A typology of teen-aged children in out-of-home care: a register-based cohort study

Many studies have shown that adolescents in out-of-home care (OHC) often have complex and intertwined problems. This prospective population-based cohort study utilized data from health care and social welfare registers including all children born in Finland in 1997 (N = 57,659) and 2002 (N = 54,007) and their biological parents. The children and parents were followed from the children’s birth until their 20th birthday. As previous research has identified gender differences in the problems faced by adolescents in OHC, analyses were conducted separately for boys and girls. Latent class analysis (LCA) was used to create a typology of teen-aged children placed in OHC between the ages of 13 and 18, based on their own problematic substance use (C-PSU), psychiatric disorders (C-PD) and behavioural or emotional disorders (C-BED) and their parents’ problematic substance use (P-PSU), psychiatric disorders (P-PD) and financial difficulties (P-FD). For both genders, Bayesian Information Criterion (BIC) values supported a three-class solution: 1) children with predominantly parental problems (35% of boys, 42% of girls), 2) children with both personal and parental problems (36% of boys, 23% of girls) and 3) children with predominantly personal problems (30% of boys, 35% of girls). Similar latent profile structures were observed for boys and girls, suggesting largely similar underlying reasons for OHC placement across genders. Overall, the findings indicate that adolescents in OHC often face challenges related to both their own behaviour and mental health, and their parents’ difficulties. These results highlight the importance of considering the whole family when supporting adolescents with complex needs in OHC.