University of Kansas, School of Social Welfare, 1545 Lilac Lane, Twente Hall, Lawrence, KS, 66045, United States.
Child Abuse Negl. 2021 Mar;113:104899. doi: 10.1016/j.chiabu.2020.104899. Epub 2021 Jan 14.
Research shows children in foster care are at amplified risk of experiencing cumulative adverse childhood experiences (ACEs). Though separate bodies of literature exist for ACEs and foster care, ample research demonstrates overlap in negative outcomes between ACEs and foster care involvement, such as substance use, early pregnancy, and poorer educational outcomes, among others. Rare are studies that have explored ACEs influence on targeted foster care outcomes.
To address this gap in the literature, this study's objective was to investigate the association between cumulative ACEs and reunification.
2,998 American children between 6-18 years old in foster care between October 2015 and July 2019 in a Midwestern state.
Cox proportional hazard regression was utilized to examine likelihood of and time to reunification, comparing children with 1-5 ACEs, 6-9 ACEs, and 10+ ACEs.
Increased cumulative ACE exposure among children in foster care significantly impeded likelihood of reunification, and slowed time to reunification. Children with 6-9 ACEs and 10+ ACEs were 28 % (HR = .72, p = .024) and 42 % (HR = .58, p = .000) less likely to reunify, respectively, when compared to their counterparts with 1-5 ACEs. Other significant predictors of reunification included: race, age at foster care entry, siblings in foster care, and placement setting type.
Results support the notion that among an already vulnerable population, subgroups of children may disproportionally experience negative foster care outcomes. Continued research is necessary to further examine intersections and implications of cumulative ACEs among children in foster care.
研究表明，寄养儿童经历累积性不良儿童期经历（ACEs）的风险更高。尽管 ACEs 和寄养有独立的文献，但大量研究表明 ACEs 和寄养参与之间存在负面结果的重叠，例如物质使用、早孕和较差的教育成果等。很少有研究探讨 ACEs 对特定寄养结果的影响。
为了弥补这一文献空白，本研究的目的是调查累积 ACEs 与 reunification 之间的关联。
2015 年 10 月至 2019 年 7 月期间，中西部一个州，年龄在 6-18 岁之间的 2998 名寄养儿童。
采用 Cox 比例风险回归分析，比较了 ACEs 暴露在 1-5 个、6-9 个和 10 个以上的儿童，以检验 reunification 的可能性和 reunification 的时间。
寄养儿童累积 ACE 暴露增加显著阻碍了 reunification 的可能性，并减缓了 reunification 的时间。与 ACEs 暴露在 1-5 个的儿童相比，ACEs 暴露在 6-9 个和 10 个以上的儿童 reunification 的可能性分别降低了 28%（HR =.72，p =.024）和 42%（HR =.58，p =.000）。 reunification 的其他显著预测因素包括：种族、进入寄养的年龄、寄养中的兄弟姐妹和安置类型。
结果支持这样一种观点，即在已经脆弱的人群中，儿童亚群可能不成比例地经历负面的寄养结果。需要进一步研究以进一步探讨寄养儿童累积 ACEs 的交叉点和影响。
