Children and youth in out-of-home care: What can predict an initial change in placement?

Merav Jedwab, Yanfeng Xu, Daniel Keyser, Terry V. Shaw - Child Abuse & Neglect



A significant proportion of children placed in out of-home care experience placement disruptions in the United States. Placement instability has deleterious effects on children’s well-being.


(a) To measure the time-to-initial placement change in different types of settings, including non-relative foster homes, kinship care, residential treatment centers (RTC), group homes and other types of settings; and (b) To identify predictors of the initial placement change.

Participants and setting

Data were obtained from the State Automated Child Welfare Information Systemoperated by the child welfare agency in a Mid-Atlantic state. The sample included 4177 children who entered into the foster care and were followed over three years.


Descriptive, bivariate, and survival Cox regression models were conducted.


More than half (53%) of the children had experienced placement change within 3 years. The mean length for an initial change in placement was longer for children in RTC and kinship care compared to children in foster and group homes, and other placements (χ2 = 322.31, p < 0.001). Several factors significantly increased the likelihood of an initial change, including: older children (p < 0.001, HR = 1.01), children with behavioral problems (p < 0.001, HR = 1.26), parental substance abuse (p < 0.05, HR = 1.12), and cases in which the parents voluntarily gave up their parental rights (p < 0.05, HR = 1.12). The type of placement also increased the risk for placement change.


Providing early interventions and services to these children and their families is essential to increase placement stability.