Placement disruption of children with disabilities in foster care

Purpose: To investigate and describe available data on children with disabilities in the United States foster care system and examine placement disruptions. Design: This quantitative descriptive study was a secondary data analysis of the Adoption and Foster Care Analysis and Reporting System (AFCARS) and included 680,611 children. Methods: Descriptive and regression analyses were conducted. Findings: Of 680,611 children in the U.S. foster care system in 2017, 22% had a medical or disability diagnosis, requiring additional or specialized care. Children with disabilities in foster care (CDFC) had a mean of 4.0 disruptions—significantly higher than the mean 2.37 disruptions among those without a disability (p <.001, d = 0.51). CDFC spent an average of 915 days in foster care compared to 514 days for children without a disability (p <.001, d = 0.59). Predictive risk factors for disruptions were increased child age, race (American Indian or Black), and increased foster parent age. Protective factors against disruptions included married foster parents and a child being placed outside of the child's initial state of residence. Conclusions: CDFC have significantly more disruptions and longer stays in foster care. While risk and protective factors affect all foster children similarly, they have significantly greater effect on foster children with disabilities. Practice implications: Increased disruptions compound the vulnerability of CDFC as relationships and support systems are broken. Understanding the extent to which childhood disabilities play a role allows school nurses, healthcare providers, and child advocates to better design interventions to improve lifelong health outcomes.