Placement, duration and re-entry outcomes for children in foster care with disabilities.

BACKGROUND AND

OBJECTIVES

National, longitudinal studies exploring characteristics and outcomes of children in foster care (CFC) with disabilities are lacking. This study explores the prevalence, characteristics and relative risk of experiencing placement instability, staying in care for longer than 2 years, and returning to care within 3 years for CFC with a disability and by disability type.

PARTICIPANTS AND

SETTING

2.9 million unique participants within the U.S. Adoption and Foster Care Analysis and Reporting System (AFCARS) data who first entered care FY2005-FY2018.

METHODS

We created a longitudinal cohort using AFCARS data. Characteristics and outcomes were compared between children with and without disability and by disability types (emotional, intellectual, hearing/vision, physical, other).

RESULTS

CFC with all disability types, except physical, had higher risk of placement instability than those without disability, with CFC with emotional disability having the highest risk (RR: 2.86, 95 % CI: 2.82-2.91). CFC with each disability type had a higher risk of remaining in care for more than 2 years, with CFC with intellectual and visual/hearing disability having the highest relative risk (RR: 1.44, 95 % CI: 1.40-1.47 and RR: 1.39, 95 % CI: 1.36-1.41, respectively). After first exit from care, children with emotional disability had higher risk of returning to care within 3 years (RR: 1.24, 95 % CI: 1.22, 1.26).

CONCLUSIONS

Findings suggest that greater effort is needed from the child welfare and healthcare systems to recognize and address the health-related needs of this population, particularly CFC with an emotional disability, and to support their caregivers.