Benefits and Outcomes of Formal and Informal Kinship Placement

Brief Review

This brief was provided for the National Indian Child Welfare Association (NICWA) by Julia Hughes, a research assistant at the Center for Innovation in Child Maltreatment Policy, Research & Training.

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Kinship care generally is the preferred placement type in child welfare policy across most developed nations. This tends to be a particularly strong theme in regard to indigenous populations with some variation in regard to the additional role and import of community in Canada and the United States as compared to Australian policies. This review focused on trying to understand the relative benefit of formal or informal kin care for indigenous children. The lack of research, however, required taking a broader focus on kinship care work overall.

Overall studies about the impact of kinship placements on children are inconclusive. Studies have been published that talk about a variety of positive and negative outcomes that kinship has on a child. However, these studies vary in sample and effect sizes. The purpose of this paper is to summarize existing research on the outcomes and identify the benefits and additional outcomes of kinship placement. It is clear that there is a lack of research to indicate that kinship placement is a reliable beneficial outcome for children. A 2018 meta-analysis found that children in kinship care exhibited better mental health outcomes than children in non-kinship care in bivariate analyses, but had mixed associations across the studies in multivariate modeling.1 Literature is identified below with summarized findings to describe the ambiguity of effects kindship placement has been identified to have. In addition, conditions of kinship and suggestions for improvement are mentioned.

Literature was retrieved from a number of sources such as JAMA, NCBI, MEDLINE/PubMed, Taylor and Francis Online, Google Scholar, Research Gate, Wiley Online Library, and JSTOR. Hyperlinked and underlined portions of this paper are the summarized takeaways from each publication regarding their implications for the benefits and outcomes of kinship placement for children.

Published Protective Benefits

• A study in 2008 examined behavioral problems after 18 and 36 months in out-of-home care, being either kinship or foster care, and found children in kinship had a lower baseline of behavioral problems and were less likely to have unstable placements than compared to those in foster placement. (32% vs 46%).2
• A 2014 review suggests that children in kinship foster care experience fewer behavioral problems, fewer mental health, better well-being, and less placement disruption, but cautions that results are based on studies that often have significant methodological flaws.3
• A study in 2014 examined the influence of the caretaker on the child among kinship and non-relative placements and found that children in kinship care always exhibited better change in social, emotional, and behavioral outcomes than youth in non-relative foster care, but this varied by the level of depression of the kin carer.4

Published Literature of No Difference

• A study in 2014 found “ambiguous” results in children placed in kinship of damaging effects on academic achievement and inconclusive effects on health and behavior.5
• A 2015 study found that there was no significant difference in children’s socioemotional problems between kinship care and foster care.6
• A 2016 study found that African American children placed in kinship care had similar rates of emotional problems as children in other out-of-home settings.7, 19

International Settings

• Although Australia has a similar emphasis on kinship care – particularly in relation to indigenous populations, little research is available on differential outcomes for these children cared for by kin versus non-kin carers.8
• One international review suggested mixed findings in regard to ongoing connections with parents once in kinship care, but there were a number of studies indicating that these arrangements may improve connections to broader family networks which were noted as greatly important to children studied.9
• Canadian child welfare also prioritizes kin care for First Nations children, but the literature focuses on grandparents as kin carers, not child outcomes.10
• Advocates have made a case for greater attachment to community not just family for First Nations children, but empirical data on outcomes was not included.11
• One 2010 study of First Nations children (age 10-17) in foster care found that greater cultural assets were associated with lower behavioral problems, but did not control for placement type.12
• A Norwegian study in 2014 found that foster care being closer to the local community was negatively associated with children’s total behavior problems.12

A Need for Informing Caregivers of Formal Kinship

It is essential to note that informal kinship placement caregivers often do not receive training or financial assistance despite the reality that 38% of kinship households,13 and almost half of those headed by the grandmother, are in poverty.14 Current characteristics of kinship caretakers, however, show a trend of having a higher need for physical and material assistance,13 a lack of clarity of what formal/informal status implies15 by both professionals and that often caretakers are unable, not offered, or unaware of the option16 and benefits of becoming a formal kinship caregiver with access to resources. Indeed, there are publications that suggest child welfare workers need to inform caregivers of the option to become licensed kin foster caregivers16 instead of asking them to take children “voluntarily” so they are able to
receive recognition and assistance. This need for assistance is also echoed in other research that finds children in informal kindship are less likely to receive school-based services.17 In addition, there is a lack of systemic support for caretakers18 that impacts their ability to promote mental health and physical wellbeing for the children in their care.

The literature cited here supports the practice of kinship placement as a viable option for children who must be removed from their homes. However, the variance in study outcomes, methodologies, and effect sizes make it difficult to draw strong conclusions about the relative benefit of kin care compared to other family home environments. So far, the most consistent finding, with caveats above, seems to relate to some improvement in child mental health.

Despite a significant emphasis on the import of kin and sometimes community across Australia, Canada, and the US in regard to indigenous children there has been very little published research including these populations and almost no work in regard to child outcomes. Given the significant under-resource faced by kin carers across populations, it makes it difficult to test the theorized benefits in regard to cultural assets and family attachment. If kinship caretakers were empowered with access to resources and assistance it might make outcomes for children in kinship care more positive overall. More robust research must be conducted before any clear statement can be made about the impact of kinship care vs. foster placement.


1Xu, Y., & Bright, C. L. (2018). Children’s mental health and its predictors in kinship and non-kinship foster care: A systematic review. Children and Youth Services Review, 89, 243-262.

2Rubin, D. M., Downes, K. J., O’reilly, A. L., Mekonnen, R., Luan, X., & Localio, R. (2008). Impact of kinship care on behavioral well-being for children in out-of-home care. Archives of Pediatrics & Adolescent Medicine, 162(6), 550-556. Retrieved from

3Winokur, M., Holtan, A., & Batchelder, K. E. (2014). Kinship care for the safety, permanency, and wellbeing of children removed from the home for maltreatment. Cochrane database of systematic reviews, (1).

4Garcia, A., O’Reilly, A., Matone, M., Kim, M., Long, J., & Rubin, D. M. (2015). The influence of caregiver depression on children in non-relative foster care versus kinship care placements. Maternal and child health journal, 19(3), 459-467. Retrieved from

5Font, S. A. (2014). Kinship and nonrelative foster care: The effect of placement type on child wellbeing. Child Development, 85(5), 2074-2090.

6Fusco, R. A., & Cahalane, H. (2015). Socioemotional problems among young children in out-of-home care: A comparison of kinship and foster care placement. Journal of Family Social Work, 18(3), 183–201. 1005783. Rufa, A. K., & Fowler, P. J. (2016). Kinship foster care among African American youth: Interaction effects at multiple contextual levels. Journal of Social Service Research, 42(1), 26–40.

7Rufa, A. K., & Fowler, P. J. (2016). Kinship foster care among African American youth: Interaction effects at multiple contextual levels. Journal of social service research, 42(1), 26-40. Retrieved from

8Bromfield, L., & Osborn, A. L. (2007). Kinship care. Australian Institute of Family Studies. NPCP Brief No. 10. Retrieved from

9Kiraly, M., & Humphreys, C. (2013). Family contact for children in kinship care: A literature review. Australian Social Work, 66(3), 358-374. Retrieved from

10Fuller-Thomson, E. (2005). Canadian First Nations grandparents raising grandchildren: A portrait in resilience. The International Journal of Aging and Human Development, 60(4), 331-342. Retrieved from

11Carriere, J., & Richardson, C. (2009). From longing to belonging: Attachment theory, connectedness, and indigenous children in Canada. Passion for action in child and family services: Voices from the prairies, 49-67.

12Vis, S. A., Handegård, B. H., Holtan, A., Fossum, S., & Thørnblad, R. (2014). Social functioning and mental health among children who have been living in kinship and non-kinship foster care: Results from an 8-year follow-up with a Norwegian sample. Child & Family Social Work, 21(4), 557–567.

13Filbert, K. M., & Flynn, R. J. (2010). Developmental and cultural assets and resilient outcomes in First Nations young people in care: An initial test of an explanatory model. Children and Youth Services Review, 32(4), 560-564. Retrieved from

14Annie E. Casey Foundation (AECF). (2012). Stepping up for kids: What government and communities should do to support kinship families. Baltimore, MD: Author.

15Geen, R. (2004). The evolution of kinship care policy and practice. The future of children, 131-149. Fergeus, J., Humphreys, C., Harvey, C., & Herrman, H. (2018). Supporting foster and kinship carers to promote the mental health of children. Child & Family Social Work.

16Baker, L. A. & Mutchler, J. E. (2010). Poverty and material hardship in grandparent-headed households. Journal of Marriage and Family, 72, 947–962. doi:10.1111/j.1741-

17Lee, E., Choi, M. J., Lee, Y., & Kramer, C. (2017). Placement Stability of Children in Informal Kinship Care: Age, Poverty, and Involvement in the Child Welfare System. Child Welfare, 95(3), 87-110.

18Stein, R. E., Hurlburt, M. S., Heneghan, A. M., Zhang, J., Rolls-Reutz, J., Landsverk, J., & Horwitz, S. M. (2014). Health status and type of out-of-home placement: Informal kinship care in an investigated sample. Academic Pediatrics, 14(6), 559–564. Retrieved from

19Fergeus, J., Humphreys, C., Harvey, C., & Herrman, H. (2018). Supporting foster and kinship carers to promote the mental health of children. Child & Family Social Work.