Why is it imperative to minimize children’s time away from family?

There is no substitute for family. Progress has been made over recent years in reducing the number of children placed in foster care, increasing the number of children placed with kin, and decreasing the number of children in group placement. However, the amount of time children spend separated from their families remains stubbornly high and has dire consequences for child well-being. The ramifications of time away from family are multifaceted and enduring, undermining the achievement of permanency and exacerbating the negative impacts of separation-induced trauma on the cognitive and emotional well-being of children.

Economic and concrete support, treatment services and parenting support, and other community-based interventions are effective approaches to preventing child welfare system involvement. But when families do become engaged with the child welfare system due to safety risks, it is critical to ensure they are minimally impacted by family separation. Once separated from their parents, children too often face unnecessary delays in returning home, and a growing body of research demonstrates the harm this inflicts on their growth and development. The struggle to achieve a timely return to family is a function of multiple challenges, including inadequate access to services for families, a lack of urgency among child protection agencies and family courts, and failure to connect children with extended family while in foster care.

Despite this complexity, there is reason for hope. With fewer children in foster care than ever before, now is the time to focus additional attention on what works best for children who are separated from their families to ensure they do not stay in foster care for one day longer than necessary. This issue brief: 1) summarizes evidence that reducing the amount of time children spend away from family is critical to their well-being; 2) identifies barriers that may be contributing to a lack of improvement on this issue; and 3) summarizes safe and effective family reunification strategies. For more detailed information on those strategies, see the companion brief: What strategies facilitate safe family reunification?

Current practice and policy

Well-functioning child protection agencies must effectively engage in prevention strategies while relentlessly pursuing permanency for all children in foster care. While the number of children in foster care is steadily decreasing, the experience of children separated from their families remains a concern. Of the almost 350,000 children in foster care in 2022, nearly one-third had been in care for two years or longer.¹ For Black and American Indian/Alaska Native children, the percentages were even higher, at 39% and 35% respectively. To a child, a few months or more away from family and community can feel like a lifetime, spanning key developmental stages that become compromised.

Since 1980, federal law has called for states to make reasonable efforts to safely prevent removal or reunify children with their parents. Reasonable efforts include services designed to help parents address the conditions that led to removal in the first place. The amount of services parents receive can impact timely reunification. The Indian Child Welfare Act’s higher standard of active, affirming, thorough, and timely efforts to keep families safely together or safely reunify separated families should be applied by all child welfare systems. In addition, the focus on legal permanency — defined as reunification, adoption, or guardianship — can obscure the importance of prioritizing relational permanency, defined as a strong connection to supportive adults.

During 2022, nearly 18,500 young people ages 21 and under exited foster care without the support of a permanent family, and the percentage of children aging out has remained stagnant for over a decade.²  Evidence is clear that young people who leave foster care without a family are less likely to go to college and more likely to be incarcerated and unemployed. Yet older youth in foster care all too often are assigned a permanency plan of Another Planned Permanent Living Arrangement (APPLA), suggesting that at some point, the system simply gives up on their prospects for returning home or thriving with extended family or other close family connections. The new SOUL Family permanency option is an innovation aimed at ensuring both relational and legal permanency as young people transition into adulthood.

Time with family is critical for child well-being

Research demonstrates the interrelationship between time with family and a wide range of developmental, mental health, physical health, and economic outcomes.

Separation from family places stress on the brain

Evidence suggests significant mental and physical health consequences associated with separation from family, specifically from one’s parents. This separation triggers the release of large quantities of cortisol, a stress hormone linked to a wide range of long-term adverse health outcomes including the long-term activation of the stress response system. Too much exposure to cortisol and other stress hormones can disrupt almost all the body’s functions. As a result, many people who experience chronic stress are at a higher risk of many health challenges, including but not limited to anxiety, depression, sleep problems, heart disease, impaired emotional regulation, and weight gain. For children who have experienced long periods away from their families, their stress often is characterized as both chronic and toxic, which occurs when strong, prolonged adverse experiences produce so much cortisol in the body that the brain’s circuits are significantly disrupted, resulting — in many cases — in cognitive delays that endure far past childhood.

Connection and consistency of caregiving matters

Advances in early brain development and trauma research have underscored the importance of a child having a consistent, nurturing caregiver, especially during the first five years of life. Developmental science characterizes early childhood as a sensitive period when emotional, cognitive, and social adaptive behaviors are formed based on interactions with adults and their material environment. It comes as no surprise that children removed from their family homes at a young age — especially those placed in group settings without strong parental presence — have been shown to exhibit dramatically decreased brain activity compared to children who did not experience removal.

Researchers have also found that Adverse Childhood Experiences (ACEs) — including time away from family due to placement in foster care — are linked to negative future economic outcomes. A comprehensive analysis of youth formerly in foster care reveals that they exhibit worse educational and employment outcomes than their counterparts never in foster care. They also encounter homelessness and the criminal justice system at higher rates than other youth. Without substantive reforms that prioritize preventing and minimizing child separation from family, child welfare system involvement will persist as a risk factor that deepens and perpetuates health, economic, and social inequities.

Increased time away decreases the likelihood of achieving permanency

Longer lengths of time in foster care are associated with heightened risk of not returning home or achieving other forms of permanency. Further, the length of time being separated from family is not only harmful in and of itself, but it also compounds with time. Evidence suggests that the longer children remain in foster care, the more likely they are to experience placement disruption. Multiple placement disruptions lead to social, emotional, and behavioral challenges for children, and diminish their prospects of being reunified with their family or finding another permanent placement.

Systemic barriers

Acknowledging and addressing the barriers to minimizing children’s time away from their family is critical to identifying the best strategies for improvement.

Inadequate services

The existing child welfare system is not designed to effectively identify or address the root causes of family separation. Research shows economic and material hardship (such as having insufficient resources to meet basic needs or experiencing housing instability) are some of the most consistent and significant predictors of child welfare involvement.³ Nearly 85% of families investigated by child protective services have annual incomes below 200% of the federal poverty line, which in 2024 is $51,640 a year for a family of three.⁴ Family conditions including but not limited to poverty, unmet behavioral health needs of children, and a lack of economic support contribute to child welfare system involvement and family separation.

Resource and practice barriers

Family court backlogs and waitlists for services can impact whether parents and children receive the support they need and in a timely fashion. A growing body of research finds that regular visits between parents and their children are associated with an increased likelihood of achieving timely permanency. Other studies suggest that delivering the right type of resources contributes to positive permanency outcomes, indicating that service quality matters as much as service access for families already involved in the system.⁵ Inadequate support to caregivers, especially kinship caregivers, contributes to stress and exacerbates the trauma that children in kinship placements will experience.

Failure to prioritize and maintain family connections

Where children land when placed outside of the home also matters. The benefits of placement with kinship caregivers are well understood. While more research is needed, evidence suggests that subsidized guardianship (GAP) also leads to improved permanency. An evaluation of a federal subsidized guardianship waiver demonstration project in Illinois (conducted before GAP became a federally funded option for all states) found that subsidized guardianship not only increased the percentage of children achieving permanency, it also sped up the rate of permanency, particularly for children ages 6 to 13. Group placement or placement in a foster home, on the other hand, can exacerbate the harmful impacts of disrupted family connections and contribute to challenges in attaining lasting permanency.

Lack of urgency and vision

Establishing an agency culture and philosophy of permanency as everyone’s responsibility can safely and effectively minimize the amount of time children spend away from their family. Creating a vision and sense of urgency around permanency requires ongoing messaging and prioritization by executive leadership and throughout the organization. It also requires demonstrating the tragic consequences when permanency is not treated as a priority — more young people aging out of foster care and transitioning into adulthood alone, without the family connections necessary to thrive.

What works

The persistent challenge of unnecessary and lengthy separation of children from families necessitates immediate attention and a comprehensive re-evaluation of contributing practices. Children thrive when they are connected to a stable family and feel that they belong.^6,7

Over the past three decades, research increasingly has demonstrated how to effectively achieve timely permanency.⁸ In situations where family separation is deemed necessary due to an imminent or existing safety concern, the following strategies are critical to minimizing the amount of time children spend away from family and thus reducing the harms of family separation:

• Prioritize placement with kin to increase the likelihood of achieving a permanent placement with family and decreasing the trauma and disruption of involvement with the child welfare system. Culturally competent active efforts, such as those required under the Indian Child Welfare Act, are models for all child protection agencies to adopt in regards to kinship placement.
• Assess and engage family members — including fathers and paternal relatives — at the outset of system involvement, and apply a careful, culturally informed focus on the key circumstances and areas of functioning that need to be addressed for children to return home safely. Strategies include: family finding; family group conferencing; motivational interviewing; safety mapping; and establishing quality relationships between parents and caregivers.
• Provide needed services to the family while a child is in foster care and regularly assess the family’s situation. Strategies include: family time; concurrent planning;⁹ in-home family reunification-focused programs such as Homebuilders, and KEEP SAFE; kinship navigators; parent partners; permanency roundtables;¹⁰ rapid permanency reviews; family-based residential substance use disorder treatment; and wraparound services.¹¹
• Connect families to post-permanency services to help stabilize children with their families so they do not re-enter foster care. Strategies include services to address family crises as they arise, such as Homebuilders, parent partners, and wrapround services.¹²  Treatment Foster Care Oregon is an innovative model worth consideration.
• Promote court practices designed to create a sense of urgency for safely returning children to family, including access to high-quality legal representation.

A renewed commitment to safe and timely permanency, carried out via evidence-based strategies, is essential for shaping a child welfare system that truly serves the best interests of children and families.

1 Data from the Adoption and Foster Care Analysis and Reporting System (AFCARS), made available by National Data Archive on Child Abuse and Neglect Data (NDACAN) and analyzed by Casey Family Programs.

2  AFCARS.

3 Hunter, A. A., & Flores, G. (2021). Social determinants of health and child maltreatment: A systematic review. Pediatric Research, 89, 269–274; Kim, H. & Drake, B. (2018). Child maltreatment risk as a function of poverty and race/ethnicity in the USA. International Journal of Epidemiology, 47, 780–787.

4 Dolan, M. (2011). National Survey of Child & Adolescent Well-Being II Baseline Report.

5 Flower, C. McDonald, J. &  Sumski, M. (2005). Review of turnover in Milwaukee County private agency child welfare ongoing case management staff. Milwaukee County Department of Social Services.

Fraser, M.W., Walton, E., Lewis, R.E., Pecora, P.J., & Walton, W.K. (1996). An experiment in family reunification: Correlates of outcome at one-year follow-up. Children and Youth Services Review, 18(4-5), 335-362.

Chaffin, M., Bard, D., Bigfoot, D. S., & Maher, E. (2012). Is a structured, manualized, evidence-based treatment protocol culturally competent and equivalently effective among American Indian parents in child welfare? Child Maltreatment, 17, 242-252. DOI: 10.1177/1077559512457239.

Walton, E. (1998). In-home family-focused reunification: A six-year follow-up of a successful experiment. Social Work Research, 22, 205-214.

6 Burge, P. (2020). Attempting to operationalize a multi-dimensional definition of permanency in child welfare practice: Results from a demonstration project. Journal of Public Child Welfare, DOI: 10.1080/15548732.2020.1835784.

7 de Finney, S. & di Tomasso, L. (2015). Creating Places of Belonging: Expanding Notions of Permanency with Indigenous Youth in Care. First Peoples Child & Family Review, 10(1), 63–85.

8 Pecora, P., Whittaker, J., Barth, R., Borja, S., & Vesneski, W. (2019). The child welfare challenge. (Fourth Edition.) New York City: Taylor and Francis, Chapters 5, 6, 8, and 10.

9 Katz, L. (1999) Concurrent planning: benefits and pitfalls. Special issue: Family Foster Care in the Next Century, 78, 71-87.

10 White, C., Corwin, T., Buher, A., O’Brien, K., DiLorenzo, P., & Kelly, S. (2015). The Multi-State Accelerated Permanency Project: Permanency Roundtables as a strategy to help older youth in foster care achieve legal permanency. Journal of Social Service Research, 41(3), 364-384.

11 Walker, J. & Bruns, E. (2006). The wraparound process: Individualized case planning and management for children and families. S. Rosenburg & J. Rosenburg (Eds.) Community Mental Health Reader: Current Perspectives. Routeledge.

12 Walker, J. & Bruns, E. (2006).