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)

Citation (Vancouver)

Hu N, Gelaw YA, Katz I, Fernandez E, Falster K, Hanly M, Newton BJ, Stephensen J, Hotton P, Zwi K, Lingam R. 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 & Neglect. 2023 May 5:106196.

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.