“For me context is the key – from that comes the understanding of everything.” Kenneth Noland, American painter, April 10, 1924–January 5, 2010

This paper identifies some of the key debates about the evidence from outcomes for children placed in foster care, the challenging issues in the design of the system, how it operates and what the outcomes for children look like. The paper explores foster care as being based in the evolution of the human species in its capacity to adapt, problem-solve and identify resources through cooperative effort between individuals and social groupings with the family as key. An essential attribute of families and parenting is the ability to form close, meaningful and sustained relationships that provide security, stability and opportunity, including connectedness to the community and the resources that are a part of this. Family forms the basis for the child being able to access personal, social, cultural and economic capital both in the present and into the future. One of the serious issues for foster care is the short-term basis of that commitment and, even when it lasts over the longer term, the care arrangement typically ends as the child reaches adulthood. These issues are explored through the concept of resilience and place foster care within an ecological framework that evolves over time.

Identifying optimal out-of-home placements for child welfare-involved youth is challenging. Examples of youth recovering within each “out-of-home” placement type (foster, relative, residential) are evident, as are examples of youth who are deteriorating. The heterogeneity in developmental history and current functioning of youth makes blanket policies regarding placement unwise. Examination of developmental heterogeneity and functioning of youth in the welfare system can provide insights about factors influencing outcomes, thereby informing practice, program and policy. We explore whether current relational health (connectedness) promotes positive outcomes for child welfare-involved youth while controlling for developmental risk (history of adverse, and lack of relationally positive, experiences). Clinicians at 19 organisations serving child welfare-involved youth used a neurodevelopmentally informed approach to intervention, the Neurosequential Model of Therapeutics (NMT), which includes metrics to assess the developmental timing of children's risk, “connectedness” and neurodevelopmental functioning (e.g., sleep, arousal, cortical control). Data-driven statistical techniques were used to produce stable, generalisable estimates. Risk during the perinatal (0–2 months) period significantly predicted children's functioning; current relational health predicted outcomes more strongly. Although early life developmental risk has a persistent effect on functioning, relationally supportive contexts may mitigate this risk. Improving relational contexts of child welfare-involved youth, regardless of placement type, is key.

This article focuses on the variability in developmental outcomes of foster children and the implications for foster care research and practice. We first provide a brief overview of our previous work, where we have shown by means of meta-analysis and a longitudinal study that foster children greatly vary with respect to their developmental functioning. We then discuss that it is both the heterogeneity of developmental trajectories and the lack of an accurate model for predicting foster children's development that make the screening and monitoring of foster children's development important. We provide suggestions for screening and monitoring, and discuss the Brief Assessment Checklist as an example of a specific instrument available for screening and monitoring of vulnerable children exposed to severe social adversity. We conclude our article with directions to improve foster care and research on foster care, including a discussion of the effectiveness of and foster children's susceptibility to interventions, support for foster parents and the potential of large national and international studies.

Placement stability is sought for children who enter care and need a place to call home. This is deemed to be necessary for the formation and continuation of secure and loving relationships with parents and carers. However, the term placement stability does not capture the quality of the placement or the subjective experience of the young person. In contrast, the term relational permanence denotes an enduring and supportive relationship between a young person and a caring adult. Research studies have tended to focus on placement stability, or legal and physical permanence, and overlook relational permanence. Within the current study, we found high levels of long-term placement stability for the study population, 354 young people who were under five and in care in Northern Ireland on the 31st March 2000. Placements for those who were adopted, on Residence Order, and rehabilitated with birth parents were more likely to be stable than those in long-term foster care and kinship foster care. However, early interview data with 30 young people and/or their parents/carers revealed high levels of relational permanence, irrespective of placement type, and that placement disruption did not necessarily mean a breakdown in the relationship. Implications for policy and practice are discussed.

It is recognised internationally that children in out-of-home care (‘children in care’ or ‘children looked after’) generally have lower educational attainments than other pupils. This article provides two forms of evidence that challenge the view that care status in itself can explain this ‘attainment gap’. A systematic review of 28 studies was conducted to assess the evidence on whether being in care is detrimental to young people's educational outcomes. This is complemented by an analysis of administrative data from England, which compares the educational outcomes of children in care at age 16 to those of children in the general population and to other children supported by social services. Taken together, the findings suggest that while research demonstrates an important attainment gap between children in care and children in the general population, this difference is reduced and in many cases disappears when other important factors are taken into consideration to reduce selection bias. We find little evidence that being in care is detrimental to the educational outcomes of children looked after, but suggest that given the heterogeneity of the population, special attention should be paid to different groups of children and their particular needs while in care.

Research on young people transitioning out of the childcare system and into young adulthood is inevitably reductionist in that it is unable to take into account the many complex forces that play a role in the development of a child from birth, into and through the care system and on to adulthood. Consequently, studies on the outcomes of care-leavers need to be interpreted with care and thought. This paper serves to illustrate these challenges in research and the various ways that research results can be interpreted by drawing on data from a study being conducted in a residential care programme in South Africa. Demographic, pre-care and in-care variables of a sample of care-leavers are compared with a set of independent living outcome variables a year after aging out of care. Unanticipated results are contrasted with those that were anticipated, and multiple interpretations of the same results are provided. Because of this, the author calls for judicious and humble use of research results when making judgements about the outcomes of care-leavers and the effectiveness of child welfare interventions.