Journal Issue: Children, Families, and Foster Care Volume 14 Number 1 Winter 2004
Brenda Jones Harden
Family Stability and Healthy Child Development
Family stability has been defined in many ways in the empirical literature. Traditionally, many researchers defined family stability in terms of factors related to family structure (for example, single parenthood).3 Specifically addressing the experiences of foster children, other scholars have defined stability as limited movement from home to home.4 However, exploring the various family processes that pertain to stability may be a more useful means of understanding the specific characteristics of family stability that support healthy child development. For example, parental mental health, stable relationships among caregivers, and positive parenting are cited as markers of family stability.5 Characteristics of the home environment, such as warmth, emotional availability, stimulation, family cohesion, and day-to-day activities, have also been implicated in the notion of family stability.6 Children who experience family stability have caregivers who remain constant, consistent, and connected to them over time; caregivers who are mentally healthy and engage in appropriate parenting practices; a cohesive, supportive, and flexible family system; and a nurturing and stimulating home environment. This definition of family stability is not offered as a standard by which to evaluate families in the child welfare system, but rather as an essential goal of child welfare intervention with biological, foster, and adoptive families.
Children are more likely to have trusting relationships with caregivers who are consistent and nurturing, which leads to a number of positive developmental outcomes.7 (See Box 1.) Moreover, the research suggests that positive and consistent caregiving has the potential to compensate for factors that have a deleterious impact on children, such as poverty and its associated risk factors.8 In other words, children have much better outcomes if their family lives are stable, despite the overwhelming influence of poverty and associated risk factors. Research has also documented that stability in the family unit promotes positive outcomes for children within particular developmental periods (see Box 2).
Conversely, child maltreatment reflects an extreme form of family instability. Data from the National Survey of Child and Adolescent Well-Being (NSCAW), the only large-scale, nationally representative study of foster children, as well as data from other studies, indicate that the majority of children enter the foster care system due to neglect.9 The next largest group enters the system due to physical abuse, and a smaller number enter due to sexual abuse.10 Moreover, almost half of children who are maltreated experience more than one type of maltreatment. Thus, many scholars recommend examining the consequences of maltreatment in general, rather than specific types of maltreatment. Nevertheless, a large body of research documents that these forms of maltreatment are associated with adverse outcomes in physical health, brain development, cognitive and language skills, and social-emotional functioning.11 For example, neglect is associated with a variety of developmental difficulties in childhood, including cognitive, language, and academic delays, poor peer relations, and internalizing (anxiety, depression) and externalizing (aggression, impulsivity) behavioral problems.12 Physical abuse, in addition to its physical health consequences, has been linked to cognitive delays, aggressive behavior, peer difficulties, posttraumatic stress disorder, and other externalizing and internalizing behavioral problems.13 Documented consequences of sexual abuse include low academic performance, depression, dissociation, inappropriate sexual behavior, and other high-risk behaviors in later childhood.14Emotional maltreatment, which is implicated in all other forms of maltreatment, leads to declines in cognitive and academic functioning, as well as a variety of behavioral problems.15 The diagnosis of “failure to thrive” is a particularly illuminating health outcome of a problematic family environment. The experience of severe parental emotional unavailability leads to serious growth delays as well as psychological difficulties in young children.16
Specific areas of child development research are particularly relevant to a consideration of the impact of family instability on foster children, and on child welfare policy and practice in general. Although the following paragraphs are by no means exhaustive, the research on attachment, brain development, and resilience seems particularly germane to an understanding of the development of foster children.
AttachmentThe capacity of maltreated children to attach to caregivers has been a key concern and has been widely studied among child welfare experts. Attachment can be defined as the enduring emotional bond that exists between a child and a primary caregiver, who could be a biological parent or an unrelated caregiver. Most children are securely attached to their caregivers: They look to their caregivers for comfort when distressed and are able to explore their environment because of the security they feel in their relationships with their caregivers. Alternatively, due to the uncertainty they feel in their relationships with their caregivers, insecurely attached children may not be adequately consoled by their caregivers or able to explore their environments. Children reared by caregivers who are inconsistent or demonstrate inadequate parenting practices are much more likely to be insecurely attached, or to have a disordered attachment.17
Attachment disorders, which lead to the most problematic outcomes for children, include those in which children have disrupted attachments to their caregivers, display overly vigilant or overly compliant behaviors, show indiscriminate connection to every adult, or do not demonstrate attachment behaviors to any adult. Children with insecure, “disordered” or “disorganized” attachments may also have many other adverse outcomes that persist throughout childhood, such as poor peer relationships, behavioral problems, or other mental health difficulties.18
Maltreated children are often exposed to inconsistent and inadequate parenting and, as a result, may experience difficulty in forming healthy attachments. Some studies suggest that upwards of three-quarters of maltreated children have disordered attachments, but that the proportion may diminish with age.19 The limited empirical work on attachment in foster children suggests that they are more likely than nonfoster children to have insecure and disorganized attachments. However, the psychological and environmental characteristics of their foster families can influence the type of attachments they have to their caregivers. In addition, research on the impact of institutionalization (that is, placement in orphanages or large-group foster care settings) on children suggests that children with multiple caregivers are more likely to display insecure attachments and indiscriminate friendliness.20
Brain DevelopmentWith the advent of less-invasive and less-expensive techniques for examining brain structure and function, contemporary developmental researchers have begun to investigate developmental processes at the level of the brain. A major conclusion derived from this research is that although children's experiences during the first three years of life are critical to brain development, the brain remains plastic even after infancy.
Although the existing research suggests diverse outcomes, scholars have documented that young children exposed to trauma (for example, maltreatment and other forms of violence) are more likely than children who have not been exposed to trauma to experience physiologic changes at the neurotransmitter and hormonal levels (and perhaps even at the level of brain structure) that render them susceptible to heightened arousal and an incapacity to adapt emotions to an appropriate level.21 This emotional state increases their sensitivity to subsequent experiences of trauma and impairs their capacity to focus, remember, learn, and engage in self-control.22
In addition, the research on institutionalized children indicates that institutionalization and other adverse early experiences (for example, having multiple caregivers and being held and stimulated less) may affect brain structure and activity.23 Findings from these studies suggest that the timing and duration of institutionalization are important. Better outcomes were noted in children who were adopted from institutions prior to their second birthdays.24
One study directly assessed the brain functioning of children in foster care using the popular method of examining levels of cortisol, the hormone produced in response to stress in humans.25,26 Children who are exposed to high levels of stress show unusual patterns of cortisol production.27 Foster children exhibited unusually decreased or elevated levels of cortisol compared to children reared by their biological parents.28 Such findings are consistent with the literature, which points to the importance of the parent-child relationship in buffering the stress responses of children.
ResilienceThe work on resilience is particularly relevant for foster children because it examines the factors that allow some children faced with severe adversities to “overcome the odds” and become successful at a variety of developmental and life-adjustment tasks.29 Several characteristics of children and their environments may compensate for the high-risk situations with which they must contend, leading to more positive outcomes. These protective factors include child IQ, temperament, and health, as well as a warm parental relationship, engagement with school, and support outside the family (such as a mentor). Although the research on resilience in foster children specifically is sorely lacking, studies of maltreated children suggest that maltreated children who exhibit resilience have high cognitive competence, self-esteem, and ego control (including flexibility, planfulness, persistence, and reflection).30 Thus, foster children, who have an increased likelihood of experiencing multiple risk factors such as poverty, maltreatment, and separation from family of origin, may have more positive outcomes if they are fortunate enough to also experience protective factors.
In summary, children in stable family environments are likely to experience positive, engaged parenting and to have positive developmental outcomes. By contrast, children in foster care have often experienced family instability and other types of maltreatment that compromise their healthy development. However, providing safe, stable, and nurturing homes for these children may lessen the harmful effects of their experiences by exposing them to protective factors that can promote resilience.