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

Thank you.Thank you.