Child Welfare
Children's Stability and Well-Being Study (CSAW): Opportunities for Reducing Placement Instability
Research Lead: David M. Rubin, M.D., M.S.C.E.
Study Team: Amanda O’Reilly, M.P.H., Catherine Zorc, M.D., M.S.H.P., Meredith Matone, M.H.S., Robin Hernandez-Mekonnen, M.S.W., Ph.D., Denise Actie, M.S.W., Sarah Zlotnik, M.S.W., M.S.P.H.
Sponsored By: William Penn Foundation, Stoneleigh Foundation, and National Institute of Child Health and Human Development
Dates: July 2006-June 2012
Background
According to national estimates, two-thirds of children who are in foster care for more than a year experience three or more placements. Placement instability is a risk factor for negative health, educational, and social-emotional outcomes. Little is known about factors that impact placement stability, and placement decisions that promote resiliency for children in out-of-home care. Federal legislation in the 2008 Fostering Connections to Success and Increasing Adoptions Act highlights the importance of placement stability through promoting educational stability and placement with kin.
Aims
1. To capture the impact of child welfare system characteristics on placement stability and child well-being through the rigorous collection of data on children in out-of-home care.
Objectives in partnership with the Philadelphia Department of Human Services:
•To quantify the effect of placement stability on child well-being
•To measure the impact of child welfare structural characteristics on placement stability
•To determine the significance of placement with siblings in out-of-home care and child well-being
•To describe the relationship between child well-being and a caregiver’s physical and mental health
2. To understand the educational experiences of children placed in out-of-home care in Philadelphia.
Objectives in partnership with the School District of Philadelphia:
•To quantify the prevalence of school absences, suspensions, and grade retention; the frequency of school changes and disruptive classroom behaviors
•To measure the temporal relationship between placement changes and school absences
Methods
Study Design: Longitudinal cohort study of children entering an out-of-home foster care placement. Children were followed during a 24-month period, and their demographic information, behavioral health, and school outcomes were evaluated through interviews with caregivers, caseworkers, and teachers. Interviews with caregivers and caseworkers were completed upon entry into care and every time a child changed placement, or every six months if no placement change occurred. Each child's teacher was also interviewed at the end of the 24 months.
Population: 407 children ages three to eight years who entered the Philadelphia child welfare system from 2006 to 2008. Education data was collected on a sub-group of 209 school-aged children ages five to eight years.
Progress
Data collection was completed on June 2010. A total of 1,565 caseworker interviews, 1,469 caregiver interviews, and 89% of teacher interviews were completed for the study cohort of 407 children.
Analysis is complete and one manuscript has been published (see below). Further manuscripts are forthcoming.
Related, the CSAW team completed a qualitative focus group study on cross-systems collaboration between child welfare and education. For more information, see its project page.
Policy Focus
• Identify important system-level interventions that promote placement stability.
• Identify barriers hindering access to behavioral health resources for children in foster and kinship care to reduce placement disruptions.
• Define uniform placement stability measures that can be applied at a national level.
Dissemination
Zorc CS, O'Reilly ALR, Matone M, Long J, Watts CL, Rubin D. The relationship of placement experience to school absenteeism and changing schools in young, school-aged children in foster care. Children and Youth Services Review. 2013;35(5):826-833. Read the 1-page brief.
Noonan K, Rubin D, Mekonnen R, Zlotnik S, O’Reilly A. Securing child safety, well-being, and permanency through placement stability in foster care. PolicyLab Fall 2009 Evidence to Action Brief.
Related Resources
Rubin DM, Noonan K. What do Romanian children living in orphanages manifesting repetitive
behaviors and American children in foster care with abnormal cortisol levels have in common?: More than you would think. Arch Pediatr Adolesc Med.2010;164:492-3.
Rubin DM, Downes KJ, O'Reilly A, Mekonnen R, Luan X, Localio AR. The impact of kinship
care on behavioral well-being for children in out-of-home care. Archives of Pediatrics & Adolescent Medicine. 2008;162(6):550-6.
Rubin DM, O'Reilly A, Luan X, Localio AR. The impact of placement stability on behavioral
problems for children in foster care. Pediatrics. 2007;119(2):336-44.
Rubin, DM, Alessandrini EA, Feudtner C, Mandell DS, Localio AR, Hadley TR. Mental health
costs and placement stability for children in foster care. Pediatrics. 2004;113(5):1336-41
