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.     

Relative foster care: An emerging trend in foster care placement policy and practice

Abstract

Increases in the foster child population, at a time when terminations in foster care placement have decreased along with a decline in the number of non‐related foster parents, has resulted in an increasing use of relative foster care placement. Relative care as an emerging trend in foster care placement, is not without controversy. Its merits, however, should be assessed in terms of its benefits to the children in care, the fiscal and organizational costs, and the problems it creates for the child welfare system. This paper reviews what is known about the characteristics of relative caregivers and the children in their care. Federal and state policies that affect the use of relatives as an alternative placement resource for children are described. The available data regarding the length of time in placement, number of placements, physical, mental health and educational and permanency outcomes for children placed with relatives are discussed. Implications for practice are drawn and areas for further research are suggested.     

Kinship care in the UK: using census data to estimate the extent of formal and informal care by relatives

Until recently, little was known about kinship care in the UK. Research has begun to illuminate the circumstances which lead to children being cared for by relatives, and the stresses and strains experienced by carers. However, most UK research has only considered ‘looked‐after’ children placed with formal approved kinship foster carers, although this group forms the smallest proportion of children in kinship arrangements. In this paper, we use microdata from the 2001 UK Population Census to examine the characteristics of kinship carers and children, and demonstrate that most children in kinship care are growing up in informal unregulated arrangements. Implications for policy and practice are discussed.     

Promoting stability and continuity of care for looked after children: a survey and critical review

This paper reports on a two‐pronged research study: a critical review of reported research concerning continuity and stability for children looked after away from home, and a telephone survey of UK managers responsible for looked after children. The review found limited research in this specific field that met the criteria of the critical review, but reports some evidence in favour of sibling co‐placement, kinship care, parental participation, professional foster care and individualized, multidimensional support. The survey revealed a culture of innovation in this field in the UK voluntary and statutory sectors, but with little evaluation of the independent effects of new interventions. The paper places the research in the context of current policy initiatives in the UK and discusses the implications of the findings for research and practice.     

Placement breakdowns in long‐term foster care – a regional Swedish study

We used a regional sample of children in long‐term foster care to investigate the prevalence of placement breakdown in adolescence, and to assess risk factors/risk markers for placement disruption. The sample consisted of all 136 foster children in the region, born 1980–1992, who on their 12th birthday had been in the same foster family for at least 4 years. They were followed in case files until date of disruption or their 18th birthday. Data on conditions before and during placement were retrieved from case files, and analysed in bi‐ and multivariate models. Results showed that one in four placements broke down in adolescence. The median child who experienced a breakdown was 14 years old, and had been in the same foster home for more than 10 years. Prominent risk factors were (i) being placed after age 2 and (ii) having a birth sibling in the same foster home. We also uncovered strong risk markers that can be viewed as precursors of placement disruption. When the child or the foster parents repeatedly over time expressed dissatisfaction with the placement, this ended with a placement breakdown in 60% of cases. Implications for practice are discussed.     

The reasons why young children are placed for adoption: findings from a recently placed sample and a discussion of implications for subsequent identity development

It is widely accepted that the processing of identity issues can be problematic for some adopted children. Needing to know why placement for adoption was necessary is often central to adopted people’s identity concerns. Adoption practices have altered and children are now placed for adoption for different reasons and from different backgrounds than were children in the past. This study aims to present an up to date picture of the reasons why children are placed for adoption. Using information from questionnaires completed by social workers, the circumstances of a sample of 168 young (mean age at placement = 18 months), recently adopted children are examined. Children fall into three groups according to the reason for their adoption: relinquished infants (14%), those whose parents had requested adoption in complex circumstances (24%), and those children required to be adopted by social services and the courts (62%). Child and birthparent characteristics and openness arrangements are examined and are found to differ significantly between the three groups, indicating that children will have different types of information to appraise and differing capacities to make sense of their personal histories. Because of the multiplicity of difficulties in children’s backgrounds, it is concluded that resolving identity issues is likely to be challenging for many children, and professionals will need to take this into account when working with adopters and birth relatives.     

Substance use and other factors associated with child welfare case duration: Looking beyond out of home care

Little is known about factors associated with child welfare case duration. Understanding factors associated with case duration may help stakeholders make more informed decisions about funding and service allocation and improve compliance with federal law. This study had two research questions: (1) What factors are associated with child welfare case duration? And (2) Do factors differ depending on whether children were placed exclusively with parents or with others (e.g. relatives and foster care) during the case? The study sample consisted of families (N = 874) with co-occurring child maltreatment and substance use in one midwestern state in the United States between 2007 and 2016. Linear regression models were used to identify correlates of case duration while controlling for child placement status. Overall, having a child under 1 year of age, benzodiazepine use, methamphetamine use and injection drug use were all associated with longer case duration, whereas marijuana use with no other substance use was associated with shorter case duration. Additionally, factors associated with case duration differed based on child placement status during the case. These findings suggest important heterogeneity in families involved with child welfare services and may allow for proactive mitigation of cases at greater risk.     

Stability and change – a 7‐ to 8‐year follow‐up study of mental health problems in Norwegian children in long‐term out‐of‐home care

The aim of the study was to explore stability and change in mental health problems in Norwegian children aged 6–12 years old (n = 70) in long‐term out‐of‐home care. The children's mental health problems were assessed shortly after the placement and 7–8 years later by the caregivers and the teachers on the Revised Rutter Scales. Information on pre‐placement and placement factors were collected from the child welfare workers. At a group level the children's mental health problems had improved significantly over time according to the teachers' reports. According to the caregivers' reports, however, the children's problems were high and stable across time. Analyses aimed at detecting individual changes revealed a great variability in development according to both informants, indicating that treating the placed children as a homogenous group could be misleading. Several pre‐placement and placement variables were associated with the change in the children's mental health problems from the time of placement to the follow‐up time according to both informants' reports. However, all the predictors were accounted for by the strong effect of the children's problem scores when entering care.     

Paved with Good Intentions: The Pathway to Adoption and the Costs of Delay

The thrust of UK adoption policy is to promote adoption as thebest route to a stable family life for children in the caresystem unable to return to their birth families. However, whatwe know about outcomes for adopted children comes mainly fromstudies that report on children already in placement. This articlereports on the findings of a study that examined the outcomesof a complete sample of 130 older looked after children whohad all been the subject of an adoption best interest decision.Many were successfully placed but, of those who were not, thestudy was able to identify factors that influenced placementoutcome. The negative impact on placement outcomes and the increasedfinancial costs of poor assessment and delays in planning andaction are highlighted in this paper. The reasons why delaysoccurred, the costs of those delays and the impact on childoutcomes lend support to recent government attempts to reducedelay by the introduction of timescales into the adoption process.     

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.     

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.     

Maintaining Sibling Relationships--Neglected Dimension in Child Care Practice

Correspondence to Marjut Kosonen, 80, Grove Road, West Ferry, Dundee DD5 1LB, UK Summary This article describes some of the findings of a study undertakento evaluate all foster and adoptive placements in one localauthority social work department in Scotland. The numbers, characteristicsand care experiences of children in foster and adoptive carewere considered. The study found that for the majority of childrenplacement in foster care led to separation from siblings. Thechildren were most vulnerable to separation at points of entryand leaving care. Separation from brothers and sisters can havelifelong consequences for the child and his or her siblings,as few of the children were found to have plans which includedreunification with their siblings. A fragmented picture emergedconcerning siblings' living situations. Children were foundto have siblings living in a variety of situations, both inand outwith the care system. Social workers lacked full informationabout the family composition where contact with parents waslost or siblings had moved from the area. Children were mostlikely to be placed with siblings in temporary and relativefoster placements.     

Emergency out‐of‐home placements in Norway: Parents' experiences

The number of emergency placements of children has increased rapidly in Norway over the recent years. Nevertheless, there is little knowledge about how parents experience the processes involved in emergency placements. We conducted 64 survey interviews with parents who have experienced this kind of placement of their children. One third of the participants' children had received interventions prior to the emergency placement. Another third were known by Child Welfare Services (CWS) through reports of concern, which were dismissed without interventions and, in some cases, without investigation. The final third had no prehistory from CWS ahead of the emergency placement. A large proportion of the participants emphasized that they had experienced problems for a long time and had earlier requests for help unmet. Another large group of parents notified CWS themselves, and some of them wanted their child emergency placed. On the basis of parents' experiences, we suggest different implications for practice: (a) CWS should be more thorough in their investigation and assessment of the families, both when it comes to reports of concern and evaluation of initiated interventions. (b) Planned placement should be promoted to a greater degree, wherever possible. (c) A greater emphasis on follow‐up of parents after emergency placements is needed.     

Multi-system factors impacting youth justice involvement of children in residential out-of-home care

Children placed in residential care are significantly over-represented in youth justice systems. Drawing on interviews and focus groups with service providers, this exploratory study examines practice factors that impact on the criminalization of this group of children across multiple services and systems, including in the residential care environment, police, lawyers, courts and youth justice systems, as well as multi-systems practice with this group in one Australian state. Positive outcomes were observed for children in residential care where well-functioning care teams existed, as well as for children in therapeutic residential care settings. However, clear limitations were identified across all phases of children's youth justice system involvement, including placement with offending peers, the criminalization of behaviours of concern, greater use of remand and detention, limited support to navigate legal and youth justice processes, challenges to service collaboration, and limited applicability of sentencing considerations. The findings indicate a pervasive level of systemic disadvantage for this group of children, and imply that a holistic strategy underpinned by affirmative action across several systems will be necessary to address the ongoing criminalization of children in residential care.     

Pathways to adoption for minority ethnic children in England – reasons for entry to care

There have been concerns about the over‐representation of minority ethnic children in care in England for many years. This paper reports on the reasons why a sample of 120 minority ethnic children with adoption recommendations entered care. The study found no evidence that children were being removed unfairly or in a discriminatory way. However, there were significant differences by ethnic group in the characteristics of children and their mothers, in reasons for entry and in age at referral. These differences needed to be better understood, and interventions targeted at improving the circumstances and stresses within families that lead to abuse, neglect or relinquishment are also needed. Simply focusing on reducing the number of minority ethnic children in care will not in itself produce better outcomes for children.     

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.     

Managing sexually abused and/or abusing children in substitute care

This paper reports on research on the characteristics, management and therapeutic treatment of sexually abused and/or abusing children in substitute care. Of the 40 sexually abused and/or abusing young people aged 10 or over in the interview sample, two‐thirds showed sexual behaviours in the placement studied but one‐third did not. The range of sexual behaviours shown by the young people is described. Analysis of the findings shows that four key components of effective management are supervision, adequate sex education, modification of inappropriate sexual behaviour and therapeutic attention to the needs that underlie such behaviour. Supervision includes planning for safe care before placement, preparing other children in the setting, teaching young people how to keep themselves safe when out on their own, and careful monitoring of contact with birth family members. The need for a proactive approach to sex education is stressed. Effective management approaches to masturbation, sexualized behaviour and sexually abusing behaviour are discussed but the processes of denial and minimization of sexual abuse and the development of high thresholds for action when looked after children are abused or at risk are shown to present obstacles to effective care. Finally, the importance of addressing children's deeper needs is emphasized, including the importance of regular review of their need for counselling. At the end of the article two case examples from the study are given.     

Risk,resilience and identity construction in the life narratives of young people leaving residential care

The role of residential care for children has developed very differently internationally, but in all cultural contexts, there are questions about the extent to which it can help young people recover from high risk backgrounds. In the UK, residential care has come to be seen as the placement of last resort, yet new government guidance on permanence has suggested that residential care can provide security and a sense of belonging. Narrative analysis of interviews with 20 care leavers identified their different pathways from birth families through residential care to early adulthood. Some experienced a transformation from a negative sense of self as victims or ‘bad children’ to survivors, while others continued to struggle. Key to successful turning points were four interacting factors, all associated with resilience; connection, agency, activity and coherence. These narratives revealed the importance of nurturing relationships and a sense of ‘family’, and also the role of support after leaving residential care, when transitions workers helped them to move on but stay connected. The study highlighted how residential care leavers from adverse backgrounds attribute very different meanings to their experiences, which affects identity construction, resilience and the need for support.     

Kinship care in Spain: messages from research

Kinship foster care has experienced significant growth within the Spanish child protection system and now carries considerable weight. Over 40% of children in the public care system are formally fostered by relatives, equalling, and in some areas exceeding, the percentage of those in residential homes. This increase is not the result of a pre‐designed global programme or clearly pre‐established objectives in the system itself. Its current weight within the system has made it the focus of attention of researchers, politicians and protection system practitioners alike. The results of research carried out in Spain have revealed more positives than negatives in this type of fostering, giving rise to an in‐depth reflection on care systems, questioning the determinism of theories anchored in the intergenerational repetition of abuse and making room for perspectives more associated with resilience and children's rights. Positive results are related to fewer breakdowns, more stability, permanency beyond the age of 18, children agreeing with their placement, academic results similar to those with non‐relatives and better results after leaving care. The negatives relate to the lack of economic, educational and psychosocial support, which generally goes with this type of fostering. The experience of support programmes for these placements contributes to the debate.     

Parental Contact with Children Fostered and in Residential Care after the Children Act 1989

Correspondence to Andy Bilson, Department of Social Work and Social Policy, University of Northumbria, Newcastle NE7 7XA. E-mail Andy_Bilson{at}Unn.AC.UK Summary Research carried out since the implementation of the ChildrenAct 1989 based on a sample of 848 children looked after by localauthorities indicates that previous estimates of the numberswho have no contact with parents may have underestimated theextent of the problem, and that despite the emphasis placedon contact by the Children Act there is still much work to bedone to improve practice. The research not only confirms earlierfindings about the instability of placements in care but alsoshows differences in face to face contact which depend on thelength of time in care or accommodation and the reason for entry,as well as differences between children placed in residentialand foster care. Finally it was found that where children havespent long periods in care they tend to have little contactwith fieldworkers, and it is suggested that there is a needto redefine the social work agenda for this vulnerable groupof children.