Survey of Child and Adolescent Well-Being: Foster Care Changes
in Relation to Internalizing and Externalizing Problems
children experience multiple placements. Although multiple
placements tend to be associated with elevated levels of behavioral
and emotional problems, it is not clear whether changes in
placements increase problems or vice versa. To test predictive
pathways between number of placements and children's problems,
Aarons et al. (2010) used data for 500 foster children participating
in the National Survey of Child and Adolescent Well-Being
(NSCAW). Ranging in age from 2 to 15 years, the children were
initially assessed with the CBCL at an average of about 5
months after the onset of child welfare investigations and
again 18 months and 36 months after the initial assessment.
The children were in out-of-home care for the entire 36 months.
Cross-lag path analyses showed that high CBCL Internalizing
and Externalizing scores significantly predicted changes in
foster home placements from baseline to 18 months, with medium
effect sizes. In addition, high Internalizing scores at 18
months predicted increased placement changes from 18 to 36
months, with a small effect size. Placement changes did not
predict increases in either Internalizing or Externalizing
scores from baseline to 18 months, but did predict increases
in Externalizing scores from 18 to 36 months, with a medium
effect size. Because high Internalizing and Externalizing
scores predicted foster home changes but foster home changes
also predicted increases in Externalizing scores from 18 to
36 months, Aarons et al. recommended "focusing on helping
children manage their behavior, providing training for caregivers
to respond effectively to child behavioral problems, and the
development of strategies to increase placement stability"
Aarons, G. A., James, S., Monn, A.R., Raghavan, R., Wells,
R.S., & Leslie, L. K. (2010). Behavior problems and placement
change in a national child welfare sample: A prospective study.
Journal of the American Academy of Child and Adolescent
Psychiatry, 49, 70-80.