Into adulthood: a follow-up study of 718 young people who were placed in out-of-home care during their teens

In this study, national register data were used to analyse long‐term outcomes at age 25 for around 700 Swedish young people placed in out‐of‐home care during their teens. The sample consisted of 70% of all 13‐ to 16‐year olds who entered out‐of‐home care in 1991. Results revealed a dividing line between young people placed in care for behavioural problems and those placed for other reasons. Young woman and men from the first group had – in comparison with peers who did not enter care – very high rates of premature death, serious involvement in crime, hospitalizations for mental‐health problems, teenage parenthood, self‐support problems and low educational attainment. Young people who were placed for other reasons had better outcomes, but still considerably worse than non‐care peers. Young women tended to do better than young men, regardless of reasons for placement. Very high rates of hospitalizations for mental health problems were found among young people placed for behavioural problems. Breakdown of placement was found to be a robust indicator of poor long‐term prognosis.     

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.     

Traditional kinship foster care in northern Ghana: the experiences and views of children, carers and adults in Tamale

Surveys were employed to explore the experiences of children in care and their carers about traditional fostering. They also examined the perspectives of randomly selected adults in the community about the practice of traditional foster care in the Tamale area of northern Ghana. The 74 participants responded to closed- and open-ended interview questions about traditional foster care. Frequencies and thematic grouping of qualitative responses showed that the need to keep family ties alive was the key reason for placement of children with family and kin. Majority of the children expressed satisfaction with living in foster care, even though they had experienced physical and emotional abuse and intimidation. Although most carers were not formally employed and had little personal income, they were positive about having the care role, but faced challenges in providing for many children in a difficult economic situation. The report highlights the role of reciprocity, altruistic and socio-cultural factors in quality of care, and the potential for the traditional kinship foster care to provide suitable avenues of placement for children as recommended by the Ghana child rights law. It also identifies the need for education for carers around children's needs and Ghana's child rights law.     

Infants who stay in foster care: child characteristics and permanency outcomes of legally free children first placed as infants

Despite growing concern in the United States about the number of children who are entering child welfare care as infants, little empirical attention has been given to the sizable group of these children who are not reunified with their biological families and who then remain in care for long periods. This study examined length of stay and permanency outcomes for 458 legally free children who initially entered out-of-home care as infants. Using a Cox proportional-hazards event history model, the study also explored the effects of race/ethnicity and gender on the likelihood of these children achieving a permanent placement (legalized adoption or guardianship) within a reasonable period of time. African–American children and boys were found to be significantly less likely to achieve permanence than Caucasian children or girls. Across all groups of children in the sample, however, long stays in care were the norm. These findings suggest the need for flexible approaches to permanency, for efforts to better differentiate among infants in care, and for attention to children's long-term developmental needs as well as to strategies that better assure placement stability.     

Exploring spirituality among youth in foster care: findings from the Casey Field Office Mental Health Study

This study examined spiritual coping mechanisms, beliefs about spirituality and participation in spiritual activities and in other positive activities among adolescents in foster care. A multidimensional measure of spirituality was developed for face-to-face interviews with 188 youth (ages 14–17) from diverse racial/ethnic backgrounds in the United States. Findings revealed 95% of youth believe in God, over 70% believe God is 'creator' and God is 'love', and 79% considered prayer a spiritual practice. Most youth said love and forgiveness help them heal. Two-thirds (67%) reported responding to 'bad or tragic things happening' by spending time alone, and over half responded by praying (59%) or sharing the problem with someone else (56%). Youth's top three spiritual goals were to follow God's plan for them, become a better person, and know their purpose in life. Based on the value youth ascribed to spiritual coping mechanisms, recommendations for policy and practice focus on the integration of spirituality into practice and caregiving for youth in foster care.     

Factors associated with family reunification for children in foster care

In this paper, we analyse reunification processes from family foster care, both kinship and non‐kinship, and the variables associated with them in a Spanish sample. Data collection was carried out after a review of child protection and foster care files, and those responsible for the cases were also consulted. The cases studied were closed, which made it possible to assess the final outcome of the fostering. We found that only one‐fifth of the children return to their birth family after the fostering, and that those in non‐kinship are less likely to do so. Seven factors were associated with family reunification processes: age of the child, kinship care with family co‐operation, drug dependence in parents, neglect due to alcoholism, foster care under voluntary arrangement with visits, short‐term fostering with family co‐operation and parental impossibility due to imprisonment. The contribution of these data takes on particular importance given that the Spanish child protection system keeps no official statistics on the development or outcome of its interventions and records even less information on the factors associated with such outcomes.     

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.     

Post‐secondary transitions of youth emancipated from foster care

This study investigated the extent to which KnowHow2Go (KH2Go), a national college access campaign developed for first‐generation students in the USA, would resonate with youth who had aged out of foster care. Interviews were conducted with 27 youth who were enrolled in a post‐secondary programme following emancipation from foster care. We found KH2Go to have a close fit with the experiences of youth who had been in foster care. Four topics emerged as particularly important for youth in our study: money management, work, parenting and transportation. Finally, the study identified attributes these youth demonstrated that contributed to their resilience during the transition process. This study and the data presented pertain to youth living in the south‐eastern USA.     

Nonresidential fathers with children in foster care: A descriptive study in the United States

This study used the data from 64 nonresidential fathers who had their children placed in foster care to describe their characteristics. The survey included questions about demographic background and personal challenges, the father's involvement with his child in foster care, the father's relationship with the mother, barriers to the father's involvement, and the relationship with child welfare agencies and workers. The average age of the participants was about 39 years, and the majority of them were African American. About 70% of the fathers reported low levels of education. Almost 69% of fathers reported frequent face‐to‐face contact with their children. On average, the participants were arrested 2.6 times, and it ranged from 0 to 34. More research is necessary to learn more about these fathers, develop programs to help them become a viable source for permanency option, and become more involved in their children's lives.     

Peer violence in foster care: a review of the research evidence

Whilst a small amount of research has been undertaken on peer violence in residential settings, very little is known about peer violence in foster care. This paper reviews the published research since 1995 about the nature and extent of peer violence in foster care and interventions for preventing and managing these negative peer interactions. The evidence indicates that young people in foster care can be the instigators and recipients of peer violence, but the limited number of studies found means that conclusions cannot be drawn about the extent of the problem. There is some evidence about the impact of this type of violence on young people and fostering households. However, there remain gaps in the evidence about the full extent of all forms of exploitation and violence that are experienced and instigated by young people in foster care, the circumstances in which it takes place, the young people affected and its co‐occurrence with other difficulties. Critically, young people's views were largely absent from included studies, an important area that requires further research.     

Congruence and incongruence in the perception of ‘family’ among foster parents,birth parents and their adolescent (foster) children

Over recent decades, listening to children's voices and viewing children as competent actors has gathered momentum in research as well as in practice. Acknowledging children's perspectives requires sensitive listeners who are willing, deliberately and as realistically as possible, to reconstruct children's ways of seeing. In our study, based in Norway, we investigated the views of 22 adolescents in long‐term foster care and 15 of their birth parents and 21 of their foster parents. Using Q methodology, we explored congruence and incongruence in the perception of ‘family’ among foster parents, birth parents and their adolescent (foster) children. We found three family perspectives among the adolescents. Within two of these perspectives, there seem to be more congruent understandings of the children's perspectives among the parent groups. We discuss some main implications in light of these findings. In Norway, as in many other countries, the policy of child welfare is that children first and foremost should grow up with their birth family. When out‐of‐home placements are necessary, a basic principle is that children should remain in contact with their birth family.     

Improving outcomes for children in out‐of‐home care: the role of therapeutic foster care

How best to support children and young people in foster care remains a challenge for child welfare. There has been little Australian research on the outcomes for children and young people placed in therapeutic foster care (TFC). This article aims to address this knowledge gap, presenting the evaluation of a state‐wide model of TFC known as the Circle Program operating in Victoria, Australia. Data sources for the study were case assessment analysis; surveys of foster carers, program workers and other stakeholders in the sector; and both focus groups and individual interviews with foster care workers. The evaluation found that the Circle Program lessened the number of unplanned exits of children from foster placements compared with generalist foster care. Another important finding was that the Circle Program positively influenced foster carers' decisions to stay in the carer role. Key components perceived as contributing to outcomes of the Circle Program included enhanced training of foster carers, intensive carer support, specialist therapeutic support to the child and carer, therapeutic service to family members and a network of services to provide support to the child.     

The relationship between foster care families and birth families in a child welfare context: The determining factors

Children placed in foster care families usually continue to see their birth parents in supervised and home visits. These children deal with the fact that they belonged to two families in a context where the relationship between the two families is sometimes complex and tense. Based on 45 semi‐structured interviews conducted with foster care families and kinship foster care families, the present study examines the relationship between foster care parents and birth parents in a placement context, and focuses on the factors affecting the nature and quality of this relationship. The results showed that the quality of the relationship dynamics varies according to the following: how well and how often the parent–child visits took place, the birth parents' characteristics, and the foster carers' attitudes. The results also showed that placements in kinship foster care families were more likely to result in conflict and tension between the two parties than placements in regular foster care families.     

Promoting quality parent–child visits: the power of the parent–foster parent relationship

Parent–child visits for children in foster care are often fraught with tension, particularly between foster parents and parents. Qualitative interviews with 42 social workers, foster parents and parents revealed more positive relations when foster parents recognized parent fears and shared power over parenting decisions with them. Social workers can support the process by clarifying visiting expectations and encouraging foster parents to reach out to parents.     

Family contact in foster care in Portugal. The views of children in foster care and other key actors

This is a pilot study on the sensitive issue of how children and young people experience family contact in foster care, and the views of key adults in their lives on the same issue. There is a special focus on the children's experiences, opinions, and feelings. The study is a response to the relative scarcity of literature on family contact based on the experiences of children and adults in caring roles. This is a qualitative and exploratory study, with a sample of 10 children and young people in care in the district of Porto, aiming to identify key issues and areas for further examination. The results allow us to conclude that the possibility of maintaining contact is positively evaluated. However, perspectives on the relationships involved, and on the reactions to and difficulties associated with visits, revealed considerable disagreement among the actors. A possible set of implications drawn from the findings pointed out to the importance of developing a monitored cooperation that improves communication processes in order to take into account the children's and young people's views in the decision‐making process; and to develop more attentive and open working relationships with parents throughout the foster care placement.     

Fostering educational prosperity: A randomized controlled trial of home tutoring in foster care

The educational gap between children in out-of-home care and their non-placed peers is well-documented. However, tutoring stands out as a promising intervention to raise children's educational attainment in out-of-home care. This study randomized 105 children in foster care (62% girls, aged 7–15 years [M = 10.3, SD = 2.0]) to the home tutoring program Foster Caregivers as Tutors (FCT) or regular public school services (treatment as usual [TAU]). In the FCT group, the foster caregivers tutored the children for 2.5 h/week for 40 weeks. The program effect is measured in learning and developmental outcomes, including reading and math ability, learning skills, IQ, executive function, and psychosocial function. Follow-up was 17.5 months after baseline. The results show a significant effect over time in both groups on IQ (effect size [ES] = 0.40, P < 0.001), verbal comprehension (ES = 0.29 P = 0.02) and perceptual reasoning (ES = 0.60, P < 0.001) measured by WISC IV. Neither the FCT nor TAU provided any significant academic recovery in reading and math nor progression in executive function, learning skills or psychosocial function. These findings, implications for practice and future efforts to support the schooling of children in out-of-home care are discussed.     

Father's involvement in the lives of children in foster care

Limited understandings exist about non‐resident fathers' views of their involvement with their children in foster care placements. Guided by the ecological systems framework, the purpose of this exploratory study was to gain insights into fathers' perceptions of their involvement with a child in foster care. Data were collected from demographic questionnaires and two focus groups with 17 men. Fathers expressed how kinship compared with non‐kinship placements affected their involvement. Fathers were also in agreement that their financial hardships were a significant factor affecting their involvement. Several fathers also reported how they experienced discrimination in the child welfare system as men. Surprisingly, uncommon to findings from other studies, few men viewed the child's mother as being a barrier to their involvement. The findings provide insights into factors requiring attention to help non‐residential fathers become involved with their children.     

Instability and caregiving in the lives of street‐involved youth from foster care

A large proportion of youth who become street‐involved have experience in foster care, and our sample of 92 street‐involved youth, aged 14–18 years, all had foster care experience. We report on (i) instability of guardians and home from birth to street involvement; (ii) the connection between perceptions about foster care and measures of well‐being; and (iii) the implications of these findings for understanding street‐involved youth and the role of foster care in their life. The average number of transitions per youth from birth to mid‐teens was nine. Youth with experience in permanent care first lived away from biological parents at age 8.5 years, and for those with temporary care experience, it was age 10 years. Foster care was one of many living situations and one of several sources of caregivers. If participants were satisfied with foster care, they were more likely to be currently hopeful and happy. Participants who experienced positive influences from at least one long‐term caregiver tended to have other positive caregiver experiences, and those with negative influences were more likely to also have a positive relationship with a female caregiver. Foster care was one of several ‘way stations’ in their lives, one whose meaning needs further study.     

Looking for best practice in caring for disabled children: a case of socialized foster care in China

This study focuses on the problems associated with caring for children with cerebral palsy (CWCP) in Chinese State Children's Welfare Institutions (SCWIs). It considers how to place these children with foster families and also provide them with the best rehabilitation services. In a pilot project, one SCWI trained foster parents as rehabilitators and provided services to CWCPs living with foster families in selected rural communities. The practice was very successful over the last decade, and more than 600 CWCPs in these communities are growing up happily. Hence, specialized foster care projects could be a solution for all SCWIs in China, where most of the institutionalized children are disabled.     

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.