Breakdown of teenage placements in Swedish foster and residential care

This article deals with the problem of breakdown in different types of out‐of‐home care (foster care/residential care) for Swedish teenagers. How often are such placements prematurely terminated against the wishes and intentions of child welfare authorities? Which factors appear to increase or decrease the risk of placement breakdown? The sample consists of a national cohort of 776 youths who started 922 placements during 1991. Every placement was followed in municipal case files for a maximum period of five years. Between 30 and 37% of all placements were prematurely terminated, the exact figure depending on whether a narrow or wide definition of breakdown was applied. The lowest rates of breakdown were found in kinship care and secure units, the highest in non‐kinship foster homes. Teenagers who display antisocial behaviour and/or have mental health problems constitute a high‐risk category for most types of out‐of‐home care, but especially in non‐kinship foster homes. Risk factors in relation to breakdown were analysed in the four main forms of Swedish out‐of‐home care separately (foster homes, privately/publicly run residential care and secure units). The analysis pointed out that risk factors are not the same in all types of care, but antisocial behaviour at time of placement increased the risk in most forms of care. Prior research indicates that placement breakdown is a major problem of child welfare in other countries, and this study found that Sweden is no exception.     

Foster care placement breakdown in the Netherlands and Flanders: Prevalence,precursors, and associated factors

Family foster care is the option of choice for children in need of out‐of‐home care in Flanders and the Netherlands. Foster care is however a vulnerable intervention, and questions can be raised as to its efficacy. Although the literature on placement breakdown has made significant progress during the last years, empirical knowledge regarding breakdown in Flanders and the Netherlands remains scant. Consequently, this study aimed at investigating prevalence and precursors of breakdowns in long‐term foster care, the duration of placement before breakdown, and the association of child and placement characteristics with breakdown. Case files of 271 Dutch and 309 Flemish foster children were analysed with a coding scheme designed for this study. After 6 years, 398 placements had terminated: 169 placements broke down and 229 placements ended positively. Placements broke down mainly because of behavioural problems of the foster child, foster parents' parenting problems, and conflicts between birth and foster parents. Foster children with behavioural problems, older foster children, foster children denied treatment, and foster children in care because of sexual abuse were more at risk of breakdown. Assessing these factors is important when evaluating the appropriateness of a family foster care placement.     

Who returns home? Study on placement outcomes of Flemish foster children

Until recently, Flemish family foster care was a temporary measure with as its most important goal, the reunification of the foster child with the birth parents. To date, nothing is known on the number of reunifications, nor has any study been undertaken into the factors (child, parent, foster parent and foster care process) associated with reunification. Case files of 127 foster children who exited foster care in 2007 were analysed. Dependent variables were type of foster care placement outcome (reunification, successful placement without reunification or breakdown) and place of residence after placement ending (with birth parents, extended family, foster family, residential care or living independently). After placement ending, only 40% of foster children went living with their parents, including foster children who were reunified (26%) and foster children who moved to their parents after a placement breakdown (14%). Characteristics of the foster children, and in particular absence of problem behaviour, were associated mainly with a return home. This may indicate that too much attention is paid to the functioning of the foster child and too little to improving the competencies of the parents and the (future) home environment.     

Factors associated with placement breakdown initiated by foster parents – empirical findings from Germany

This study investigates the effects of covariates on the probability of placement breakdown in non‐kinship family foster care. Breakdowns are distinguished according to the initiator: children, carers, foster parents and the local child welfare authorities. The children concerned had entered foster care at ages ranging from 0 to a maximum of 17 years (n = 14 171). A significantly higher risk of breakdown on the initiative of the foster parents is found in male children, children whose parents receive financial support, children whose parents were removed from the register of carers, children who were between 6 and 15 years old when they joined the foster family, children who had earlier lived in a different foster family or residential care, children from patchwork families and children whose joining of a foster family was the result of disruptive social behaviour. Two‐thirds of the children from non‐kinship family foster care who stay in the foster family was ended on the initiative of the foster parents are subsequently looked after in residential care. That is three times the rate for all terminated foster relationships. Breakdowns on the initiative of the foster parents thus indicate a high risk of unstable care history developing and accordingly necessitate prevention strategies.     

Assessment of problem behaviour by foster parents and their foster children

This study investigates the level of agreement between foster parents and foster children about problem behaviour and how this is associated with the breakdown of a foster care placement. The study took a sample of foster parents and their foster children (n= 60), who were aged 11–17 years, and analysed the severity of problem behaviour displayed by the foster children within 3 months of placement in the foster family and a year and a half later. The level of agreement was established with the intra‐class correlation coefficient, which represents both the differences in scores and the differences in ranking. This coefficient shows that there is a statistically significant difference in the level of agreement on the Internalizing Problems scale of the Child Behaviour Checklist between the placements that broke down and those that continued. The level of agreement is associated with the severity score, which in turn is associated with the outcome of the foster care placement. To avoid placement breakdown, problem behaviour should also be assessed from the perspective of the foster child.     

Intergenerational pathways leading to foster care placement of foster care alumni's children

This study examined a path model that postulated intergenerational relationships between biological parent psychosocial functioning and foster care alumni mental health, economic status and social support; and from these to the likelihood of children of foster care alumni being placed in foster care. The sample included 742 adults who spent time in foster care as children with a private foster care agency and who reported having at least one biological child. A full pathway was found between poorer father's functioning to greater alumni depression, which was in turn associated with negative social support, and then a greater likelihood of child out‐of‐home placement. Other parent to alumni paths were that poorer father functioning was associated with alumni anxiety and post‐traumatic stress disorder (PTSD), and poorer mother's mental health was associated with PTSD; however, anxiety and PTSD were not implicated as precursors of foster care placement of the child. Findings support the need for increased practice and policy support to address the mental health needs of parents of children in or at risk of foster care, as well as the children themselves, as family history may have a lasting influence on quality of life, even when children are raised apart from biological parents.     

Predictors of outcome for unrelated adoptive placements made during middle childhood

This paper reports on a follow‐up to adolescence of two longitudinal prospective studies of children placed from public care with non‐related adoptive families in the UK. Factors associated with outcome are presented for 99 children (one index child per adoptive family) who were between 5 and 11 years of age at placement. Information concerning the children's backgrounds and care histories was obtained shortly after placement (T1), from social workers. Adopters were interviewed at T1 and again at the end of the first year (T2). A further follow‐up was conducted an average of six years after placement (T3). Outcomes at T3 were classified as either disrupted, which was true for 23%, continuing and ‘positive’ (49%) or continuing but ‘difficult’ (28%). Bivariate analyses revealed a number of attributes, related to both the child and the adoptive parents, which were associated with differential outcomes. Logistic regression produced five predictors of placement disruption: age at placement, behavioural problems, preferential rejection, time in care and the child's degree of attachment to the new mother. Differences were found between ‘positive’ and ‘difficult’ outcomes in continuing placements as well as between continuing and disrupted placements. The analysis suggests that adoption should certainly be considered as an option for children over 5 years of age while recognizing the need for both preparation and post‐placement support. Evidence of differential outcome in continuing placements provides support for efforts to reduce the number of placements and returns home that a child at risk experiences.     

Breakdown of teenage placements in Danish out‐of‐home care

This study deals with the problem of breakdown in out‐of‐home placements for Danish teenagers. How often are these placements prematurely terminated against the requests and intentions of the child welfare authorities? Which factors seem to increase and decrease placement breakdown? The sample consists of 225 youths and 367 placements during the years 2004–2008. Among the 225 youths, 44% experienced a breakdown, and 33% of the 367 placements ended with a breakdown. A large proportion of the placement breakdowns (20%) occurred before 4 months, and within the first year, 62% of the placement breakdowns had taken place. Replacements took place in 61% of all placement breakdowns. The analysis showed that type of placement and number of youth at the same placement had significant association to placement breakdown, but variables based on the social worker's clinical assessment showed no association to breakdown. However, while the logistic regression model was significant, it explained only 6% of the variance. Earlier studies have indicated that breakdown is a substantial problem of child welfare in several other western countries, Denmark is no exception. These corresponding breakdown rates point out that no child welfare system yet have found a method to reduce breakdown substantially.     

Mortality after care among young adult foster children in Sweden

This exploratory study looks at mortality after care among 13,100 former Swedish foster children, placed before their teens. Sources used are two national databases, on child welfare interventions and causes of death. Risk ratios of death for foster children are compared with those of their peers in the general population and with a comparison group, consisting of 10,668 young adults from adverse home backgrounds, who never entered foster family care before their teens. Both ex-foster children and the comparison group were young adults (19–26 years old) at time of follow-up. Results show a moderately elevated risk ratio for both groups compared with peers in the general population, mainly due to more frequent unnatural deaths, especially suicides. Time at first placement was not related to mortality among men, but there was a weak tendency of a higher risk ratio for girls placed at age 7–12. Information on time spent in care is used with caution, due to possible problems with reliability. Almost all comparisons between the foster care and the comparison group fell short of statistical significance. For foster children who had spent more than five years in care, the risk ratio tended to be higher than for foster children with shorter care experience, and similar to that of the comparison group. Foster children who had been in care for less then six years thus tended to have a lower risk ratio than the comparison group.     

“We felt completely left to ourselves.” Foster parents' views on placement disruption

The purpose of this paper is to explore the reasons for unintended placement disruptions in foster care. Based on a semistructured survey, the paper presents the views of 132 Norwegian foster parents who have experienced placement disruption between 2013 and 2015. Foster parents rated several relevant causes of placement disruption: the child's behaviour, the need for care, concern for the well‐being of their biological children, and lack of support from the Child Welfare Service (CWS). Although the child's behaviour was the cause most frequently reported in the quantitative data, CWS‐related factors such as poor collaboration, not being valued and listened to, insufficient support and follow‐up, and a mismatch between the child's needs and the foster carers' capacity were reported most frequently in the qualitative data. Placement disruption appears to be caused by the sum and interaction of several coexisting causes. It may not be the child's behaviour per se but rather the combination of challenging behaviour, concern for one's biological children, and insufficient support from CWS that lead to disruption. Good collaboration with the CWS in the form of respect, recognition, support, and follow‐up appears to be of the utmost importance in reducing the risk of placement disruption.     

Could I do something like that? Recruiting and training foster carers for teenagers “at risk” of or experiencing child sexual exploitation

Child sexual exploitation (CSE) is a category of child abuse that was historically created to recognize the victimhood of children and young people, illuminating the ways that their evolving capacity to consent to sex is manipulated and undermined. Using evidence from the evaluation of specialist foster care provision and a CSE training course for foster carers, this paper considers how training might be used to widen the pool of potential foster carers for children affected by CSE and identifies qualities displayed by effective carers. It argues that improving the recruitment of foster carers can create safer home environments for teenagers at risk of or experiencing sexual exploitation and reduce the risk of further harm and that informed and effective foster care provision is crucial to prevent both the sexual exploitation of looked‐after teenagers and placement breakdowns that can ultimately increase risk.     

Young children returning home from care: the birth parents' perspective

While a wide range of literature exists on the experiences of children in foster care or adoption, much less is known about children who return home from care to their birth parents. This paper focuses on the perspectives of a small sample of birth parents of young children who returned home from care. It draws on findings from the Northern Ireland Care Pathways and Outcomes Study that has been following a population ( n  = 374) of children who were under 5 years and in care in Northern Ireland on the 31st of March 2000. As part of this study, interviews were conducted with the foster parents of 55 children, the adoptive parents of 51 children and the birth parents of nine children who had returned home from care. The paper explores the birth parents' views on how they coped while their child was in care, how they were coping after the child had returned home and how their child was faring at home. Results revealed that these parents, and their children, were experiencing multiple difficulties and struggled to cope after the children had returned home.     

The consequences of adolescent parenthood on men's depression,parental satisfaction,and fertility in adulthood

This study examines some social and emotional consequences of fathering a child during adolescence in the US. Data are obtained from the 1987/88 US National Survey of Families and Households among 13,017 individuals aged 19 years and older and under age 19 if currently married. This study's sample included only men who reported fathering a child before their 30th birthday and were aged 18-40 years at the time of the interview. There were 227 men who fathered a child before the age of 20 years (Fathered as Teen--FAT) and 1032 men who fathered a child between their 20th and 30th birthday (Fathered as Adult--FAA). Outcome measures include depression (Center for Epidemiologic Studies-Depression scale (CES-D) and parental satisfaction. Control variables are race, age, number of children, and socioeconomic status. Fertility is a control and a dependent variable. The FAT group had a smaller percentage of marriages, a greater percentage of never married, and a greater percentage of second and third marriages. 32% of the FAT group and only 17% of the FAA group were Blacks. 57% of the FAT group and 72% of the FAA were Whites. The evidence from multiple regression analysis using ordinary least squares techniques supports the hypothesis that adolescent fathers, like adolescent mothers, experience similar long-term outcomes of greater depression and fertility compared to men who become parents "on-time" during their 20s. Limitations to the study are the lack of control for the degree of contact with first-born children, educational status, and standardized measures with group norms. The authors furthermore caution that the study sample may not be representative of men who fathered as adolescents and does not consider mediating factors such as social supports during adulthood. However, the finding that adolescent men and women are more subject to depression regardless of socioeconomic status, race, fertility, or age warrants appropriate intervention strategies.     

Fostering confidence: Foster caregivers' relationship efficacy and associations with marital and co‐parenting relationship quality

Although healthy marital and co‐parenting relationships are important characteristics of a high‐quality, two‐parent foster home, little attention has been given to foster caregiver couples' perceptions of their marital and co‐parenting relationships and the contextual factors that influence these perceptions. Guided by the contextual model of family stress and social cognitive theory, the current study explores patterns of foster caregivers' relationship efficacy, covariates associated with efficacy, and how efficacy is associated with marital and co‐parenting relationship quality. On the basis of data collected from a random sample of 93 foster caregivers, latent profile analysis identified 49.5% as reporting moderate levels of relationship efficacy and 50.5% as reporting high relationship efficacy. Additionally, findings suggested that those who had been married previously, did not have a current placement, had been married longer, had fewer children, and received support from family reported higher levels of relationship efficacy, which was positively associated with positive marital and co‐parenting relationship quality. Implications for how the child welfare system can support foster caregiver marital and co‐parenting relationships are shared.     

Foster care assessment: an exploratory study of the placement assessment process in Flanders and the Netherlands

Family foster care placement decision‐making has a weak scientific underpinning. The identification of clusters of foster children (groups of foster children with similar characteristics) can help improve decision quality. In this study, we investigated if foster children could indeed be clustered, which problems were identified at the time of placement and what might be the influence of placement history. Two clusters of foster children were found: (i) young children with coinciding parental child‐rearing incapacity and familial problems, and (ii) older children with child problems. At the time of placement, familial problems were more often identified in younger children with a placement history. These findings stress the importance of approaching foster care assessment as part of a dynamic decision‐making process. It is key to finding the most appropriate situation for the child. At the same time, it must be decided how the desired situation can be realized, wherein placement decisions are based on an appraisal of whether or not a foster placement is an appropriate solution. In conjunction with this, it needs to be decided how the parents can be supported towards reunification, or whether or not long‐term foster care is the best option for the child, and if so what conditions need to be met.     

Research Review: In a rush to permanency: preventing adoption disruption

Since the late 1990s, US, UK and Canadian policy have increasingly focused on improving permanency outcomes for looked‐after children. Although the ideal permanency outcome of reunification is attained for about half of the children entering out‐of‐home care, an increasing number of children are adopted each year. The vast majority of adoptions are stable and secure, but concerns about adoption disruption haunt child welfare workers when making this important permanency decision. Despite a variety of definitions employed in the literature, adoption disruption is a general term used to describe the failure or breakdown of an adoptive child’s placement. Studies dating back to the 1970s have reported adoption disruption rates and the characteristics associated with those involved in such cases. This paper reviews available research, principally from the United States, and offers possible explanations for the wide range of reported disruption rates in the literature. After reviewing the research, practice implications for improving adoption outcomes and suggestions for future research are presented.     

Educational attainments of former child welfare clients – a Swedish national cohort study

We used national register data for nearly 800,000 Swedish-born young people in eight national birth cohorts to examine educational attainments of former child welfare clients. A total of 31,355 former child welfare clients were compared with 744,425 majority population peers. Logistic regression models were used to estimate risks of having only a basic education at time of follow-up, and of chances of having a post-secondary education. Odds ratios for core results were recalculated into relative risks.
Compared with majority population peers with low educated mothers, children who experienced interventions before ado-lescence, or had been in long-term stable foster care, had a two- to threefold elevated relative risk of entering adult life with only a compulsory education. Youths who experienced intervention during adolescence had approximately a fourfold risk of having only basic education at the time of follow-up. Majority population peers with low educated mothers were between two and six times more likely to have a post-secondary degree when compared with former child welfare clients.     

Social Background and Placement Course – The Case of Denmark

The scope of this article, founded on a nationwide survey in Denmark, is first to describe the social characteristics of families with a child placed outside home, and, further, to examine whether differences in regard to the parents' social background are correlated with different placement courses. A range of hypotheses on the correlation between social background and the course of placement are examined. It appears, for example, that children from low-resource families come into contact with the social system earlier, and are placed outside the home at an earlier age than children from high-resource families. Low-resource children are more often placed in foster care, and are more often subject to contact restrictions. The article discusses whether these differences reflect a socio-cultural discrimination. Secondly, a discussion is raised whether the supportive measures available are adequate in relation to the serious problems of the families concerned.     

Social services provided for physically abused children in Sweden: background factors and interventions

This study aims at describing and analysing what kinds of social services are provided for physically abused children in Sweden. The social services files were examined for 113 children under 15 years of age (67 boys and 46 girls) who had been reported to the police as having been physically abused by a parent or equivalent caretaker in a particular police district. The children's social services files indicated an increased risk of a parental abusive behaviour prior to the abuse incident. There had been former interventions in 81 per cent of the families and previous reports on neglect or abuse in 44 per cent of the 113 families. After the abuse incident, investiga-tions were opened in 80 per cent of the cases. The three most common interventions were placement in foster care, referrals to Child and Adolescent Psychiatric Service and Social Services support contacts. The study shows that there was a tendency towards more proactive work with injured children, children of immigrant parents and children of mentally ill parents.     

Outcomes of permanent family placement for children of minority ethnic origin

The paper explores the outcomes of permanent family placement for children of minority ethnic origin, using a sample of 254 placements drawn, in the main, from a cohort of 1165 British children placed between 1980 and 1985. Statistical techniques are used to explore the relationship between 'success' (defined, for the purposes of this paper, as the placement not known to have broken down) and a range of variables, including the characteristics of the child, the birth parents and the adoptive parents, and the type of placement. In most respects, the findings are consistent with those of similar studies. Age at placement is found to have an important effect, with success least likely for children placed in the middle age range. Lack of problem behaviours in the children at the time of placement is also found to be associated with success. Variables which are found to have no effect on the probability of success include ethnic origin of the child, whether it is an adoptive or permanent foster placement, and whether contact with birth parents continued after placement. There was an interesting gender effect in that boys did better in 'transracial' than in 'matched' placements, but the opposite was the case for girls.