Risk Factors of Out-of-Home Placement in Families With Intellectual Disabilities

Out-of-home placement is an impactful measure to protect and care for children who cannot live with their birth parents due to unsafety. Children in families in which at least one parent and/or child has an intellectual disability are disproportionately represented among those placed in out-of-home care. The aim of this study was to investigate (1) which risk factors increase the likelihood of out-of-home placement and (2) whether a cumulation of multiple risk factors increases the likelihood of out-of-home placement within families with intellectual disabilities.

Case files of 138 children between the ages of 0 and 18 from families with intellectual disabilities with a family supervision order were analysed using logistic regression. In 38% of these case files, the child was placed out of home (M = 9.85, SD = 5.61).

The bivariate analyses showed that several child factors (being a girl, intellectual disabilities, judicial contact), one maltreatment factor (sexual abuse) and one child-rearing factor (emotional overload) increased the likelihood of out-of-home placement. Only sexual abuse significantly contributed to a higher likelihood of out-of-home placement in the multivariate analysis. The data provided limited evidence for a cumulative effect of child risk factors, increasing the likelihood of an out-of-home placement.

Placement decisions are complex and sexual abuse of the child should be understood within a broader constellation of adversities within families with intellectual disabilities, requiring trauma-informed systemic interventions.