NACAC worked with Generations United and the National Foster Parent Association as the Advocates for Families First collaboration to create a united voice for advocates of children in kinship, foster, and adoptive families that informs, educates, and inspires the public and policymakers about the needs of families and better ways to connect them with state and local services near their homes.
We are committed to building a unified, cohesive, and sustainable national advocacy effort in support of kinship, foster, and adoptive families who care for children and youth, promote their healing, and help them thrive.
With this messaging memo, we hope to help organizations and individuals supporting children in kinship care, foster care, and adoption advocate for family placements when children cannot remain with their first family. The goal is to provide advocates with information and suggestions they can use to develop op-eds and commentaries, advocate for supported, family-based placements, and respond to articles suggesting that children can’t grow up in a family. Be sure to read our Communication Tips fact sheet as well. (Much of the research presented here was gathered from The Annie E. Casey Foundation’s 2015 policy report, Every Kid Needs a Family: Giving Children in the Child Welfare System the Best Chance for Success.)
Below we outline key messages, sample talking points, and — when available — relevant research. Our key messages are:
- Every child and youth has a right to have a lifelong family.
- We all want what’s best for children. Children and youth do best in a family.
- Family placements result in permanency for children.
- Too many children are placed in group care instead of families.
- Children who have experienced trauma face challenges, but their families can be successful when they have support.
- Placing children and youth in families saves government and other funds.
- Federal law requires that children be placed into families whenever possible.
- One of the most fundamental rights a person can have is to have a family. Children want — and deserve — a mom, dad, grandparent, or other relative who will love them, care for them, tend to their hurts, go to events and meetings at school, celebrate their successes, and otherwise take care of them.
- Children can age out of foster care or the child welfare system. Kids never age out of a family.
- Children and youth of all ages fare better in families than they do in group care. We owe it to children and youth to provide them with their best opportunity to thrive.
- Studies have shown that family care is safer for children than group care.
- Group placements often separate brothers and sisters, force children to change schools, and break connections children have with friends and communities.
- Families provide a level of commitment and connection that staff in group care can never accomplish, no matter how skilled they are.
- Even a child with a history of abuse or neglect who has not formed secure attachments with her birth parents can develop them with relatives, close family friends, or caring foster or adoptive parents. A family provides a safe launching pad for youth to engage in the larger community and develop life skills in ways that group care cannot. Young adults can turn to their families for help when times get tough.
- Children report overwhelmingly positive experiences with the foster parents who care for them. More than 90 percent “like who they are living with” and “feel like part of the family.” Rates of positive experiences are highest for children who live with kin and lowest for children who experience group placement.[i]
- Children in group care are four times more likely than those in non-kin foster homes and 10 times more likely than those in kinship care to report that they do not like the people with whom they are living.[ii]
- In his comprehensive review of research on family-based foster care and institutional care, Richard Barth concludes “…there is virtually no evidence to indicate that group care enhances the accomplishment of any of the goals of child welfare services: it is not more safe or better at promoting development, it is not more stable, it does not achieve better long-term outcomes, and it is not more efficient as the cost is far in excess of other forms of care.”[iii]
- Research shows that children who live in a family while in the child welfare system are better prepared to thrive in a permanent home, whether that involves a return to their birth parents, permanent placement with kin, or adoption.[iv]
- When children grow up without the protective effects of a loving family, research shows there is harm.[v] A 2008 study found youth in group placements were more than twice as likely to be arrested compared with similar youth living with foster families.[vi]
- Leading experts have concluded children raised in institutional settings are at high risk of developing clinical attachment disorders.[vii]
- In the long-term, children who spent time in institutional care stand a greater chance of becoming psychologically impaired and economically unproductive adults.[viii]
- Children who are denied the opportunity to form a consistent relationship with a caregiver in their childhood years are at serious risk for developmental problems and long-term personality disorders.
- Children who were adopted or who are in foster families experienced more intimate, consistent, caring, and closer attachments to their caregivers compared to those who grew up in residential establishments. Only one in every eight children raised in residential care expressed any real enthusiasm for the quality of care and attachments they experienced with house parents.[x]
- Placing children who have already been traumatized in group settings can put them at greater risk of abuse, when compared with children placed in families.[xi]
- Children and youth are most likely to be adopted by their foster parents or relatives. Placing them in group care reduces their chance of finding a family and leaving foster care for good.
- Millions of relatives care for their family members’ children and youth. These children and youth don’t have to enter foster care and are cared for by their permanent family.
- The vast majority (83 percent in 2013) of children adopted from foster care are adopted by their relatives and by foster parents.[xii] Each year, thousands of children and youth also leave foster care to guardianship,[xiii] most often with relatives.
- When teens are sent to group placements, they often age out of care without ever joining a permanent family.[xiv]
- Children in group care have three times the odds of children in non-kin foster homes and six times the odd of those in kinship care of reporting not wanting their current arrangement as a permanent home.[xv]
- We can do better. Right now too many children spend too much time in group care.
- Children’s needs can be met in families.
- If we do more to recruit, train, and support kinship, foster, and adoptive parents, children will have the family they need.
- More than one in seven children are placed in institutional group placements while in the child welfare system.[xvi] Many are sent to a group placement as their very first experience after being removed from home.
- One in five children in foster care will experience a non-family placement.[xvii]
- One in three teenagers in foster care is in a group placement.[xviii]
- Research has shown that children and adolescents who have been in group care were not significantly different from those who did not experience such episodes with regard to family risk, developmental problems, and health problems.[xix]
Children who have experienced trauma face challenges, but their families can be successful when they have support.
- Supporting kinship, foster, and adoptive families enables children to heal from past trauma, helps keep the families together, and improves outcomes for all.
- Children who have been separated from their birth parents have experienced trauma that can affect their behaviors, mental health, and ability to attach.
- Children and youth in out-of-home care are at increased risk for physical and mental health disorders and disabilities.
- A lack of support may make parents or caregivers fear that they will not be able to meet a child’s needs.
- Kinship, foster, and adoptive parents need information and support to help them address the needs of children who can’t remain with their birth parents.
- A study showed that the amount of support a parent received had a statistically significant impact on increasing stability of foster placements.[xx]
- A national study of children and teens in the child welfare system found more than 70 percent of the children had experienced chronic or repeated trauma.[xxi]
- Complex trauma can affect children’s ability to express and control emotions, concentrate, handle conflict, and form healthy relationships.[xxii]
- Researchers have found that the “amount and quality of support that adoptive families receive when parenting a child with a history of abuse or neglect is an important factor that contributes to family permanency . . . .”[xxiii]Forty percent of the families who leave foster parenting do so primarily because of inadequate agency support.[xxiv]
Placing children and youth in families saves government and other funds.
- Children are often placed with relatives to maintain their family connections, and these kinship placements often prevent children from having to enter foster care. Preventing foster care placement saves significant public funds even when the relatives receive support.
- Group care is much more expensive than even well-supported kinship, foster, or adoptive placements.
- Group care can be 7 to 10 times as expensive as family foster care. When children receive additional mental health services or are placed into group care settings out of their state of residence, the cost can increase even further.[xxv]
- Research has shown that each adoption from foster care can save as much as $235,000 in public dollars.[xxvi]
- Analysis suggests that placing children with relatives instead of in foster care saves at least $4 billion in government money each year.[xxvii]
- Current federal law — and many state laws — require that children and youth be placed in the “least restrictive setting” — which means a family.
- Federal law requires child welfare agencies to seek permanent families for children in care, whether through reunification with birth family, relative placement, or adoption or guardianship.
- The Adoption and Safe Families Act[xxviii] codifies the federal government’s belief that children in the child welfare system should grow up in families — maintained in their own homes whenever possible to do so safely and in new, permanent families when it is not. The law requires that out-of-home placements be in the “least restrictive setting” possible — the setting most like a family.[xxix]
Concerns and Responses
Below we provide some specific information to respond to common questions related to placing children in kinship, foster, or adoptive families.
Can children with serious disabilities or special needs be cared for in a family?
Across the country today, children and youth with many challenges are being successfully parented at home. With the right supportive services, parents can care for children who are medically fragile, who have difficult behaviors, and who have mental health challenges. In your messaging documents, tell real stories of families you know who are successfully caring for children and youth who might otherwise be in group care.
- About 4 out of 10 of children in group placements have no mental health diagnosis, medical disability, or behavioral problem that would warrant such a restrictive setting.[xxx]
- Children and youth shouldn’t be relegated to group or institutional care because of their disability. Even with supportive services, it’s less expensive and far more humane to care for children in families.
- Residential treatment centers and psychiatric hospitals should be viewed much like emergency rooms — they serve a vital role in cases of serious and acute issues, but are not the best long-term treatment choice.
Do some children and youth need residential treatment?
Many children and youth — even those with serious behavioral or mental health challenges — can be served in their homes and communities. When kinship, foster, and adoptive families have access to effective or evidence-based home- or community-based treatments, they can keep their children and youth safe at home.
- Research shows foster parents are capable of effectively meeting the needs of the same kinds of children most frequently placed in group settings. Several studies have shown that children with similar backgrounds and profiles do just as well or better in family foster care than in a residential program.[xxxi] The number of evidence-based, culturally sensitive treatments for young people who have serious emotional and behavioral problems has grown considerably in recent years,[xxxii] making it possible for more children to be cared for within families.
- When children and youth do need out-of-home treatment, they also need a family. Families are key partners in effective treatment, especially for children and youth dealing with grief, loss, trauma, and attachment challenges. The best residential treatment is short-term and outcome-focused, and uses a strong family engagement model. Studies have found that residential treatment programs have the best chance of success if they focus on family involvement, discharge planning, and reintegration into the community.[xxxiii]
- Research shows that even those young people who need specialized residential treatment likely should not be there for longer than three to six months.[xxxiv]S. children in group placements are spending an average of eight to nine months there.[xxxv] More than a third of children in group placements are there even longer.
Tips for Targeted Audiences
When talking to judges, remember:
- Emphasize the letter and spirit of the law: safety, permanency, and well-being.
- Use scientific facts as often as possible, including new developmental research based on scientific evidence.
- Keep in mind that “what’s best for kids” is the best message.
- Put “nurturing” before family as a way of adding quality to relatives, foster, and adoptive families.
- When talking to agency leaders, remember:
- They understand and are increasingly inclined not to place newborns, babies, and young children in group placements. Thank them for these efforts.
- Messages about cost savings and effectiveness are a must.
- Emphasize that even children and youth facing serious challenges are and can be raised in supported families.
- Add examples of successful transitions— for kids, families, and service providers — in communities and states that have increased the number of kids living in families and decreased the use of group placements.
When talking to policymakers:
- Focus on cost-effective outcomes, rather than just saving money.
- Acknowledge that more attention is needed to develop policies and practices that promote recruiting, training, and supporting kin, foster, and adoptive families so that child welfare systems can provide quality family care for children who cannot remain at home.
[i]National Survey of Children and Adolescent Well-Being. (2003). One year in foster care: Wave 1 Data Analysis Report. Washington, D.C.; U.S. Department of Health and Human Services, Administration of Children and Families. Retrieved from https://www.acf.hhs.gov/opre/report/nscaw-one-year-foster-care-wave-1-data-analysis-report March 8, 2015. See also: Barth, R.P. (2002). Institutions vs. Foster Homes: The Empirical Base for the Second Century of Debate. Chapel Hill, NC: UNC, School of Social Work, Jordan Institute for Families. And, Chama, S. and Ramirez, O. (2014.) Young People’s Perceptions of a Group Home’s Efficacy: A Retrospective Study. Residential Treatment for Children & Youth, 31:2, 120-134, DOI: 10.1080/0886571X.2014.918442
[ii]National Survey of Children and Adolescent Well-Being. (2003).
[iii] Barth, R.P. (2002).
[iv] Barth, R. P., Greeson, J. K., Guo, S., Green, R. L., Hurley, S., & Sisson, J. (2007). Outcomes for youth receiving intensive in-home therapy or residential care: a comparison using propensity scores. American Journal of Orthopsychiatry, 77(4), 497.
[v] Aviezer, O., Van IJzendoorn, M. H., Sagi, A., & Schuengel, C. (1994). Collective child rearing: Implications for socio emotional development from 70 years of experience in Israeli kibbutzim. Psychological Bulletin, 116, 99–116. doi:10.1037/0033-2909.116.1.99. And, Annie E. Casey Foundation. (2013). Reconnecting child development and child welfare: Evolving perspectives on residential placement. Baltimore, MD; Author.
[vi] Ryan, J. P., Marshall, J., Herz, D., & Hernandez, P. (2008). Juvenile delinquency in child welfare: Investigating group home effects. Children and Youth Services Review, 30, 1088 –1099. doi:10.1016/j.childyouth.2008.02.004
[vii] Consensus statement on group care for children and adolescents: A statement of policy of the American Orthopsychiatric Association. Dozier, Mary; Kaufman, Joan; Kobak, Roger; O’Connor, Thomas G.; Sagi-Schwartz, Abraham; Scott, Stephen; Shauffer, Carole; Smetana, Judith; van IJzendoorn, Marinus H.; Zeanah, Charles H. American Journal of Orthopsychiatry, Vol 84(3), May 2014, 219-225. http://dx.doi.org/10.1037/ort0000005. Special Section: Residential Care and Treatment of Children and Adolescents: Current Issues in the United States and Abroad.
[viii] Frank, D., Klass, P., Earls, F., Eisenberg, L. (1996). Infants and young children in orphanages: One view from pediatrics and child psychiatry. Pediatrics, 97(4), 569-578.
[x] Triseliotis, J. & Russell, J., (1984). Hard to Place: The Outcome of Adoption and Residential Care, Heinemann (ESRC/DHSS Studies in Deprivation and Disadvantage 13), London.
[xi] Dozier, et al. (2014). And, Judge David L. Bazelon Center for Mental Health Law. (Undated). Fact Sheet: Children in residential treatment centers. Washington, DC: Author. And, Freundlich, M., Avery, R. J., & Padgett, D. (2007). Care or scare: The safety of youth in congregate care in New York City. Child Abuse & Neglect, 31(2), 173–186.
[xii] Children’s Bureau, Adoption and Foster Care Analysis and Reporting System, Prior Relationship of Adoptive Parent(s) to Child: October 1, 2012 to September 30, 2013 (2014)
[xiii] Children’s Bureau, AFCARS Report No. 21. (2014)
[xiv] Hartnett, M. A. & Bruhn, C. (2006). The Illinois child well-being study: Year one final report. Urbana- Champaign, IL: Children and Family Research Center, School of Social Work, University of Illinois at Urbana-Champaign. And, The Annie E. Casey Foundation. (2015). Too many teens: Preventing unnecessary out-of-home placements.
[xv] National Survey of Children and Adolescent Well-Being. (2003).
[xvi] Child Trends analysis of 2013 Adoption and Foster Care Annual Reporting System (AFCARS) data
[xvii] Wulczyn, Fred; Alpert, Lily, Martinez, Zach and Weiss, Ava. (2015.) Within and between state variation in the use of group and other types of congregate care. Chicago, Il.; Center for State Child Welfare Data, Chapin Hall Center for Children, University of Chicago.
[xviii] Child Trends’ analysis of 2013 AFCARS data on children from birth to age 20
[xix] James, S., Roesch, S., & Zhang, J., (2011). “Characteristics and Behavioral Outcomes for Youth in Group Care and Family-Based Care: A Propensity Score Matching Approach Using National Data” Journal of Emotional and Behavioral Disorders.
[xx] Crum, W. (2010). Foster parent parenting characteristics that lead to increased placement stability or disruption. Child and Youth Services Review, 32, 185–190.
[xxi] Spinazzola, J., Habib, M., Knoverek, A., Arvidson, J., Nisenbaum, J., Wentworth, R., Hodgdon, H., Pond, A., & Kisiel, C. (2013). The heart of the matter: Complex trauma in child welfare. Child Welfare 360: Trauma-Informed Child Welfare Practice. The Center for Advanced Studies in Child Welfare, University of Minnesota.
[xxii] Spinazzola et al. (2013).
[xxiii] Houston D. & Kramer, L. (2008). Meeting the long-term needs of families who adopt children out of foster care: A three-year follow-up study. Child Welfare, 87, 145–170.
[xxiv] The Annie E. Casey Foundation. (2012). Building successful resource families: A guide for public agencies. Baltimore, MD; Author.
[xxv] Barth, R. P. (2002). And Ward, H., & Holmes, L. (2008). Calculating the costs of local authority care for children with contrasting needs. Child & Family Social Work, 13, 80-90.
[xxvi] Hansen, M. (2006). The Value of Adoption, American University Department of Economics Working Paper Series, No. 2006-15.
[xxvii] Generations United. (2014). The State of Grandfamilies in America: 2014
[xxviii] The current iteration of the Adoption Assistance and Child Welfare Act of 1980. The Indian Child Welfare Act, 25 U.S.C. § 1902, also reinforces these policy principles.
[xxix] 42 U.S.C. § 675 (2012)
[xxx] U.S. Department of Health and Human Services, Administration for Children and Families, Children’s Bureau. (2015). A national look at the use of congregate care in child welfare. Washington, D.C.; Author.
[xxxi] Barth, R. P., Greeson, J. K., Guo, S., Green, R. L., Hurley, S., & Sisson, J. (2007). And, James, S., Roesch, S., & Zhang, J. J. (2012).
[xxxii] James, S., Roesch, S., & Zhang, J. J. (2012).
[xxxiii] Dinges, K., Discher, J., Leopold, M., Matyas, C., Ruiz, C., Marciano, D., … & Happ, D. (2008). Perspectives on Residential and Community-Based Treatment for Youth and Families. Magellan Health Services Children’s Task Force. Retrieved March 8, 2015 from http://herohealthhire.com/media/2718/CommunityResidentailTreatment_White_Paper.pdf
[xxxiv] Dinges, K., et al. (2008).
[xxxv] U.S. Department of Health and Human Services, Administration for Children and Families, Children’s Bureau. (2015).