The impact of placement stability on behavioral well-being for children in foster care
The impact of placement stability on behavioral well-being for children in foster care
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DOI：
10.1542/peds.2006-1995
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发表时间：
2007-02-01
期刊：
影响因子：
8
通讯作者：
Localio, A. Russell
中科院分区：
文献类型：
--
作者：
Rubin, David M.;O'Reilly, Amanda L. R.;Localio, A. Russell
OBJECTIVE.儿童在进入寄养家庭时遇到的问题可能解释了先前的研究结果，即频繁的安置变化与不良结果有关。本研究试图解开这种级联关系，以确定独立的影响，安置稳定性的行为结果下游。设计/方法。来自全国儿童和青少年健康调查的729名儿童在家庭外护理的前18个月的安置稳定性被分类为早期稳定性（45天内稳定安置），晚期稳定性（45天以上稳定安置）或不稳定（从未实现稳定）。根据基线属性预测安置不稳定性的倾向分数被分为风险类别，并添加到逻辑回归模型中，使用儿童行为检查表和全国青年纵向调查的气质分数来检查安置稳定性和行为幸福感之间的独立关联。一半（52%）的儿童实现了早期稳定，19%实现了后期稳定，28%仍然不稳定。早期稳定剂更有可能是年轻的，有正常的基线行为，没有儿童福利史，亲生父母没有精神健康问题。在考虑基线属性后，稳定性仍然是18个月时幸福的重要预测因素。不稳定的儿童比那些在各种不稳定风险水平上早期达到稳定的儿童更容易出现行为问题。在低风险儿童中，早期稳定儿童行为问题的概率为22%，而不稳定儿童为36%，仅由于不稳定，行为问题增加了63%。寄养儿童经历的安置不稳定与他们的基线问题无关，这种不稳定对他们的行为健康有重大影响。这一发现将支持制定干预措施，促进安置稳定性，作为改善进入护理的青年结果的一种手段。
OBJECTIVE. The problems children have upon entering foster care can potentially explain prior research findings that frequent placement changes are associated with poor outcomes. This study sought to disentangle this cascading relationship in order to identify the independent impact of placement stability on behavioral outcomes downstream.DESIGN/METHODS. Placement stability over the first 18 months in out-of-home care for 729 children from the National Survey of Child and Adolescent Well-being was categorized as early stability ( stable placement within 45 days), late stability ( stable placement beyond 45 days), or unstable ( never achieving stability). Propensity scores predicting placement instability based on baseline attributes were divided into risk categories and added to a logistic regression model to examine the independent association between placement stability and behavioral well-being using the Child Behavior Checklist and temperament scores from the National Longitudinal Survey of Youth.RESULTS. Half (52%) of the children achieved early stability, 19% achieved later stability, and 28% remained unstable. Early stabilizers were more likely to be young, have normal baseline behavior, have no prior history with child welfare, and have birth parents without mental health problems. After accounting for baseline attributes, stability remained an important predictor of well-being at 18 months. Unstable children were more likely to have behavior problems than children who achieved early stability across every level of risk for instability. Among low-risk children, the probability of behavioral problems among early stabilizers was 22%, compared to 36% among unstable children, showing a 63% increase in behavior problems due to instability alone.CONCLUSIONS. Children in foster care experience placement instability unrelated to their baseline problems, and this instability has a significant impact on their behavioral well-being. This finding would support the development of interventions that promote placement stability as a means to improve outcomes among youth entering care.