Nyhet
In others’ hands – Infants in out-of-home care
Separating an infant from their parents is one of the most far-reaching decisions made by social services. Yet knowledge about how these children fare in the long term has been limited. Researchers have now followed children who were placed in care during their first year of life into adulthood, providing new insights into their living conditions, development, and future prospects.
When people talk about children in out-of-home care, thoughts often turn to teenagers, since adolescence is when most children are placed for the first time. What many do not know is that among younger children, the risk of being placed in care is actually highest during the very first year of life, says Hilma Forsman, associate professor of Social work at Stockholm university and principal investigator of both a completed and an ongoing Forte-funded research project focusing on the youngest children in care.
While teenagers’ situations are often linked to school problems, delinquency, or concerns about social development, infants exist in a much more private sphere.
– Infants move within a much smaller social world than older children, cannot make their voices heard, and are entirely dependent on their parents or other caregivers for security and care. For that very reason, they occupy a particularly vulnerable yet often hidden position, says Hilma.
These are often children who are born into very difficult circumstances
Hilma Forsman
Associate professor of social work at Stockholm University
One per cent of all children are placed in out-of-home care each year
In Sweden and other European countries, approximately one per cent of all children are placed in out-of-home care each year. Children who are placed during their first year of life rarely have a single risk factor behind their placement.
– These are often children who are born into very difficult circumstances. Parents may experience mental ill health, substance abuse problems, or severe social and economic disadvantage. We also see medical vulnerabilities more frequently, such as premature birth or low birth weight. In other words, it is seldom a single factor but rather several interacting risks surrounding the child, says Hilma.
Many of these families are already in contact with different authorities because of their particular challenges.
– This means there are often opportunities to identify needs at an early stage. Increased knowledge can help identify risks early and provide preventive support before the situation becomes so serious that placement is necessary.
Each individual was followed for almost four decades
In the previous project, researchers used long-term data from Swedish registers covering seven different birth cohorts, that is, groups of children born during the same period. Together, the material includes nearly 700,000 individuals born between 1975 and 1981. What makes the study unique is that each individual could be followed from birth and almost four decades forward, up to the age of 38, making it possible to study psychosocial outcomes much later in life.
– We see that placement during the first year of life is associated with increased risks of various difficulties later in life, extending into early middle age. This does not mean that the placement itself causes these outcomes. Rather, it demonstrates the profound importance of the very earliest life conditions. It provides a more nuanced understanding of what early interventions are really about, explains Hilma.
The findings therefore do not point to simple cause-and-effect relationships. Instead, they paint a picture of how a very difficult start in life can have long-lasting consequences and how society’s early and far-reaching interventions can be understood from a life-course perspective.
Attachment and the importance of the first years of life
A key concept in research on children in out-of-home care is placement patterns; that is, how placements develop over time. For children in their first year of life, when attachment and fundamental development are taking shape, repeated disruptions may be particularly significant. Understanding how different placement patterns are associated with later life conditions is therefore crucial, Hilma argues.
– Infant placements vary greatly. Some children are placed for a short period, others for a longer time, and many experience multiple placements during childhood. Stability and continuity have proven important for the development of children in care. For infants, who are in the midst of an intensive developmental period, stability may be especially important.
New research follows children born between 1995 and 2025
In a new research project, Hilma and her colleagues are building on previous findings by following children born between 1995 and 2025. The aim is to investigate what infant placements look like today, how these children fare in the short and long term, and the significance of different placement patterns for their development.
– These children are almost invisible in Swedish research and policy. We hope that the research can contribute to a more long-term perspective and a stronger focus on stability for young children, says Hilma.
The knowledge generated may provide guidance for social services, policymakers, and other stakeholders who make some of the welfare state's most far-reaching decisions, concerning children who are not yet able to make their own voices heard.
Children in out-of-home care
Approximately 25,800 children and young people are placed in residential care each year. The majority receive care on a voluntary basis, and half are under the age of 15. Foster care is the most common form of placement, followed by residential care and supported accommodation.
Many children experience multiple placements, and a mapping study conducted by the National board of health and welfare in 2023 shows that 57 per cent had more than one placement.
The relationship between the number of placements and educational attainment is clear: the more placements a child experiences, the poorer their school results. These differences become more pronounced as children grow older.
Overall, national statistics show that:
- Children and young people in care are significantly less likely to meet educational attainment targets.
- Only about half are eligible for upper secondary school at age 17, compared with approximately 85 per cent of other children.
- Only around half have completed a three-year upper secondary education by age 20.
These disparities are clear for both girls and boys.
Source: Swedish Association of Local Authorities and Regions (SALAR)
TEXT: Michelle Bornestad
