Children who leave their homes because of maltreatment appear to have fewer behavioral problems three years later if they are placed with relatives than if they are placed in foster care, according to a report in the June issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.

In the last two decades, increasing numbers of children are being raised by relatives other than their birth parents in an arrangement known as kinship care, according to background information in the article. In 2005, more than 2.5 million children were living with relatives. “The growth in kinship care is the result of a sustained effort to improve permanency for children since the Adoption and Safe Families Act of 1997,” the authors write. “Since then, child welfare agencies have increased efforts to place children with kin despite scant and conflicting evidence of improved outcomes for children in kinship care compared with children in general foster care.”

To better understand the experiences and outcomes of children in these two types of care, in 1996 Congress mandated that the Department of Health and Human Services conduct the National Survey of Child and Adolescent Well-Being. David M. Rubin, M.D., M.S.C.E., of The Children’s Hospital of Philadelphia, and colleagues analyzed data from 1,309 children participating in the survey who entered out-of-home care following a report of maltreatment between 1999 and 2000. At the beginning of the study and again at 18 months and at 36 months later, interviews were conducted with children, caregivers, birth parents, child welfare workers and teachers.

Of the participating children, 599 were initially placed in kinship care. A total of 710 entered foster care; of those, 17 percent moved to kinship care after at least one month in foster care. After controlling for a number of other factors, including the stability of the placement and the child’s risk for behavior problems at the time of removal from the home, 32 percent of children entering kinship care directly had behavioral problems 36 months later, compared with 39 percent of children who moved from foster care to kinship care and 46 percent of children who stayed in foster care.

Children in kinship care were also less likely to change placements frequently—when assessed at 36 months, 58 percent of them were found to have achieved a sustained placement or were reunified with their parents, compared with 32 percent of those in foster care. Fifty-eight percent of those who began in foster care but transferred to kinship care were in a sustained placement or reunified with their parents after 45 days, compared with 40 percent of those who stayed in foster care. “Placement stability is a common goal of child welfare systems and has consistently been shown to result in better outcomes for all children living in out-of-home care,” the authors write.

“This finding supports efforts to maximize placement of children with willing and available kin when they enter out-of-home care,” they conclude. “When kinship care is a realistic option and appropriate safeguards have been met, children in kinship care might have an advantage over children in foster care in achieving permanency and improved well-being, albeit with the recognition that their needs will remain great, exceeding those of children who have not experienced child maltreatment.”

(Arch Pediatr Adolesc Med. 2008;162[6]:550-556. Available pre-embargo to the media at http://www.jamamedia.org.)

Editor’s Note: This study is supported by a Career Development Award from the National Institute of Child Health and Human Development and by a supplemental grant from the Office of Research, Planning and Evaluation for the Administration of Children and Families at the Department of Health and Human Services. Additional support was also provided by the Doris Duke Charitable Foundation. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

Editorial: Better Behavior May Be Cause and Effect of Living With Relatives

“Being in kinship care and having fewer behavior problems likely comprise a relationship that is too complicated to be thought of as being causal and one-way,” writes Richard P. Barth, M.S.W., Ph.D., of the University of Maryland, Baltimore, in an accompanying editorial.

“The implications that the behavior problems of children in kinship care are fewer than those of children in non-kinship care are not obvious, as children cannot be assigned to kinship care rather than to non-kinship care if kin are unavailable,” Dr. Barth continues. “So, there may be some children whose behavior is so troubling that kin are unable or are unwilling to take them into their homes.”

However, the findings support actions that reduce the number of placement moves for children, as well as those that support caregivers. “The recommendations of the authors to expand the resources given to kinship providers with a national kinship guardianship program and to endeavor to more expeditiously notify kin and place children into kinship care deserve underscoring,” Dr. Barth concludes. “These are low-cost strategies that deserve implementation given the evidence that children prefer to be placed with relatives and that the care of relatives may support better behavioral outcomes.”

(Arch Pediatr Adolesc Med. 2008;162[6]:586-587. Available pre-embargo to the media at http://www.jamamedia.org.)

Editor’s Note: Please see the article for additional information, including author contributions and affiliations, financial disclosures, funding and support, etc.

###

For more information, contact JAMA/Archives Media Relations at 312/464-JAMA (5262) or e-mail .(JavaScript must be enabled to view this email address).

Contact: Juliann Walsh
267-426-6054
JAMA and Archives Journals