Foster care is a system in which a
minor
Minor may refer to:
* Minor (law), a person under the age of certain legal activities.
** A person who has not reached the age of majority
* Academic minor, a secondary field of study in undergraduate education
Music theory
*Minor chord
** Barb ...
has been placed into a
ward
Ward may refer to:
Division or unit
* Hospital ward, a hospital division, floor, or room set aside for a particular class or group of patients, for example the psychiatric ward
* Prison ward, a division of a penal institution such as a pris ...
,
group home
A group home, congregate living facility, or care home (the latter especially in British English and Australian English) is a residence model of medical care for those with complex health needs. Traditionally, the model has been used for children ...
(
residential child care community Residential child care communities or children's homes are a type of residential care, which refers to long-term care given to children who cannot stay in their birth family home. There are two different approaches towards residential care: The fam ...
,
treatment center, etc.), or private home of a state-
certified
Certification is the provision by an independent body of written assurance (a certificate) that the product, service or system in question meets specific requirements. It is the formal attestation or confirmation of certain characteristics of a ...
caregiver, referred to as a "foster parent" or with a family member approved by the state. The placement of the child is normally arranged through the government or a social service agency. The institution, group home, or foster parent is compensated for expenses unless with a family member. In some states, relative or "Kinship" caregivers of children who are wards of the state are provided with a financial stipend.
The state, via the
family court
Family courts were originally created to be a Court of Equity convened to decide matters and make orders in relation to family law, including custody of children, and could disregard certain legal requirements as long as the petitioner/plaintif ...
and
child protective services agency, stand ''
in loco parentis
The term ''in loco parentis'', Contemporary Latin, Latin for "in the place of a parent" refers to the legal responsibility of a person or organization to take on some of the functions and responsibilities of a parent.
Originally derived from ...
'' to the minor, making all legal decisions while the foster parent is responsible for the day-to-day care of the minor.
Scholars and activists are concerned about the efficacy of the foster care services provided by NGOs.
Specifically, this pertains to poor retention rates of social workers. Poor retention rates are attributed to being overworked in an emotionally draining field that offers minimal monetary compensation.
The lack of professionals pursuing a degree in social work coupled with poor retention rates in the field has led to a shortage of social workers and created large caseloads for those who choose to work and stay in the field.
The efficacy of caseworker retention also affects the overall ability to care for clients. Low staffing leads to data limitations that infringe on caseworkers' ability to adequately serve clients and their families.
Foster care is correlated with a range of negative outcomes compared to the general population. Children in foster care have a high rate of ill health, particularly psychiatric conditions such as anxiety, depression, and eating disorders. One third of foster children in a US study reported abuse from a foster parent or other adult in the foster home. Nearly half of foster children in the US become homeless when they reach the age of 18, and the poverty rate is three times higher among foster care alumni than in the general population.
By country
Australia
In Australia foster care was known as "boarding-out". Foster care had its early stages in
South Australia
South Australia (commonly abbreviated as SA) is a state in the southern central part of Australia. It covers some of the most arid parts of the country. With a total land area of , it is the fourth-largest of Australia's states and territories ...
in 1867 and stretched to the second half of the 19th century. It is said that the system was mostly run by women until the early 20th century. Then the control was centered in many state children's departments. "Although boarding-out was also implemented by non-government
lchild rescue organizations, many large institutions remained. These institutions assumed an increasing importance from the late 1920s when the system went into decline." The system was re-energized in the postwar era, and in the 1970s. The system is still the main structure for "out-of-home care." The system took care of both local and foreign children. "The first adoption legislation was passed in
Western Australia
Western Australia (commonly abbreviated as WA) is a state of Australia occupying the western percent of the land area of Australia excluding external territories. It is bounded by the Indian Ocean to the north and west, the Southern Ocean to th ...
in 1896, but the remaining states did not act until the 1920s, introducing the beginnings of the closed adoption that reached it peak in the period 1940–1975. New baby adoption dropped dramatically from the mid-1970s, with the greater tolerance of and support for single mothers".
Cambodia
Foster care in Cambodia is relatively new as an official practice within the government. However, despite a later start, the practice is currently making great strides within the country. Left with a large number of official and unofficial
orphanage
An orphanage is a Residential education, residential institution, total institution or group home, devoted to the Childcare, care of orphans and children who, for various reasons, cannot be cared for by their biological families. The parent ...
s from the 1990s, the Cambodian government conducted several research projects in 2006 and 2008, pointing to the overuse of orphanages as a solution for caring for vulnerable children within the country. Most notably, the studies found that the percentage of children within orphanages that had parents approached 80%. At the same time, local NGOs like "Children In Families" began offering limited foster care services within the country. In the subsequent years, the Cambodian government began implementing policies that required the closure of some orphanages and the implementation of minimum standards for
residential care
Residential care refers to long-term care given to adults or children who stay in a residential setting rather than in their own home or family home.
There are various residential care options available, depending on the needs of the individual. P ...
institutions. These actions lead to an increase in the number of NGOs providing foster care placements and helped to set the course for care reform around the country. As of 2015, the Cambodian government is working with UNICEF, USAID, several governments, and many local NGOs in continuing to build the capacity for child protection and foster care within the Kingdom.
Canada
Foster children in Canada are known as permanent wards, (crown wards in Ontario).
[Anne Tweddle]
"Youth Leaving Care Report"
, September 2005 A
ward
Ward may refer to:
Division or unit
* Hospital ward, a hospital division, floor, or room set aside for a particular class or group of patients, for example the psychiatric ward
* Prison ward, a division of a penal institution such as a pris ...
is someone, in this case a child, placed under protection of a
legal guardian
A legal guardian is a person who has been appointed by a court or otherwise has the legal authority (and the corresponding duty) to make decisions relevant to the personal and property interests of another person who is deemed incompetent, call ...
and are the legal responsibility of the
government
A government is the system or group of people governing an organized community, generally a state.
In the case of its broad associative definition, government normally consists of legislature, executive, and judiciary. Government is a ...
. Census data from 2011 counted children in foster care for the first time, counting 47,885 children in care. The majority of foster children – 29,590, or about 62 per cent – were aged 14 and under.
[National Pos]
"Census 2011: Canada's foster children counted for first time"
September 19, 2012 The wards remain under the care of the government until they "age out of care." All ties are severed from the government and there is no longer any legal responsibility toward the youth. This age is different depending on the province.
Israel
In December 2013, the Israeli
Knesset
The Knesset ( he, הַכְּנֶסֶת ; "gathering" or "assembly") is the unicameral legislature of Israel. As the supreme state body, the Knesset is sovereign and thus has complete control of the entirety of the Israeli government (with ...
approved a bill co-drafted by the
Israel National Council for the Child
The Israel National Council for the Child (NCC; המועצה הלאומית לשלום הילד), in Jerusalem, Israel, is an Israeli independent non-profit non-governmental organization that advocates for children's rights and well-being. to regulate the rights and obligations of participants in the foster care system in Israel.
Japan
The idea of foster care or taking in abandoned children actually came about around 1392-1490s in Japan. The foster care system in Japan is similar to the Orphan Trains because Brace thought the children would be better off on farms. The people in Japan thought the children would do better on farms rather than living in the "dusty city." The families would often send their children to a farm family outside the village and only keep their oldest son. The farm families served as the foster parents and they were financially rewarded for taking in the younger siblings. "It was considered an honor to be chosen as foster parents, and selection greatly depended on the family's reputation and status within the village". Around 1895 the foster care program became more like the system used in the United States because the
Tokyo Metropolitan Police
The serves as the prefectural police department of Tokyo Metropolis. Founded in 1874, it is headed by a Superintendent-General, who is appointed by the National Public Safety Commission, and approved by the Prime Minister.
The Tokyo Metro ...
sent children to a hospital where they would be "settled". Problems emerged in this system, such as
child abuse
Child abuse (also called child endangerment or child maltreatment) is physical, sexual, and/or psychological maltreatment or neglect of a child or children, especially by a parent or a caregiver. Child abuse may include any act or failure to a ...
, so the government started phasing it out and "began increasing institutional facilities". In 1948 the Child Welfare Law was passed, increasing official oversight, and creating better conditions for the children to grow up in.
United Kingdom
In the United Kingdom, foster care and adoption has always been an option, "in the sense of taking other people's children into their homes and looking after them on a permanent or temporary basis." Although, nothing about it had a legal foundation, until the 20th century. The UK had "wardship," the family taking in the child had custody by the
Chancery Court. Wardship was not used very often because it did not give the guardian "parental rights." In the 19th century came a "series of baby farming scandals." At the end of the 19th century they started calling it "boarding-out" like they did in Australia. They started placing the children in
orphanage
An orphanage is a Residential education, residential institution, total institution or group home, devoted to the Childcare, care of orphans and children who, for various reasons, cannot be cared for by their biological families. The parent ...
s and
workhouse
In Britain, a workhouse () was an institution where those unable to support themselves financially were offered accommodation and employment. (In Scotland, they were usually known as poorhouses.) The earliest known use of the term ''workhouse'' ...
s as well. "The First World War saw an increase in organized adoption through adoption societies and child rescue organizations, and pressure grew for adoption to be given legal status." The first laws based on adoption and foster care were passed in 1926. "The peak number of adoptions was in 1968, since then there has been an enormous decline in adoption in the United Kingdom. The main reasons for children being adopted in the United Kingdom had been unmarried mothers giving up their children for adoption and stepparents adopting their new partner's children".
United States
In the United States, foster care started as a result of the efforts of
Charles Loring Brace
Charles Loring Brace (June 19, 1826 – August 11, 1890) was an American philanthropist who contributed to the field of social reform. He is considered a father of the modern foster care movement and was most renowned for starting the Orphan Tra ...
. "In the mid 19th Century, some 30,000 homeless or neglected children lived in the New York City streets and slums."
["Foster Care History & Accomplishments." The Children's Aid Society. N.p., n.d. Web. 05 Oct. 2013.] Brace took these children off the streets and placed them with families in most states in the country. Brace believed the children would do best with a Christian farm family. He did this to save them from "a lifetime of suffering"
[Nordmark, Oliver. "Orphan Train History.": REVEREND CHARLES LORING BRACE. N.p., 09 Feb. 2010. Web. 19 Oct. 2013.] He sent these children to families by train, which gave the name The
Orphan Train
The Orphan Train Movement was a supervised welfare program that transported children from crowded Eastern cities of the United States to foster homes located largely in rural areas of the Midwest. The orphan trains operated between 1854 and 1929, ...
Movement. "This lasted from 1853 to the early 1890s and transported more than 120,000 250,000? children to new lives." When Brace died in 1890, his sons took over his work of the Children's Aid Society until they retired.
The Children's Aid Society created "a foster care approach that became the basis for the federal
Adoption and Safe Families Act
The Adoption and Safe Families Act (ASFA, Public Law 105–89) was signed into law by President Bill Clinton on November 19, 1997, after having been approved by the United States Congress earlier in the month.
Background
ASFA was enacted in an ...
of 1997" called Concurrent Planning. This greatly impacted the foster care system.
From August 1999 - August 2019, 9,073,607 American children have been removed from their families and placed in foster homes according to the federal government Adoption and Foster Care Analysis and Reporting System.
As last reported in August 2019, 437,238 children nationally were removed from their families and placed in foster homes according to the federal government Adoption and Foster Care Analysis and Reporting System.
- 24% of foster children are between the ages of 0 and 2
- 18% of foster children are between the ages of 3 and 5
- 28% of foster children are between the ages of 6 and 12
- 40% of foster children are between the ages of 13 and 21
- Average # of birthdays a child spends in foster care: 2
- 22% of children had three or more placements during a length of 20 months in foster care.
- 91% of foster children under the age of 2 are adopted.
France
In France, foster families are called ''familles d'accueil'' (literally "welcome families"). Foster homes must obtain an official approval from the government in order to welcome a minor or an elderly person. In order to receive this approval they must follow a training and their home is inspected to be sure it is safe and healthy. In 2017, 344 000 minors and 15000 elderly persons were welcomed in foster homes.
Placement
Family-based foster care is generally preferred to other forms of out of home care. Foster care is intended to be a short-term solution until a permanent placement can be made.
[Dorsey et Al. ''Current status and evidence base of training for foster and treatment foster parents''] In most states, the primary objective is to reconcile children with the biological parents. However, if the parents are unable or unwilling to care for the child, or if the child is an
orphan
An orphan (from the el, ορφανός, orphanós) is a child whose parents have died.
In common usage, only a child who has lost both parents due to death is called an orphan. When referring to animals, only the mother's condition is usuall ...
, then the first choice of adoptive parents is a relative such as an
aunt
An aunt is a woman who is a sibling of a parent or married to a sibling of a parent. Aunts who are related by birth are second-degree relatives. Known alternate terms include auntie or aunty. Children in other cultures and families may refer ...
,
uncle
An uncle is usually defined as a male relative who is a sibling of a parent or married to a sibling of a parent. Uncles who are related by birth are second-degree relatives. The female counterpart of an uncle is an aunt, and the reciprocal relat ...
or
grandparent
Grandparents, individually known as grandmother and grandfather, are the parents of a person's father or mother – paternal or maternal. Every sexually-reproducing living organism who is not a genetic chimera has a maximum of four genetic gra ...
, known as
kinship care
Kinship care is a term used in the United States and Great Britain for the raising of children by grandparents, other extended family members, and unrelated adults with whom they have a close family-like relationship such as godparents and close f ...
. Most
kinship care
Kinship care is a term used in the United States and Great Britain for the raising of children by grandparents, other extended family members, and unrelated adults with whom they have a close family-like relationship such as godparents and close f ...
is done informally, without the involvement of a court or public organization. However, in the United States, formal kinship care is increasingly common. In 2012, a quarter of all children in formal foster care were placed with relatives instead of being placed into the system.
If no related family member is willing or able to adopt, the next preference is for the child to be adopted by the foster parents or by someone else involved in the child's life (such as a
teacher
A teacher, also called a schoolteacher or formally an educator, is a person who helps students to acquire knowledge, competence, or virtue, via the practice of teaching.
''Informally'' the role of teacher may be taken on by anyone (e.g. whe ...
or
coach
Coach may refer to:
Guidance/instruction
* Coach (sport), a director of athletes' training and activities
* Coaching, the practice of guiding an individual through a process
** Acting coach, a teacher who trains performers
Transportation
* Co ...
). This is to maintain continuity in the child's life. If neither above option are available, the child may be adopted by someone who is a stranger to the child.
If none of these options are viable, the plan for the minor may be to enter OPPLA (Other Planned Permanent Living Arrangement). This option allows the child to stay in custody of the state and the child can stay placed in a foster home, with a relative or a long-term care facility, such as a
residential child care community Residential child care communities or children's homes are a type of residential care, which refers to long-term care given to children who cannot stay in their birth family home. There are two different approaches towards residential care: The fam ...
or, for children with development disabilities, physical disabilities or mental disabilities, a
treatment center.
671,000 children were served by the foster care system in the United States in 2015.
"After declining more than 20 percent between FY 2006 and FY 2012 to a low of 397,000, the number of children in foster care on the last day of the fiscal year increased to 428,000 in FY 2015, with a slightly higher percent change from 2014 to 2015 (3.3%) than observed from 2013 to 2014 (3.2%)." Since FY 2012, the number of children in foster care at the end of each FY has steadily increased.
The median amount of time a child spent in foster care in the U.S. in 2015 was 13.5 months. That year, 74% of children spent less than two years in foster care, while 13% were in care for three or more years.
[Id.] Of the estimated 427,910 children in foster care on September 30, 2015: 43 percent were White, 24 percent were African-American, 21 percent were Hispanic (of any race), 10 percent were other races or multiracial, and 2 percent were unknown or unable to be determined.
Children may enter foster care voluntarily or involuntarily. Voluntary placement may occur when a biological parent or lawful guardian is unable to care for a child. Involuntary placement occurs when a child is removed from their biological parent or lawful guardian due to the risk or actual occurrence of physical or psychological harm, or if the child has been orphaned. In the US, most children enter foster care due to neglect. If a biological parent or
legal guardian
A legal guardian is a person who has been appointed by a court or otherwise has the legal authority (and the corresponding duty) to make decisions relevant to the personal and property interests of another person who is deemed incompetent, call ...
is unwilling to care for a child, the child is deemed to be dependent and is placed under the care of the child protection agency. The policies regarding foster care as well as the criteria to be met in order to become a foster parent vary according to legal jurisdiction.
Especially egregious failures of child protective services often serve as a catalyst for increased removal of children from the homes of biological parents. An example is the brutal torture and murder of 17-month-old
Peter Connelly, a British toddler who died in
London Borough of Haringey
The London Borough of Haringey (pronounced , same as Harringay) is a London borough in North London, classified by some definitions as part of Inner London, and by others as part of Outer London. It was created in 1965 by the amalgamation of t ...
, North London after suffering more than 50 severe injuries over an eight-month period, including eight broken ribs and a broken back. Throughout the period of time in which he was being tortured, he was repeatedly seen by Haringey Children's services and
NHS
The National Health Service (NHS) is the umbrella term for the publicly funded healthcare systems of the United Kingdom (UK). Since 1948, they have been funded out of general taxation. There are three systems which are referred to using the " ...
health professionals. Haringey Children's services already failed ten years earlier in the case of
Victoria Climbié
Victoria most commonly refers to:
* Victoria (Australia), a state of the Commonwealth of Australia
* Victoria, British Columbia, provincial capital of British Columbia, Canada
* Victoria (mythology), Roman goddess of Victory
* Victoria, Seychelle ...
.
In the time since his death, in 2007, cases have reached a record rate in England surpassing 10,000 in the reporting year ending in March 2012.
Abuse and negligence
From 1993 through 2002 there were 107 recorded deaths; there are approximately 400,000 children in out-of-home care, in the United States. Almost 10% of children in foster care have stayed in foster care for five or more years. Nearly half of all children in foster care have chronic medical problems. 8% of all children in foster care have serious emotional problems, 11% of children exiting foster care aged out of the system, in 2011. Children in foster care experience high rates of
child abuse
Child abuse (also called child endangerment or child maltreatment) is physical, sexual, and/or psychological maltreatment or neglect of a child or children, especially by a parent or a caregiver. Child abuse may include any act or failure to a ...
, emotional deprivation, and physical
neglect
In the context of caregiving, neglect is a form of abuse where the perpetrator, who is responsible for caring for someone who is unable to care for themselves, fails to do so. It can be a result of carelessness, indifference, or unwillingness and ...
. In one study in the United Kingdom "foster children were 7–8 times, and children in residential care 6 times more likely to be assessed by a pediatrician for
abuse
Abuse is the improper usage or treatment of a thing, often to unfairly or improperly gain benefit. Abuse can come in many forms, such as: physical or verbal maltreatment, injury, assault, violation, rape, unjust practices, crimes, or other t ...
than a child in the general population". A study of foster children in Oregon and Washington State found that nearly one third reported being abused by a foster parent or another adult in a foster home. The "Parent Trauma Response Questionnaire" states that parental overprotection can be just as harmful psychologically as neglect.
Development
As of 2019, the majority of children in the foster care system were under 8 years of age.
These early years are quite important for the physical and mental development of children. More specifically, these early years are most important for brain development. Stressful and traumatic experiences have been found to have long-term negative consequences for the brain development in children whereas talking, singing, and playing can help encourage brain growth. Since the majority of children are removed from their homes due to neglect, this means that many of these children did not experience stable and stimulating environments to help promote this necessary growth.
In a research study conducted at the University of Minnesota, researchers found that children placed in non-parental homes, such as foster homes, showed significant behavior problems and higher levels of internalizing problems in comparison to children in traditional families and even children who were mistreated by caregivers. According to an article written by Elizabeth Curry titled 'The five things you should know about how orphanage life affects children' they state that a child who has lived in an orphanage or a home for multiple children, they will have learned survival skills but lack family skills due to them never understanding permanency.
Medical and psychiatric disorders
A higher prevalence of physical, psychological, cognitive and epigenetic disorders for children in foster care has been established in studies in various countries. The Casey Family Programs Northwest Foster Care Alumni Study was a fairly extensive study of various aspects of children who had been in foster care.
Individuals who were in foster care experience higher rates of physical and psychiatric morbidity than the general population and suffer from not being able to trust and that can lead to placements breaking down.
In the Casey study of foster children in
Oregon
Oregon () is a U.S. state, state in the Pacific Northwest region of the Western United States. The Columbia River delineates much of Oregon's northern boundary with Washington (state), Washington, while the Snake River delineates much of it ...
and
Washington state
Washington (), officially the State of Washington, is a state in the Pacific Northwest region of the Western United States. Named for George Washington—the first U.S. president—the state was formed from the western part of the Washington ...
, they were found to have double the incidence of
depression, 20% as compared to 10% and were found to have a higher rate of
posttraumatic stress disorder
Post-traumatic stress disorder (PTSD) is a mental and behavioral disorder that can develop because of exposure to a traumatic event, such as sexual assault, warfare, traffic collisions, child abuse, domestic violence, or other threats on ...
(PTSD) than combat veterans with 25% of those studied having PTSD. Children in foster care have a higher probability of having
attention deficit hyperactivity disorder
Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterised by excessive amounts of inattention, hyperactivity, and impulsivity that are pervasive, impairing in multiple contexts, and otherwise age-inap ...
(ADHD), and deficits in
executive functioning
Executive ( exe., exec., execu.) may refer to:
Role or title
* Executive, a senior management role in an organization
** Chief executive officer (CEO), one of the highest-ranking corporate officers (executives) or administrators
** Executive dire ...
,
anxiety
Anxiety is an emotion which is characterized by an unpleasant state of inner turmoil and includes feelings of dread over anticipated events. Anxiety is different than fear in that the former is defined as the anticipation of a future threat wh ...
as well as other developmental problems.
These children experience higher degrees of
incarceration
Imprisonment is the restraint of a person's liberty, for any cause whatsoever, whether by authority of the government, or by a person acting without such authority. In the latter case it is "false imprisonment". Imprisonment does not necessari ...
,
poverty
Poverty is the state of having few material possessions or little income. Poverty can have diverse social, economic, and political causes and effects. When evaluating poverty in ...
,
homelessness
Homelessness or houselessness – also known as a state of being unhoused or unsheltered – is the condition of lacking stable, safe, and adequate housing. People can be categorized as homeless if they are:
* living on the streets, also kn ...
, and
suicide
Suicide is the act of intentionally causing one's own death. Mental disorders (including depression, bipolar disorder, schizophrenia, personality disorders, anxiety disorders), physical disorders (such as chronic fatigue syndrome), and s ...
. Studies in the U.S. have suggested that some foster care placements may be more detrimental to children than remaining in a troubled home, but a more recent study suggested that these findings may have been affected by
selection bias
Selection bias is the bias introduced by the selection of individuals, groups, or data for analysis in such a way that proper randomization is not achieved, thereby failing to ensure that the sample obtained is representative of the population int ...
, and that foster care has little effect on behavioral problems.
Neurodevelopment
Foster children have elevated levels of
cortisol
Cortisol is a steroid hormone, in the glucocorticoid class of hormones. When used as a medication, it is known as hydrocortisone.
It is produced in many animals, mainly by the ''zona fasciculata'' of the adrenal cortex in the adrenal gland ...
, a
stress
Stress may refer to:
Science and medicine
* Stress (biology), an organism's response to a stressor such as an environmental condition
* Stress (linguistics), relative emphasis or prominence given to a syllable in a word, or to a word in a phrase ...
hormone
A hormone (from the Greek participle , "setting in motion") is a class of signaling molecules in multicellular organisms that are sent to distant organs by complex biological processes to regulate physiology and behavior. Hormones are required ...
, in comparison to children raised by their biological parents. Elevated cortisol levels can compromise the immune system. (Harden BJ, 2004). Most of the processes involved in typical neurodevelopment are predicated upon the establishment of close nurturing relationships and environmental stimulation. Negative environmental influences during this critical period of brain development can have lifelong consequences.
Post traumatic stress disorder
Children in foster care have a higher incidence of
posttraumatic stress disorder
Post-traumatic stress disorder (PTSD) is a mental and behavioral disorder that can develop because of exposure to a traumatic event, such as sexual assault, warfare, traffic collisions, child abuse, domestic violence, or other threats on ...
(PTSD). In one study,
60% of children in foster care who had experienced sexual abuse had PTSD, and 42% of those who had been physically abused met the PTSD criteria. PTSD was also found in 18% of the children who were not abused. These children may have developed PTSD due to witnessing violence in the home. (Marsenich, 2002).
In order to figure out if a child is going through PTSD, there is a PTSD module, the 'anxiety disorder interview'. This is considered a reliable resource for establishing if a child is going through post traumatic stress disorder due to physical, sexual, or mental abuse.
In a study conducted in Oregon and Washington state, the rate of PTSD in adults who were in foster care for one year between the ages of 14–18 was found to be higher than that of combat veterans, with 25 percent of those in the study meeting the diagnostic criteria as compared to 12–13 percent of Iraq war veterans and 15 percent of Vietnam war veterans, and a rate of 4% in the general population. The recovery rate for foster home alumni was 28.2% as opposed to 47% in the general population.
"More than half the study participants reported clinical levels of mental illness, compared to less than a quarter of the general population".
Eating disorders
Foster children are at increased risk for a variety of
eating disorders
An eating disorder is a mental disorder defined by abnormal eating behaviors that negatively affect a person's physical or mental health. Only one eating disorder can be diagnosed at a given time. Types of eating disorders include binge eating ...
in comparison to the general population. In a study done in the United Kingdom, 35% of foster children experienced an increase in
Body Mass Index
Body mass index (BMI) is a value derived from the mass (weight) and height of a person. The BMI is defined as the body mass divided by the square of the body height, and is expressed in units of kg/m2, resulting from mass in kilograms and he ...
(BMI) once in care. Food Maintenance Syndrome is characterized by a set of aberrant eating behaviors of children in foster care. It is "a pattern of excessive eating and food acquisition and maintenance behaviors without concurrent obesity"; it resembles "the behavioral correlates of Hyperphagic Short Stature". It is hypothesized that this syndrome is triggered by the stress and maltreatment foster children are subjected to, it was prevalent amongst 25 percent of the study group in New Zealand.
Bulimia nervosa
Bulimia nervosa, also known as simply bulimia, is an eating disorder characterized by binge eating followed by purging or fasting, and excessive concern with body shape and weight. The aim of this activity is to expel the body of calories eate ...
is seven times more prevalent among former foster children than in the general population.
Poverty and homelessness
Nearly half of foster children in the U.S. become homeless when they turn 18. One of every 10 foster children stays in foster care longer than seven years, and each year about 15,000 reach the age of majority and leave foster care without a permanent family—many to join the ranks of the homeless or to commit crimes and be imprisoned.
Three out of 10 of the
United States homeless are former foster children. According to the results of the Casey Family Study of Foster Care Alumni, up to 80 percent are doing poorly—with a quarter to a third of former foster children at or below the
poverty line
The poverty threshold, poverty limit, poverty line or breadline is the minimum level of income deemed adequate in a particular country. The poverty line is usually calculated by estimating the total cost of one year's worth of necessities for t ...
, three times the national poverty rate. Very frequently, people who are homeless had multiple placements as children: some were in foster care, but others experienced "unofficial" placements in the homes of family or friends.
Individuals with a history of foster care tend to become homeless at an earlier age than those who were not in foster care. The length of time a person remains homeless is longer in individuals who were in foster care.
Suicide-death rate
Children in foster care are at a greater risk of suicide. The increased risk of suicide is still prevalent after leaving foster care. In a small study of twenty-two
Texan
Texas (, ; Spanish: ''Texas'', ''Tejas'') is a state in the South Central region of the United States. At 268,596 square miles (695,662 km2), and with more than 29.1 million residents in 2020, it is the second-largest U.S. state by bo ...
youths who aged out of the system, 23 percent had a history of suicide attempts.
A
Swedish
Swedish or ' may refer to:
Anything from or related to Sweden, a country in Northern Europe. Or, specifically:
* Swedish language, a North Germanic language spoken primarily in Sweden and Finland
** Swedish alphabet, the official alphabet used by ...
study utilizing the data of almost one million people including 22,305 former foster children who had been in care prior to their teens, concluded:
Death rate
Children in foster care have an overall higher mortality rate than children in the general population. A study conducted in Finland among current and former foster children up to age 24 found a higher mortality rate due to substance abuse, accidents, suicide and illness. The deaths due to illness were attributed to an increased incidence of
acute
Acute may refer to:
Science and technology
* Acute angle
** Acute triangle
** Acute, a leaf shape in the glossary of leaf morphology
* Acute (medicine), a disease that it is of short duration and of recent onset.
** Acute toxicity, the adverse eff ...
and
chronic medical conditions and
developmental delays
Specific developmental disorders (SDD) was a classification of disorders characterized by delayed development in one specific area or areas.Ahuja Vyas: ''Textbook of Postgraduate Psychiatry'' (2 Vols.), 2nd ed. 1999 Specific developmental disorders ...
among children in foster care.
Georgia Senator
Nancy Schaefer
Nancy Smith Schaefer (28 June 193626 March 2010) was an American politician and conservative legislator who served in the Georgia State Senate from 2004 to 2008.
Education
Born in Clayton, Georgia and of German descent, Schaefer went to the Univ ...
published a report "The Corrupt Business of Child Protective Services"
stating:
Academic prospects
Educational outcomes of ex-foster children in the Northwest Alumni Study:
* 56% completed high school compared to 82% of the general population, although an additional 29% of former foster children received a
G.E.D.
The General Educational Development (GED) tests are a group of four subject tests which, when passed, provide certification that the test taker has United States or Canadian high school-level academic skills. It is an alternative to the US high ...
compared to an additional 5% of the general population.
* 42.7% completed some education beyond
high school
A secondary school describes an institution that provides secondary education and also usually includes the building where this takes place. Some secondary schools provide both '' lower secondary education'' (ages 11 to 14) and ''upper seconda ...
.
* 20.6% completed any degree or certificate beyond high school
* 16.1% completed a
vocational degree
Vocational education is education that prepares people to work as a technician or to take up employment in a skilled craft or trade as a tradesman, tradesperson or artisan. Vocational Education can also be seen as that type of education give ...
; 21.9% for those over 25.
* 1.8% complete a
bachelor's degree
A bachelor's degree (from Middle Latin ''baccalaureus'') or baccalaureate (from Modern Latin ''baccalaureatus'') is an undergraduate academic degree awarded by colleges and universities upon completion of a course of study lasting three to six ...
, 2.7% for over 25, the completion rate for the general population in the same age group is 24%, a sizable difference.
The study reviewed case records for 659 foster care alumni in Northwest USA, and interviewed 479 of them
between September 2000 and January 2002.
Higher Education
Approximately 10% of foster youth make it to college and of those 10%, only about 3% actually graduate and obtain a 4-year degree. Although the number of foster youth who are starting at a 4-year university after high school has increased over the years, the number of youth who graduate from college continues to remain stable. A study of 712 youth in California, the results revealed that foster care youth are fives times less likely to attend college than youth who do not go through foster care.
There are different resources that offer both financial and emotional support for foster youth to continue their education. Simultaneously, there are also many barriers that make getting to a college or university difficult.
Borton describes some of the barriers youth face in her article, ''Barriers to Post-Secondary Enrollment for Former Foster Youth''. A few of those barriers include financial hurdles, navigating through the application process with little to no support, and lack of housing.
Many studies have shown that there are a few factors that have seemingly played a role in the success of foster youth making it to and graduating from a college or university. While having financial resources for foster youth is a huge help, there are other components to look at. Beginning with having support for these youth at the high school level. In order for foster youth to obtain a college degree, they must enroll at a university first.
Out of the different factors that play in increasing college enrollment such as youth participating in extended foster care, reading ability, etc., youth who received assistance or had supportive relationships from adults, were more likely than youth who did not have supportive relationships, to enroll at a university.
At colleges across the nation, there are programs that are specifically put in place to help youth who have aged out of the foster care system and continued into higher education. These programs often help youth financially by giving them supplemental funds and providing support through peer mentor programs or academic counseling services. While funding is an important key in helping get through college, it hasn't been found as the only crucial component in aiding a youth's success.
A study done by Jay and colleagues provides insight on what youth view as important in helping them thrive on a college campus. The study, which had a sample of 51 foster youth, used Conceptual Mapping to break down the different components of support that may be important for youth to receive on a college campus. It is important to take in the different factors that can be helpful for youth at a university and to look beyond providing financial support.
Psychotropic medication use
Studies have revealed that youth in foster care covered by
Medicaid
Medicaid in the United States is a federal and state program that helps with healthcare costs for some people with limited income and resources. Medicaid also offers benefits not normally covered by Medicare, including nursing home care and pers ...
insurance receive
psychotropic medication
A psychoactive drug, psychopharmaceutical, psychoactive agent or psychotropic drug is a chemical substance, that changes functions of the nervous system, and results in alterations in perception, mood, consciousness, cognition or behavior.
T ...
at a rate that was 3 times higher than that of Medicaid-insured youth who qualify by low family income. In a review (September 2003 to August 2004) of the medical records of 32,135 Texas foster care 0–19 years old, 12,189 were prescribed psychotropic medication, resulting in an annual prevalence of 37.9% of these children being prescribed medication. 41.3% received 3 different classes of these drugs during July 2004, and 15.9% received 4 different classes. The most frequently used medications were
antidepressants
Antidepressants are a class of medication used to treat major depressive disorder, anxiety disorders, chronic pain conditions, and to help manage addictions. Common side-effects of antidepressants include dry mouth, weight gain, dizziness, heada ...
(56.8%), attention-deficit/hyperactivity disorder drugs (55.9%), and antipsychotic agents (53.2%). The study also showed that youth in foster care are frequently treated with
concomitant
Concomitance is the condition of accompanying or coexisting. A concomitant is something that accompanies something else.
Concomitant or concomitance may refer to:
* Concomitance (doctrine), a Christian doctrine
* Concomitant (classical algebraic ...
psychotropic
A psychoactive drug, psychopharmaceutical, psychoactive agent or psychotropic drug is a chemical substance, that changes functions of the nervous system, and results in alterations in perception, mood, consciousness, cognition or behavior.
Th ...
medication, for which sufficient evidence regarding safety and effectiveness is not available.
The use of expensive, brand name, patent protected medication was prevalent. In the case of
SSRI
Selective serotonin reuptake inhibitors (SSRIs) are a class of drugs that are typically used as antidepressants in the treatment of major depressive disorder, anxiety disorders, and other psychological conditions.
SSRIs increase the extracellul ...
s the use of the most expensive medications was noted to be 74%; in the general market only 28% are for brand name SSRI's vs generics. The average out-of-pocket expense per prescription was $34.75 for generics and $90.17 for branded products, a $55.42, difference.
Therapeutic intervention
Children in the child welfare system have often experienced significant and repeated traumas and having a background in foster homes—especially in instances of sexual abuse—can be the precipitating factor in a wide variety of psychological and cognitive deficits it may also serve to obfuscate the true cause of underlying issues. The foster care experience may have nothing to do with the symptoms, or on the other hand, a disorder may be exacerbated by having a history of foster care and attendant abuses. The human brain however has been shown to have a fair degree of
neuroplasticity
Neuroplasticity, also known as neural plasticity, or brain plasticity, is the ability of Neural circuit, neural networks in the brain to change through growth and reorganization. It is when the brain is rewired to function in some way that diffe ...
. and adult
neurogenesis
Neurogenesis is the process by which nervous system cells, the neurons, are produced by neural stem cells (NSCs). It occurs in all species of animals except the porifera (sponges) and placozoans. Types of NSCs include neuroepithelial cells (NECs) ...
has been shown to be an ongoing process.
Multidimensional Treatment Foster Care (MTFC), also referred to as Treatment Foster Care Oregon (TFCO) and Treatment Foster Care (TFC) is a community-based intervention that was created in 1983 by Dr. Patricia Chamberlain and her associated colleagues with the initial design intended to offer a replacement for group facilities.
MTFC has differing approaches for different age groups. Preschoolers receive “a behavior-management approach and intensively trains, supervises, and supports foster caregivers to provide positive adult support and consistent limit setting” coupled with “coordinated interventions with the child’s biological parents.”
MTFC for adolescence consists of individual placement with an intensely trained foster family providing “coordinated interventions in the home, with peers,
ndin educational settings.”
MTFC has been shown to provide better results than group facilities
and proves to be more cost effective.
Reports show that Multidimensional treatment has effective results in reducing depression, arrest rates, deviant peer affiliations, placement disruption, and pregnancy rates while having positive replication trials.
It is one method that attempts to incorporate
trauma- and violence-informed care Trauma- and violence-informed care (TVIC) describes a framework for working with and relating to people who have experienced negative consequences after exposure to dangerous experiences. There is no one single TVIC framework, or model, and some go ...
into its design.
Researchers have faced difficulty when it comes to accurately assessing what makes MTFC and other similar programs that involve multiple levels of intervention successful. It seems to remain in a "black box" scenario where it is unsure what aspect of the treatment plan is actually producing positive effects.
Multiple peer-reviewed research articles on foster care programs point out a lack of research effectively evaluating the outcomes of specific foster care programs,
calling for more complete assessments to be conducted in order to properly compare outcomes between treatment plans and evaluate what practices in MTFC are most effective.
Ethical concerns have also been raised by Therese Åström and other associated researchers when conducting a systematic review on behalf of the Swedish Agency for Health Technology Assessment and Assessment of Social Services in 2018, noting that on the one hand MTFC is evaluated as effective, however, it tends to be implemented in a way that diminishes the child's agency.
Cross-cultural adoption policies
George Shanti, Nico Van Oudenhoven, and Ekha Wazir, co-authors of ''Foster Care Beyond the Crossroads: Lessons from an International Comparative Analysis'', say that there are four types of Government foster care systems. The first one is that of developing countries. These countries do not have policies implemented to take care of the basic needs of these children and these children mostly receive assistance from relatives. The second system is that of former socialist governments. The historical context of these states has not allowed for the evolution of their foster care system. NGO's have urged them to evolve; however the traditional system of institutionalizing these children is still in place. Thirdly, liberal democracies do not have the support from its political system in order to take care of these children, even though they have the resources. Finally, social democracies are the most advanced governments in regards to their foster care system. These governments have a massive infrastructure, funding, and support system in order to help foster care children.
Adoption
Foster care adoption is a type of domestic adoption where the child is initially placed into a foster care system and is subsequently placed for adoption.
Children may be placed into foster care for a variety of reasons; including, removal from the home by a governmental agency because of maltreatment. In some jurisdictions, adoptive parents are licensed as and technically considered foster parents while the adoption is being finalized. According to the U.S Department of Health and Human Services Children's Bureau, there were approximately 408,425 children in foster care in 2010. Of those children, twenty-five percent had a goal of adoption. In 2015, 243,060 children exited foster care and twenty-two percent were adopted. Nationwide, there are more than one hundred thousand children in the U.S. foster care system waiting for permanent families.
Outcomes
Youth who are aging out of foster care often face difficulties in transitioning into adulthood, especially in terms of finding stable housing, employment, finances, and educational opportunities.
The suspected reason for these difficulties involves a lack of stability experienced while in the foster care system, and the reported abuse and/or neglect in their childhood, which may affect their ability to cope with significant life changes.
In the United States, there are independent living programs designed with the intent to serve the needs of transitioning foster youth.
However, youth aging out of foster care have indicated that these programs are failing to fully address the needs of young adults without familial assistance.
In a study conducted by Gypen et al. (2017),
involving a cross-database analysis of research articles relevant to the outcomes of former foster youth, they found that the educational, mental health, employment, income, stable housing, criminal involvement and substance abuse issues outcomes for youth who have aged out of the foster care system are substantially poorer than their peers. For example, Gypen et al. (2017),
indicated that only 45% of former foster youth received a high school diploma, which is 23% lower than the general population. There are also significantly poorer outcomes for children who were formerly in foster care than children from low-income households.
Children who are eventually adopted by their placement family show greater outcomes, in terms of finding stable housing, employment, finances and education opportunities, than those who aged out of the foster care system without a permanent placement.
It has also been reported that former foster youth have a higher chance of ending up in
prostitution
Prostitution is the business or practice of engaging in Sex work, sexual activity in exchange for payment. The definition of "sexual activity" varies, and is often defined as an activity requiring physical contact (e.g., sexual intercourse, n ...
, and even fall prey to
sex trafficking
Sex trafficking is human trafficking for the purpose of sexual exploitation. It has been called a form of modern slavery because of the way victims are forced into sexual acts non-consensually, in a form of sexual slavery. Perpetrators of the ...
. This has also been called the "foster care to prostitution pipeline". a 2012 study in Los Angeles found that 59% of juveniles arrested for prostitution were or had been in foster care, but the generalizability of these findings has been disputed.
Most LA country youths held for prostitution come from foster care
/ref>
See also
* Assisted living
An assisted living residence or assisted living facility (ALF) is a housing facility for people with disabilities or for adults who cannot or who choose not to live independently. The term is popular in the United States, but the setting is s ...
* Attachment theory
Attachment theory is a psychological, evolutionary and ethological theory concerning relationships between humans. The most important tenet is that young children need to develop a relationship with at least one primary caregiver for normal ...
* Child abandonment
Child abandonment is the practice of relinquishing interests and claims over one's offspring in an illegal way, with the intent of never resuming or reasserting guardianship. The phrase is typically used to describe the physical abandonment of a ...
* Child and family services
Child and family services is a government or non-profit organisation designed to better the well being of individuals who come from unfortunate situations, ''environmental'' or ''biological''. People who seek or are sought after to participate in ...
* Child and youth care
Child and Youth Care (CYC) is a profession which focuses on the developmental needs of children and families within the space and time of their daily lives.Adapted from Stuart, C. (2013). Foundations of child and youth care. Dubuque: Kendall Hunt. ...
* Community-based care Community-based care serves as a "bridge" between orphanage and settlement house. Adolescents are placed in a family in their community. The guardians will provide individual care and nurture in the context of a family and community. This teaches ...
* Community integration
Community integration, while diversely defined, is a term encompassing the full participation of all people in community life. It has specifically referred to the integration of people with disabilities into US society from the local to the nation ...
* Complex post-traumatic stress disorder
Complex post-traumatic stress disorder (C-PTSD; also known as complex trauma disorder) is a psychological disorder that is theorized to develop in response to exposure to a series of traumatic events in a context in which the individual perceive ...
* Congregate Care
* Cottage Homes
* Independent living
Independent living (IL), as seen by its advocates, is a philosophy, a way of looking at society and disability, and a worldwide movement of disabled people working for equal opportunities, self-determination, and self-respect. In the context o ...
* Orphan train
The Orphan Train Movement was a supervised welfare program that transported children from crowded Eastern cities of the United States to foster homes located largely in rural areas of the Midwest. The orphan trains operated between 1854 and 1929, ...
* Orphanage
An orphanage is a Residential education, residential institution, total institution or group home, devoted to the Childcare, care of orphans and children who, for various reasons, cannot be cared for by their biological families. The parent ...
* Reactive attachment disorder
Reactive attachment disorder (RAD) is described in clinical literature as a severe and relatively uncommon disorder that can affect children, although these issues do occasionally persist into adulthood.DSM-IV-TR (2000) American Psychiatric Ass ...
* Residential education
Residential education, broadly defined, is a pre-college education provided in an environment where students both live and learn outside their family homes. Some typical forms of residential education include boarding schools, preparatory schools ...
* Substance dependence
Substance dependence, also known as drug dependence, is a biopsychological situation whereby an individual's functionality is dependent on the necessitated re-consumption of a psychoactive substance because of an adaptive state that has develope ...
* Supported living
* Supported housing
Supportive housing is a combination of housing and services intended as a cost-effective way to help people live more stable, productive lives, and is an active "community services and funding" stream across the United States. It was developed by ...
* Teaching-family model
The Teaching-Family Model (TFM) is a model of care for persons in need of services and care necessary to support an improved quality of life and increase opportunities to live to their potential. The TFM is used internationally in residential homes ...
* Family support Family support is the support of families with a member with a disability, which may include a child, an adult, or even the parent in the family. In the United States, family support includes "unpaid" or "informal" support by neighbors, families, an ...
*Wraparound (childcare)
The wraparound process is an intensive, individualized care management process for youths with serious or complex needs. Wraparound was initially developed in the 1980s as a means for maintaining youth with the most serious emotional and behaviora ...
References
Further reading
* Bald, Anthony, Joseph J. Doyle Jr., Max Gross, and Brian A. Jacob. 2022. "Economics of Foster Care." Journal of Economic Perspectives, 36 (2): 223–46.
* Hurley, Kendra (2002)
"Almost Home"
Retrieved June 27, 2006.
*
* Knowlton, Paul E. (2001). "The Original Foster Care Survival Guide"; A first person account directed to successfully aging out of foster care.
* McCutcheon, James, 2010. "Historical Analysis and Contemporary Assessment of Foster Care in Texas: Perceptions of Social Workers in a Private, Non-Profit Foster Care Agency". Applied Research Projects. Texas State University
Texas State University is a public research university in San Marcos, Texas. Since its establishment in 1899, the university has grown to the second largest university in the Greater Austin metropolitan area and the fifth largest university ...
br>Paper 332.
External links
The Mental Health of Children in Out-of-Home Care: Scale and Complexity of Mental Health Problems
Effects of Enhanced Foster Care on the Long-term Physical and Mental Health of Foster Care Alumni
The impact of foster care on development
Effects of early psychosocial deprivation on the development of memory and executive function
Enduring neurobehavioral effects of early life trauma mediated through learning and corticosterone suppression
*
{{Authority control
Adoption forms and related practices
Adoption, fostering, orphan care and displacement
Family