Outcome-Network.org

Paper

How do children fare in care: a longitudinal study of outcomes

• issue: Issue 2 / 2008
• authors: Elizabeth Fernandez
• keywords: Australia, carers, foster care, children

• views: 4539
• downloaded: 1
• download pdf (85 Kb)

abstract

Background. This paper reports research into the outcomes of child welfare interventions designed to protect children and promote their well being through foster care. Child welfare interventions are publicly financed and subject to public statute and accountability. Children in protective care are from the most disadvantaged sections of society. Given the generational inequality children experience in terms of their relationship with caregivers and professionals, social policy and programs need to be responsive to their vulnerabilities and rights.

Purpose. The placement of children in foster care is a planned intervention for children who cannot grow up in their birth families due to maltreatment or other circumstances. The issue of out of home care for children who cannot live with their families of origin, the quality of that care and its impact on children's development is significant for international child welfare. Yet the well being of children in care presents a challenge to researchers, and policy makers and educators. Consistently there has been emphasis internationally on the need for greater accountability and commitment to the rights of children. Several commentators have emphasised the pressing need to develop and monitor methods of assessing outcomes of such interventions in order to enhance the wellbeing of children in care. This would parallel initiatives in the fields of heath and education, and is driven by the increasing need to establish the effectiveness and accountability of child welfare interventions in the context of publicised scandals affecting maltreated children and children in care. There is also the need to build theory and extend the knowledge base of practice with children and families to enhance practice and policy.

The last two decades have seen an increase in child abuse notifications and removal of children into protective care. Across Australia, over the last five years the numbers of notifications of child abuse and neglect increased from 107,134 in 1999-2000 to 252,831 in 2004-2005. On investigation of maltreatment reports and substantiation or verification a court may make Care and Protection Orders. The number of Care and Protection Orders varied from 3.4 to 5.8 per 1000 in different Australian states. In 2005 there were 23, 695 children in out of home care representing an increase of 70% since 1996 and a rate of 4.9 per 1000 children in care rising from 3.0 per 1000 in 1997. Children in care are a profoundly disadvantaged group whose needs and service outcomes require research scrutiny. Their position in out of home care systems has been subject to intense criticism by individuals and organisations advocating children's rights. Major criticisms have been levelled against the protracted periods children spend in unplanned care, the instability they experience, their poor educational achievement and vocational prognosis, and importantly, the lack of preventive and supportive services to families. This paper reports research undertaken on children's and carers' perspectives on the experience of being in care and related interventions affecting children in care.

Children's views are rarely accorded the significance warranted. Their thoughts, feelings and words of children themselves are rarely heard (Qvortrup, 1987; Gilligan, 2000). The concept of children's participation and the notion of researching children's perspectives is still relatively recent. Current thinking about children's rights emphasise their well being and their participatory rights in practice and policy decisions affecting their wellbeing, and their entitlement to have their accounts represented in research focusing on them. There is a growing recognition that children be given a greater voice in defining the issues that affect their wellbeing and taken seriously as actors in their own right (Groden & Glantz, 1994; Morrow & Richards, 1996). This awareness, influenced by a reconceptualisation of childhood and child adult relations, has stimulated a range of psychological and social research incorporating views of children and young people and their conceptions of their social world (Greig & Taylor, 1999).

Overview. This paper reports research on outcomes of long term foster care from an 8 year longitudinal study of foster care placements. The study uses a prospective, repeated measures design, incorporating quantitative and qualitative methodologies using personal face to face interviews and semi-structured questionnaires. Standardized measures, for which general population normative data are available, are used in the study, including the Achenbach Child Behaviour Checklist, Hare Self Esteem Scale, Interpersonal Parent and Peer Attachment Scale and Foster Care Alliance Scale.

The needs, challenges and achievements of 60 children and responses of caseworkers and carers to these were assessed at different stages of care. Data from personal interviews with children over 8 years and with respective foster and adoptive carers and caseworkers of all children in the sample highlight the complex interactions of personal and environmental dimensions of problems encountered. Outcomes in the spheres of education, emotional and behavioural development and family and social relationships will be highlighted in the paper. Overall findings from the study indicate that despite concerns related to placement stability, academic performance and emotional and social development, children in this sample displayed resilient outcomes in some domains such as family and social relationships and pro-social behaviours as they progressed over time in their care placements. Results from teachers' comparative assessments of the children in care and a comparison group lend support to the resilience literature that views the school environment and educational process as affording structure, boundaries and security to children in care systems and enhancing their wellbeing. The voices of children add an important dimension to the study bringing into the research their lived experiences and demonstrating their potential to contribute to policy and service development.

 Selected findings. Salient results relate to care history, foster family attachment and cohesion, birth family contact and children's self esteem.

• On average children have been in care for 8.2 years and have had an average of 4.4 placements.
• 75% of children indicated they got on very well with their foster mothers and 55% rated their relationship with the foster father similarly.
• 86% were positive about their relationship with their foster sibling.
• Higher cohesion scores were associated with positive feelings, outcomes and behaviours.
• Analyses of foster parent and peer attachment assessed through the Interpersonal Parent and Peer Attachment Scale (IPPA) at the third and sixth year in care indicated statistically significant changes in the positive direction on maternal attachment, trust and communication and overall peer attachment. (Table 1). Most encouragingly the strongest changes were observed for boys and older children who seemed to be catching up with girls and younger children.

Other significant correlations noted were: (Table 2)

• greater maternal trust and communication was associated with less conduct problems and lower peer,
• problem ratings,
• lower paternal trust and communication were associated with higher relationship problems with carers.
• Better foster father cohesion was associated with fewer conduct problems and fewer prosocial problems.
• The majority of respondents reported contact with birth mothers (90%) and birth fathers (58%) with 78% wanting more contact with birth fathers.
• Birth father contact was associated with fewer negative feelings and mood statements and increased relationship building skills.

Care history is related to negative feelings and behaviours:

• higher number of placement changes impact negatively on development of prosocial behaviours.
• peer self esteem was negatively correlated with total number of placements.
• Younger children and children who had less time in care had better self esteem scores.
• Girls remained stable in their self esteem scores over 3 waves of data collection, boys improved on their self esteem scores at the third wave.
• Those children who have been with their carer for three years have on average better academic adjustment and overall adjustment as assessed by caseworkers.

Tab.  1 - Changes in IPPA scores from Interview 2 to Interview 3 for all children

Tab. 2 - Correlations between IPPA Maternal attachment and LAC scores at Interview 3

Implications and recommendations. Intervention strategies to promote resilient out­comes and facilitate children's wellbeing in care will be discussed outlining implications for evidence based 'best practice' and directions for outcome-based research. The need of expanding the range of theory to underpin research in the field of child welfare will be explored. The importance of developing a sound theoretical and empirical foundation for improved practice in child welfare will also be canvassed. Methodological issues that are unique to the conduct of longitudinal research and the vulnerabilities of children and young people in the research process (Greig & Taylor, 1999) will be addressed.

Key references

Fernandez, E. (2007). Unravelling Emotional, Behavioural and Educational Outcomes in a Longitudinal Study of Children in Foster-Care. British Journal of Social Work (Advance Access published on April 18, 2007). (doi:10.1093/bjsw/bcm028).

Fernandez, E. (2007). How Children Experience Fostering Outcomes: Participatory Research with Children. Child and Family Social Work, 12(4), 349-359.

Gilligan, R. (2000). The importance of listening to children in foster care. In G. Kelly, & R. Gilligan (Eds.), Issues in Foster Care: Policy, Practice and Research (pp. 40-58). London: Jessica Kingsley.

Greig, A., & Taylor, J. (1999). Doing Research with Children. London: Sage.

Grodin, M.A. & Glantz, L.H. (1994). Children as research subjects: Science, Ethics and Law. Oxford: Oxford University Press.

Morrow, V. & Richardson, M. (1996). The ethics of social research with children: An overview. Children and Society, 10, 90-105.

Qvortrup, J. (1987). The Sociology of Childhood. International Journal of Sociology, 17(3).

Contacts: Elizabeth Fernandez, University of New South Wales, Australia, School of Social Sciences and International Studies University of New South Wales, Sydney 2052

E-mail: e.fernandez@unsw.edu.au, Phone 612 93851865, 612 96619467.