بزهکاری نوجوانان در رفاه کودکان: بررسی اثرات اصلی گروه

Abstract Group homes fall into the broad category of residential care, a category that also includes half-way homes, campus based homes, emergency shelters, self-contained settings, and staff secured setting. In general, residential care services represent an option of last resort. In the current study we use administrative records from a large urban county and propensity score matching to investigate the relationship between group home placements in child welfare and the risk of delinquency (n = 8226). The results indicate that the relative risk of delinquency is approximately two and one half times greater for adolescents with at least one group home placement as compared with youth in foster care settings. This finding raises serious questions about the use of group homes for victims of physical abuse and neglect.

1. Introduction Group homes fall into the broad category of residential care, a category that also includes half-way homes, campus based homes, emergency shelters, self-contained settings, and staff secured setting (Curtis et al., 2001 and Child Welfare League of America, 2005). In general, residential care services represent an option of last resort. That is, child welfare systems attempt to work with children and families in the least restrictive environment. Such practices reflect the 1980 Adoption Assistance and Child Welfare Act (P.L. 96272) which established the foundation for a continuum of care (Stuck, Small, & Ainsworth, 2000). When less restrictive environments are unavailable or insufficient with regard to meeting needs of individuals, child welfare systems move youth up the continuum of care and into more secure settings. In the current study we investigate the relationship between group home placements in child welfare and the risk of delinquency. Our review of the literature focuses on the definition of group homes, the characteristics of youth served in group homes, and the potential problems associated with group home placements. Group homes are utilized in a variety of social service settings including child welfare, mental health, and juvenile justice. Within the child welfare system, approximately 11% of all substitute care placements are associated with a group home (CA RADD, 2001). Group homes are smaller than other residential facilities, consisting of a medium size home capable of housing between 6 and 9 adolescents in a community based setting. Within the social service continuum of care, group homes are less restrictive than in-patient psychiatric clinics and juvenile detention centers, but more restrictive than family foster care (Handwerk, Friman, Mott, & Stairs, 1998). Group homes are considered staff secured as opposed to a locked facility. In contrast with large residential care facilities, group homes generally do not provide academic instruction and the adolescents served within these programs largely attend local public schools. In part, the relatively low number of youth served within each group home and the staff required to manage each facility causes group homes to be one of the most expensive placements options for child welfare systems. Congregate care placements cost between six and ten times as much as placement in a foster family home (Barth, 2002). In 2000 for example, 43% of all substitute care dollars in the state of California were associated with group home placements (CA RADD, 2001). As the vast majority of youth never enter a group home setting, the high costs and overall proportion of the budget allocated to group home placements is concerning for child welfare systems. The current study focuses not on the concerns related to cost, but rather concerns related to program effectiveness. 1.2. Characteristics of youth served in group homes The placement of children in group homes, like other placement settings, is not random. That is, some children and adolescents in the child welfare system are significantly more likely to experience at least one spell of care in a group home. In part, this non random selection process makes it difficult to fully disentangle individual and group home specific effects. Adolescents placed in group home settings are older, more likely to be male, minority, experience a range of socio-emotional and behavioral problems, and are more likely to have prior involvement with the juvenile justice system as compared with adolescents living in traditional foster care or a specialized foster care home (Berrick et al., 1993, Curtis et al., 2001, Knapp et al., 1987 and Mech et al., 1994). Using the Child Behavior Checklist several studies document the significantly higher rates of externalizing behaviors and conduct disorders with adolescents in group care settings (Heflinger et al., 2000 and McMillen et al., 2005). Given the prevalence of such problems, youth in group care settings are also more likely to receive psychotropic medications. In a recent study of medication for youth in care, Breland-Noble et al. (2004) report that adolescents in group home placements were significantly more likely than youth in therapeutic foster care settings to take medication and to take more medications (polypsychopharmacology). In addition to individual characteristics, the potential for delinquency in group home settings may also result from high rates of placement instability and the exposure to other high risk adolescents. Placement instability is a common phenomenon and characteristic associated with residential placement settings (Courtney, 1998 and Knapp et al., 1987). In part, such instability can be explained with how group home placements are utilized. Children and adolescents are rarely removed from the biological family home and placed directly into a congregate care setting. In general, out of home placements commence in kin or non kin foster family homes, and when such arrangements no longer work, individual youth are moved up the continuum into more secure settings. There are a variety of reasons placements “don't work” but foster parent unwillingness is the most pervasive. In a recent and comprehensive study of placement instability, Zinn et al. (2006) reports that 76% of placement disruptions were due, at least in part, to foster parents' inability or unwillingness to continue fostering. Among those moves attributed to foster parents, the reason most commonly cited (28%) was foster parents' inability to tolerate children's behavioral or emotional problems. Placement instability is problematic because it is associated with a range of negative outcomes including child behavior problems, feelings of insecurity, and overall dissatisfaction with the foster care experience (Festinger, 1983, Kurtz et al., 1993 and Redding et al., 2000). Specific to the current study, evidence indicates that frequent placement changes within the child welfare system significantly increase the risk of juvenile delinquency (Ryan and Testa, 2005). Perhaps even more than placement instability, the negative effects of peer contagion within the group home is disconcerting for practitioners and policy makers. Such concern focuses largely on the exposure and socialization processes (e.g. social learning) that are likely to shape and support deviant attitudes and behaviors. Dishion et al. (1999) report that peer group interventions increase problem behaviors and negative life outcomes through adolescence and in to early adulthood. The authors argue that detaining youth in congregate residential settings and specifically the prolonged exposure to high risk peers has the unintended effect of exacerbating deviance via positive social relationships. The conceptualization of deviance includes but is not limited to smoking, school problems, aggression, substance abuse, and delinquency (Lee, 2007). The potential for problems associated with group home placements seems to increase as ties are severed between group home youth and other more positive role models. Group homes often cut juveniles off from their nondelinquent and prosocial peers and keep youth with others that are often delinquent and/or have emotional and behavioral problems including conduct disorders and ADHD (Osgood & Briddle, 2006). The potential positive effects of living in a group home may be lost to the effects of social anxiety, peer pressure and other residual occurrences of being in the presence of peers, especially such peers with strong personalities, as is often the case with deviant youth (Dodge, Dishion & Landsford, 2006). The risk for delinquency also appears to be mediated by the level of deviance a peer has upon entrance into a group facility, the number of deviant peers present, and the length and amount of deviant peer exposure one has. Specifically, a child who is moderately deviant is most susceptible to become more entrenched in delinquent friendships (Dodge & Sherrill, 2006). With regard to specific outcomes in the child welfare system, group care has achieved little success. In fact, a recent review entitled Institutions vs. Foster Homes: the Empirical Base for a Century of Action indicates that there is virtually no evidence to support the use of group care in child welfare ( Barth, 2002). Group homes are described as unsafe, unable to support healthy development, unstable, and costly. Moreover, children in group care settings report seeing family members less often as compared with children in kinship care, and are less likely to experience reunification with biological caregivers; this is especially true for children aged 6–12 ( Barth, 2002 and Wulczyn et al., 2000). Problems associated with group homes within the child welfare system are also reported in the academic domain. Compared with youth in family foster care arrangements, youth in group homes received mostly Cs and lower in school, have truanting problems, take remedial classes in school, and attain lower levels of education (Berrick et al., 1993, Festinger, 1983, Knapp et al., 1987 and Mech et al., 1994). Educational problems may be more prevalent for those in group care because of the limited opportunity for children to be involved in extra-curricular activities—activities that promote well-being and self-confidence. Moreover, the highly structured nature of group living can hinder children's pursuit of individual development in academic and extra-curricular activities (Barth, 2002). Areas for studying and learning at the group facilities may be limited due to the shortage of resources (e.g., lack of both available staff to help with homework and appropriate or adequate study areas) and the presence of disruptive peers. Similarly, children in group care have fewer opportunities and are less likely to demonstrate the ability to engage in real life tasks (Barth, 2002 and Mech et al., 1994). It is important to note that the criticisms associated with child welfare placements are not limited to group care. In fact, there exists a long standing debate with regards to how states can best serve families involved with child protection. Advocates of family preservation argue for keeping families intact and providing a variety of clinical and concrete services in the family home (citation needed). Such advocates assert that too many families have their children removed only to then experience the secondary trauma of placement (citation needed). Regardless of whether states have the correct population of children and adolescents in care, it is critical to understand the outcomes associated with such placement experiences and to identify whether or not certain types of placement (e.g. foster care) are more likely to improve strengths and reduce risks as compared with others (e.g. group homes). The current study builds on the child welfare literature and makes a unique contribution by focusing the discussion on the types of placements that might be most problematic. As the term “placement” as used in previous studies often encompasses a variety of unique settings, conclusions drawn from this work may lead to misguided shifts in policy and practice. For example, Doyle (in press) reports that children on the margin of placement achieve better outcomes when they remain in the home as compared with children placed in “foster care.” Specifically, Doyle (in press) concludes that children in “foster care” have significantly higher delinquency rates, teen birth rates, and significantly lower earnings. With this finding one might logically argue against the use of foster care. Yet Doyle (in press) uses the term “foster care” to represent any and all placements within the child welfare system. Foster care is in fact only one of several different types of placements used in the child welfare system. Thus, a methodological approach that differentiates and compares various settings within the child welfare system is critical to understanding “placement” effects. In the current paper, we disentangle the differences between two commonly used placements in child welfare: foster care and group homes. In summary, group home placements are often associated with a range of negative outcomes. Yet to date there exist no studies of group home placements and the likelihood of delinquency in the child welfare system. In the current study we use sophisticated analytic techniques to help minimize sample selection bias and focus on the likelihood of delinquency for youth in group home placements.

Results The matched sample is 47% African American, 34% Hispanic, 17% White and 2% Asian. On average, children were 8.5 years old at the time of their first placement. Fifty-four percent of the sample is male. As the sample is matched, 50% are associated with at least one group home placement. On average children stayed in care for 52 months. With regard to delinquency, 1142 (14%) of the 8226 adolescents in placement had at least one arrest subsequent to their first placement episode. The results from the bivariate analyses are displayed in Table 2. Consistent with prior studies and the overall risk of delinquency in the general population, males in the child welfare system are more likely to engage in delinquency as compared with females in the child welfare system (16% vs. 11%). African Americans had the highest risk of delinquency (16%) as compared with Hispanics (14%), whites (9%) and Asians (9%). There was a difference in risk associated with reason for placement: neglect (11%), physical abuse (16%), sexual abuse (10%), and emotional abuse (10%). The reasons for instability also appear to impact the likelihood of delinquency. Movements associated with AWOLs (27% vs. 12%) and child behavioral problems (20% vs. 13%) are associated with an increased likelihood of delinquency. With regard to group home placements, adolescents with at least one group home placement are at an increased risk of delinquency (20% vs. 8%). Table 2. Bivariate results: child and placement characteristics and delinquency: (n = 8226) No arrest Arrest % % Race* African American 84 16 Hispanic 86 14 White 91 9 Asian 91 9 Sex* Female 89 11 Male 84 16 Reason for placement* Physical abuse 84 16 Neglect 89 11 Emotional 90 10 Sexual abuse 90 10 AWOL reason for instability* Other reason 88 12 AWOL 73 27 Child behavior reason for instability* Other reason 87 13 Child behavior 80 20 Type of placement* Foster care 92 8 Group home 80 20 Mean Mean Age at first placement* 8.4 9.1 Length of time in substitute care placements 53.0 56.9 Total changes in placement* 4.7 5.5 *p < .01 Table options 3.1. Survival analysis The results from the Cox regression are displayed in Table 3. The table includes the coefficient and standard error for each independent variable as well as the hazard ratio. A hazard ratio greater than 1 indicates a higher likelihood of delinquency. A hazard ratio less than 1 indicates a lower likelihood of delinquency. If 1 is subtracted from the hazard ratio and the remainder is multiplied by 100, the resultant is equal to the percentage change in the hazard of arrest. Of the 8226 adolescents, 1142 (14%) were arrested at least one time subsequent to the start of their first placement. The Cox regression model includes child demographics, indicators of maltreatment (reference category is physical abuse), and placement information (type and frequency of placement changes). Table 3. Cox regression: Delinquency for adolescents in child welfare placements (n = 8226) B S.E. Exp(b) Age at placement .05* .01 1.05 African American .59* .10 1.80 Hispanic .28* .10 1.32 Asian − .09 .31 0.91 Male .59* .06 1.80 Physical Abuse .17* .08 1.18 AWOL related movement .96* .08 2.60 Child behavior related movement .32* .08 1.38 Length of stay .01* .01 1.01 Placement changes .01* .01 1.01 Group home placement .88* .07 2.40 *p < .01 Table options We find that the results of the Cox regression are similar to those reported in the bivariate tables. Group home status, placement changes associated with AWOL, race, and gender have the biggest impact on subsequent delinquency. The relative risk of delinquency is approximately two and one half times greater for youth with at least one group home placement (Exp(b) = 2.40) and for youth with an AWOL related placement change (Exp(b) = 2.60). The risk of delinquency increased by 80% for males (Exp(b) = 1.80) as compared with females, by 80% for African Americans, and by 32% for Hispanics as compared with white youth. The race and gender effects are consistent with prior studies of delinquency in the general population as well as within the context of the child welfare system ( Ryan & Testa, 2005). Also consistent with prior research, placement instability significantly increases the risk of delinquency. This is in addition to the effects associated with reasons for placement change. Finally, adolescents placed for reasons associated with physical abuse were more likely to experience arrest. The results of the Cox regression models indicate that adolescents with at least one group home placement are more likely to engage in delinquency relative to adolescents with no group home placements. But at what point are these youth arrested? Are these adolescents arrested during their stay in the group home or subsequent to their release? These analyses utilize the initial sample of 20,309 youth (i.e. the original sample prior to matching). Of these 20,309 youth, 2106 adolescents were associated with at least one arrest, and 1671 (79%) of these youth experienced their first arrest in a substitute care placement setting (see Table 4). Of the 1671 adolescents arrested in placement, 675 (40%) occurred while the youth was placed in a group home. As only about 25 of the sample ever experienced a group home placement, the estimate of 40% is concerning. The timing of arrests is an important distinction as it addresses whether there is a lingering group home effect or whether the experiences and impact of the group home are more immediate. An adolescent slowly adopting values and beliefs consistent with a deviant lifestyle and then acting upon those beliefs subsequent to their release from the group home might be indicative of a lingering or sleeper effect. Yet the adolescents in the current study are arrested during their group home placement—perhaps indicating that the effect of these placements is more immediate. Table 4. Placement location at time of initial arrest (n = 1671) Location at time of initial arrest n (%) Group home 675 (40%) Foster care 900 (54%) AWOL (run away from placement) 66 (4%) On home trial visit 15 (1%) Shelter 15 (1%) Total 1671 (100%) Table options So group home placements appear to increase the risk of delinquency. This is evident by the estimates generated in the Cox regression models and by a more detailed descriptive analysis of the location of each you at the time of initial arrest. A question remains however with regard to the types of offenses committed by youth in various placement settings. We compare the offense types for adolescents in group homes and foster care settings. We construct and compare five broad categories of offending—categories that are similar to those used by the federal government (Snyder, 2005). These categories include property, violent, threats, drug and weapon related offenses. The property offenses include burglary, larceny-theft, motor vehicle theft and arson. The violent related offenses include murder and nonnegligent manslaughter, forcible rape, robbery, aggravated assault and other assault. Three significant differences emerge. Adolescents in group homes are significantly less likely to be arrested for a weapons related offense (4% vs. 8%). In contrast, adolescents in group homes are significantly more likely to be arrested for a threat related offense (9% vs. 3%) and significantly more likely to be arrested for a violent related offense (29% vs. 18%). It's important to note that the percentage of violence related offenses are greater than the percentages reported within the general delinquency population. In 2003, approximately 2.2 million minors were arrested. Of these arrests, approximately 335,000 (15%) were violence related (Snyder, 2005).