Continuity and coherence for Danish children and young people placed outside their homes – a positive development?

Inge Marie Bryderup, Aalborg University

Sofie Aggerbo Johansen, Aalborg University

1          Introduction

Research shows that on several dimensions, children and young people placed outside their homes do not perform as well as other children and young people. For example, international and Danish studies have shown that children and young people placed outside their homes underperform in relation to schooling and education (Bryderup, Engen & Kring, 2017; Bryderup & Trentel 2012; Olsen, Egelund & Lausten, 2011; Andersen & Fallesen, 2010; Egelund, Hestbæk, & Andersen, 2004; Jackson & Cameron, 2014; Vinnerljung, Öman, & Gunnarson, 2005; Courtney, Piliavin, Grogan-Kaylor, & Nesmith, 2001). Many studies also find that adults who were placed outside their homes as children, are more likely to have an unstable labor force status than others (Olsen et. al., 2011; Andersen & Fallesen, 2010; Vinnerljung, Sundell, Löfholm, & Humlesjö, 2006). In terms of psychological well-being as well, research has shown that children and young people placed outside their homes are more likely to experience social problems such as involvement in serious crime, hospitalizations connected with mental-health issues and teenage parenthood (Olsen et al., 2011; Egelund et al., 2008; Vinnerljung, Hjern, & Lindblad, 2006; Vinnerljung & Sallnäs, 2008).[1]

There is a variety of explanations as to why children and young people placed outside their homes underperform in several of the dimensions mentioned above. Some studies indicate that a repeated number of breakdowns and instability in placements could be an explanation, since breakdowns and instability might reduce the possibility for children and young people placed outside their homes to establish close and stable relations to family, other adults and peers (Bryderup & Trentel, 2012; Egelund, 2006).

The ostensible purpose of placing children and young people outside their homes is to give them a more stable upbringing than they would have had if they had continued living with their parents. Yet research has shown that many children and young people placed outside their homes have experienced quite unstable placements (Bryderup et al., 2017; Bryderup & Trentel, 2012; Andersen, 2010; Egelund, 2006; Nielsen, 2005; Mølholt, 2017; Kayed et al., 2015).

The purpose of this article is to discuss the concept of continuity for children and young people placed outside their homes by reviewing the developments in legislation followed by an assessment of how these developments has affected the chances for continuity for children and young people placed outside their homes in Denmark. By continuity is meant a stable and coherent upbringing with close and stable relations that improves the child’s or young person’s ability to cope with situations in their life by strengthen their comprehensibility, manageability and meaningfulness.

This article will examine the developments in legislation and social policy during the last three decades, with a special focus on how the legislation has prioritized and interpreted the issue of continuity for children and young people placed outside their homes. By presenting our own and other researcher’s studies, we will discuss how the increasing focus on continuity in out-of-home care legislation has affected the experience of continuity for children and young people placed outside their homes. We take as our point of departure in the concept of continuity and current theoretical approaches that can shed light on the consequences of instability for young people. In addition, research on the perspectives from young people who had been placed outside their homes as children provide insight into those factors regarded as important for continuity. In line with these approaches, we will present research on breakdowns, continuity in contact with family and issues concerning schooling and education as they affect children who have been placed outside their homes. First, we will introduce the Danish Child Welfare System.

2          The Danish Child Welfare System

In Denmark, children and young people are placed outside their homes based on national legislation enacted by the Danish Parliament. The policies and procedures for children and young people placed outside their homes are described in chapter 11 of the Social Services Act (Serviceloven). Chapter 11 describes different kinds and measures for children and young people in need of special support offered by and under the control of the Danish authorities. The aim of this support is to ensure that these children and young people recieve the same opportunities for personal development, health and an independent adult life as other children and young people at the same age (Serviceloven 2020, § 46). While the parliament adopts and formulates the overall policy framework for the placement of children and young people outside their homes, the 98 local municipalities have the responsibility to implement and administer the placements, which may be in foster care, residential care centers or group homes.

The Danish child welfare system has a wide range of services for children and families extending from universal mainstream care and education services to the most intrusive intervention of all - placement outside their homes away from birth parents. In addition, the Danish legislation is based on the idea of voluntariness, meaning that all decisions regarding child placements should strive to be made with the consent of the parents and with the child when over the age of 14 (Cameron & Bryderup, 2014).

In Denmark, education and out-of-home care are conceptualized separately within legislation and government administration. As mentioned above out-of-home care is regulated mainly by the Social Services Act, while primary education is regulated by the Folkeskole Act. In Denmark, there are nine years of compulsory education for all children, starting from the year the child turns six. It is a fundamental principle of Danish education policy that everyone should have the same access to schooling, education and training. Students who are struggling can be offered part-time or full-time special education in schools, or they can be enrolled in a specialist school. All students are entitled to education that is adapted to their situation and special needs (Cameron & Bryderup, 2014).

In Denmark, children can be placed outside their homes from the age of 0 to 17, and some young people stay in after-care until they turn 23, when it is considered to be of significant importance in relation to the young person's need for support.

The proportion of children and young people placed outside their homes in Denmark has been constant for more than 100 years – around 1 % of all children and young people aged 0-17 years (Bryderup, 2005). In 2019, 11,428 children and young people from age 0 to 17 were placed outside their homes (Statistics Denmark, n.d.). In 2019, 63 percent of children and young people were placed in foster care, while the remaining 37 percent were placed in residential care centers, group homes, boarding schools or continuation schools. For the past two decades, most of the children and young people have grown up in foster care settings, at least for a period (Statistics Denmark, n.d.).

Most of the younger children are placed in foster care. The probability of being placed in a residential institution or group home increases by age (Bryderup et al., 2017). In Denmark, there are currently four different types of foster care; 1) regular foster care, the purpose of which is to give the child or young person a caring family setting and a predictable everyday life; 2) enhanced foster care, which are for children and young people with a moderate to enhance need for support, 3) specialized foster care, intended children and young people with an enhanced need for support, and 4) network foster care, where the child or young person is placed with someone from the child’s own family or network (Socialstyrelsen, 2019, p. 32-24). These four types of foster care were introduced in 2019 and replaced the former regular foster care, kinship or network foster care and municipal foster care. Most of the placements take place in regular foster care and are carried out with consent of the parents. However, an increasing proportion of the placements are decided without consent of the parents – around 25 percent of all placements in 2019 (Statistics Denmark, n.d.).

Adoption of a child who has been placed in foster care can be seen as the ultimate continuity solution. If there is an assumption that a child placed in foster care might be placed for perhaps several years, the municipal council needs to consider whether the child should rather be put up for adoption, out of consideration for the continuity and stability of the child’s long-term well-beeing (Serviceloven, 2020, § 68 d). The adoption can be carried out with or without parental consent if the municipal committee overseeing children and youth affairs consider it to be in interest of the child (Serviceloven, 2020, § 68 e). Over the past several years and as recently as in 2015, the adoption legislation has been modified a number of times making it easier to carry out adoptions without consent from the parents (DEFACTUM, 2018, p. 1). Since the modifications of the legislation in 2015, 69 children have been adopted without the consent from the parents in the period 2016-2020 (Ankestyrelsen, n.d.).

3          Developments in legislation and social policy

Since 1998, the Danish out-of-home-care system has been regulated by the Social Services Act which replaced the former Social Assistance Act. Here, we will review developments in legislation and social policy, since the Social Services Act became effective in 1998. While the Social Services Act touches many aspects of the Danish welfare system, this review will focus on those of significance for children and young people placed outside their homes, and especially in relation to the childrens experience of continuity.

Prior to 1998, it was the Social Assistance Act that regulated the Danish out-of-home care system. In 1988, in the wake of criticism about efforts to support children and young people, the Danish Ministry of Social Affairs formed a committee to review the Social Assistance Act. The goal of this review was to improve the legal rights of children, young people and their families (Graversen betænkningen, 1990, p. 7). The work of this committee, called the Graversen Committee (Graversen-udvalget), became very important for the changes in the legislation and social policy (Ebsen, 2017, p. 47). The committee declared that the principle of continuity in childhood and adolescence should be the key principle of Danish child welfare legislation (Graversen betænkningen, 1990, p. 28).

The Graversen Committee listed a number of recommendations aimed at ensuring the continuity for children and young people in need of special support. According to the committee, one of the most central points to ensure continuity was to maintain the relationship and contact between the child and his or her parents. Another recommended means of ensuring continuity for children and young people was to make sure that all decisions were made on an informed basis and with the involvement of the implicated child or young person and the parents. The committee also recommended that there should be a written plan, so that the purpose of the placement was always clear to both the family and to the social worker who should follow the child’s situation. The recommendations also contained a number of improvements in the legal rights for the children and their families (Graversen betænkningen, 1990).

These recommendations lead to revisions in the Social Assistance Act in 1993 and they subsequently affected the formulation of the Social Services Act that was enacted five years later. In 1998 under a general reform of the social welfare system, the Social Assistance Act was thus replaced by three new acts, two of which directly implicated children and young people placed outside their homes: The Consolidation Act on Legal Protection and Administration in Social Matters and the Social Services Act. The overall aim of the Social Services Act provisions concerning children and young people in need of special support was to ensure the best possible upbringing and that these children would have possibilities for personal development and health equal to other children of the same age despite their individual difficulties. The Social Services Act also stipulate that the support must be provided early and continuously and based on a concrete assessment of the child's and family’s situation. Furthermore, the Act emphasizes the importance of involving the child and his or her family in the solution (Serviceloven 1997, § 32). The overall difference between the Social Assistance Act and the Social Services Act was the presence of a number of new regulations about the purpose, counselling, inspection, obligation to give notice of dishonor, assessment and measures, placements without consent, termination of placements, placement plan, maintaining the attachment between children and parents, administrative procedures, complaint options, restrictions on the use of restraints and financing (Bryderup et al., 2017, p. 55).

Since 1998, the Social Services Act has also undergone a number of changes, where especially the Out-of-Home Care Reform in 2006 and the Children’s Reform in 2011 had significance for children and young people placed outside their homes. The Out-of-Home Care Reform aimed to ensure children and young people placed outside their homes the same opportunities to pursue in relation to schooling, employment and family life as other children and young people. The reform included a number of changes and clarifications in relation to assessments, social progress plans, decisions, more involvement of the child and his or her family and network, new regulations on inspection and follow-up on measurements (Servicestyrelsen, 2007, p. 7). In addition, a new type of foster care called ‘network care’ was introduced. According to new regulation, the kinship and network care option must be considered in any case involving the placement of children or young people outside their homes (Servicestyrelsen, 2007, p. 125). In 2018, 1135 children and young people were placed in kinship or network care arrangements, corresponding to eight percent of all children and young people placed outside their home (Statistics Denmark, n.d.). This is an increase since 2006, when 454 children and young people were placed in kinship or network foster care, comprising just 4 percent of all children placed outside their homes (Bryderup et al., 2017, p. 117).

The Children’s Reform became effective in 2011. This reform measure, was directly related to the Out-of-Home Care Reform also aimed to support children’s and young people’s opportunities for well-being by promoting security in upbringing, legal rights for children and young people, early intervention and quality in the effort (Servicestyrelsen, 2011, p. 7). The Children’s Reform emphasized that the best interests of the child should always be the most significant priority when working with children and young people with the need of special support (Servicestyrelsen, 2011, p. 4). One central change in the regulation was the formulation of the ‘Objectives’ clause, which specified that the special support measures for children and young people should focus on continuity, personal development, schooling and education, health and preparation for adult life (Servicestyrelsen, 2011, p. 12).

Overall, the Children’s Reform had a strong focus on continuity for children and young people and its many revisions at ensuring a safer care environment for children and young people placed outside their homes. Here the assessment of the child and their family, the placement plan and the direct involvement of the child and family and network played an important role. In addition, there were regulations that focused on promoting a more stable placement with fewer placement moves and breakdowns. For instance, it was made possible to continue a placement without a time limit if the placement were considered as being in the best interests of the child (Servicestyrelsen, 2011, p. 187).

As can be seen, the Danish Child Welfare system has experienced significant changes over the past two decades. In 2020, the Danish government has begun working on additional regulations aimed at enhancing towards children and young people with the need of special support. Three themes are in focus: earlier intervention and better quality in the placements, giving the child more voice in decisions and in navigating the transition to adult life (Social- og Indenrigsministeriet, 2020).

To sum up, the Danish legislation and social policy has placed an increasing focus on continuity for children and young people placed outside their homes. With this new priority, we examine in the next section how the concept of continuity is used in both legislation and in social work research.

4          The concept of ‘continuity’ as applied to children and young people placed outside their homes

In the Social Services Act legislation, the ‘continuity’ concept is linked to “a safe care environment, that offers close and stable relations to adults, by among other things supporting the child’s or the young person’s family relations and relations to other network” (Serviceloven 2020, § 46). In the Handbook to the Children’s Reform continuity is also linked to the term coherence. Providing continuity and coherence in the child's life is seen as crucial to attaining good well-being and development for the child. The handbook highlights five key objectives that can help to ensure continuity for the child: 1) continuity in the contact between the child and his or her family and network during the placement period; 2) continuity in the placement; 3) continuity in the case work; 4) continuity in the inter-disciplinary co-operation between social worker, school and other institutions; and 5) continuity in relation to a coherent welfare policy for children and young people (Servicestyrelsen, 2011, p. 181).

These are some of the same aspects as children and young people in out-of-home care themselves bring out as important factors in relation to obtain an experience of continuity. To obtain a fuller understanding of the experience of continuity for children and young people placed outside their homes, we will examine some of the research that highlights young people’s own perspectives and experiences on continuity having been placed outside their homes as children. Even though discontinuity for children and young people placed outside their homes is well documented in an international context we will here focus on research from Denmark, since there might be some national differences that might influence on the experiences and perspectives of the children and young people.

Nielsen (2005) was one of the first studies in a Danish context to carry through a comprehensive analysis of the perspectives of children and young people in out-of-home care. Nielsen collected out-of-home care experiences from 39 participants who had been placed outside their homes as children.[2] Nielsen (2005) found that most of the participants had experienced many interruptions and break ups with friends and family both during and after their time in care. Even though some of these interruptions might have been in the interest of the child, the participants still describe the situations as very chaotic and drastic. The participants especially emphasized that they did not receive the necessary support and information. In addition, they did not feel that they were involved in the decisions. For some of the participants the placement did also lead to isolation since they broke their contact with parents, siblings, grandparents, friends and other people from their network, with the result that they did not have any network to support them if their later years (Nielsen, 2005, p. 212). Many of the participants describe especially the break up with their parents and siblings as very import. In spite of the parents’ comprehensive failure, many of the participants describe loving feelings to their parents (Nielsen, 2005, p. 205).

Another study by Bryderup & Trentel (2012) also examined the experiences of 35 young people who were placed outside their homes as children with a focus on their current situation in relation to schooling and education.[3] The young people in this study had different family backgrounds and placement histories but it was common to them that they dreamed of a future with an education, a good job and family life (Bryderup & Trentel, 2012, p.108). The study found a connection between schooling and education meaning that the young people who experienced a stable schooling without school changes, bullying and school absence were also the young people with the most promising processes in education (Bryderup & Trentel, 2012, p. 108). The young people's experiences also reflected some relatively isolated lives with few social relations (Bryderup & Trentel, 2023, p. 168). Only half of the young people were able to point out an important supportive adult in their lives. At the same time the analyses found that young people who engaged in close relations were also the young people who performed the best in relation to schooling and education (Bryderup & Trentel, 2012, p. 111).

Mølholt (2017) examined the constructions of meaning found in the recollection narratives of eight young people who were placed outside their homes as children.[4] Generally, these young people characterized their lives as unstable during as well as after their placements. As an example, Mølholt describes how the young people had to deal with what she defined as ‘temporal conditional care’, reflecting their awareness that the care and support they received in foster families or institutions was conditioned by the payment of the people who practice it, and that they could not expect that the care might continue, after they left the foster family or institution (Mølholt, 2017, p. 302). Mølholt found that the relationship between these young people and their parents remained important both during and after placements. These relationships were characterized as a struggle between detaching from the parents and at the same time a desire for a close family relation to the parents. The young people also describe the relationship with parents as a balance between caring for their family and caring for themselves (Mølholt, 2017, p. 303). Because of the unstable relations with foster caregivers, institutions and parents, the young people’s relations with their peers took on a special importance. Peer relations were a channel where they could obtain a feeling of belonging while being placed outside their homes as a child. At the same time, these out-of-home experiences also complicated their relations with peers. As an example, the young people expressed a need for friendships while they also felt exploited by other people (Mølholt, 2017, p. 241).

These three studies along with others (for instance Warming, 2005; Beck, 2014; Egelund, Jakobsen, Hammen, Olsson, & Høst, 2010; Børnerådet, 2012; Kildedal, 1996) indicate that young people who have been placed outside their homes as children tend to characterize their conditions of life as unstable during and after their placements. The relationship between young people and their parents is seen as very important and at the same time very complex. The young people find the sense of instability to be difficult to cope with and this has considerable influence on their schooling and education.

There exist a wide range of understandings and definitions of the term continuity in connection with out-of-home placements. In this article, we will use a broader understanding of the concept continuity. By continuity is meant a stable and coherent upbringing with close and stable relations that improves the child’s or young person’s ability to cope with situations in their life. We are inspired by the research presented above on young people’s experience of beeing placed outside their homes as children. Hence, we will focus on continuity in three aspects of the life of children and young people placed outside their homes: 1) continuity in relation to placement stability and breakdown; 2) continuity in relation to contact with family and 3) continuity in relation to schooling and education. These three aspects, as we will show on the following pages, are closely linked together. Moreover, we will see that a sense of continuity is closely connected to the child’s or young person’s experience of coherence in their life situation.

Let us examine the concept of coherence further. According to Aaron Antonovsky, a sense of coherence consists of three elements: comprehensibility, manageability, and meaningfulness. Individuals who views their life as generally comprehensible, manageable, and meaningful will be better equipped to cope with stressful situations (Antonovsky, 1987, p. 19). Antonovsky developed the theoretical concept of sense of coherence in order to understand why some people, against all odds, continue to have a strong constitution and can get through stressful situations or crisis. Since Antonovsky developed the concept in 1979, the ‘sense of coherence’ concept has also been used in a wide range of fields such as child development and education (Idan et al., 2017, p. 107). According to Antonovsky, a sense of coherence is not a static condition. It develops through learning processes in the child’s upbringing and through life experiences (Antonovsky, 1987, p. 19).

According to Antonovsky, ‘sense of coherence’ has several elements. The first comprehensibility, understood as the extent to which a person perceives the stimuli he or she encounter as cognitively comprehensible and therefore coherent rather than chaotic or inexplicable (Antonovsky, 1987, p. 16-17). Comprehensibility would often be a prerequisite for obtaining a high level of manageability and meaningfulness. You need to understand the demands you meet, to be able to assess whether you have the right resources available. An individual, who experiences life as incomprehensible, will find it harder to believe that they can cope with the situation (Antonovsky, 1987, p. 20).

The second element that makes for a sense of coherence is manageability. According to Antonovsky, manageability concerns the extent to which a person perceive that they can obtain access to sufficient resources with which to deal with life demands (Antonovsky, 1987, p. 17). If a person feels that they do not have sufficient resources to cope with a situation; it would affect their experience of meaningfulness and their ability to cope with the situation (Antonovsky, 1987, p. 21).

The third, and probably the most important element comprising the sense of coherence is meaningfulness. Meaningfulness refers to the extent to which an individual feels that their life is meaningful on an emotional level. An individual who senses that their life is meaningful would feel that it is worth engaging with the problems and demands with which they are confronted in order to overcome them (Antonovsky, 1987, p. 18). When a person feels engaged in what they are doing, it will also facilitate greater understanding (comprehensibility) and resources (manageability) (Antonovsky, 1987, p. 21).

In this article, we focus on three aspects of continuity and coherence for children and young people placed outside their homes: 1) continuity in relation to placement stability and breakdown; 2) continuity in relation to contact with parents, and 3) continuity in relation to schooling and education. We use this delimitation because research shows that these three aspects are essential for children and young people placed outside their homes obtaining a sense of coherence. In other words, the more of these three types of continuity, the greater sense of coherence the young person will have. Our focus on these three aspects of continuity and their importance for a sense of coherence is also supported by research findings highlighting young people’s perspectives on continuity while been placed outside their homes as children.

Let us discuss the three types of continuity in more detail. First, placement stability must be considered as essential in relation to obtaining a sense of comprehensibility for children and young people placed outside their homes. If a child or young person experiences several movements or breakdowns, these ruptures can influence the child’s or young person’s general view of life as chaotic and random. This is especially the case if the child or young person do not get the right amount of support and information to cope with the situation (Nielsen, 2005, p. 212).

Contact with the child’s or young person’s family must also be considered as essential for obtaining a sense of comprehensibility as well as meaningfulness. If a child or a young person does not have contact with their parents, it might be hard to obtain a meaningful understanding of who they are and what they are coming from. In addition, stable relations to significant others might strengthen the child or young person’s manageability in relation to establish and maintain new social relations. A quality that is essential to gain a network that can support them later on in life (Bryderup & Trentel, 2012, p. 175-176).

The third type of continuity, schooling and education must be considered as essential to obtain a sense of manageability that is itself so crucial to coherence in the child’s life. Schooling and education are means of obtaining resources and self-esteem for all children and young people, but especially important for those placed outside their homes. If the child or young person can attain a sense of manageability in the school settings, they might be able to transfer this to other areas in their lifes. As illustrated in Bryderup & Trentel (2012) education can also contribute to the children and young people’s experience of meaningfulness. Many of the young people in this study saw education as an opportunity to dissociate them from the lives of their parents and to get to live a so-called normal life with a good job and family life (Bryderup & Trentel, 2012, p. 108).

Three decades since the Graversen committee elevated continuity in childhood and adolescence as the key principle in Danish child welfare legislation, we still have no longitudinal research in a Danish context that has assessed the development of continuity and coherence for children and young people in terms of the factors mentioned above. Therefore, we will present the most recent research in the field, assessing continuity for children and young people placed outside their homes today.

We begin this assessment by discussing research on continuity in relation to placement stability and breakdown, followed by continuity in relation to contact with family and finally we focus on continuity in relation to schooling and education.

5          Placement stability and breakdowns

A large proportion of the research about continuity for children and young people focuses on placement stability and breakdowns. These studies are both focusing on causes and consequences of placement breakdowns or placement moves (Newton, Litrownik, & Landsverk, 2000; Rubin, O'Reilly, Luan, & Localio, 2007; Egelund, 2006; Oosterman et al., 2007; Unrau, 2007).

The international research contains several definitions of what is meant by a ‘breakdown in placement’. Some studies consider every time a child or a young person move from one care environment to another as a case of breakdown. Other studies distinguish between ‘placement moves’ and ‘placement breakdowns’. A placement move can be a natural and planned move, such that it could actually benefit the child. A breakdown would occur if the placement ended earlier than expected and are not in line with plans made by the authorities (Egelund, 2006).

Andersen (2010) has made one of the first studies in a Danish context of what she calls ‘revolving door children’ (svingdørsbørn), meaning children, who move from one placement to another throughout their childhood. Andersen reviewed data for almost 16.000 adults born between 1983 and 1987, who at some point in their lifes have been placed outside their homes. Andersen calculated the proportion of children and young people who had experienced these unstable placements in the Danish Child Welfare system and tried to isolate specific characteristic for these young people. Andersen found, that in fact, 60 percent of these children and young people placed outside their homes had had one single placement (no moves), 21 percent had had one placement move, 9 percent had two placement moves and 10 percent experienced three or more placement moves (Andersen, 2010, p. 142).

Andersen (2010) also found that those children and young people who had experienced the most complex placements had come from families with the least social and material resources. For those children who had their first placement between the ages of zero and six years, Andersen found that the mothers of those children with the most complex placements have more unemployment, less education, lower income and more criminal offences than mothers of children with simple placements. In addition, the fathers of the children with the most complex placements also had more unemployment, less education and lower income, although the fathers of children with complex placements had fewer criminal offences than fathers of children with simple placements. Andersen’s study also found that more of the children with complex placements grew up with a single mother and fewer grew up with their father compared to children with simple placements. At the same time, children with complex placements had fewer siblings, then children with simple placements. Finally, Andersen found that children who had complex placements came from districts with a higher rate of unemployment compared to the children with simple placements. Andersen found a similar pattern for those children who had their first placement at age 13-17 (Andersen, 2010, p. 154-156).

In 2016, Bryderup et al. (2017) carried out a national questionnaire survey targeting all regular foster families in Denmark. The survey sought to examine characteristics of foster families and of the children and young people placed in foster care. In the survey, the foster families were questioned about the three most recently placed children and young people in their care, which ended up beeing a total of 4.770 of children and young persons. Bryderup et al. found a relatively large proportion of unstable placements in terms of breakdowns and placement moves before the placement in this foster care. More precisely, the study found that 29.3 percent of the foster children and young people had one placement move, 6.6 percent had two placement moves, and 4.0 percent had experienced three or more placement moves. Taking into consideration that almost half of the children in the study were at the age of 0-5 when they were placed in the foster family, it is relatively many children, who have experienced several placements. It should also be noted that 14.2 percent of the children and young people were repatriated to their parental homes followed by a re-placement (Bryderup et al., 2017, pp. 393-395). When the foster families in the questionnaire were asked whether the movement from this foster care was planned or not, the foster families answered that 64 percent of the movements were planned, while 36 percent were not planned (Bryderup et al., 2017, p. 395).

These findings correspond to Andersen’s findings, even though she focusses on an older cohort of children: i.e. those born between 1983 and 1987, that would have been placed outside their home from the late 1980s to early 2000s. The overlap between the findings would indicate no progress in preventing breakdowns over the past two decades.

The research on child and youth placement points to several factors that increases the risk of placement instability or breakdowns (Barth et al., 2007; Rubin Alessandrini, Feudtner, & Mandell, 2004; Strijker et al., 2008; Camberlain et al., 2006; Clark et al., 2020). Some of the studies focus on factors related to the individual child: there are correlation between behavioral problems, trauma, mental health issues and unstable placements (Barth et al., 2007; Rubin et al., 2004; Strijker et al., 2008; Clark et al., 2020). Other studies focus on the childrens social background (Andersen, 2014; Fallesen, 2014). Fallesen for example found that children with a high number of risk factors associated with foster care entry were also the most likely to embark on an ‘unstable placement career’ (Fallesen, 2014).

Other studies examine factors related to the placement constellation in order to explain why some placements are more stable than others. Christiansen et al. (2010) found that many of the placement breakdowns are attributed primarily to shortcomings in the foster home or setting itself. Their study described how certain foster parents had not understood or were simply not prepared for the challenges of being foster careers. However, the child's difficulties and challenging behaviour were also cited as part of the explanation for placement breakdown (Christiansen et al., 2010, p. 919).

Surveying the research, we find that most children and young people placed outside their homes have experienced relative stabile placements with few breakdowns and the vast majority of moves with just a single placement (Andersen 2010; Bryderup et al., 2017). Nevertheless, there remains a relatively large group of children and young people placed outside their homes, 30-40 percent who have experienced placement instability in connection with one or more placement moves.

6          Contact with family during placements

Contact with family and their network is a key factor in the understanding of continuity for children and young people placed outside their homes as stipulated in both the legislation and described in research. Yet, relatively few studies have examined the extent to which children and young people actually have contact with their family and network during placements. According to the Danish legislation, a child or a young person placed outside their home has the right to regular contact with their parents (Serviceloven, 2020, § 71).

Lausten & Jørgensen (2016) found that 89 percent on the children in their study had contact with their mother, while 65 percent had contact with their father (Lausten & Jørgensen, 2016, 24).[5] Bryderup et al. found that 18 percent of the children and young people in their study had not had any contact with their mother and 43 percent had not had contact with their father during their placement in foster care. Eleven percent of the children and young people had no contact with either parent while being in placement. Furthermore, the Bryderup et al. study found that while home visits 61 percent of the children did not sleep at their mother’s home and 69 percent did not sleep at their father’s home during their placement in foster care (Bryderup et al., 2017, 395-398). The same study showed that the average placement time in foster families is more than five years (Bryderup et al. 2017, p. 392).

Bryderup et al. also found that many foster families do not have further contact with the children or young persons, who have left their care. One-third of foster parents (36.2 percent) did not have any contact at all with their former foster children. Twenty-two percent saw the former foster child or young person once every half-year or less (Bryderup et al. 2017, p. 420).

In summary, a relatively large group of children and young people do not have contact with their parents during their placements. At the same time, many children do not see their former foster families after their placement has ended. This is despite the fact that most of the children and young people spend around five years of their childhood in foster care. This means that you can question the continuity in the lifes for children and young people who are or have been placed outside their homes. As mentioned above the Social Services Act promote continuity in the form of ‘a safe care environment, that offers close and stable relations to adults, by among other things supporting the child’s or the young person’s family relations and relations to other network’ (Serviceloven, 2020, § 46).

7          Continuity in schooling and education

In their schooling and education children and young people placed outside their homes underperform on a wide range of parameters compared to other children and young people of the same age (Bryderup & Trentel, 2012, Bryderup et al., 2017; Cameron & Bryderup, 2014; Olsen et al., 2011; Andersen & Fallesen, 2010; Courtney et al., 2001; Egelund et al., 2004; Vinnerljung et al., 2005). A number of studies have sought to link the underperformance of children and young people placed outside their homes to instabilities in placements (Bryderup & Trentel; Bryderup et al., 2017; Cameron & Bryderup, 2014; Osborne, Alfano & Winn, 2010).

Changes in placements often lead to transfer from one school to another. Changing school might influence the child's or the young person’s opportunity to achieve close and stable relations with teachers, pedagogues and peers. At the same time, poor school results might also make it difficult for children and young people to experience continuity over the long term. Poor school results might lead to more unstable or insecure conditions of education and employment. Therefore, it is important, that children and young people obtain the right kind of support that can facilitate both stable placement and schooling (Bryderup & Trentel, 2012).

Lausten, Frederiksen & Olsen (2020) have examined the situation for children and young people placed outside their homes when they turn 18 using data from the Danish Longitudinal Study of Children born in 1995. They found that 71 percent of the young people who were placed outside their homes left ninth or tenth grade with a final exam as compared to 93 percent of other young people. This means that 29 percent of the young people in out-of-home care do not leave school with a diploma. Furthermore, the young people placed outside their homes who obtain diploma have received lower grades than their counterparts who have not been placed outside their homes.

Lausten et al. also found that children and young people placed outside their homes experienced a higher number of school changes than did their peers: 33 percent of the children and young people experienced one school change, compared to 17 percent of other young people. Further, 15 percent of the children and young people who were placed outside their homes experienced two or more school changes compared to just two percent of the other young people (Lausten et al., 2020).

Within the school setting itself, Bryderup et al. (2017) found that a large proportion of the foster children and young people study have had difficulties in school. For instance, about half of the out-placed children performed below average in Danish reading, Danish spelling and mathematics. Sixteen percent of the children and young people do not thrive in school. The authors argue that these bleak results can be partly explained by the childrens instability in placements that effects the child’s or young person’s opportunity of continuity in school. They found that 24.6 percent of the children and young people in their study have had periods when they did not attend school at all. Among those children and young people who did not participate in any classes, 41.4 percent were absent for an aggregate of more than a half year (Bryderup et al., 2017, p. 408-413).

Olsen & Montgomery (2018) have examined the relationship between school change and educational outcome. Using administrative data combined with two rounds of the Danish Longitudinal Study of Children born in 1995, they found that school change is negatively correlated to educational outcome. In addition, Olsen & Montgomery found that children and young people placed outside their homes are exposed to more school changes than other children and young people at the same age, and that school change has a more negative impact on them compared to their peers (Olsen & Montgomery, 2018).

A study by Bryderup and Trentel (2012) examined how many young people had completed some kind of secondary education. They used data from Statistics Denmark about all young people aged 27-30 years born in 1976-1979 and compared this group to young people of the same age group who had been placed outside their homes for at least one year when they were 16 years. The findings showed that among the young people who had been placed outside their homes 40 percent had had a secondary education versus 80 percent among all young people in the same age group (Bryderup & Trentel, 2012 p. 55).

The research described above indicates that a relatively large group of children and young people placed outside their homes do not experience continuity in relations to schooling and education. As mentioned above, the most recent changes in legislation – The Children’s Reform from 2011 – emphasized continuity, schooling and education and preparation for adult life (Servicestyrelsen, 2011, p. 12). Research findings from the past ten years lead us to question the actual results of this policy. The childrens experience of continuity, success in schooling and education and thereby preparation to adult life seems to have been inadequate for a large proportion of children and young people placed outside their homes.

8          Conclusions: rethinking continuity in the light of legislation and experiences from children and young people

The purpose of this article is to discuss continuity for children and young people by presenting developments in legislation and looking into how these changes in legislation has affected the lives of children and young people and their experience of continuity. Although Danish legislation on out-of-home care has placed an increasing focus on continuity for children and young people placed outside their homes, a relatively large group of children and young people continue to experience lack of continuity and coherence connected with their placements, in contact with their families during placements and in their schooling and education.

In this article, we have used a broad definition of continuity centred on the experiences of children and young people’s lives in general and with special focus on three key areas of potential continuity/discontinuity: stability/instability in placements, contact with family during placements and schooling and education. These three areas were chosen with point of departure in the research among young people who had been placed outside their homes as children. It was shown that these adults characterized their conditions of life as unstable, both during and after their placements. The relationship between young people and their parents was viewed as very important, even if it was also complex. The young people experienced profound feelings of instability and this kind of instability had a major impact on their schooling and subsequent secondary education.

Inspired by the work of Antonovsky, on the concept of coherence we have sought to combine continuity and coherence into a single analytic framework. According to Antonovsky, a sense of coherence consists of three elements: – comprehensibility, manageability, and meaningfulness. We found Antonovsky’s framework useful in analysing the experiences of continuity for children and young people in out-of-home care.

Placement stability, the first feature of continuity, must be considered as essential for obtaining a sense of comprehensibility for children and young people placed outside their homes. Research shows that a relatively large group of children and young people placed outside their homes experienced placement instability as a result of one or several placement-moves; this is the case for 30-40 percent of all children and young people in out-of-home-care. If a child or a young person were to experience several unplanned movements or breakdowns, it would have a likely impact on their view on life as chaotic and inexplicable.

The second feature, contact with their families during placements is also essential in obtaining a sense of comprehensibility as well as meaningfulness. Our review of the research has shown that a relatively large group of children and young people has little or no contact with their parents during placements. At the same time, many children and young people do not see their former foster families after their placement period has ended. This absence of such contact with either parental or foster family could lead to a sense of discontinuity in the lives of children and young people who are or have been placed outside their homes. At the same time, our data indicates problems with the childrens sense of coherence. If a child or a young person does not have ongoing contact with their parents, it might be difficult to involve and engage them if they do not find a connecting thread of the demands they are met by.

Schooling and education, the third factor in continuity, are essential for young people obtaining a sense of manageability in their lives. Our research review has shown that a relatively large group of children and young people placed outside their homes have difficulties in school, and that this difficulty may be related to lack of continuity in their out-of-home care. Research from the past ten years calls into question the experience of continuity, schooling and education and thereby preparation for adult life especially for those children and young people placed outside their homes. Schooling and education are also ways to obtaining resources and gaining a sense of self-esteem. This is true for all children, but especially necessary for children and young people placed outside their homes whose life situations may be unstable and insecure in other ways. If the child or the young person can obtain a sense of manageability in school, they can transfer this kind of self-confidence to other areas of their life.

To sum up, for several decades, Danish social policy has promoted the goal of ensuring continuity and coherence in children and young people's lifes including the three aspect we have discussed above. Findings from research cast doubt on whether this goal has been achieved for a relatively large group of children and young people placed outside their homes.

However, the extend of these shortcomings in children’s experiences means that further research and reassessment are needed in order to determine why this policy has failed so many children and young people.

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Author´s Address:
Inge Marie Bryderup, adjunct professor
Department of Sociology and Social Work, Aalborg University, Denmark
Frederikskaj 10B, C, 25
2450 København SV, Denmark
9940 8127

bryderup@socsci.aau.dk

Author´s Address:
Sofie Aggerbo Johansen, research assistant
Department of Sociology and Social Work, Aalborg University, Denmark
Frederikskaj 10B, C, 310b
2450 København SV, Danmark
9940 2819

sajo@socsci.aau.dk



[1]Studies on out-comes of out-of-home care struggle with methodological issues, as it cannot be demonstrated that the negative outcomes are related to the placement itself.

[2]The experiences were collected through focus group sessions at two conferences and a series of meetings for people, who had been placed outside their homes as children. The project was carried out by a project group consisting of relevant actors from the field for instance actors from different interest groups. The participant group was covered a wide range of age groups (18-60), who have been placed outside their homes at different times. The final result was published in a book along with a number of recommendations for the Danish Child Welfare system (Nielsen, 2005).

[3]Bryderup & Trentel (2012) used several different kinds of data sources that also included 35 in-depth interviews with young people who had been placed outside their homes as children. These in-depth interviews were repeated one year after the first ones. The young people were included based on that they all had promising education meaning that they had finished primary and lower secondary school for 6- to 16-year-olds and that they had started or were just about to start further education. This means that the young people on this study probably has coped better than many of their peers in out-of-home care (Bryderup & Trentel, 2012).

[4]Mølholt’s PhD (2017) is based on interviews with eight young people who has been placed outside their home as children, Mølholt follows the young people over a period of two years, interviewing them every six months over this two-year period. The age of the young people ranged from their early 20’s to their mid-30’s (Mølholt, 2017, p.14).

[5] The character and the extent of the contact was not elaborated further in the study beside the fact that for those who saw their mother most of them saw her on a weekly basis and that most of them saw her in the mothers’ home (Lausten & Jørgensen, 2016, p. 24).