Practice Profile: Kinship Care for Children Removed from Home for Maltreatment

Winokur, Holtan, and Batchelder (2014) conducted a meta-analysis to evaluate the effects of kinship care placement, compared with foster care placement, on the safety, permanency, and well-being of children removed from the home due to maltreatment. Their comprehensive search for studies of kinship care included a keyword search of online abstract and literature databases (such as MEDLINE, PsycINFO, ERIC) and hand searches of volumes of Child Abuse & Neglect, Children and Youth Services Review, Child Welfare, Research on Social Work Practice, and Families in Society: The Journal of Contemporary Social Services, from 2006 and 2007. In addition, they contacted several key authors of studies included in the review for knowledge of other studies not yet identified. The authors also screened the reference lists of published literature reviews for relevant studies.

Literature included in the meta-analysis was current through March 2011. Only the studies that met the following criteria were included: 1) controlled experimental and quasi-experimental studies, in which children placed in kinship care were compared cross-sectionally or longitudinally with children placed in foster care (studies that compared kinship care with more restrictive out-of-home settings (e.g., residential facilities) were not considered for this review); 2) children and youth under the age of 18 who were removed from the home because of abuse, neglect, or other maltreatment, and subsequently placed in kinship care; 3) formal kinship care placements, regardless of whether the kin caregivers were licensed or unlicensed (studies that exclusively examined informal or private kinship care arrangements were not considered); and 4) studies that analyzed child welfare outcomes in the well-being, permanency, or safety domains. Primary outcomes for the review were behavior and adaptive problems, well-being, number of placements, reunification, attachment, and institutional abuse. Appropriate measures of behavior problems, adaptive problems, well-being, and attachment included case records, caregiver reports, teacher reports, self-reports, and standardized instruments. Appropriate measures of the number of placements, reunification, and institutional abuse included child welfare administrative databases.

A total of 102 studies were identified and included in a qualitative synthesis. All but 13 of the studies were conducted in the United States. Of the international studies, four studies were conducted in Australia, two in Spain, two in the Netherlands, and one in each of the following countries: Ireland, Israel, Norway, Sweden, and the United Kingdom. Only 87 of the 102 studies reported data on participant characteristics. The average age at placement for children in both the treatment and control groups was 4 years and 10 months. On average, the study samples were 52 percent female. Of the samples, 45 percent of the children were Black, 22 percent were Hispanic, and the race/ethnicity of the other children was not reported. Sixty percent of the children were removed for neglect; however, it was not reported why the other 40 percent were removed from the home. Eighty percent of the children lived in urban settings, 13 percent lived in rural settings, and the settings for the other 7 percent were not reported. The average length of placement for the treatment group in kinship care was 36 months, and the average length of placement for children in foster care was 34 months.

Of the 102 studies included in the qualitative synthesis, only 71 studies were included in the meta-analysis. Standardized mean differences and odd ratios were calculated to measure program effects between the treatment and control groups. Using a 95-percent confidence interval, mean effect sizes were calculated for all eligible studies.