Predictors of foster care exits to permanency: A competing risks analysis of reunification, guardianship, and adoption

Abstract

Nearly 800,000 children spend time in foster care each year, with many children experiencing lengthy stays and exiting without a permanent family. The main objective of this study was to identify which child and placement characteristics were significant predictors of foster care exit to three types of permanency: reunification, guardianship, and adoption. A nonexperimental longitudinal design was used to observe an annual entry cohort of 3,351 children who entered Kansas foster care in state fiscal year 2006. The sample was observed for 30 to 42 months. Data sources were two state administrative databases, one which tracks all children in foster care and one on mental health services. The primary data analysis was competing risks survival analysis. Study findings showed that children in foster care exit to different types of permanency at different rates. Reunification occurs the most quickly, followed by guardianship, and then adoption. While patterns of predictors varied by type of permanency, three major categories of important permanency predictors were identified: 1) demographic characteristics of age at entry and race, 2) clinical needs related to child disabilities and mental health problems, and 3) continuity and connections represented by kin placements, sibling placements, early stability, and absence of runaway events. Implications suggested that social work practice be age-differentiated and culturally appropriate, and that children's needs related to disabilities and mental health problems be addressed with thorough assessment and evidencebased services. Social work practices should also strive to keep children connected to family and in stable placements. The major social work theory implication suggested that permanency theory balance the primordial solidarities principle that stresses family connections with the bureaucratic institutions principle that emphasizes structures for ensuring stability. In addition, ii this study's findings indicated the need to improve and expand timely permanency for more children. Policy implications included: using guardianship as a viable permanency option for more children; revising federal policy to promote the discovery and implementation of new, creative approaches to permanency; and, reforming the current financing structure to be more flexible and better aligned with the promotion of permanency outcomes.iii

Permanence for disabled children and young people through foster care and adoption: A selective review of international literature

“…A longitudinal study of 3351 children who entered foster care in the US in 2006 found that 32% of the disabled children were adopted, compared to 8.3% of their non-disabled peers: however, this was because the majority of the latter returned home (Akin, 2011). B longitudinal study found no evidence that, overall, disabled children were less likely to be adopted than others, except those with intellectual disabilities whatever their age or other impairments ), the latter point being supported by research in mid-west America (Schmidt-Tieszen & McDonald, 1998).…”

“…Akin (2011), in a US study, tracked 3351 children for 30-42 months after entering foster care and found that 58.7% of non-disabled children returned home compared to only 27.5% of disabled children. (Baker, 2007) conducted a longitudinal study tracing outcomes for 596…”

“…Studies in the US and UK have found them no less likely to be adopted than non-disabled children (Baker, 2007;McDonald et al, 2007), while in mid-west America, Akin (2011) found this was more likely. Research in San Diego reported that children with physical impairments were over four times more likely than typical children to live permanently in non-kin foster care (Romney et al, 2006).…”

“…Children with mental health needs are less likely than others to reunify with birth families, (Akin, 2011), twice less likely to have a successful exit from foster care (Becker, Jordan, & Larsen, 2007), have less chance of timely adoption (McDonald, Press, Billings, & Moore, 2007) and are 10 times less likely to be given a probationary adoption placement (Burge, 2007). A Scottish study of 182 fostered children, of whom 60% showed evidence of mental health problems, concluded that although they received a high level of support from various agencies, Child and Adolescent Mental Health Services were failing them (Minnis, Everett, Pelosi, Dunn, & Knapp, 2006).…”

RCT of a Mentoring and Skills Group Program: Placement and Permanency Outcomes for Foster Youth

“…3 Research has identified several child, family, and system characteristics that predict placement instability and failure to achieve timely permanence for children in foster care: being older, being placed in care with a nonrelative (versus a relative), and having a prior history of removal, placement instability, and/or residential treatment. [4][5][6][7][8][9][10][11][12][13] One of the most robust predictors of negative placement and permanency outcomes is a child's behavioral and mental health problems. [7][8][9][10]12,13 Although it is widely believed that placement changes are harmful and that permanency is beneficial for children involved in the child welfare system, it has been difficult to establish empirically the relationship between placement characteristics and child well-being, in part because many studies have not controlled for children' s baseline functioning.…”