Fostering gains

The foster care system in the United States gets plenty of bad press. There’s room for optimism, though. Kids removed from their homes because of abuse or neglect display encouraging behavioral and emotional responses to two alternative foster care tactics, new studies find.

One strategy calls for children to live in the homes of responsible relatives. Another enrolls youngsters in a private foster care program that offers expanded services compared with public foster care.

“Children prefer to be placed with relatives, and the care of relatives may support better behavioral outcomes,” remarks social worker Richard Barth of the University of MarylandSchool of Social Work in Baltimore.

That’s what a team led by psychiatrist David Rubin of Children’s Hospital of Philadelphia found. Maltreated children placed into the families of relatives displayed fewer behavior problems three years after their placement than those placed with unrelated foster families did, Rubin and his colleagues report in the June Archives of Pediatrics & Adolescent Medicine.

Rubin’s group studied 1,309 children who were participating in a larger national survey of youth well-being conducted by other researchers that ran from October 1999 to March 2004. Half started in kinship care and 17 percent of those who started in foster care later switched to kinship care. Most youngsters ranged in age from 2 to 14. Kin and foster parents filled out extensive questionnaires on each child’s behavior at 18 months and 3 years after placement. Earlier research established that these questionnaire responses reflected children’s actual daily behavior patterns.

The researchers statistically controlled for each child’s behavior problems before placement, and also controlled for the length of placements and any reunification attempts with the birth family. The team estimates that, three years after initial placement, serious behavior problems appeared in 32 percent of those children assigned to kinship care from the start, in 39 percent of those who switched to kinship care and in 46 percent of those assigned to foster care.

Kin may be more willing to accept relatively untroubled, emotionally stable kids, partly accounting for the observed protective effect of kinship care, Barth notes.

High-quality foster care services also provide long-term benefits to teens removed from their families because of abuse or neglect, say sociologist Ronald Kessler of HarvardMedicalSchool in Boston and his colleagues.

They tracked 14- to 18-year-olds from one such service, Casey Family Programs in Oregon and Washington. Casey programs include intensive aid from caseworkers, additional funds for foster parents and job training or college scholarships for the children after high school.

Compared with 368 teens in public foster care programs, 111 youngsters in the Casey system displayed lower rates of major depression, anxiety disorders and substance abuse when interviewed one to 13 years after leaving foster care. Casey alumni also exhibited lower rates of diabetes, hypertension and heart disease.

The Casey program reduced, but did not entirely remove, the negative effects of child maltreatment, the researchers report in the June Archives of General Psychiatry. Anxiety disorders afflicted 29 percent of Casey alumni in the year before they were interviewed, compared with 43 percent of public program alumni and only 16 percent of all teens in a 2004 national survey of mental disorders.

Kids in the private program, who ranged in age from 14 to 18, spent an average of nearly 10 years in foster care, compared with about seven years for those in public programs. Casey alumni stayed in foster care for longer periods and suffered fewer instances of abuse or neglect in foster care.