Improving quality of life for adult foster care alumni with physical or psychiatric disabilities

Date Published: 

Anctil, T.M., McCubbin, L.D., O’Brien, K., Pecora, P., & Anderson-Harumi, C.A. (2007). Predictors of adult quality of life for foster care alumni with physical and/or psychiatric disabilities. Child Abuse & Neglect, 31, 1087-1100.

Reviewed by: 
Sydney Duder

This study examined the quality of life (QOL) of adults (N=1087) who had been placed in a private foster care program for at least 12 months in the period 1966-98, and who had been discharged at least 12 months before the start of the study. Data—from archival case records and interviews by trained professionals—included:

QOL outcomes: economic (education, earnings, job satisfaction & job turnover) and health-related (medical care history, Rosenberg’s self-esteem scale, SF-12 Health Survey, supportive relationships).

Risk factors: age at original placement; educational instability (school changes, special education services); maltreatment (neglect or abuse).

Protective factors: therapeutic services and supports; foster family fun activities; preparation for leaving care (training & resources), close and confiding relationship with adult.

A number of QOL measures—both economic and health-related—were found to be significantly lower for alumni who had been diagnosed with physical and/or psychiatric disabilities while in foster care than for those who had not.

For the sample with disabilities (N=578) the effects of specific risk and protective factors were then analyzed. Having received special education services was the most significant risk factor, perhaps because this indicated more severe disability. Sexual abuse was also a significant risk factor for poor self-esteem. On the other hand, services and resources that prepared for discharge were significant protective factors, predicting both better economic outcomes and higher self-esteem; this finding has useful implications for planning social services for these clients.

Methodological notes: 

The study was generally well-conducted, Quality of life is rather a slippery concept, which can be defined and measured in a number of different ways; the multidimensional approach taken here was useful in including a number of objective measures as well as subjective self-ratings.

Multivariate statistical procedures included: (1) 2x2 MANCOVAs—outcome by gender and disability status, controlling for age—to compare the disabled and nondisabled samples; economic and health outcomes were analyzed separately. (2) Hierarchical regression analysis of cases with disabilities to determine the effects of three blocks of variables—demographics, risk factors and protective factors; this was a very conservative approach to the evaluation of protective factors.

The authors identified several limitations. Subjects–from a private foster care agency for children who would not be reunified or adopted—were not necessarily representative of all foster care alumni. The protective factors examined were limited to available data, which did not include the amount and quality of services actually delivered. Also, the sample size was too small to permit analysis of the nature and severity of disabilities.