Family reunification for placed children in Québec, Canada: A longitudinal study Tonino Esposito a, ⁎, Nico Trocmé c , Martin Chabot b , Delphine Collin-Vézina c , Aron Shlonsky d , Vandna Sinha c a Université de Montréal, School of Social Work, Canada b McGill University, Centre for Research on Children and Families, Canada c McGill University, School of Social Work, Canada d University of Toronto, Faculty of Social Work, Canada abstract article info Article history: Received 17 April 2014 Received in revised form 26 June 2014 Accepted 27 June 2014 Available online 6 July 2014 Keywords: Family reunification Out-of-home placement Child maltreatment Neighborhood effects Clinical-administrative data Longitudinal analysis This is the first Canadian longitudinal study to use province-wide clinical administrative data to explore when family reunification is most likely to occur and for whom. Clinical administrative child protection data were merged with the 2006 Canadian Census data for the province of Québec; the final dataset included 24,196 children admitted to out-of-home care for the first time between April 1, 2002 and March 31, 2011, of which 80.2% (N = 19,412) return to live in their natural family milieu. The overall cohort was divided into two groups: children 0 to 9 years old (N = 8369) at initial placement of which 68.9% return to live in their natural family milieu; and children 10 to 17 years old (N = 15,827) at initial placement of which 86.3% return to live in their natural family milieu. Cox proportional hazard results indicate that younger children, specifically those aged 2 to 5 years old at initial placement, have the lowest likelihood of returning to live with their natural families over time. Irrespective of age at initial placement, the decreased likelihood of family reunification was statistically explained by a combination of psychological abuse, physical and health neglect, parents' high risk lifestyle, sexual abuse, school neglect, hospital referrals, placement instability, number of investigations, and neighborhood area socioeconomic disadvantages. © 2014 Elsevier Ltd. All rights reserved. 1. Introduction The child protection system in Canada is responsible for the safety and well-being of children, and prioritizes family reunification for chil- dren in out-of-home care. The focus is on returning children to their parents, and if that is not appropriate, placing children with extended family. These objectives suggest that children are best parented in their family milieu and require continuity of relationships that promote growth and functioning. However, with the exception of a longitudinal study by Courtney and Wong (1996), most placement studies define family reunification in the traditional sense of a return to children's birth parents. In this study, family reunification is viewed more broadly and includes returning children to live with their natural families, including extended family members. 1 Family reunification studies have been conducted mostly in the United States, the United Kingdom and Australia, where child protection services differ significantly from those in Canada. Even within the United States, differences in jurisdictional practice are reported to influence children's chances of reunification (Dickens, Howell, Thoburn, & Schofield, 2005; Wulczyn, 1991). Wulczyn (1991), for example, reported that high family reunification rates were related to high admis- sion rates; more recently Dickens et al. (2005) reported that children in out-of-home care receiving services from child protection authorities with higher thresholds of admission tend to have a higher level of needs and therefore are less likely to reunify. Also, in the United States and the United Kingdom, younger children represent the majority of those admitted to out-of-home care, whereas in Canada and specifically in Québec, they represent a minority of first admissions (Esposito et al., 2014; Thoburn, 2010). For example, a province-wide longitudinal study by Esposito et al. (2014) examining the placement stability of 29,040 children admitted to out-of-home care in Québec reports that the ma- jority were aged 14 to 17 years old at initial placement (44.0%), followed by 10 to 13 year olds (19.6%), 0 to 1 year olds (13.6%), 2 to 5 year olds (11.6%) and 6 to 9 year olds (11.2%). Based on these admission differences, 2 there may be a significant variation regarding the extent to which child protection services target younger children versus adolescents. While practice objectives centered on maintaining family continuity and encouraging reunification for placed children appear to be universal across child protection jurisdictions in North America, the United Children and Youth Services Review 44 (2014) 278–287 ⁎ Corresponding author at: Université de Montréal, School of Social Work, Canada. Tel.: + 1 514 691 6517. E-mail address: Tonino.esposito@umontreal.ca (T. Esposito). 1 The broad definition of family reunification used in this study focuses less on the phys- ical return of children to their birth parents and more on maintaining family continuity. 2 For more details refer to: Esposito et al. (2013). http://dx.doi.org/10.1016/j.childyouth.2014.06.024 0190-7409/© 2014 Elsevier Ltd. All rights reserved. Contents lists available at ScienceDirect Children and Youth Services Review journal homepage: www.elsevier.com/locate/childyouth