The impact of care-related factors on the communication skills and wellbeing of looked after and adopted children

  • Darren Maguire

Student thesis: Doctoral ThesisDoctorate in Clinical Psychology


The research project explores the severity and specificity of language and communication difficulty in a population of Looked After and Adopted Children and the association between these difficulties and several care-related factors, mental health and Adverse Childhood Experiences (ACEs). 68% of a sample of 57 children performed in the bottom 10% of the general population for language and communication ability. Similar levels of severity were found for both structural and pragmatic abilities. Language and communication difficulties were associated with older children, later age of entry into care and placement type (foster care vs. adoption) but not placement disruption. A significant relationship was found between mental health and language difficulty, but no link was established with ACEs.

A systematic review was conducted to explore the literature regarding the impact of placement instability on behavioural and mental health outcomes in foster care children. 14 studies were included in the final review. The findings indicated that placement instability was a consistent predictor of externalising behaviour in children, although some evidence was counter-indicative in this regard. There was also evidence to suggest a relationship with internalising behaviours, and mental health difficulties, in particular PTSD symptoms. Methodological quality and design varied between studies which limited direct comparisons and there was a lack of consensus on how to quantify and measure placement instability.

Thesis embargoed until 31 December 2026.
Date of AwardDec 2021
Original languageEnglish
Awarding Institution
  • Queen's University Belfast
SupervisorDavid McCormack (Supervisor) & Tim Fosker (Supervisor)


  • Foster care
  • looked after children
  • adoption
  • language and communication
  • language development
  • children's communication checklist
  • adverse childhood experiences
  • assessment checklist for children
  • placement instability
  • systematic review
  • care-related factors
  • mental health
  • behaviour

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