We know that children in foster care have experienced adverse events including trauma, violence, and neglect. Removing a child from their parents is a traumatic event itself and it is well recognized that placement changes while in foster care also compound the trauma to children.1 In fact, states are required to report placement stability to the Department of Health and Human Services.
In this month’s Pediatrics, Liming et al (10.1542/peds.2021-052700) evaluated a cohort of over 3,000 children in foster care in Kansas. Over 40% of the children in their sample experience placement instability (defined 3 or greater placements per year). They were more likely to have placement instability if they were males, older in age, and non-White. These data are similar to prior studies1 and further support the concerns for systemic racism in our child welfare system.
Liming et al took the work one step further and compared placement stability to exposure to 19 recognized adverse childhood experiences (ACEs). 37.5% of the children in the cohort had greater than 10 ACEs and these children were 1.31 times more likely to have placement instability.
While these results are not unexpected, they can serve to support further interventions and supports for our children in foster care. If we can use demographics and ACEs to identify children who are more at risk for placement disruptions, can we then put more supports into place for those families? Can foster families be given more education or resources to reduce placement disruptions? Can we prioritize higher risk children for behavioral health care?
Research such as this can help the system provide better, trauma-informed care for our most vulnerable children and families and may serve to improve outcomes and reduce trauma for these children.
- Konijn C, Admiraal S, Baart J, et al. Foster care placement instability: A meta-analytic review. Children and Youth Services Review. 2019; 96:483-499.