kinship care and behavioral outcomes for children in the child welfare system david rubin, md msce...
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Kinship Care and Behavioral Outcomes for Children in the Child Welfare System
David Rubin, MD MSCE
Director or Research & Policy
Safe Place: The Center for Child Protection & Health
Background: Background: • Child welfare workers often choose between Child welfare workers often choose between
available kin vs. non-relative foster parents when available kin vs. non-relative foster parents when faced with the decision to remove children from their faced with the decision to remove children from their homes.homes.
• Exits to kinship care in recent years have been Exits to kinship care in recent years have been largely responsible for a nearly 10% drop in the out-largely responsible for a nearly 10% drop in the out-of-home population.of-home population.
• Children in supervised kinship care represent less Children in supervised kinship care represent less than 10% of the 2.5 million children being raised in than 10% of the 2.5 million children being raised in kinship settingskinship settings
Background:Background:• Competing theories on kinship care: Competing theories on kinship care:
““Blood is thicker than water”Blood is thicker than water”
• Stronger attachment between caregiver and childStronger attachment between caregiver and child
• Less disruptiveLess disruptive
““The apple doesn’t fall far from the tree”The apple doesn’t fall far from the tree”
• Kin may share the same risk factors as the birth Kin may share the same risk factors as the birth parentsparents
• Unrestricted and unregulated contact with birth Unrestricted and unregulated contact with birth parentsparents
MethodsMethods
• Data Source:Data Source:
– National Survey of Child & Adolescent Well-National Survey of Child & Adolescent Well-Being (NSCAW)Being (NSCAW)
• Study Population:Study Population:
– Children who entered kinship care or non-Children who entered kinship care or non-relative foster care following reportrelative foster care following report
• GenderGender::54% female54% female
46% male46% male
• AgeAge: : 28% < 2 years28% < 2 years
50% 2-10 years50% 2-10 years
22% > 10 years22% > 10 years
• Race & EthnicityRace & Ethnicity::50% White50% White
38% African-American38% African-American
13% Hispanic13% Hispanic
• Abuse typeAbuse type::57% neglect/abandonment57% neglect/abandonment
19% physical abuse19% physical abuse
9% sexual abuse9% sexual abuse
Results: Results: Total study population (Total study population (N = 1,309N = 1,309))
• Initial Placement SettingInitial Placement Setting– 50% kinship care 50% kinship care – 50% non-relative foster care50% non-relative foster care
• 36-month CBCL Scores36-month CBCL Scores – 38% had scores indicating behavioral problems38% had scores indicating behavioral problems
Results: Results:
Were children who were placed Were children who were placed into kinship care different from into kinship care different from those who were placed into those who were placed into non-relative foster care?non-relative foster care?
0%
10%
20%
30%
40%
50%
60%
Mental HealthService Use
(p=.003)
Birth Parent w/Mental Health
Problems (p=.006)
AbnormalBehavioral Well-
Being Score (p=.04)
Perc
enta
ge o
f Gro
up
General Foster Care Kinship Care
Differences in Baseline Characteristics by Initial Placement Setting
0%
10%
20%
30%
40%
50%
General FosterCare
Kinship Care
Perc
enta
ge o
f Gro
up
Low Risk
Medium Risk
High Risk
χχ22: : p = .007p = .007
Child’s Baseline Risk for Placement Instability
Did children in kinship care have Did children in kinship care have more stability than children in more stability than children in non-relative foster care?non-relative foster care?
0%
10%
20%
30%
40%
50%
60%
GeneralFoster Care
KinshipCare
Per
cen
tag
e o
f Gro
up
Early Stable
Late Stable
Unstable
Actual Placement Stability (36 Months)
χχ22:: p < .001p < .001
Controlling for the lower Controlling for the lower baseline risk and increased baseline risk and increased placement stability among placement stability among children in kinship care, were children in kinship care, were behavioral outcomes different behavioral outcomes different between children in kinship between children in kinship and non-relative foster care?and non-relative foster care?
0
0.1
0.2
0.3
0.4
0.5
0.6
General FosterCare
Kinship Care
Pred
icte
d Pr
obab
ility
EarlyStable
LateStable
Unstable
Predicted Probability of Behavior Problems at 36 Months Based on Placement Stability and Setting*
31%
30% 25%
*Marginal standardization, adjusting for baseline risk and *Marginal standardization, adjusting for baseline risk and reunification statusreunification status
Some words of cautionSome words of caution
• Although children in kinship had fewer behavioral Although children in kinship had fewer behavioral problems than children in non-relative foster problems than children in non-relative foster care, their rates of behavioral problems were care, their rates of behavioral problems were greater than other children in general.greater than other children in general.
• Kinship care is not a realistic option for all Kinship care is not a realistic option for all children who enter out-of-home care.children who enter out-of-home care.
• Reporting bias among the kinship care Reporting bias among the kinship care population might have explained some of the population might have explained some of the difference.difference.
From Policy to ImpactFrom Policy to Impact
Non-RelativeNon-Relative
Kin CareKin Care
CPS CPS ReportReport
Child Child removedremoved
Guardianship Guardianship vs. Adoptionvs. Adoption
ReunificationReunification
AdoptionAdoption
RiskRisk
Informal Informal Kinship Kinship
CareCare
From Policy to ImpactFrom Policy to Impact
Non-RelativeNon-Relative
Kin CareKin CareGuardianship Guardianship vs. Adoptionvs. Adoption
ReunificationReunification
AdoptionAdoption
NotificationNotification
CPS CPS ReportReport
Child Child removedremoved
RiskRisk
Informal Informal Kinship Kinship
CareCare
From Policy to ImpactFrom Policy to Impact
Non-RelativeNon-Relative
Kin CareKin CareGuardianship Guardianship vs. Adoptionvs. Adoption
ReunificationReunification
AdoptionAdoption
LicensingLicensingCPS CPS ReportReport
Child Child removedremoved
RiskRisk
Informal Informal Kinship Kinship
CareCare
From Policy to ImpactFrom Policy to Impact
Non-RelativeNon-Relative
Kin CareKin CareGuardianship Guardianship vs. Adoptionvs. Adoption
ReunificationReunification
AdoptionAdoption
Guardianship Guardianship BenefitsBenefits
CPS CPS ReportReport
Child Child removedremoved
RiskRisk
Informal Informal Kinship Kinship
CareCare
From Policy to ImpactFrom Policy to Impact
Non-RelativeNon-Relative
Kin CareKin CareGuardianship Guardianship vs. Adoptionvs. Adoption
ReunificationReunification
AdoptionAdoption
CPS CPS ReportReport
Child Child removedremoved
RiskRisk
Informal Informal Kinship Kinship
CareCare NavigatorsNavigators
NavigatorsNavigators
NavigatorsNavigators
ConclusionsConclusions
• Children raised in kinship settings had Children raised in kinship settings had more stability than children in non-more stability than children in non-relative foster carerelative foster care
• Kinship care conferred benefits to Kinship care conferred benefits to children beyond the increased stability children beyond the increased stability that was achievedthat was achieved
Implications:Implications:
• Provides empirical data to support efforts to Provides empirical data to support efforts to improve the early placement of children with improve the early placement of children with kin when appropriatekin when appropriate
• Also reinforces the need to provide better Also reinforces the need to provide better services (via accessible navigator programs) services (via accessible navigator programs) among kinship families, which can only among kinship families, which can only support efforts to achieve stability and support efforts to achieve stability and maintain permanencymaintain permanency
Acknowledgements:Acknowledgements:
• Funding:Funding:– Dr. Rubin’s work was supported through a K23 mentored Dr. Rubin’s work was supported through a K23 mentored
career development award from NICHD (1 K23 HD045748-career development award from NICHD (1 K23 HD045748-01A1) and a supplemental grant from the Office of 01A1) and a supplemental grant from the Office of Research & Planning of the Adminstration of Children & Research & Planning of the Adminstration of Children & FamiliesFamilies
• Special thanks to:Special thanks to:– Kevin DownesKevin Downes– Amanda O’Reilly MPHAmanda O’Reilly MPH– Xianqun Luan MSXianqun Luan MS– A. Russell Localio JD PhDA. Russell Localio JD PhD– Robin Mekonnen MSWRobin Mekonnen MSW
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