Interventions for pre‐school children in foster care: A systematic review of randomised controlled trials of child‐related outcomes

Abstract Background Children in foster care are at high risk of future mental health and developmental difficulties. A number of interventions may be helpful; however, the effectiveness of interventions specifically for pre‐school children in foster care is not well established. This is an important...

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Main Authors: Natalie Kirby, Camilla Biggs, Megan Garside, Gloria Cheung, Philip Wilson, Matt Forde, Manuela Deidda, Dennis Ougrin, Fiona Turner, Karen Crawford, Helen Minnis
Format: Article
Language:English
Published: Wiley 2025-03-01
Series:JCPP Advances
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Online Access:https://doi.org/10.1002/jcv2.12273
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author Natalie Kirby
Camilla Biggs
Megan Garside
Gloria Cheung
Philip Wilson
Matt Forde
Manuela Deidda
Dennis Ougrin
Fiona Turner
Karen Crawford
Helen Minnis
author_facet Natalie Kirby
Camilla Biggs
Megan Garside
Gloria Cheung
Philip Wilson
Matt Forde
Manuela Deidda
Dennis Ougrin
Fiona Turner
Karen Crawford
Helen Minnis
author_sort Natalie Kirby
collection DOAJ
description Abstract Background Children in foster care are at high risk of future mental health and developmental difficulties. A number of interventions may be helpful; however, the effectiveness of interventions specifically for pre‐school children in foster care is not well established. This is an important omission, since infancy and early childhood may be the optimal period for interventions to prevent future problems. The current systematic review set out to establish the existing evidence base for interventions to improve social‐emotional, developmental and relational outcomes for pre‐school children in foster and kinship care. Methods Searches of online databases were undertaken in June 2023 with keyword search terms related to the study population and design. Studies utilising a randomised control design to measure the effectiveness of interventions for foster children aged 0–7 years were included. The methodological quality of included studies was assessed using the Cochrane Risk of Bias (ROB‐2) tool and effects evaluated using narrative synthesis and GRADE assessments of included interventions and outcomes. Results Searches identified 6815 results. Twenty studies, describing seven interventions, met inclusion criteria. Fifteen studies reported intervention benefits comparative to control in at least one outcome domain, with particularly good evidence for Attachment and Behaviour Catch‐Up (ABC) in improving developmental outcomes. There was also evidence for Multi‐Treatment Foster Care for Pre‐Schoolers (MTFC‐P), Kids In Transition To School (KITS), Parent‐Child Interaction Therapy (PCIT) and HeadStart in improving behavioural outcomes. The findings for relational outcomes, including attachment, were mixed; however, there was some evidence for MTFC‐P and ABC in reducing avoidant attachment. Conclusions This systematic review contributes to our current understanding of how we might best support pre‐school children in foster care. It remains unclear whether the effectiveness of particular interventions may be moderated by participant or intervention characteristics. Further research is needed to understand which interventions work best for whom in this group. Despite some variability in methodological quality and heterogeneity across studies, our findings suggest that certain interventions are likely to be helpful for young children in foster care. Dissemination and ongoing evaluation of the evidence‐based interventions highlighted within this review should be implemented in clinical practice.
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spelling doaj-art-1dab58e8647e4ae787cdd7fd4c77fd9c2025-08-20T03:05:43ZengWileyJCPP Advances2692-93842025-03-0151n/an/a10.1002/jcv2.12273Interventions for pre‐school children in foster care: A systematic review of randomised controlled trials of child‐related outcomesNatalie Kirby0Camilla Biggs1Megan Garside2Gloria Cheung3Philip Wilson4Matt Forde5Manuela Deidda6Dennis Ougrin7Fiona Turner8Karen Crawford9Helen Minnis10Leeds and York Partnership NHS Foundation Trust Leeds UKUniversity of Glasgow Glasgow ScotlandLeeds and York Partnership NHS Foundation Trust Leeds UKYork and Scarborough Teaching Hospitals NHS Foundation Trust York UKInstitute of Applied Health Sciences University of Aberdeen Aberdeen ScotlandNSPCC London UKHEHTA School of Health and Wellbeing Glasgow ScotlandYouth Resilience Unit Centre for Psychiatry and Mental Health Wolfson Institute of Population Health WHO Collaborating Centre for Mental Health Services Development Queen Mary University of London London UKSchool of Health and Wellbeing University of Glasgow Glasgow ScotlandSchool of Health and Wellbeing University of Glasgow Glasgow ScotlandSchool of Health and Wellbeing University of Glasgow Glasgow ScotlandAbstract Background Children in foster care are at high risk of future mental health and developmental difficulties. A number of interventions may be helpful; however, the effectiveness of interventions specifically for pre‐school children in foster care is not well established. This is an important omission, since infancy and early childhood may be the optimal period for interventions to prevent future problems. The current systematic review set out to establish the existing evidence base for interventions to improve social‐emotional, developmental and relational outcomes for pre‐school children in foster and kinship care. Methods Searches of online databases were undertaken in June 2023 with keyword search terms related to the study population and design. Studies utilising a randomised control design to measure the effectiveness of interventions for foster children aged 0–7 years were included. The methodological quality of included studies was assessed using the Cochrane Risk of Bias (ROB‐2) tool and effects evaluated using narrative synthesis and GRADE assessments of included interventions and outcomes. Results Searches identified 6815 results. Twenty studies, describing seven interventions, met inclusion criteria. Fifteen studies reported intervention benefits comparative to control in at least one outcome domain, with particularly good evidence for Attachment and Behaviour Catch‐Up (ABC) in improving developmental outcomes. There was also evidence for Multi‐Treatment Foster Care for Pre‐Schoolers (MTFC‐P), Kids In Transition To School (KITS), Parent‐Child Interaction Therapy (PCIT) and HeadStart in improving behavioural outcomes. The findings for relational outcomes, including attachment, were mixed; however, there was some evidence for MTFC‐P and ABC in reducing avoidant attachment. Conclusions This systematic review contributes to our current understanding of how we might best support pre‐school children in foster care. It remains unclear whether the effectiveness of particular interventions may be moderated by participant or intervention characteristics. Further research is needed to understand which interventions work best for whom in this group. Despite some variability in methodological quality and heterogeneity across studies, our findings suggest that certain interventions are likely to be helpful for young children in foster care. Dissemination and ongoing evaluation of the evidence‐based interventions highlighted within this review should be implemented in clinical practice.https://doi.org/10.1002/jcv2.12273developmentfoster careinfantinterventionsmental healthpre‐school
spellingShingle Natalie Kirby
Camilla Biggs
Megan Garside
Gloria Cheung
Philip Wilson
Matt Forde
Manuela Deidda
Dennis Ougrin
Fiona Turner
Karen Crawford
Helen Minnis
Interventions for pre‐school children in foster care: A systematic review of randomised controlled trials of child‐related outcomes
JCPP Advances
development
foster care
infant
interventions
mental health
pre‐school
title Interventions for pre‐school children in foster care: A systematic review of randomised controlled trials of child‐related outcomes
title_full Interventions for pre‐school children in foster care: A systematic review of randomised controlled trials of child‐related outcomes
title_fullStr Interventions for pre‐school children in foster care: A systematic review of randomised controlled trials of child‐related outcomes
title_full_unstemmed Interventions for pre‐school children in foster care: A systematic review of randomised controlled trials of child‐related outcomes
title_short Interventions for pre‐school children in foster care: A systematic review of randomised controlled trials of child‐related outcomes
title_sort interventions for pre school children in foster care a systematic review of randomised controlled trials of child related outcomes
topic development
foster care
infant
interventions
mental health
pre‐school
url https://doi.org/10.1002/jcv2.12273
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