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Literature review
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Comparing outcomes for maltreated children: out-of-home care versus remaining at home – a literature summary

Child behaviour Residential care Child welfare Early childhood development Child mental health Vulnerable children Out-of-home care New South Wales

This literature summary reviews key research studies that compare developmental, educational, health and wellbeing, and criminal justice outcomes for maltreated children who were placed in out-of-home care (OOHC) with those who remained with their birth families.

NSW Communities and Justice has a responsibility to achieve the best outcomes for children at risk. While safety is always of paramount concern, it is important to determine whether children in out-of-home care fare better or worse than maltreated children who remain with their birth families.

  • Findings from research are ultimately inconclusive. Some evidence suggests out-of-home care might have a protective effect for children in the physical health, language, cognitive and education domains, but not in the emotional or social domains or in relation to police contacts. Children in out-home-care have considerably higher rates of diagnosed mental health disorders.
  • Research into this question faces methodological challenges that make it hard to determine the contribution of out-of-home care placements to varied outcomes for maltreated children. Children in out-of-home care have often experienced greater socio-economic disadvantage, more severe maltreatment and trauma, and higher levels of prior contact with child protection services than children at risk who were not removed from their parents’ custody.
  • There is also limited research that differentiates outcomes for Aboriginal and non-Aboriginal children at risk. Further research could provide stronger evidence of the effectiveness of out-of-home care versus remaining at home for improving the wellbeing of maltreated children. However, some methodological challenges will remain, even with robust research.
  • These findings reinforce the importance of continued intra- and inter-agency collaboration to support children at risk and in out-of-home care to improve a range of developmental and wellbeing outcomes. In particular, there is an ongoing need for investment in programs that address high rates of mental health disorders and higher police contacts for children in out-of-home care.
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