Sunday, July 8, 2007

The evidence is in

NCCPR long has argued that many children now trapped in foster care would be far better off if they had remained with their own families and those families had been given the right kinds of help.

Turns out that’s not quite right.

In fact, many children now trapped in foster care would be far better off if they remained with their own families even if those families got only the typical help (which tends to be little help, wrong help, or no help) commonly offered by child welfare agencies.

That’s the message from the largest study ever undertaken to compare the impact on children of foster care versus keeping comparably maltreated children with their own families. The study was the subject of a front-page story in USA Today. The full study is available here.

The study looks at outcomes for more than 15,000 children. It compares foster children not to the general population but to comparably maltreated children left in their own homes. The result: On measure after measure the children left in their own homes do better.

In fact, it’s not even close.

Children left in their own homes are far less likely to become pregnant as teenagers, far less likely to wind up in the juvenile justice system and far more likely to hold a job for at least three months than comparably maltreated children who were placed in foster care.


● The study examined cases in Illinois from 1990 through mid-2003. That means for most of the time, it was looking at the Illinois system before it reformed, when it was much like most of the rest of the country is today.

● The study uses the term “foster care” generically; it includes children placed in any form of substitute care. That’s important because whenever information like this comes out, people who want to warehouse children in orphanages try to use it to justify their schemes. But this study was not limited to family foster homes. And it takes three single-spaced pages just to list all the other studies documenting the harm of orphanages. (Those pages are available from NCCPR.)

● This does not mean that no child ever should be placed in foster care. But it means many fewer children should be placed in foster care.

The study excluded the most severe cases of maltreatment, a very small proportion of any child protective worker’s caseload, precisely because, horror stories that make the front page notwithstanding, these are cases where everyone with time to investigate would agree that removal from the home was the only alternative.

Rather, the study focused on, by far, the largest group of cases any worker sees, those that can best be called the “in-between cases” where the parent is neither all victim nor all villain; cases where there are real problems in the home, but wide disagreement over what should be done. As the study itself notes: “These are the cases most likely to be affected by policy changes that alter the threshold for placement.” They also, are, of course, the cases most likely to be affected by a foster-care panic – which also alters the threshold for placement.

Even among these cases, the figures are averages. Certainly there are some individual cases among the more than 15,000 studied in which foster care was the less harmful alternative. But what the data make clear is that foster care is vastly overused, damaging large numbers of children who would do better in life had they remained in their own homes, even with the minimal help most child welfare agencies offer to families.

This says less about how well child protection agencies do in helping families than it does about how enormously toxic a foster care intervention is. Anything that toxic must be used very sparingly and in very small doses.

● I expect that, from coast to coast, child welfare agencies will offer up a disingenuous response to this study along these lines: “Why yes, of course,” they’ll say. “This study just shows what we’ve always said ourselves: foster care only should be used as a last resort; of course we keep families together whenever possible.” But this study shows that agency actions belie their words. This study found thousands of children already in foster care who would have done better had child protection agencies not taken them away in the first place.

● The USA Today story quotes one deservedly well-respected expert as saying this is the first study to produce such results. But that is an error. Actually it’s at least the second in just the past year or so. A University of Minnesota study used a different methodology and measured different outcomes, but came to very similar conclusions. (Byron Egeland, et. al., “The impact of foster care on development” Development and Psychopathology, (Vol. 18, 2006, pp. 57–76)).

● Though the USA Today story says other “studies” go the other way, the one cited, with less than 1/100th the sample size of the new study, a shorter duration and at least one other serious flaw (omitting foster children in care for less than six months) is the only one we know of.

And of course that study also compared foster care only to typical “help” for families in their own homes, which generally is little or nothing. Providing the kinds of real help NCCPR recommends (See Eleven Ways to do Child Welfare Right) would likely change the result and, in the case of the two more recent and more rigorous studies, create an even wider gap in outcomes favoring keeping families together.

● Perhaps most intriguing, this study suggests it actually may be possible to quantify the harm of a foster-care panic, a huge, sudden upsurge in needless removals after the death of a child “known to the system” gets extensive news coverage.

Thanks to this study, we now have an estimate of how much worse foster children do on key outcomes compared with comparably maltreated children left in their own homes. It’s also usually possible to calculate how many more children are taken away during a foster-care panic. So it should be possible to estimate how many more children will wind up under arrest, how many more will become pregnant and how many more will be jobless as a result of a foster-care panic.

It also should be possible to estimate roughly how many children have been saved from these rotten outcomes in states and localities that have reformed their systems to emphasize safe, proven programs to keep families together.

This new study and the Minnesota study are in addition to the comprehensive study of foster care alumni showing that only one in five could be said to be doing well as a young adult – in other words, foster care churns out walking wounded four times out of five. (See NCCPR’s publication 80 Percent Failure for more on this study) and the mass of evidence showing that simply in terms of physical safety, real family preservation programs have a far better track record than foster care. (See NCCPR Issue Paper #1.)

The buzzword in child welfare lately is “evidence-based.” What that really means is: How dare proponents of any new, innovative approach to child welfare expect to get funding if they can’t dot every i and cross every t on evaluations proving the innovation’s efficacy beyond a shadow of a doubt? Old, non-innovative programs, however, are not held to this standard. If they were, child welfare would be turned upside down by the results of this new study.

Because now, more than ever, the evidence is in.