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Paper

The development of problem behaviour in foster children: A Flemish longitudinal research

abstract

Aim. When children cannot grow up in their own family because their safety cannot be warranted (e.g. due to abuse), an out-of-home placement may be required. Due to prior experiences of trauma and abuse, many children in care, family foster homes as well as residential care, have behavioural problems. A placement in family foster care is expected to reduce problem behaviour and to promote prosocial behaviour. However, in most studies behavioural problems increase or remain stable during the family foster placement (Nilsen 2007; Van Holen, Vanderfaeillie, & Trogh 2007; Van Oijen 2010).

The development of behavioural problems in children is determined by multiple factors. In foster children, a distinction can be made between several groups of influencing factors that can be ordered according to the level of proximity to the foster child's everyday experience. Following factors can be distinguished: contextual factors (e.g. socio-economical situation of the foster family), placement-related factors (e.g. number of previous placements, length of placement, kind of placement and referrer), distal family factors (e.g. family stress), proximal family factors (e.g. parenting) and child factors (e.g. gender, age and problem behaviour).

Insight in factors promoting a reduction or an increase of behavioural problems in foster children is limited. The aim of this study is to investigate at an individual level how problem behaviour of foster children developed longitudinally. Associations of an increase or decrease of behavioural problems with contextual (education level of foster mother), placement-related (number of previous placements, length of placement, kind of placement and referrer), family (parenting stress and parenting behaviour) and child factors (gender, age and problem behaviour at the start of the study) were also examined.

Methods. The development of behavioural problems of 49 foster children over a two year period and the association with contextual, placement-related, family and child factors were examined. At the first data wave collection all children were aged six to twelve years and had lived at least six months in the foster family. Data were gathered on both data wave collections with questionnaires (Cbcl, Ghent Parental Behaviour Scale and Nijmegen Questionnaire for the Parenting Situation) filled out by the foster mothers.

The development of problem behaviour in each child was examined by calculating a Reliable Change Index (Rci) for the Cbcl Total Problem score. The Rci is a measure that can be used to determine if a change is statistically significant or due to chance. A Rci is the difference between the raw scores obtained at T0 and those obtained at T1 divided by the standard of error of the difference. It is accepted to consider a Rci greater than 1.64 or smaller than -1.64 as statistically significant (Van Yperen & Veerman 2008).

However, statistically significant changes are not always clinically relevant. To determine whether statistically significant changes were clinically relevant, the Cbcl T-scores were used. A significantly and clinically relevant change is a Rci score greater than 1.64 or smaller than -1.64 where respectively a transition from a deviant score (T-score ≥ 60) to a normal score (T-score < 60) or vice versa was made.

The association of child variables (age, gender and problem behaviour T0), family factors (parenting behaviour of foster mother and family stress), placement-related factors (number of previous placements, length of placement, kind of placement - kinship versus non-kinship placement - and referrer - juvenile court versus Committee of Special Youth Care), and contextual factors (educational level foster mother) with a significant increase or decrease in problem behaviour at case level were examined using Mann-Whitney U and Fisher exact tests. In a first series of analyses, the categories of the dependent variable were an increase in problem behaviour (Rci < -1.64) versus a decrease and stabilization in problem behaviour (Rci ≥ -1.64). In a second series of analyses, the categories were a decrease in problem behaviour (Rci > 1.64) versus an increase and stabilization in problem behaviour (Rci ≤ 1.64). The strength of the associations is expressed with an effect size r. An r smaller than .10 is trivial, between .10 and .30 small, between .30 and .50 moderate, and greater than .50, large.

Findings. Over a two year period 18 foster children had more, 23 just as much and 8 less problem behaviour. Of the 8 foster children who showed improvement, no one made clinically relevant progress. If we only take into consideration foster children whose behaviour deteriorated, 8 had more behavioural problems after two years.

An increase in problem behaviour was associated only with family factors. No child, placement-related or contextual factor was associated with an increase. Positive parenting (U = 180.50, p< .05, r = .29) was negatively and the factors discipline (U = 179.00, p < .05, r = .30), harsh punishment (U = 115.50, p < .001, r= .64) and negative control (U = 133.00, p< .01, r = .43) were positively associated with an increase in problem behaviour. Parenting stress was also positively related to the development of problem behaviour (U = 139.00, p < .01, r = .42).

A decrease of problem behaviour was weakly related to the use of supportive parenting (U = 83.00, p < .05, r = .31) and to the absence of parenting stress (U = 86.00, p < .05, r = .30). Again no child, placement-related or contextual factor was associated with a decrease.

Conclusions. Foster care aims at offering support to the foster child and his/her parents. Boosting the development of the foster child - including a reduction in problem behaviour - is often a target. However, in accordance with the literature, an increase in problem behaviour in foster children was more common than a decrease. The expectation that behavioural problems of foster children decrease or continue to decrease during a foster care placement is not justified. Even high-quality substitute parenting may not easily produce substantial change (Biehal, Ellison, Baker, & Sinclair 2010). In addition, mainly evidence of the importance of parenting behaviour and parenting stress for an increase or decrease of problem behaviour was found. The effect sizes suggest that negative parenting strategies have a greater influence than supportive parenting. Support of foster parents aiming at reducing the use of negative discipline practices and promoting the use of supportive parenting may have a positive effect on the development of foster children and the effectiveness of family foster care.

Key references

Biehal, N., Ellison, S., Baker, C., & Sinclair, I. (2010). Belonging and permanence. Outcomes in long-term foster care and adoption. London: BAAF.

Nilsen, W. (2007). Fostering futures: a preventive intervention program for school-age children in foster care. Clinical Child Psychology and Psychiatry, 12, 45-63.

Van Holen, F., Vanderfaeillie, J., & Trogh, L. (2007). Longitudinaal onderzoek naar gezinsbelasting en gedrags- en emotionele problemen in pleegzorg. Tijdschrift voor Orthopedagogiek, 46, 233-242.

Van Oijen, S. (2010). Resultaat van pleegzorgplaatsingen. Een onderzoek naar breakdown en de ontwikkeling van adolescente pleegkinderen bij langdurige pleegzorgplaatsingen. (Dissertation), Rijksuniversiteit Groningen, Groningen.

Van Yperen, T., & Veerman, J. W. (2008). Zicht op effectiviteit. Handboek voor praktijkgestuurd effectonderzoek in de jeugdzorg. Delft: Eburon.

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