Journal Issue: Children, Families, and Foster Care Volume 14 Number 1 Winter 2004
Developmental Needs and Outcomes of Older Youths
The different modes of entry into foster care in terms of child age and patterns of stay have implications for the developmental needs and outcomes of older youths. The United States has generally a bimodal pattern of foster care placement. At one end of the age range, about 38% of children are 5 years old or younger when placed in care. At the other end, about 29% of children who enter (or reenter) care are between the ages of 11 and 15. Another 11% are between the ages of 16 and 18. Some of these older children are reunified with their birth families or are adopted, but many emancipate from foster care.3
Despite the emphasis on permanency planning and adoption, foster care stays of a year or more are common in the United States.4 In 2001 about 36% of children in foster care had been there less than a year, but 74% had been in care for a year or more.5 Of those who exited care, about half had been in care for less than one year, whereas half had been in care for one year or longer. Nearly 30% had been in care for at least two years. No matter what the length of stay, after a safe home environment has been established, the developmental needs of children should become the priority for families, caseworkers, and the supporting cast of helpers.
Developmental Needs of Older Youths in Foster Care
Youth development is a life process. According to the U.S. Department of Health and Human Services (DHHS), positive youth development means that adolescents receive the services and opportunities necessary to develop “a sense of competence, usefulness, belonging, and empowerment.”6 For older youths in care (and especially for children who have survived abuse and neglect), needed supports include stable living situations; healthy friendships with peers their own age; stable connections to school; educational skills remediation; dental, medical, and vision care; mental health services; consistent, positive adults in their lives; and networks of social support. Life-skills preparation is also very important, covering such areas as daily living tasks, self-care, social development, career development, study skills, money management, self-determination, self-advocacy, and housing and community resources.7
Reviews of program emphasis show a high degree of focus on clinical and rehabilitation services, whereas more universal or normative activities, such as school, recreation, making and keeping social contacts with peers, work skills, and job experience, are not emphasized strongly enough. A more balanced approach is necessary, particularly in the placement of older children who have a much shorter time to learn to be responsible for themselves.8
Testimony of Terry, former foster youth:
Aging out of foster care shouldn't mean being totally on your own. The end of foster care cannot mean the end of a community's caring.9
Siblings10 and relatives become crucial resources for older youths in foster care—especially if kinship care (or guardianship with relatives) is heavily used as a mode of caregiving. Transitioning out of kinship foster care is different than transitioning from a nonrelative foster home. For example, in most cases, relatives often feel more of an obligation to the children in their care than nonrelatives. According to one expert, it is important to differentiate between these two groups to better ascertain which children need different types of support in the transition to adulthood. More specifically, those living with a nonrelative foster family are more likely to need reunification support (such as locating and reunifying with biological families and other relatives); “independent living” support; and enduring support networks.11
Testimony of Lisa, former foster child:
You know, children in foster care have wings, but they need someone to teach them to fly, someone to lead them in the right direction, someone to be there when they fall. I am here today because of those people who taught me how to fly.12
Developmental Outcomes of Youths in Foster Care
Under pressure from private and public agencies, juvenile court judges, class-action lawsuits, physicians, and various other stakeholder groups, foster care systems are beginning to be held accountable for the effects of their services.13 As a result, although data are sparse, foster care service-delivery systems have begun tracking a core set of outcomes encompassing the developmental needs of older youths outlined above, as well as other crucial elements such as cultural identity, decision making, and social networking.
The available research indicates that youths transitioning from foster care are likely to experience a number of negative outcomes.14 For example, studies have found that, compared with the general population, a higher proportion of these youths are involved in the criminal justice system,15 and they are at higher risk for teen pregnancy and parenting.16 Because most youths in foster care have changed schools multiple times, many have lower reading and math skills, as well as lower high school graduation rates.17 In addition, youths transitioning from foster care are more likely to experience homelessness.18 In fact, one study found that one in five foster care alumni who had never been homeless before did not have a place to call home for at least a week sometime after age 18.19 Other studies show that foster care alumni tend to have higher rates of alcohol and other drug abuse20 and higher rates of unemployment and dependence on public assistance.21, 22
Several studies have found more mixed results, with some youths doing very well while others struggle to complete classes and learn the skills necessary to succeed as young adults living independently. For example, some studies show that youths placed in foster care tend to have disproportionately high rates of physical, developmental, and mental health problems, but at least two large alumni studies have found that their physical health overall is on par with the general population and their mental health difficulties are confined to just a few areas (such as posttraumatic stress disorder, panic disorder, and bulimia).23
In summarizing what we know about the outcomes for older youths in care and foster care alumni, we need to exercise caution. Not only do the study methods vary in type and rigor, but youth outcomes are affected by variables outside the control of those providing services, including characteristics of the children, birth families, other relatives, and foster parents; ecological factors before services began (such as schooling and neighborhood environment); and a child's degree of resiliency.24 (See the articles by Jones Harden and by Stukes Chipungu and Bent-Goodley in this journal issue.) In addition, because of the lack of “strengths-oriented” research and the media preoccupation with negative effects, the many success stories of older youths in foster care often are not publicized.25 Stereotypes abound, even though conditions are not uniformly deplorable. Further research on youth outcomes is needed to identify the nature and extent of supports required, the types of skill building different groups of youth need, and the most promising strategies for delivering those services. Of equal importance is the need to link good outcomes to the cost to achieve them. Until the cost data are more available, including transparent reporting of appropriately commingled funding streams, child welfare organizations cannot be adequately accountable for the “real” costs of obtaining good results and therefore will be less likely to make a winning case for additional resources from either public or private funding sources.