Estimating the effects of placement changes on internalizing and externalizing symptoms

Placement instability for youth in foster care can adversely affect child well-being, including emotional and behavioral disorders. Placement instability is common among youth in out-of-home care and can lead to behavioral challenges. Behavioral problems can also be a reason for placement change. This analysis explores the relationship between placement instability and internalizing and externalizing behaviors. The bidirectional nature of this relationship makes it more challenging to parse the effects of placement changes on a child’s behavior. To isolate this, we use a longitudinal sample of youth involved in child welfare who have not yet experienced a placement change at baseline. We investigate how placement changes, traumatic experiences, social support, and community connections contribute to internalizing and externalizing symptoms over three years using fixed effects. Fixed effects models allow us to account for time-invariant differences between respondents and focus on within-individual variation. In this analysis, we find that placement changes are associated with an average decrease in internalizing and externalizing symptoms, and those with higher trauma scores have more behavioral problems than their peers with lower trauma scores. We also discuss how this develops differently for girls and boys, along with the implications of our findings.