Cumulative Effects of Child Maltreatment Experience on Psychosocial Well-Being of Children in Informal Kinship Care

Background:  This study examined cumulative effects of prior child maltreatment experience on psychosocial health of children in informal kinship care. Previous research suggests that children in kinship care are as likely to suffer from adverse experiences and to exhibit low functioning as those in non-kinship foster care. However, children in private or voluntary kinship care are often underserved and their needs are not well known. This study advances knowledge about the well-being of children in informal kinship care, particularly those who are vulnerable given their child maltreatment history.

Methods: Two sources of data were used: (1) a survey of 303 caregivers, and (2) the child welfare records of 455 children in their care. The survey included demographic and household characteristics, parenting stress, and reasons for out-of-home care. As part of the survey, caregivers were also asked to rate the psychosocial health of up two children using the Pediatric Quality of Life Inventory, a scale developmentally appropriate for youth 2-18 years old. The child welfare records of the children were retrieved administratively from the state child welfare agency. The total number of cases involving child protective services (CPS) per child was used to measure the magnitude of child maltreatment experience. Prior non-relative foster care placement was also included. Data were analyzed using generalized estimating equations (GEE) model to compensate for the clustered structure of children within a family.

Results: Analysis sample included 365 children. Child’s age ranged from 2 to 20 (Mean: 9.78) and 53% of children were female. Caregiver’s age ranged from 20 to 86 (Mean: 52.53). 45% of the households were living at or below 150% poverty line. 55% of caregivers reported maternal mental health issues as a reason for out of home care. Children had an average of 2.36 CPS cases, but 25% had no prior CPS records. 18% had a prior foster care placement. Final multivariate models (340 children in 261 kinship families) indicate that the number of CPS cases were inversely associated with psychosocial health of child (b=-0.99, p<.01). Maternal mental health issue was a predictor of poor psychosocial health of child (b=-4.02, p<.01). Other significant covariates included parenting stress scores (b=-0.18, p< .001) child’s age (b=-0.52, p<.001) and caregiver age (b=0.15, p<.05). Household poverty and prior foster care placement were not significant predictor of children’s psychosocial health.

Implications: Many children in informal kinship care have extensive child maltreatment experience. A significant number of them experienced multiple episodes of parental neglect and abuse and some were placed in foster care before they moved into kinship care. The study’s findings support the cumulative effects of child maltreatment experience on children’s mental health. Increased interaction with CPS can be indicative of greater familial instability and having a mother with mental health issues also places children at higher risk. However, children in informal care receive far fewer supports than those in formal care. These findings demonstrate the needs of children in informal kinship care, especially those with extensive child welfare reports. Policies should address the gaps in services.