In addition, foster youth exhibit higher rates of mental illness, substance abuse, teen pregnancy and criminal justice involvement compared to peers in the general population (e.g. Hughes et al., 2008, McMillen et al., 2005, Narendorf and McMillen, 2010, Svoboda et al., 2012).

Nevertheless, not all youth exhibit dysfunctional outcomes during this vulnerable time period. Some demonstrate relatively uncompromised, or “resilient”, functioning as they leave the child welfare system and begin to live on their own (e.g. Daining and DePanfilis, 2007, Hass and Graydon, 2009, Hines et al., 2005, Jones, 2012, Samuels and Pryce, 2008). Others function successfully in domains such as education and employment, but struggle with mental health difficulties, low self-esteem and compromised peer relationships (e.g. Keller et al., 2007, Yates and Grey, 2012). Overall, available evidence suggests that different subgroups may exist within this population, calling for a “nuanced” approach to research, policy and practice (Courtney, Hook, & Lee, 2012).

Existing studies on the functioning of foster youth typically used a variable-oriented approach to analysis, which examines how certain predictor variables relate to outcomes in specific domains (Keller et al., 2007, Yates and Grey, 2012). While this approach is useful for identifying the correlates of individual outcomes, it fails to capture the multidimensional nature of youths' adaptation (Keller et al., 2007). As noted by Courtney et al. (2012), “an alternative to the variable-oriented approach…is the person-oriented approach, which assumes that development cannot be understood by examining single factors in isolation from their relationships with other interacting factors” (p. 410). Person-oriented methods aim to detect meaningful subgroups in a given population who share similar characteristics and experiences in multiple domains. Identifying subgroups of foster youth characterized by specific strengths and vulnerabilities offers important implications for practice, including better design and targeting of child welfare services and programs (Courtney et al., 2012).

Several existing studies employed person-oriented methods to examine the functioning of older youth in foster care. In a study by Keller et al. (2007), data from 17 and 18-year-olds residing in three Midwestern states were used to identify four subpopulations. The largest group identified, “distressed and disconnected”, represented about 43% of the sample and included youth with high rates of behavioral problems and non-optimal employment and education outcomes. The second largest group, “competent and connected”, represented about 38% of the sample and included youth with positive education and employment experiences and no significant problem behaviors. The last two groups, “struggling but staying” and “hindered and homebound”, presented variable adaptation patterns, with strengths in some domains and challenges in others. The authors concluded that identifying subgroups who share similar characteristics holds promise for improving service delivery to this population.

In another study, Yates and Grey (2012) identified four profiles of functioning among emancipated foster youth in California between the ages of 17 and 21. The outcome domains included educational and vocational competence, civic engagement, interpersonal relationships, self-esteem and mental health. The largest group identified (47%) presented a “resilient” profile, fairing reasonably well in all domains. Two other groups exhibited “discordant” patterns of adjustment, where some youth demonstrated psychological health despite functional difficulties (“internally resilient”, 30%), while others presented emotional problems despite apparent functional competence (“externally resilient”, 6.5%). An additional group exhibited a “maladaptive” profile (16.5%) characterized by problematic functioning in all domains.

Several other studies also employed person-oriented methods to explore the outcomes of current and former foster youth (e.g. Courtney et al., 2012, Yampolskya et al., 2014). Most identified unique subpopulations requiring different levels of support and supervision on the part of child welfare officials. Taken together, existing evidence suggests that foster youth are a heterogeneous population, pointing to the need for developing intervention strategies tailored specifically to different subgroups. Utilizing a “nuanced” approach to service delivery may enhance youths' motivation and engagement in services and facilitate long-term competence (Courtney et al., 2012).

Although person-oriented studies consistently identified meaningful subgroups among older adolescents in foster care, they failed to identify a reliable set of factors differentiating between well-functioning youth and their more challenged peers. For instance, Keller et al. (2007) noted that members of the least adaptive group in their sample reported increased child maltreatment, residence in non-family care arrangements and considerable placement instability. In contrast, Yates and Grey (2012) failed to detect similar differences, noting that their subgroups were comparable with respect to child welfare experiences. The contribution of demographic factors was similarly inconsistent, with Keller et al. (2007) pointing to female gender and African–American race as related to more adaptive profiles, but Yates and Grey (2012) finding no significant differences. Research is needed to understand how various subgroups differ from one another so that appropriate services can be provided to mitigate risks and facilitate competent functioning. Demographic factors and reasons for out-of-home placement need further investigation, as these represent pre-existing risks which may relate to variations in youths' functioning (e.g. Lee et al., 2014, Stott, 2013). The contribution of post-removal factors – especially placement type and stability – should also be explored, as these are more amenable to intervention and can increase or mitigate existing risks (Newton et al., 2000, Ryan and Testa, 2005, Rubin et al., 2007, Stott, 2013). Prior research revealed that residence in stable, family-based settings is associated with better functioning, regardless of youths' pre-exiting conditions (e.g. Barber and Delfabbro, 2003, Newton et al., 2000, Rubin et al., 2007).

The present study employed cluster analysis as a person-oriented method to identify distinctive profiles of functioning in a large, national sample of 17-year-old foster youth. Prior studies were based on relatively small samples confined to one or few states; therefore, utilizing a national sample is an important next step for the field. By limiting our study to 17-year-olds, we aimed to assess youths' functioning while they still had several years before formal emancipation. As most states currently allow youth to remain in foster care until the age of 21, examining their functioning at 17 provides a period of time for intervention to remediate risk and facilitate competent functioning.

This study included six outcome indicators relevant to youths' prospects for a successful transition to adulthood: educational attainment, connection with a supportive adult, teen parenthood, and a history of homelessness, substance abuse referral and incarceration. The domains selected considered the developmental tasks most relevant to this age group. Indicators related to employment, independent living and economic self-sufficiency were excluded, as they did not apply to the majority of 17-year-olds still under the care and supervision of child welfare agencies. In contrast, educational attainment, connections to adults and avoidance of risky behaviors were deemed developmentally appropriate as markers of successful adaptation at this age. Following the identification of the clusters, we compared the obtained subgroups on various child welfare factors which may relate to variations in youths' functioning.

The specific goals of the present study were to:

• Identify unique profiles of functioning in a large, national sample of 17-year-olds based on the outcome domains described above (i.e. education, connection to adult, childbirth, homelessness, substance abuse referral and incarceration).

• Examine whether the obtained clusters relate in meaningful ways to youths' pre-removal factors, including gender, race/ethnicity, number of removal episodes, age at the most recent removal and reasons for out-of-home placement.

• Examine whether the obtained clusters relate in meaningful ways to youths' post-removal factors, including length of the current foster care episode and placement type and stability.