Predictors of Foster Care Exits to Permanency: A Competing Risks Analysis of Reunification, Guardianship, and Adoption

Abstract

Nearly 800,000 children spend time in foster care each year, with many children experiencing lengthy stays and exiting without a permanent family. The main objective of this study was to identify which child and placement characteristics were significant predictors of foster care exit to three types of permanency: reunification, guardianship, and adoption. A nonexperimental longitudinal design was used to observe an annual entry cohort of 3,351 children who entered Kansas foster care in state fiscal year 2006. The sample was observed for 30 to 42 months. Data sources were two state administrative databases, one which tracks all children in foster care and one on mental health services. The primary data analysis was competing risks survival analysis. Study findings showed that children in foster care exit to different types of permanency at different rates. Reunification occurs the most quickly, followed by guardianship, and then adoption. While patterns of predictors varied by type of permanency, three major categories of important permanency predictors were identified: 1) demographic characteristics of age at entry and race, 2) clinical needs related to child disabilities and mental health problems, and 3) continuity and connections represented by kin placements, sibling placements, early stability, and absence of runaway events. Implications suggested that social work practice be age-differentiated and culturally appropriate, and that children's needs related to disabilities and mental health problems be addressed with thorough assessment and evidence-based services. Social work practices should also strive to keep children connected to family and in stable placements. The major social work theory implication suggested that permanency theory balance the primordial solidarities principle that stresses family connections with the bureaucratic institutions principle that emphasizes structures for ensuring stability. In addition, this study's findings indicated the need to improve and expand timely permanency for more children. Policy implications included: using guardianship as a viable permanency option for more children; revising federal policy to promote the discovery and implementation of new, creative approaches to permanency; and, reforming the current financing structure to be more flexible and better aligned with the promotion of permanency outcomes.