Developmental trajectories of socio-emotional outcomes of children and young people in out-of-home care - Insights from data of Pathways of Care Longitudinal Study (POCLS)

Nan Hu; Yalemzewod Assefa Gelaw; Ilan Katz; Elizabeth Fernandez; Kathleen Falster; Mark Hanly; B J Newton; Jennifer Stephensen; Paul Hotton; Karen Zwi; Raghu Lingam

doi:10.1016/j.chiabu.2023.106196

Developmental trajectories of socio-emotional outcomes of children and young people in out-of-home care - Insights from data of Pathways of Care Longitudinal Study (POCLS)

Child Abuse Negl. 2024 Mar:149:106196. doi: 10.1016/j.chiabu.2023.106196. Epub 2023 May 5.

Authors

Affiliations

¹ Population Child Health (PCH) Research Group, School of Clinical Medicine, UNSW Medicine & Health, Bright Alliance, High Street, Randwick, New South Wales 2031, Australia.
² Population Child Health (PCH) Research Group, School of Clinical Medicine, UNSW Medicine & Health, Bright Alliance, High Street, Randwick, New South Wales 2031, Australia; Telethon Kids Institute, Perth Children's Hospital, 15 Hospital Avenue, Nedlands 6009, Western Australia, Australia.
³ Social Policy Research Centre, UNSW Sydney, High Street, Kensington 2052, Australia.
⁴ School of Social Sciences, UNSW Sydney, High Street, Kensington 2052, Australia.
⁵ School of Population Health, UNSW Sydney, High Street, Kensington 2052, Australia.
⁶ Centre for Big Data Research in Health, UNSW Sydney, High Street, Kensington 2052, Australia.
⁷ Discipline of Paediatrics & Child Health, School of Clinical Medicine, UNSW Medicine & Health, Bright Alliance, High Street, Randwick, New South Wales 2031, Australia; Sydney Children's Hospitals Network (SCHN), High Street, Randwick, New South Wales 2031, Australia.
⁸ Population Child Health (PCH) Research Group, School of Clinical Medicine, UNSW Medicine & Health, Bright Alliance, High Street, Randwick, New South Wales 2031, Australia; Sydney Children's Hospitals Network (SCHN), High Street, Randwick, New South Wales 2031, Australia.
⁹ Population Child Health (PCH) Research Group, School of Clinical Medicine, UNSW Medicine & Health, Bright Alliance, High Street, Randwick, New South Wales 2031, Australia. Electronic address: [email protected].

PMID: 37149427
DOI: 10.1016/j.chiabu.2023.106196

Abstract

Background: There has been a limited understanding of the longitudinal trajectory and determinants of socio-emotional outcomes among children in out-of-home care (OOHC).

Objectives: This study aimed to examine child socio-demographics, pre-care maltreatment, placement, and caregiver factors associated with trajectories of socio-emotional difficulties of children in OOHC.

Participants and setting: The study sample (n = 345) included data from the Pathways of Care Longitudinal Study (POCLS), a prospective longitudinal cohort of children aged 3-17 years who entered the OOHC system in New South Wales (NSW) Australia, between 2010 and 2011.

Methods: Group-based trajectory models were used to identify distinct socio-emotional trajectory groups based on the Child Behaviour Check List (CBCL) Total Problem T-scores completed at all four Waves 1-4. Modified Poisson regression analysis was conducted to assess the association (risk ratios) of socio-emotional trajectory group membership with pre-care maltreatment, placement, and caregiver-related factors.

Results: Three trajectories of socio-emotional development were identified: 'persistently low difficulties' (average CBCL T-score changed from 40 to 38 over time), normal (average CBCL T-score changed from 52 to 55 over time), and clinical (average CBCL T-score remained at 68 over time) trajectories. Each trajectory presented a stable trend over time. Relative/kinship care, as compared with foster care, was associated with the "persistently low" socio-emotional trajectory. Being male, exposure to ≥8 pre-care substantiated risk of significant harm (ROSH) reports, placement changes, and caregiver's psychological distress (more than two-fold increased risk) were associated with the clinical socio-emotional trajectory.

Conclusions: Early intervention to ensure children have a nurturing care environment and psychological support to caregivers are vital for positive socio-emotional development over time among children in long-term OOHC.

Keywords: Children in out-of-home care; Socio-emotional difficulties; Socio-emotional trajectories.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Child
Emotions*
Female
Foster Home Care
Home Care Services*
Humans
Longitudinal Studies
Male
Prospective Studies