Barriers to Reunification and Overrepresentation of Young Children Affected By Parental Substance Abuse: Selecting a Data-Informed Child Welfare Target Population

Background and Purpose: Parental substance abuse was the single most common reason that children entered the foster care system in Kansas last year, accounting for one in five of the children placed in care. Exposure to parental substance abuse substantially impacts young children (ages 0-3) due to their increased vulnerability to social-emotional, behavioral, cognitive, and developmental deficits and to long-term negative impacts on child wellbeing, as a result of early adversity. In a Children’s Bureau regional partnership project that aims to improve safety, permanency, and wellbeing among substance-affected children, as a formative step, this study was designed to test the hypothesis that the target population of children ages 0-3 are overrepresented in child welfare and that those in this 0-3 age group who are in out-of-home placement for reasons associated with parental substance use experience lower rates of reunification when compared to peers who were removed for non-substance use related reasons. The objective of this study was to appropriately identify a target population who is experiencing a high level of risk in order to optimize the impact of the intervention.

Methods: Prevalence by age for substance-affected families was first examined. Survival analysis was conducted on entry cohorts from 2009-2014 from the Longitudinal AFCARS 2009A-2014B data to examine reunification rates over time for substance abuse affected families versus non-substance abuse affected families. Children ages 47 months and younger when entering out-of-home placement were selected and the sample consisted of 6,724 children, including 3,538 non-substance affected children and 3,186 substance affected children.

Results: Younger children were more than 200% more likely to be placed out-of-home due to parental substance use than older peers with a removal rate of 29% for children 0-3 versus 14.2% for children ages 4-17).Survival analysis results indicate that among the entry cohort of children 0-47 months, children removed from the home with parental substance abuse (PSA) as a contributing factor had a 12-month reunification rate of 21% compared to a rate of 32% for non-PSA counterparts. The overall reunification rate was 56% for children with PSA, compared with 61% for non-PSA children (Chi-square(1)=53.37, p < .001).

Conclusions and Implications: These results suggest that the target population of young children removed from the home as a result of parental substance use is in need of additional intervention to target disparate reunification rates and overrepresentation in the foster care system. Therefore, identifying children 0-47 months affected by parental substance use as the target population is an appropriate selection for the larger study to improve child safety, permanency, and wellbeing. This finding is important as it identifies a particularly vulnerable group who will be the recipient of statewide scale-up and testing of a family-based evidence-informed parenting intervention that seeks to improve and reduce disparate outcomes for young children in foster care. Results of the larger study will inform statewide policy and child welfare practice to better serve this vulnerable population.