title: Out-of-home placement decision-making and outcomes in child welfare: a longitudinal study.
abstract: After children enter the child welfare system, subsequent out-of-home placement decisions and their impact on children's well-being are complex and under-researched. This study examined two placement decision-making models: a multidisciplinary team approach, and a decision support algorithm using a standardized assessment. Based on 3,911 placement records in the Illinois child welfare system over 4 years, concordant (agreement) and discordant (disagreement) decisions between the two models were compared. Concordant decisions consistently predicted improvement in children's well-being regardless of placement type. Discordant decisions showed greater variability. In general, placing children in settings less restrictive than the algorithm suggested ("under-placing") was associated with less severe baseline functioning but also less improvement over time than placing children according to the algorithm. "Over-placing" children in settings more restrictive than the algorithm recommended was associated with more severe baseline functioning but fewer significant results in rate of improvement than predicted by concordant decisions. The importance of placement decision-making on policy, restrictiveness of placement, and delivery of treatments and services in child welfare are discussed.
authors.affiliation: Department of Child and Adolescent Psychiatry, Center for Mental Health Implementation and Dissemination Science in States for Children, Adolescents, and Families (IDEAS Center), New York University Child Study Center, New York University School of Medicine, 1 Park Avenue, 7th Floor, New York, NY, 10016, USA, brian.chor@nyumc.org.
authors.forename: Ka Ho Brian
authors.initials: KH
authors.lastname: Chor
authors.forename: Gary M
authors.initials: GM
authors.lastname: McClelland
authors.forename: Dana A
authors.initials: DA
authors.lastname: Weiner
authors.forename: Neil
authors.initials: N
authors.lastname: Jordan
authors.forename: John S
authors.initials: JS
authors.lastname: Lyons
mesh_terms: D000293:Adolescent; D000465:Algorithms; D002648:Child; D002669:Child Welfare / Q000706:statistics & numerical data*; D002675:Child, Preschool; D003657:Decision Making; D005260:Female; D005581:Foster Home Care / Q000592:standards*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007400:Interprofessional Relations; D008137:Longitudinal Studies; D008297:Male; D020380:Needs Assessment