The Cumulative Effect of Prior Maltreatment on Emotional and Physical Health of Children in Informal Kinship Care

Objective: Millions of children cared for by their grandparents or other kin without a biological parent present are not part of the foster care system. Maltreatment may have precipitated out-of-home care arrangements, but most children in informal kinship care are not being tracked or receiving services. Importantly, the extent of previous child welfare involvement and its association with well-being among this population are not well known. Methods: Kinship caregivers known to social service and community agencies were recruited for this study. Caregivers who agreed to participate rated the physical and emotional health of children under their care. Maternal mental health and demographic data were collected, and matched records of children were retrieved from the state child welfare database. The nested structure of children within families was addressed using a generalized estimating equation model. Results: The sample included 365 children from 274 families. Only 25% of the children were in private kinship care with no known Child Protective Services (CPS) involvement. An average of 2.37 open CPS cases were observed for those in voluntary kinship care. One out of 4 children scored below the clinical level of emotional health. The number of CPS cases and kin caregiver's parenting stress were inversely associated with child's physical and emotional health. The presence of maternal mental health problem was significantly associated with poor child emotional well-being. Conclusion: Many children in informal kinship care experienced multiple episodes of maltreatment. This study's results add further evidence of the cumulative negative effects of child maltreatment on child well-being. Children in informal kinship care are in need of services to mitigate their traumatic experiences.