The Home or Care study: comparing outcomes for children in out of home care:

Research has shown that outcomes for children in out-of-home care (OHC) are often poor. However, most studies have failed to disentangle the effects of being in OHC from the impact of the abuse or neglect that led to... [ view full abstract ]

Research has shown that outcomes for children in out-of-home care (OHC) are often poor. However, most studies have failed to disentangle the effects of being in OHC from the impact of the abuse or neglect that led to admission. The objectives of the Home or Care? study were therefore to investigate (1) which maltreated children are placed in OHC and (2) whether outcomes for children admitted to OHC are better or worse than those for maltreated children who remain at home.

This comparative, longitudinal study drew a representative sample of 390 children who had experienced abuse or neglect by age seven and followed them up an average of four years later. Outcomes for children who entered OHC due to maltreatment (the care group) were compared to those for children who had never entered care and were instead monitored and supported by social workers on a Child Protection Plan for a time (the home group). A survey of social workers collected data on the children’s histories, family circumstances and the reasons for intervention and included a standardised measure of the nature, severity and timing of the maltreatment the children had experienced (the Modified Maltreatment Classification System, or MMCS). Outcome data on the children’s progress and development at follow-up were collected in interviews with parents (of the home group) or foster carers (of the care group).

Thresholds for support in the community and for admission to OHC were both very high, as the majority of children in both groups had experienced multiple and severe forms of maltreatment. The evidence on health, mental health and educational progress by follow-up was complex but, overall, outcomes for children in OHC were similar to those for the maltreated children who remained at home.  These findings have important implications for policy and practice.