Children’s Stability and Well-being Study

The Challenge

National estimates reveal that two-thirds of children who are in foster care for more than one year experience three or more placements. Unsurprisingly, placement instability is a significant risk factor for negative health, educational, and social-emotional outcomes. However, little is known about the specific factors that impact placement stability and placement decisions that promote resiliency for children in out-of-home care.

The Project

This Stoneleigh Fellowship enabled Dr. Dave Rubin to undertake the nation’s first longitudinal study of children in foster care that specifically focused on gathering detailed information at every change of placement. In addition to the Stoneleigh Foundation, the project received substantial start-up funding from the National Institute of Child Health and Development and the William Penn Foundation. Dave partnered with the Philadelphia Department of Human Services to capture how the child welfare system influenced placement stability and child well-being among a group of 400 young children who entered out-of-home care in Philadelphia between 2006-2008. The study examined (1) the relationship of placement stability to school outcomes for children, (2) the challenges for relatives who were raising their children in kinship care, and (3) the system barriers that worked against providing placement stability for children.

The study’s results had regional and national influence in guiding reforms within the child welfare system. Locally, Dave and his PolicyLab colleagues worked with the performance management unit of Philadelphia’s child welfare system to measure placement disruptions on children more systematically, increase the availability of behavioral services earlier in care, strengthen coordination of services with the School District of Philadelphia, and improve the use of kinship care as a resource to improve outcomes for children. The results also pointed to several new areas of important work led by PolicyLab focused on the over-prescription of psychotropic medications to youth in foster care and developing more integrated models of behavioral health services embedded within the child welfare care system. In addition, the study has been frequently cited by the U.S. Children’s Bureau as they have sought to respond to the needs of youth in the nation’s child welfare system.

David Rubin's Headshot

David Rubin, MD, MSCE

Stoneleigh Fellow

2007 - 2012

University of California

Current Position

Executive Vice President of Health
PolicyLab at Children’s Hospital of Philadelphia


Project Updates