What impacts placement stability?

When children are removed from their families and placed in foster care, child protective services has a duty to ensure that they are placed in stable and nurturing homes with caregivers well equipped to address a range of needs and behaviors. Effective placement decisions reflect the following commitment: first placement, best placement, family placement, only placement. This brief is the first part of a series on placement instability. It explores the importance of placement stability and the challenges that prevent it.

Why does placement stability matter?

Across the country, placement stability continues to be a challenge for most child protection agencies: less than 40 percent of states are able to achieve the goal of two or fewer placement settings for children in care.1

Placement instability has a negative impact on all three goals of the child protection agency: safety, permanency, and well-being. Safety is impacted when a child is maltreated in a resource home and must be moved; permanency is delayed when a child experiences multiple placements; and well-being is affected in multiple ways, including poorer educational outcomes as a result of changing schools, and increased behavioral and mental health issues.2 Child development research tells us that children need consistency, predictability, and attachment to a caring adult to thrive. This is especially true for children in foster care, who have experienced trauma leading up to and including removal from their home and community. Children in out-of-home care need stable adult connections to support their well-being. These secure attachments can best be assured in stable placements that help young people transition in and out of care and into permanency without delay.

Children’s behavioral challenges are often cited among the main reasons for placement disruption. Children in care have generally experienced trauma before the initial removal, and then they experience subsequent traumas as a result of being separated from their families. Even children without externalizing behavioral problems in their first placement are likely to develop behavioral challenges if they are moved, given the additional trauma that accompanies increased numbers of placements.3 One study, which controlled for children’s behaviors at entry into foster care, found that children with multiple placements had between 36 and 63 percent greater risk of developing behavioral challenges than did children in stable placements.4 Multiple placements have also been found to lead to delayed permanency outcomes, academic difficulties, and struggles to develop meaningful attachments.5

What do the data tell us?

Children experience more placements the longer they linger in foster care. According to the Child Welfare Outcomes 2010–2014 Report to Congress, the majority of children in foster care for less than 12 months experience no more than two placements.6 While that is still one placement too many, this proportion decreases significantly for those children who remain in care 24 months and beyond:

The converse is also true: placement instability also impacts a child’s chances for permanency through reunification, adoption, or guardianship.7 For example, a landmark study in Illinois revealed that the likelihood of reunification is impacted by placement moves, such that:8

  • One-third of children in foster care reunite with their parents after the first placement;
  • Only 13 percent reunite after their second placement; and
  • A mere 5 percent reunite after the third placement.

When we make the monumental decision to intervene and remove a child from their home, we have a responsibility to ensure that we’ve placed them in a safe, stable, and healing environment, and that they are better off in this new setting than they would have been had they remained with their family of origin.

– DAVID SANDERS, Casey Family Programs

What factors are associated with placement instability?

Research has identified a range of individual child characteristics, placement elements, foster parent characteristics, and organizational factors that are associated with placement instability.9

Individual child characteristics

Children who are removed as a result of sexual or physical abuse are more likely to experience placement instability than children who are removed due to neglect.10 Older youth have elevated risks of placement instability.11 While research varies about whether youths’ behavioral and mental health needs lead to multiple placements or vice versa, data suggest increasing difficulty in maintaining stable placements as children grow older.12

Children with clinical diagnoses of emotional disturbance generally experience greater placement instability than their peers, and children with behavioral or physical health challenges or additional medical diagnoses are even more likely to be moved.13 One study found that a child with a diagnosed emotional disorder is three times more likely to have three or more placements than a child without a diagnosis.14

Placement characteristics

Initial placement type is also a critical factor in achieving placement stability. Children initially placed with relatives are the least likely to experience placement changes, while children first placed in congregate care experience a higher average number of moves.

Placement moves may also be influenced by the number of children living in a resource home: evidence suggests that placement instability is twice as likely for children living in homes with three or more other children in care.16

Resource family characteristics

Foster parent empathy and tolerance have been noted as predictors of placement stability. For example, foster families who assist children placed in their homes in adapting to their new environment experience greater placement stability than foster parents who expect children to adapt naturally on their own.17 Likewise, resource families that have a solid network of social support are likely to have fewer placement disruptions.18 On the other hand, 10 percent of placement changes occur because of emerging concerns about the resource parents (e.g., abuse allegations), which underscores the importance of careful screening and assessment of potential resource homes.19

Organizational factors

Caseworker turnover has also been linked with instability.20 Turnover during critical junctures in a child’s placement may result in resource parents losing the support they need to maintain a placement, as well as escalation of a child’s behaviors. The depth of a caseworker’s cultural competency and understanding of children’s needs may also be contributing factors to placement stability.21

1 Jones, A. S., Rittner, B., & Affronti, M. (2016). Foster parent strategies to support the functional adaptation of foster youth. Journal of Public Child Welfare, 10:3, 255-273, p. 255
2 Center for Advanced Studies in Child Welfare. (2010).
3 Jones, A. S. & Wells, S. J. (2008). PATH/Wisconsin-Bremer Project: Preventing placement disruptions in foster care. Final report. Retrieved from https://cascw.umn.edu/portfolio-items/path-bremer-placement-disruption-pub/
Arkansas Advocates for Children and Families. (2015). Increasing placement stability in foster care. Retrieved from http://www.aradvocates.org/wp-content/uploads/Increasing-Placement-Stability-in-Foster-Care.pdf
4 Rubin, D. M., O’Reilly, A. L., Luan, X., & Localio, A. R. (2007). The impact of placement stability on behavioral well-being for children in foster care. Pediatrics, 119(2), 336-344, para. 3.
5 Rutter, M., & Sroufe, L. A. (2000). Developmental psychopathology: Concepts and challenges. Development and Psychopathology, 12(3), 265-296. Retrieved from https://pdfs.semanticscholar.org/f8ef/fc8dae0f0d9f051ddab79d4091d1d32694cf.pdf
Goerge, R. M. (1990). The reunification process in substitute care. Social Service Review, 64(3), 422-457.
6 U.S. Department of Health and Human Services, Children’s Bureau. (2015). Child welfare outcomes 2010–2014. Retrieved from https://www.acf.hhs.gov/cb/resource/cwo-10-14, p. 50
7 Connell, C.M., Vanderploeg, J.J., Flaspohler, P., Katz, K.H., Saunders, L., & Tebes, J.K. (2006). Changes in placement among children in foster care: A longitudinal study of child and case influences. Social Services Review, 80(3), 398-418. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4204626/
8 Goerge (1990).
9 Carnochan, S., Moore, M., & Austin, MJ. (2013).
10 Webster, D., Barth, R. P., & Needell, B. (2000). Placement stability for children in out-of-home care: A longitudinal analysis. Child Welfare, 79, 614-632.
11 Child and Family Research Center, School of Social Work, University of Illinois at Urbana-Champaign.  (2004). Multiple placements in foster care: Literature review of correlates and predictors. Retrieved from https://cfrc.illinois.edu/pubs/lr_20040201_MultiplePlacementsInFosterCare.pdf
Wedeles, J. (2016). Placement stability in child welfare. Retrieved from http://www.oacas.org/wp-content/uploads/2016/08/PARTicle-Placement-Stability-in-Child-Welfare-FINAL.pdf
12 University of California-Davis, Extension, The Center for Human Services. (2008). A literature review of placement stability in child welfare services: Issues, concerns, outcomes and future directions. Retrieved from http://www.childsworld.ca.gov/res/pdf/PlacementStability.pdf
13 Wedeles, J. (2016)
14 Courtney, J. R. & Prophet, R. (2011). Predictors of placement stability at the state level: The use of logistic regression to inform practice. Child Welfare, 90(2): 127-142, p. 136
15 Wulczyn, F., Chen, L., & Hislop, K. B. (2007). Foster care dynamics, 2000-2005: A report from the multistate foster care data archive. Retrieved from https://fcda.chapinhall.org/wp-content/uploads/2013/10/Foster-Care-Dynamics-2000-2005.pdf, p. 30
16 Noonan, K., Mekonnen, R., Zlotnick, S., & O’Reilly, A. (2009). Securing child safety, well-being, and permanency through placement stability in foster care. Evidence to Action, 1, 1–12. Retrieved from https://policylab.chop.edu/evidence-action-brief/securing-child-safety-well-being-and-permanency-through-placement-stability, p. 4
17 Butler, S., & Charles, M. (1999). The past, the present, but never the future: Thematic representations of fostering disruption. Child and Family Social Work, 4, 9-20
18 Child and Family Research Center, School of Social Work, University of Illinois at Urbana-Champaign. (2004), p. 5
19 James, S. (2004). Why do foster care placements disrupt? An investigation of reasons for placement change in foster care. Social Service Review, 78(4): 601-627. Retrieved from http://www.ocfcpacourts.us/assets/files/list-772/file-997.pdf,  p. 620
20 Ryan, J. P., Garnier, P., Zyphur, M., & Zhai, F. (2006). Investigating the effects of caseworker characteristics in child welfare. Children and Youth Services Review, 28(9), 993-1006.
21 Pelech, W., Badry, D. & D’Aoust, G. (2013). It takes a team: Improving placement stability among children and youth with Fetal Alcohol Spectrum Disorder in care in Canada. Children and Youth Services Review, 35, 120-127. https://doi.org/10.1016/j.childyouth.2012.10.011

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