Patterns of change over time in children's out-of-home placement: associated risk factors and outcomes

• In Event: 1-110 - Evaluating the differential effects of multiple domains of violence and adversity exposure among youth

Integrative Statement

Introduction. Out-of-home placement (OOHP) is a traumatic experience for children with exposure to child abuse and neglect. Two lines of research converge for OOHP of children. The first line of inquiry focuses on risk factors for OOHP (e.g. parental factors and maltreatment exposure; English et al., 2015) and the other focuses on negative outcomes associated with OOHP (e.g. poorer mental health; Mennen, Brensilver, & Trickett, 2010). However, few studies have evaluated patterns of change over time in OOHP. Moreover, risk factors and child outcomes that may be associated with such patterns over time are not clearly understood. Both these gaps are addressed in the present research.

Methods. Data come from the National Survey of Child and Adolescent Wellbeing I, which includes a national sample of children in contact with Child Protective Services (CPS). Three waves of data (waves 1, 2, and 4) over a three-year period was used in the present research.
Child OOHP, type of maltreatment, parental incarceration, parental mental health, parental drug and alcohol use, and domestic violence were reported by the CPS caseworker at wave 1. Child report at wave 4 was used to assess adolescent trauma and depressive symptoms, as well aggressive and delinquent behaviors.
Latent transition analysis was conducted in Mplus 7.4 to evaluate patterns of change in OOHP over time. In Model 1 (multinomial regression), risk factors (predictors) that were more strongly linked to patterns of OOHP change over time (i.e. maltreatment type, parent substance and alcohol use, parent mental health and parent incarceration) were estimated. In model 2 (OLS regression), OOH patterns were used to assess problem behavior outcomes among youth.

Results. Results from the latent transition analysis indicate four patterns of change over time in children’s OOHP: Class 1: Continuous OOHP (n = 144), Class 2: OOHP at one wave (n = 89), Class 3: OOHP at two waves (n = 68), and Normative Class: no OOHP (n = 779).
Results from model 1 indicate that children in Classes 1, 2, and 3 were 5.50 times, 5.90 times and 11.29 times more likely to be sexually abused. Class 3 experienced 8.07 times more parental drug use and 3.60 times more parental incarceration. Similarly, Class 2 was exposed to more parental drug use (OR = 11.29) and emotional abuse (OR = 6.08).
Results from model 2 show that membership in Class 3 was associated with more depressive and trauma symptoms as well as more delinquent and aggressive behaviors. Class 1 membership was associated with more trauma symptoms and Class 2 membership was associated with more delinquency.

Conclusion. Sexual and emotional abuse, parental drug use and incarceration were risk factors associated with OOHP and greater exposure family-level risk factors were associated with more instability of placement over time. Additionally, Class 3 was most vulnerable in terms of negative outcomes. Findings highlight a need for prevention efforts targeting childhood trauma and family-level risk factors and improving outcomes among children with unstable placements following child abuse and neglect.

Authors

• Aura Ankita Mishra, Purdue University
  Presenting Author

• Sharon L. Christ, Purdue University
  Non-Presenting Author