> As for the idea that "even a single CPS placement" is worse than being left with violent parents - I've never seen anything supporting this but if you have some I'd love to read it.
Well, reactive attachment syndrome is the expected outcome for something like 60% of placements, and 80%+ of kids that are placed more than once. These multiple replacements are not exactly rare. Apparently there is a small group where the first placement remains stable for a long time which has reasonable results, and there is a large group that keep getting placed again and again where the outcomes are terrible.
The vast majority of parents aren't violent but neglectful. And even then, our standards of neglect have moved quite a bit. These days some interventions are done because of "bad" food in lunch boxes (think: mars bars, not sandwiches).
The long term consequences of neglect and violence that isn't random are "parentification. TLDR: kids start acting like adults at a very young age, and obviously with less than ideal success. Think 7 year olds that make sure the rent is paid and their little sister sees a doctor once a year, or when she's ill. These kids will fight for their independence, for obvious reasons, at a very young age. This can, and does, lead to depression and less than ideal school results (because in that situation the kids don't consider school very important and of course caring for others takes time that can't be spent on homework or hobbies or even actually going to class when there's a crisis). The worst outcomes are observed where the kid takes total control of the home situation and the KID abuses this power. But even that is nothing compared to even mild attachment syndrome.
The worse cases of reactive attachment disorder, well, from Wikipedia: "Actions that otherwise would be classified as conduct disorder, such as mutilating animals, harming siblings or other family, or harming themselves intentionally"
And of course, it is anecdotal and probably lacks validity but if you look up mass murderers, whilst diagnosis is missing their family background is really quite common and are the sort of circumstances that you'd expect to generate RAD. Obviously, that outcome is very rare, but does exist.
> Well, reactive attachment syndrome is the expected outcome for something like 60% of placements,
Absolutely, completely false. Also nonsensically false that "mars bars instead of sandwiches" would get any intervention.
You are very misinformed on this topic. Almost everything you have said is directly, easily contradicted simply by looking at the widely available data on foster care. Children arrive in foster care with attachment disorders - the majority of children don't even enter foster care until they are too old to develop an attachment disorder, according to the diagnostic criteria. Almost 50% of children who are taken into foster care in the US have only one placement (1). (Unsurprisingly, being diagnosed with RAD correlates very highly with having more placements. There's likely causality in both directions there.)
I don't know why you have such a strong opinion here, but it's not based on reality.
Non-permanent placements (most obviously crisis care), which by itself happens to 20-30% of children in care. A placement in a youth institution is a per-6-month assignment by a judge and therefore obviously very unstable in essentially all cases. Even when they are stable, because of the 6 month time limit, after which a decision the child has zero possibility to influence might change their environment 100%, do you really think this will be experienced as stability and is correctly classified as "no change"?
Additionally, in clinic or some forms of foster care one might even say that given the rate of changes in the group (and personnel) even if the child remains in the same location, everyone around them changes in something like 8 months, every 8 months (because 10 children per group, every one has 6 month placement, so you can expect some change every 2 weeks). On top of that, personnel changes are very common in all youth institutions. So even in the case of a stable placement a youth institution will not be experienced as anything remotely resembling stability by a child living there.
The viewpoint of the child is obviously what matters here.
Breakdowns of placements (ie. foster parents/institution requiring child to be removed immediately, without waiting for placement to end): 20% to 65% of children, depending on age and gender.
Is it really so controversial for you that multiple changes of caregivers and environment are experienced by almost all children in state care? And that constant large changes of environment are experienced by a large subset of these children?
I did not say the worst possible form of reactive attachment disorder is the expected outcome in 60% of cases, some form of attachment disorder is expected in 60% of cases. And granted, you can certainly make a valid argument that this is at least partially because every DSM revision loosens the definition of attachment disorder, which is also seen in other diagnoses and results in absurd levels of comorbidity.
The real problem that everyone does agree on is that reactive attachment disorder sharply rises when social services intervene in the lives of children, irrespective of the reason. Even abused children have sharply lower incidence of attachment problems than children in clinic or foster care.
This is controversial, that's certainly true. Why? Hmmm, let's ask ourselves ... why might a very good reason to avoid interference in families by social services that has historically been used to deny almost all interference (and with that came the consequence that it robbed many social workers of a job and greatly limited the size of the sector) be controversial? I wonder why that might happen...
> Also nonsensically false that "mars bars instead of sandwiches" would get any intervention.
This is seen as neglect and will most definitely cause intervention by social services. Hopefully placement is rare, but the issue is that if you attract the attention of social services, a child getting an out-of-home placement is greatly dependent on the child services investigator as the first linked study pointed out, not on the child, the parent, or what is actually going on. Just for that reason alone it will happen.
Actually, the major driver of pushback against these diagnoses in foster care in my experience is former foster children, who object to having been diagnosed with these conditions for what they feel was perfectly reasonable behavior. But yes, let's jump to a conspiracy theory about bad social workers instead.
It seems that you are attempting to argue something completely different to your original claims, and I'm not interested in trying to follow you and your goalposts.
> Actually, the major driver of pushback against these diagnoses in foster care in my experience is former foster children
I don't get it, you accuse me of conspiracy and then claim this is all because of a conspiracy by the children, the victims. And victims is the correct word because VERY few foster children had any hand in or possibility to influence their placement at all, and the vast majority, as the paper says too, are "marginal", meaning their placement was the choice of the social services investigator. I'm sure it's nevertheless all their fault and they deserve it, and the social workers who are totally financially dependent on robbing them of their home just don't have .
Besides, those are children have experienced firsthand the consequences of social workers' help, and really didn't want that help, don't want it now, and will never want it.
Who would know better than they do? Nobody would.
> let's jump to a conspiracy theory about bad social workers instead
You have met some social workers, right? Bad is the standard there. Even outright malevolence is not rare. Hidden agendas and lies are the norm in youth protection social workers, because if they told the truth to children, it'd be comical: "do you want my help? We can take everything from you, friends, parents, school, ... everything, declare you sick with 20 diagnoses and if we start now we can have you in prison before you're 20. Yes almost all foster children become criminals. So do you want our help?". Children will be running in tears to abusers begging them to take them back ...
https://sci-hub.se/10.1257/aer.97.5.1583
> As for the idea that "even a single CPS placement" is worse than being left with violent parents - I've never seen anything supporting this but if you have some I'd love to read it.
Well, reactive attachment syndrome is the expected outcome for something like 60% of placements, and 80%+ of kids that are placed more than once. These multiple replacements are not exactly rare. Apparently there is a small group where the first placement remains stable for a long time which has reasonable results, and there is a large group that keep getting placed again and again where the outcomes are terrible.
The vast majority of parents aren't violent but neglectful. And even then, our standards of neglect have moved quite a bit. These days some interventions are done because of "bad" food in lunch boxes (think: mars bars, not sandwiches).
The long term consequences of neglect and violence that isn't random are "parentification. TLDR: kids start acting like adults at a very young age, and obviously with less than ideal success. Think 7 year olds that make sure the rent is paid and their little sister sees a doctor once a year, or when she's ill. These kids will fight for their independence, for obvious reasons, at a very young age. This can, and does, lead to depression and less than ideal school results (because in that situation the kids don't consider school very important and of course caring for others takes time that can't be spent on homework or hobbies or even actually going to class when there's a crisis). The worst outcomes are observed where the kid takes total control of the home situation and the KID abuses this power. But even that is nothing compared to even mild attachment syndrome.
The worse cases of reactive attachment disorder, well, from Wikipedia: "Actions that otherwise would be classified as conduct disorder, such as mutilating animals, harming siblings or other family, or harming themselves intentionally"
And of course, it is anecdotal and probably lacks validity but if you look up mass murderers, whilst diagnosis is missing their family background is really quite common and are the sort of circumstances that you'd expect to generate RAD. Obviously, that outcome is very rare, but does exist.
https://en.wikipedia.org/wiki/Parentification
I would say, read both entries and judge for yourself which is the worse one. But I don't think there will be much disagreement.