Child welfare involvement and adjustment among care alumni and their children: a systematic review of risk and protective factors

Background Recent research and policy recognize care alumni (i.e., adults formerly in out-of-home care [OHC]) as a population with a high accumulation of disadvantages well into adulthood, often in combination with early parenthood compared to the general population. Objective The aim of this systematic review is to provide an overview on the impact of parental OHC on outcomes for both parents (i.e. parental adjustment, parenting) and their children (i.e. prevalence rates of OHC or child welfare system (CWS) involvement, adjustment, development), as well as protective and risk factors associated with those outcomes. Methods Relevant articles were searched in four electronic databases from conception to 16 February 2022 according to PRISMA guidelines for systematic reviews; supplemented with hand-searched citations from relevant references. Evidence was synthesized via a qualitative summary. Results A total of 38 studies were included (19 quantitative, 14 qualitative, and 5 mixed-methods studies). Studies confirm increased rates of early parenthood among care alumni and an elevated risk of OHC among their children. However, most children remain with their care alumni parents, and some parents were met with the needed support to cope with challenging circumstances. Qualitative studies point to a great need for specialized services, including parenting programs that address past trauma and attachment issues. They also highlight potential protective factors. Conclusions Findings suggest that care alumni parents experience compounding disadvantage, which may increase their children's risk of OHC. More research is needed on child adjustment, and on protective factors that can be leveraged to design effective interventions that decrease transgenerational CWS involvement.