Long-Term Placement Trajectories of Children Who Were Maltreated and Entered the Child Welfare System at an Early Age: Consequences for Physical and Behavioral Well-Being

J Pediatr Psychol. Jan-Feb 2016;41(1):46-54. doi: 10.1093/jpepsy/jsv031. Epub 2015 Apr 1.


Objective: This study aimed to identify children's long-term placement trajectories following early child welfare involvement and the association of these trajectories with subsequent physical and behavioral well-being.

Method: Participants were 330 children who entered out-of-home care following a substantiated report of child abuse or neglect during infancy/early childhood and their caregivers. Participants were interviewed at child ages 4 and 12 years to assess children's physical and behavioral well-being and every 2 years in between to determine child placements.

Results: Latent Class Analyses identified four stable placement trajectories (i.e., adopted [32%], kinship care [15%], stable reunified [27%], and stable foster care [9%]), and two unstable trajectories (i.e., disrupted reunified [12%] and unstable foster care [5%]). Logistic regressions revealed that children in the unstable trajectories had significantly poorer physical and behavioral well-being than children in stable trajectories.

Conclusions and relevance: Maltreated children placed in out-of-home care are at risk for long-term placement instability and poorer physical and behavioral well-being.

Keywords: behavior problems; child maltreatment; child trauma; child welfare placement; foster care; physical well-being.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adoption*
  • California
  • Child
  • Child Abuse*
  • Child Behavior Disorders / etiology*
  • Child Health / statistics & numerical data*
  • Child Welfare / statistics & numerical data*
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Foster Home Care / statistics & numerical data*
  • Humans
  • Logistic Models
  • Male