Are the Average Effects of Foster Care Placement Really Close to Zero?

In their provocative article, Barth and colleagues interrogate existing research on a series of claims about the child welfare system. In this reply, we focus on just one of their conclusions: that foster care placement does little, on average, to cause the poor outcomes of children who are ever placed in care. Our argument proceeds in three stages. In the first, we dispute the claim that the average effects of foster care placement on children are “settled” in any scientific sense. In the second, we note that the lack of agreement about what constitutes the appropriate counterfactual makes the idea of average effects of foster care placement in this area problematic. In the third, we problematize the idea that near-zero average effects equate to unimportant effects by showing how different types of effect heterogeneity may lead us to think differently about how the system is working.

Adverse Childhood Experiences and Foster Care Placement Stability

OBJECTIVES To examine the impact of cumulative adverse childhood experiences (ACEs) on a child’s foster care placement stability in Kansas. METHODS Secondary data analysis was conducted by using a purposive cohort sample of 2998 children, from 6 to 18 years old, in Kansas’s foster care system between October 2015 and July 2019. Multivariate hierarchical logistic regression models were used to examine the influence of cumulative ACEs on a child's placement stability. ACEs were measured at foster care intake and self-reported by the child. Placement stability variables were obtained through the state administrative database. RESULTS Children in foster care with greater cumulative ACE exposure were significantly more likely to experience placement instability. Compared to children with 1 to 5 ACEs, when controlling for all other variables, children with ≥10 ACEs had an increased odds of experiencing placement instability by 31% (odds ratio: 1.31; P < .05); and children with 6 to 9 ACEs had a 52% (odds ratio: 1.52, P < .001) increased odds of experiencing placement instability. A child’s race, biological sex, age at episode start, and whether they had siblings in foster care all significantly influenced placement instability. CONCLUSIONS Findings from this study, in conjunction with previous research on ACEs and foster care, highlight the need to proactively address ACEs and trauma exposure at foster care entry.

Cumulative Prevalence of Confirmed Maltreatment and Foster Care Placement for US Children by Race/Ethnicity, 2011–2016

Objectives. To estimate the cumulative prevalence of confirmed child maltreatment and foster care placement for US children and changes in prevalence between 2011 and 2016. Methods. We used synthetic cohort life tables and data from the Adoption and Foster Care Analysis and Reporting System and the National Child Abuse and Neglect Data System and population counts from the Centers for Disease Control and Prevention. Results. US children’s cumulative prevalence of confirmed maltreatment remained stable between 2011 and 2016 at about 11.7% (95% confidence interval [CI] = 11.6%, 11.7%) of the population and increased by roughly 11% for foster care placement from 4.8% (95% CI = 4.8%, 4.8%) to 5.3% (95% CI = 5.3%, 5.4%). American Indian/Alaska Native children experienced the largest change, an 18.0% increase in confirmed maltreatment risk from 13.4% (95% CI = 13.1%, 13.6%) to 15.8% (95% CI = 15.6%, 16.1%) and a 21% increase in foster care placement risk from 9.4% (95% CI = 9.2%, 9.6%) to 11.4% (95% CI = 11.2%, 11.6%). Conclusions. Confirmed child maltreatment and foster care placement continued to be experienced at high rates in the United States in 2012 through 2016, with especially high risks for American Indian/Alaska Native children. Rates of foster care have increased, whereas rates of confirmed maltreatment have remained stable.