Longitudinal trajectories of behavioral problems among children in out-of-home care: A systematic review

•Behavior problems show heterogeneity in their trajectory patterns.•Heterogeneity calls for further investigation of small, well-defined subgroups.•Baseline problem behavior and maltreatment consistently predict later behavior.•Large gaps in the literature on the effects of socioemotional competence are found. While there are many studies that examine the adverse effects of behavior problems among children in out-of-home care, evidence to understand the cumulative evidence of factors that may change such behavioral paths is limited. Research indicates that children in out-of-home care tend to have higher levels of internalizing and externalizing symptoms, conduct disorders, depression levels, and suicidal behavior compared to children in the general population. To effectively mitigate the risk of behavioral maladjustment, it is important to determine variables that may change behavioral paths, and lead to better outcomes. To address this evidence gap, this study presents a narrative systematic review to examine the quantitative evidence on factors associated with behavioral development of children in out-of-home care. Findings from a total of 146 studies were extracted to investigate what the longitudinal trajectories of behavior problems for children in out-of-home care look like and what variables are associated with particular developmental paths. Results indicated that various individual and ecological variables significantly influence the level of problem behavior that developed over time. Evidence gaps, implications and recommendations for researchers, policy makers and practitioners are presented.