The Needs and Experiences of Young Adults Who Aged out of Foster Care: A Systematic Review

Purpose: While recent studies have clearly documented that youth exiting the foster care system by aging out are at increased risk in early adulthood for adverse outcomes (e.g., homelessness, greater mental health needs, etc.), little is known about how the needs and experiences of this population have changed over time. Thus, to explore the experiences and needs of foster youth who aged out of care over time, this systematic review was conducted to examine studies where youth were interviewed between 1974-2004. This timeframe captures results that were gathered from participants who would now be approximately 30-60 years old, that were served by child welfare under the Child Abuse Prevention and Treatment Act (P.L.93-247), and that can describe how the needs and risks changed over three decades. As such, a review of these studies can guide future research by identifying key questions as well as the extent of evidence across time.

Methods: This systematic review was conducted in accordance with best practice guidelines established by Littell, Corcoran, and Pillai (2008) and Petticrew (2008).  Additionally, data extraction guidelines established by AMSTAR and PRISMA were followed. Five databases (PsycINFO, MedLine, WorldCat, SocIndex with Full Text, ProQuest Congressional) were searched from 1974-2010 to locate manuscripts to be included in the review. Inclusion criteria was established a priori and stipulated articles must have interviewed participants between 1974-2004, must be in English, and studies must have been conducted in the United States. Studies that were published using data sets that had previously been reported on the literature were excluded from the review.

Results: 1,146 studies met initial criteria and were then screened again against the a priori inclusion criteria leading to a final sample of 14 manuscripts. Two independent researchers rated all articles against a priori criteria to select the final studies included in the review with an original inter-rater reliability of 75% but after recoding all eligible articles, inter-rater reliability was increased to 100%. Dissertations, agency reports, books, and peer-reviewed studies were all represented in the final sample. The vast majority of located studies presented only descriptive statistics of youth who had aged out of care. Therefore, all reported descriptive statistics were coded, themed, and grouped into the following content domains for analysis and presentation: employment and housing, education, social and familial support, physical health, mental health and substance use, crime and victimization, and relationship outcomes.

Conclusions and Implications: Overall, the findings of this systematic review indicated that needs and outcomes for young adults who have aged out of foster care are remarkably stable over time across all domains. Additionally, when the outcomes were compared to more recent studies describing this population, the results were notably similar as well. Given the numerous policies and programs aimed at helping this population over the last 30 years, these findings raise interesting questions about the impact of these services on outcomes for this population. As such, researchers can now begin evaluating policies, programs, and services for youth who are aging/have aged out of care.