Out-of-Home Placement Decision-Making and Outcomes in Child Welfare: A Longitudinal Study

Ka Ho Brian Chor, Gary M. McClelland, Dana A. Weiner, Neil Jordan, John S. Lyons

Research output: Contribution to journalArticlepeer-review

18 Scopus citations


After children enter the child welfare system, subsequent out-of-home placement decisions and their impact on children’s well-being are complex and under-researched. This study examined two placement decision-making models: a multidisciplinary team approach, and a decision support algorithm using a standardized assessment. Based on 3,911 placement records in the Illinois child welfare system over 4 years, concordant (agreement) and discordant (disagreement) decisions between the two models were compared. Concordant decisions consistently predicted improvement in children’s well-being regardless of placement type. Discordant decisions showed greater variability. In general, placing children in settings less restrictive than the algorithm suggested (“under-placing”) was associated with less severe baseline functioning but also less improvement over time than placing children according to the algorithm. “Over-placing” children in settings more restrictive than the algorithm recommended was associated with more severe baseline functioning but fewer significant results in rate of improvement than predicted by concordant decisions. The importance of placement decision-making on policy, restrictiveness of placement, and delivery of treatments and services in child welfare are discussed.

Original languageEnglish
Pages (from-to)70-86
Number of pages17
JournalAdministration and Policy in Mental Health and Mental Health Services Research
Issue number1
StatePublished - Jan 2014

Bibliographical note

Publisher Copyright:
© 2014, Springer Science+Business Media New York.


  • Child welfare
  • Decision support algorithm
  • Out-of-home placements
  • Outcomes
  • Team decision-making

ASJC Scopus subject areas

  • Psychiatric Mental Health
  • Health Policy
  • Public Health, Environmental and Occupational Health
  • Psychiatry and Mental health


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