How different are their experiences and outcomes? Comparing aged out and other child welfare involved youth

This paper adds to the growing body of research examining the experiences of youth aging out of the child welfare system. Through a comparison of youth aging out with two other groups of child welfare-involved youth—those whose families received child welfare services but were never placed out of home and those who were in out-of-home placement but did not age out—it presents a profile of their care careers and other system involvement (e.g., mental health, justice system). Analyses indicate that young people aging out of care have experienced significant amounts of time in out-of-home placement, a great deal of placement instability, and high levels of other system involvement. In general, their involvement is more extensive than that of the two comparison groups. However, the justice system involvement of youth who experienced out-of-home placement but did not age out is just as high as that of youth who have aged out. This finding highlights the importance of devoting resources not only to youth aging out of care but also to similarly-aged young people with prior child welfare involvement.     

Homelessness and aging out of foster care: A national comparison of child welfare-involved adolescents

The present study represents the first large-scale, prospective comparison to test whether aging out of foster care contributes to homelessness risk in emerging adulthood. A nationally representative sample of adolescents investigated by the child welfare system in 2008 to 2009 from the second cohort of the National Survey of Child and Adolescent Well-being Study (NSCAW II) reported experiences of housing problems at 18- and 36-month follow-ups. Latent class analyses identified subtypes of housing problems, including literal homelessness, housing instability, and stable housing. Regressions predicted subgroup membership based on aging out experiences, receipt of foster care services, and youth and county characteristics. Youth who reunified after out-of-home placement in adolescence exhibited the lowest probability of literal homelessness, while youth who aged out experienced similar rates of literal homelessness as youth investigated by child welfare but never placed out of home. No differences existed between groups on prevalence of unstable housing. Exposure to independent living services and extended foster care did not relate with homelessness prevention. Findings emphasize the developmental importance of families in promoting housing stability in the transition to adulthood, while questioning child welfare current focus on preparing foster youth to live.     

Foster youth transitions to adulthood: a longitudinal view of youth leaving care

The well-being of youths who age out of the out-of-home care system in the U.S. has long been of great interest to child welfare practitioners and policymakers. In spite of this interest, however, very little is known about how these youths fare when they must make the transition to independence. The Foster Youth Transitions to Adulthood Study is tracking the experiences of 141 young adults who left care in Wisconsin in 1995 and 1996. This article describes these youths and their experiences in the first 12 to 18 months after leaving care. The findings suggest that the transition to independence is a difficult time for youth leaving the out-of-home care system.     

Rules or No Rules? Three Strategies for Engagement with Young People in Mandated Services

A qualitative study of 61 youth receiving mandated services (child welfare, mental health, probation) or services where there were no alternatives (residential care for homeless youth) explored worker-client relationships from the perspective of young people themselves. Findings suggest three different but related roles played by workers that successfully engage adolescent clients: (1) “Informal supporters” de-professionalize their role and flatten hierarchies, emphasizing empathy and enforcing few rules; (2) “Administrators” enforce rules that are in the child’s best interest but do so with little emotional engagement; and (3) “Caregivers” who hold reasonable expectations and impose structures but are flexible in their negotiations with youth when rules were broken. While youth spoke most positively about their workers when they acted as informal supporters, a deeper analysis of the data showed that youth also engaged well with workers who enforced rules when those rules were necessary for the child’s safety, applied flexibly, age-appropriate, and fit with cultural norms. Use of all three approaches to youth engagement may help workers create better therapeutic relationships with youth receiving mandated services.     

What do we really know about usual care child protective services?

The term “usual care” is often used in clinical research to refer to a comparison or control group that is receiving whatever normal services an organization may provide. In the US child protection system, “usual care” is the practice from the point of screening in a report, to assessment and possible in-home services or a decision to place a child in out of home care. Policy and practice variations across states and counties, as well as changes in policy over time, make research on normative child welfare practice services challenging but necessary. The service delivery mechanism in child protection is understudied, limiting our ability to inform decision-making at the local, state and federal levels. Gaps in knowledge also confound intervention research because a clear understanding of a given service platform is key when interpreting effect sizes against usual care controls. This article overviews what is known about “usual care” in child protective services and seeks to encourage more research in this area by reviewing six key factors related to measuring the impact of usual care from the point of initial report through the provision of services.     

What Happens to Foster Kids: Educational Experiences of a Random Sample of Foster Care Youth and a Matched Group of Non-Foster Care Youth

Older youth often “age out” of foster care when they reach 18 or 21. Then what happens to them? How do their educational experiences during and after high school compare with children raised in intact families? This study used existing longitudinal data from 1980 through 1986 to investigate the high school and post high school experiences of a group of foster care youth and a matched group of youth living with at least one parent. The results were unequivocal: the foster youth dropped out of high school at a much higher rate and were significantly less likely to have completed a GED. The foster care high school graduates received significantly less financial assistance for education from their parents or guardians. Foster youth reported more discipline problems in school and experienced more educational disruption due to changing schools. They were significantly less likely to be in a college preparatory high school track. The adults in the lives of the foster care youth were less likely to monitor homework. These findings have important implications for child welfare policy and practice.     

Interventions for youth aging out of care: A scoping review

Youth aging out the child welfare system are being transitioned out of the child welfare system with few interventions in place to support their move to independence. In developed countries, compared to their peers, youth aging out of care face poorer outcomes when it comes to education, employment, and housing. A better understanding of the effectiveness of the existing interventions that support youth in care is warranted. This paper presents a critical scoping review of the available evidence on interventions available to youth who are aging out of the child welfare system and identifies gaps for future research. Arksey and O'Malley's framework for scoping reviews shaped the process of this review. A total of thirteen databases were searched resulting in the retrieval of 1978 articles. Of the 1978 retrieved, only 68 met the review's criteria. Studies included were in English, described an intervention that was implemented and evaluated in developed countries, and published within the last 20 years. Interventions were categorized as: housing, employment, education, mentorship, independent living, and health. The majority of studies fell under the independent living category which provide cohesive resources to improve education, housing, and employment. Studies evaluating these programs generally reported positive outcomes on youth's ability to complete their education and attain part- or full-time employment. Methods of evaluations were found to be methodologically weak with respect to determining the effectiveness of interventions in ensuring youth's successful transitions to independence. Future research should look at longitudinal outcomes of youth and cost-benefit analysis of supporting youth transitioning out of the child welfare system. Recommendations also include policy changes extending the age of eligibility for youth transitioning out of the child welfare system.     

Decision-making skills of emerging adults aging out of foster care

This study examines the decision-making skills of emerging adults that have aged out of foster care and transitioned to independent life. Emerging adults face a wide variety of life-direction determining decisions and those aging out of foster care experience even more significant transitional issues. Youth aging out of foster care may lack the requisite decision-making competencies for coping with these challenges. This study compares the decision-making skills of foster care alumni to a group of similar individuals who were not involved in the child welfare system. Using a validated quantitative survey instrument, 29 foster care alumni and 29 demographically similar non-fostered participants described their general decision-making skills and elaborated on their personal experiences of reaching the age of majority. Statistical analyses of group differences indicate foster alumni score lower on overall decision-making skills and the decision-making process. In anecdotal comments, foster alumni tended to focus on their experience of leaving the foster system, while the non-fostered population elaborated on what it was like to become a legal adult. This study suggests that youth aging out of the foster care system may need support with the aspects of decision-making relating to the generation of alternatives and inferential reasoning about decision consequences as one way to augment and improve the transitional services designed to prepare foster youth for independent life.     

Why youth leave care: Understandings of adulthood and transition successes and challenges among youth aging out of child welfare

Child welfare policies and practices are changing to allow more youth to remain in care beyond age 18. Yet, the majority of youth do not stay. Given recent evidence suggesting that remaining in care may be beneficial, there is a need to understand why youth leave. Using data gathered from in-depth interviews with young people aging out of care, this paper explores this question, relating it to youths' understandings of adulthood and the successes and challenges they face during their transitions. We find that youth leave care because of misunderstanding and misinformation about the requirements for remaining in care, as well as because of a desire for autonomy and independence. Specifically, many youth equated adulthood with independence, and thus felt that they needed to leave care to achieve adulthood. Unfortunately, these efforts to be independent often hinder youths' development of supportive relationships, which they reported to be one of the greatest challenges in their transitions. Based on these findings, we conclude by challenging the conflation of adulthood and independence, as well as of childhood and dependence, calling for connected autonomy as a goal for child welfare involved young people of all ages.     

Youth leaving care: how do they fare?

This chapter summarizes recent Canadian and international research on the outcomes for youth after they age out of the child welfare system. It paints a disturbing picture for this small and vulnerable population. Youth leaving care face many challenges in making the transition from state care to independence and adulthood. They bear the emotional scars of childhood neglect or abuse. They do not have a family support network, have limited or no financial resources, are often lacking in life skills, and usually have not completed school. Despite these setbacks, we expect them to function independently once they reach age eighteen. Research shows that once youth leave care, they do not fare as well as their peers. They are at much greater risk of relying on social assistance, becoming homeless, engaging in substance abuse, becoming single parents, experiencing mental health problems, or coming into contact with the criminal justice system. Some youth aging out, however, have more successful transitions. These typically have completed high school, have role models, have access to postsecondary opportunities, refrain from alcohol or drug use, and obtain life skills and independent living training. Having stable placements while in care is also critical in ensuring more positive outcomes. Canada does not have the capacity to track the outcomes of youth as they leave the child welfare system, nor can it identify the types of interventions showing the most promise in helping them achieve better outcomes. Canadian governments need to improve their transitional planning for youth in care who are approaching the age of majority. Some recommendations include extending the age for services and financial assistance to age twenty-four, developing standards to prepare youth for leaving care, and exploring ways to enable youth to pursue higher education or training. Finally, Canada should develop a national longitudinal survey to monitor the outcomes of youth after they leave care.     

Entering into a Collaborative Search for Meaning with Gay and Lesbian Youth in Out-of-Home Care: An Empowerment-Based Model for Training Child Welfare Professionals

Utilizing an empowerment-based approach, which incorporates self-identified gay and lesbian youths and openly gay and lesbian child welfare professionals as collaborative partners in the process, this article offers a model for training child welfare professionals to work more effectively with gay and lesbian youth in out-of-home care. This three hour training model empowers the gay and lesbian youth, whose voices have been subjugated, to emerge as the experts in training child welfare professionals to more competently and responsively address and meet their needs.     

Lost in transition: Illicit substance use and services receipt among at-risk youth in the child welfare system

This study examined the use of mental health and substance abuse services among adolescents in the child welfare system (CWS) who reported use of illicit substances. 1004 adolescents age 11–15 years at baseline were followed for 5–7 years, over five waves of data collection. Shortly after the investigation for maltreatment (baseline), 69.1% of youths using illicit substances received mental health and/or substance abuse outpatient specialty services. By the last follow-up, during the transition to adulthood, only 21.5% of young adults using illicit substances received outpatient specialty services. Youth who used illicit substances were more likely to receive outpatient and inpatient specialty services than non-users at the time of contact with the CWS (mostly baseline), but this difference faded over the follow-up period. By 5–7 years follow-up, there was no significant difference in specialty services receipt for illicit substances users versus non-users. Predictors of outpatient service use at most waves were having Medicaid, mental health needs, and having recently seen a school counselor or primary care physician. Among illicit substance users transitioning to adulthood, African American youths were less likely to receive outpatient specialty services than White youths. These findings reveal a need for more attention to illicit substances use among youth in the CWS, better cross agency integration, and special attention to the needs of transition-age youth to better connect them with services as they age out of the CWS.     

Lives in Motion: A Review of Former Foster Youth in the Context of their Experiences in the Child Welfare System

In light of the poor prospects facing many former foster youths during the transition to adulthood, it is surprising that so little attention has been given to substitute care contexts during child welfare system involvement. A review of child welfare research finds that many former foster youths go through an alarming number of placement changes and report a high rate of placement into congregate care settings and other unplanned events. Future research should take explicit account of substitute care contexts in designing and carrying out studies examining the adult outcomes of aging out foster care populations. Interventions intended to circumvent high rates of movement in foster care should also be broadened to target multiple aspects of substitute care contexts.     

Prior Placements of Youth Admitted to Therapeutic Foster Care and Residential Treatment Centers: The Odyssey Project Population

Two samples of youth in the child welfare system were compared—youth entering residential treatment centers (RTCs) and youth entering therapeutic foster care (TFC). Three questions were addressed: (1) Where were youth living prior to the current placement? (2) Had youth been treated in other systems of care? (3) How many prior placements did youth have? Time 1 data of the national “Odyssey Project” developed by the Child Welfare League of America were used. The^.measure utilized was the child and family characteristics form (CFC). Results revealed that youth admitted to RTCs were more likely to be entering from other systems of care and stepping down to the RTC while youth entering TFCs were more likely to be entering from within the child welfare system and stepping up to a higher level of care. The results have implications for improving clinical practice and for the development of a cross-system perspective on serving troubled youth.     

Perspectives on Independent Living Services Among Resilient Youth

This article describes the results of a qualitative research study of youth who are primarily aging out of foster care and utilizing Independent Living Services. Interviews and focus groups from youth revealed the following four themes: (1) emotional support needed (family support, case manager support), (2) tangible independent living services requested (financial resources, life skills, daycare), (3) communication of program services, and (4) the role of resiliency. A discussion of the themes and recommendations for child welfare agencies that work with this population are forwarded.     

The potential educational benefits of extending foster care to young adults: Findings from a natural experiment

Research has demonstrated the employment and earnings benefits accompanying educational attainment, and the relatively poor educational attainment and economic well-being of young people who transition to adulthood from foster care. Policymakers' concern over these poor outcomes has long been reflected in U.S. child welfare policy, most recently in the provisions of the 2008 Fostering Connections to Success Act allowing states to claim federal reimbursement for extending foster care from age 18 to age 21. While the policy of allowing youth to remain in foster care past age 18 has promise as a strategy for helping them continue their education, empirical evidence of its impact is lacking. Using data from a longitudinal study of youth (n = 732) who transitioned to adulthood from foster care, this study takes advantage of between-state policy variation in the age at which youth are required to leave care to assess the relationship between extended foster care and educational attainment at age 26. Distinguishing between not having obtained a high school diploma or GED, having only a high school diploma or GED, and having obtained at least one year of college, each additional year in care is associated with a 46% increase in the estimated odds that former foster youth will progress to the next level of educational attainment, controlling for a range of youth characteristics measured at ages 17–18. Background characteristics including youth's gender, race, employment, parenting, educational performance and aspirations, and indicators of behavioral health problems are also associated with educational attainment in early adulthood.     

Not too late: Effects of a diligent recruitment program for hard to place youth

Among child welfare professionals there is agreement on the negative consequences for youth who age out of foster care without an attachment to a caring adult. There is a particularly challenging sub-population of youth in foster care at highest risk for this scenario: special-needs youth who reside in a congregate care setting and who have been freed for adoption. This paper details the “Parent for Every Child” initiative (PFEC), a federally funded diligent recruitment program which targeted special needs youth who resided in congregate care settings and who had been freed for adoption. PFEC had two primary objectives: 1) identify effective recruitment strategies for matching caring adults with youth in need of permanence and (2) improve permanency outcomes for youth in the target population, inclusive of both legal and relational permanence. The methods used for studying the initiative are described as well as the study's randomly assigned participants, inclusive of both intervention and control groups. Findings related to the initiative's main goals are presented with respect to: the various recruitment strategies employed by project staff and staff working in the control condition; the extent to which those efforts yielded “matches” between youth in need and potential resource families; and, the extent to which youth enrolled in the PFEC project had better permanency outcomes compared to youth in the control group. The limitations of the study are discussed as well as promising directions for future research in this area.     

Parenting Under Pressure: Experiences of Parenting While Aging Out of Foster Care

Youth “aging out” of foster care experience higher rates of adolescent parenting than their peers who have not been in care. Due to their history of maltreatment, high adolescent pregnancy rates, and poor psychosocial outcomes, youth aging out who are parents are a vulnerable at-risk group. This study examines the parenting experiences of 33 youth aging out (21 mothers and 12 fathers) using data from a larger ethnography. Field notes of observation and transcribed interviews of youth aging out who are parents were analyzed using open coding strategies. Findings show parents encountered challenges while aging out and parenting, yet they found joy in their children and strived to be good parents despite having limited parenting skills, few resources, and little support. Desiring a better life for their children and fearing their children would enter foster care, parents were motivated to improve their lives for their children. Implications are discussed.     

The role of interagency collaboration in facilitating receipt of behavioral health services for youth involved with child welfare and juvenile justice

Unmet need for behavioral health care is a serious problem for crossover youth, or those simultaneously involved with the child welfare and juvenile justice systems. Although a large percentage of crossover youth are serious emotionally disturbed, relatively few receive necessary behavioral health services. Few studies have examined the role of interagency collaboration in facilitating behavioral health service access for crossover youth. This study examined associations for three dimensions of collaboration between local child welfare and juvenile justice agencies - jurisdiction, shared information systems, and overall connectivity - and youths' odds of receiving behavioral health services. Data were drawn from the National Survey of Child and Adolescent Well-Being, a national survey of families engaged with the child welfare system. Having a single agency accountable for youth care increased youth odds of receiving outpatient and inpatient behavioral health services. Inter-agency sharing of administrative data increased youth odds of inpatient behavioral health service receipt. Clarifying agency accountability and linking databases across sectors may improve service access for youth involved with both the child welfare and juvenile justice systems.     

Culturally Competent Practice with African American Juvenile Sex Offenders

African American juveniles adjudicated for sexual offenses may struggle with the mistrust of both the judicial and treatment systems. Unlike general mental health services, juvenile sex offender treatment is often mandated by the court or child welfare services, thus these youths and their families must engage in the treatment process. Without clinicians and services that can acknowledge and respond to a minority youth’s experience in a sensitive, culturally competent manner, there could be significant resistance to treatment. Traditional treatment approaches fail to prioritize issues involving cultural competence. This article addresses the unique challenges of African American juvenile sex offenders and makes recommendations for creating culturally competent practice for these youth and their families.