Adverse Childhood Experiences and Foster Care Placement Stability

Pediatrics. 2021 Dec 1;148(6):e2021052700. doi: 10.1542/peds.2021-052700.

Abstract

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.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adverse Childhood Experiences / ethnology
  • Adverse Childhood Experiences / statistics & numerical data*
  • Age Factors
  • Child
  • Child, Preschool
  • Data Analysis
  • Exposure to Violence
  • Female
  • Foster Home Care / standards*
  • Humans
  • Infant
  • Kansas
  • Logistic Models
  • Male
  • Odds Ratio
  • Sex Factors
  • Siblings