Cochrane Database Syst Rev. 2009 Jan 21;(1):CD006546.
Kinship care for the safety, permanency, and well-being of children removed from the home for maltreatment.
Winokur M, Holtan A, Valentine D.
Social Work Research Center / School of Social Work, Colorado State University, 110 Education, Fort Collins, Colorado 80523, USA. marc.winokur@colostate.edu
Abstract
BACKGROUND: Every year a large number of children around the world are removed from their homes because they are maltreated. Child welfare agencies are responsible for placing these children in out-of-home settings that will facilitate their safety, permanency, and well-being. However, children in out-of-home placements typically display more educational, behavioral, and psychological problems than do their peers, although it is unclear whether this results from the placement itself, the maltreatment that precipitated it, or inadequacies in the child welfare system. OBJECTIVES: To evaluate the effect of kinship care placement on the safety, permanency, and well-being of children removed from the home for maltreatment. SEARCH STRATEGY: The following databases were searched to Februrary 2007: CENTRAL, MEDLINE, C2- Specter, Sociological Abstracts, Social Work Abstracts, SSCI, Family and Society Studies Worldwide, ERIC, PsycINFO, ISI Proceedings, CINAHL, ASSIA, and Dissertation Abstracts International. Relevant social work journals and reference lists of published literature reviews were handsearched, and authors contacted. SELECTION CRITERIA: Randomized experimental and quasi-experimental studies, in which children removed from the home for maltreatment and subsequently placed in kinship foster care, were compared with children placed in non-kinship foster care on child welfare outcomes in the domains of well-being, permanency, or safety. DATA COLLECTION AND ANALYSIS: Reviewers independently read the titles and abstracts identified in the search and selected appropriate studies. Reviewers assessed the eligibility of each study for the evidence base and then evaluated the methodological quality of the included studies. Lastly, outcome data were extracted and entered into REVMAN for meta-analysis with the results presented in written and graphical forms. MAIN RESULTS: Sixty two quasi-experimental studies were included in this review. Data suggest that children in kinship foster care experience better behavioral development, mental health functioning, and placement stability than do children in non-kinship foster care. Although there was no difference on reunification rates, children in non-kinship foster care were more likely to be adopted while children in kinship foster care were more likely to be in guardianship. Lastly, children in non-kinship foster care were more likely to utilize mental health services. AUTHORS' CONCLUSIONS: This review supports the practice of treating kinship care as a viable out-of-home placement option for children removed from the home for maltreatment. However, this conclusion is tempered by the pronounced methodological and design weaknesses of the included studies.
PMID: 19160287 [PubMed - indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/19160287
Isabella Brooke Knightly and Austin Gamez-Knightly
In Memory of my Loving Husband, William F. Knightly Jr. Murdered by ILLEGAL Palliative Care at a Nashua, NH Hospital
Saturday, May 22, 2010
encyclopedia of adoption
encyclopedia of adoption
Generally refers to the system set up to protect children who are abused, neglected or abandoned or whose parents or primary caretakers are unable to fulfill their parenting obligations because of illness, emotional problems or a host of other reasons. In such latter cases, the placement into foster care by parents may have been voluntary.
Children who are involuntarily removed from their families are placed in the state's custody by the court and reside with foster parents or in GROUP HOMES or RESIDENTIAL TREATMENT CENTERS.
It should be noted that there is still much confusion in the general public about the difference between an adoptive home and a foster home. An adoptive family has the same parental rights and obligations as a birth family does when the child is born to them. A foster family must defer many decisions about a child's welfare to a state or county social worker. Although a child may remain in a foster home for years as a foster child, the state can (and has) removed foster children for a variety of reasons. An adopted child, however, can only be removed for the same reasons as a birth child.
It is also true that some private adoption agencies place children into their own approved "foster care" homes for a period of days, weeks or months, allowing birthparents to make final decisions about adoption and to sign consent forms prior to the time judges sign permanent termination of parental rights. Such families are generally not the families referred to (sometimes in a pejorative manner) when the media discusses foster care, foster children and foster families. Such private agency foster care is usually funded by the agency rather than by the state. The remainder of this essay refers solely to foster children in state care.
Foster care can be very costly to society at large. According to the book, Assessing the Long-Term Effects of Foster Care, as many as 40% of adults who were foster children are receiving welfare benefits or are in jail. Only about half graduate from high school, compared to 78% of the general public. Their homeless rate is at least four times that of the general population and the dismal statistics go on and on.
Reason for Placement in Foster Care
In a 1998 study reported in Pediatrics, researchers examined the primary reasons why children entered foster care and also looked at medical problems of foster children. Researchers studied 749 foster children in the San Francisco area. They found that neglect was the most common reason that children had entered foster care (30%), followed by physical abuse (25%) and "no available caretaker" (24%). Other children entered care because of a failed placement or sexual abuse.
Researchers also looked at the reason for entry into foster care and the age of the child, breaking age into the categories of 0-6 years, 7-12 years and 13-18 years.
Of children who entered foster care in the 0-6 age bracket, more than half were neglected or abandoned. In the case of adolescents age 13-18, a majority were in care because of failed placements. (Reasons were varied for children admitted into the system when they were 7-12 years, with no reason dominating.)
The researchers also looked at characteristics of the biological parents of the foster children. They found that substance abuse was identified in 30% of the cases, followed by incarceration in 9% and psychiatric illness of the parents in 5% of the cases. Also, of parents who had used illegal drugs, 15% had been imprisoned and 4% had psychiatric problems.
Many of the younger children had medical problems, and 62% had more than one problem. The most common medical problem for foster children ages 0-6 was upper respiratory illnesses (27.4%), followed by skin problems at 20.5%. In addition, 22.5% of the younger children were screened and found to have developmental delays. Nearly 10% were anemic. About 9% had poor vision.
One disturbing finding, not seen in other age groups, was that about 12% of the adolescents were positive for tuberculosis. Said the researchers, "The 12.3% tuberculin test positivity rate among adolescents is substantially higher than figures available for healthy adult populations, ranging from 2.5% among U.S. Navy recruits to 6.1% among applicants to a department of corrections. With high rates of parental substance abuse, children placed in foster care are significantly more likely than the general population to be exposed to adults with at least one risk factor for tuberculosis." Most of the children had not been screened for tuberculosis, thus researchers recommended routine screening on entry into foster care.
Another intriguing finding was that children who had been neglected or abandoned or in failed placements had more medical problems and appeared to have worse health than children who were physically or sexually abused. The researchers stated, "Although intense media coverage and public outcry have been associated with incidents of abuse, the increasing proportion of foster placement attributable to other reasons provides additional impetus to explore further the relationship between different types of maltreatment and health outcomes."
According to a study of factors that affect the length of a child's stay in foster care, predictors for a longer time in foster care were the following variables: the child had been abandoned; the child was black; the child was male; the child was physically or mentally impaired; or adoption was being planned. (One possible reason why children with pending adoptions remain longer is the length of time required to terminate parental rights in the court.)
Children tended to spend a shorter than normal time in foster care if the child was in care because of abuse or other problems in the parent-child relationship, the goal of the social services department was reunification, parental contact with the child continued or the social worker had a degree in social work.
Foster care is theoretically a temporary solution, and social workers should determine whether the problem causing the child's removal from the home has been resolved and when the child could be expected to return home or be placed with adoptive parents or guardians. In addition, a court hearing regarding the child's status must be held after a child has been in foster care for 12 of the last 15 months. At this time, the court may decide to return the child to his or her home, retain the child in foster care, recommend the process of terminating parental rights be started or decide to delay action altogether.
Foster care providers must be licensed, and a limit is set on the number of children that may be placed in a home; however, practicality often rules (see FOSTER PARENTS). If there are not enough licensed foster homes for the children coming into care, state social services workers may be forced to place additional children in a foster home on an emergency basis (a problem that may contribute to abuse or neglect by an overwhelmed foster parent).
The Process
The child is removed from the parental or permanent caretaker on an emergency basis after abuse, neglect or abandonment has been substantiated and/or the child is perceived as at risk for being abused. (The process may be different when a parent voluntarily requests the child be placed in foster care, depending on state laws.)
The social worker will then request a court date, at which time the court will decide the conditions under which the child should return home or stay in foster care.
Rules on foster care vary from state to state, but federal regulations also apply; for example, the federal government requires that "reasonable efforts" be made to prevent a removal from the home. New federal law, the ADOPTION AND SAFE FAMILIES ACT, also provides specific instances when "reasonable efforts" are not required.
Expenses of Caring for Foster Children
Foster parents usually receive a monthly stipend to cover the child's expenses, and this amount varies from state to state.
Most foster parents consider this amount highly inadequate to cover all the child's expenses and often spend their own money to cover basic expenses for food and clothes.
In many cases, the child may arrive in a foster home with the clothes on her back and nothing else because of the hurried nature of the move. Foster parents often are not equipped with the child's family medical/genetic history. This can be a serious problem, and physicians such as Burton Sokoloff urge that adequate medical records, including immunizations, be maintained. According to Sokoloff, good records are essential, especially in medical emergency situations (for example, when there is a scar on a child with a "suspicious abdomen"). He also urges that two medical records be kept: one by the foster parents and one by social worker.
Foster children are usually on MEDICAID, and foster parents may use the Medicaid card to obtain health care for the child.
Behavior and Development Problems in Foster Care
Often ungrateful about being "saved" and resentful of the social worker, foster children will sometimes act out: ACADEMIC PROGRESS may plummet, the child may over- or undereat, behave aggressively, withdraw and so forth. If possible, siblings are placed together in a foster home to reduce the stress of the move as much as possible. If there are many children in the family, the probability they will stay together in the same foster home is low.
Children from newborns to age 18 are foster children, and increasing numbers of infants are entering the system because of drug and crack cocaine use, HIV/AIDS in the birthparent and other reasons. (See ABUSE; DRUG ABUSE)
Visitations with parents are usually arranged by social workers. REUNIFICATION attempts are mandated whenever possible by the federal government as well as by state governments.
As a result, the child's social worker will attempt to arrange visits between the child and parents on a weekly basis or as frequently as is feasible. The child is likely to act out in the foster home after visits, but social workers generally believe that visits with parents are in the child's best interests.
Visits may be supervised visits in the social services office or visits with the child at the foster home, depending on the individual case.
Adoption of Foster Children
If all attempts at reunification with the parents fail, adoption may be considered as the plan for the child. Parental rights will be legally terminated, and the child can then be adopted. Older children who probably could be placed with adoptive families may decide against adoption for themselves. (If a child is over a certain age, for example, 12 years, in some states, he or she has the option of declining adoption. In such a case, a legal guardianship of extended foster case may be feasible.
In an increasing number of cases, foster children are adopted by their foster parents or placed in a legal risk situation with a family interested in adoption at the beginning of foster care or placed with extended family, and thus there is no need to relocate the child to another home, another school, new parents or new friends.
If the foster parents do not wish to adopt the child or are inappropriate for some reason, the caseworker will seek an adoptive home for the child. With the passage of the ADOPTION AND SAFE FAMILIES ACT in 1997, it is hoped that many more children will either return quickly to their biological families or be adopted and thus not entrapped in the foster care quagmire for many years. (Study after study shows that the older the child is, the less likely he or she is to be adopted.)
Recruitment for adoptive parents is achieved through MEDIA advertising, photolisting books and listings on state and national computer databanks. Many state social service agencies also offer picnics, bringing WAITING CHILDREN to the picnic in the hope the child and prospective parents may meet. In addition, the caseworker may already know a family who appears a good match for the child.
Most social workers seek to find a same-race match for a child and use TRANSRACIAL ADOPTION as a last resort. See the MULTIETHNIC PLACEMENT ACT.
Increasingly, older children and children with SPECIAL NEEDS are successfully placed with adoptive parents who may be older parents, single parents or parents with children in the home already. (See also DISRUPTION; FOSTER PARENTS; FOSTER PARENT ADOPTIONS; OLDER CHILD; SIBLINGS). Richard P. Barth and associates studied foster children who were adopted and found other salient factors related to a child's likelihood to be adopted. Researchers evaluated data from 1,268 families who had adopted 1,396 children. From this sample, they based their findings on about 500 children who had been in foster care and were then adopted.
Said the researchers, "The items found to be negatively related to timely adoption were exposure to sexual abuse, physical abuse, and neglect; history of multiple foster care placements; severe behavioral problems; greater age at entry into foster care; and the fact that the social worker and foster family did not plan that the child would be adopted by the family at initial placement."
They also found that children who were most likely to stay in foster care for an extended period and not be adopted fell into one or more of the following categories: children who entered foster care after age one; children who had been abused or neglected; children who had experienced multiple placements and children for whom adoption was not planned at the time of placement.
In another study, published in a 1998 issue of Children and Youth Services Review, researchers studied factors that mitigated for or against adoption. The study included 150 children in foster care. The average age was 11 years.
They found three variables that were significant. First was age, and this had the strongest correlation of the variables. Next was the number of siblings placed together, and last was a genetic or family history. They found that an adolescent in foster care was 33 times more likely to remain in foster care than a preschool child.
Children not placed with siblings were more likely to stay in foster care, contrary to what most people might think. (Although it is not clear if this was because of social workers' desire to keep families together or because of another reason.)
Another intriguing finding was that children with a genetic or family history indicating possible problems were more likely to be placed, which seems to fly in the face of what one would expect. The researchers said it was "surprising that what may be considered a deficiency would sway the permanency plan towards adoption. Perhaps when considered with other factors such as age, the presence of a risk which has not yet blossomed does not emerge as a prohibiting factor in the workers' or adoptive parents' estimations of adoptability."
One factor found significant was race, with nonwhite children more likely to remain in foster care. Another was developmental disabilities, with disabled children more likely to remain in care.
How Children Feel About Foster Care
In the book The Heart Knows Something Different: Teenage Voices from the Foster Care System, a poignant work that shares first-person stories from foster children, one can gain a feeling for how foster care feels from the inside. This revealing book only deepens the sense of urgency to help so many children who are lost in a complex system.
Wrote a 17-year-old girl, "My biological mother used to beat me for no reason, just because she was angry. She told me to keep the bruises on my body a secret from everyone, but if she was in a good mood she'd be very nice to me and say, 'I'll be there for you.'
"My foster mother doesn't know about my past. She doesn't know that everything I once owned has been taken away from me.
"My brother has been adopted and I haven't seen him in years. Perhaps he wouldn't have been adopted if I could have shown him I loved him.
"My mother abused me and I take some of the blame. I just wish I could have been a better child."
http://encyclopedia.adoption.com/entry/foster-care/144/1.html
Generally refers to the system set up to protect children who are abused, neglected or abandoned or whose parents or primary caretakers are unable to fulfill their parenting obligations because of illness, emotional problems or a host of other reasons. In such latter cases, the placement into foster care by parents may have been voluntary.
Children who are involuntarily removed from their families are placed in the state's custody by the court and reside with foster parents or in GROUP HOMES or RESIDENTIAL TREATMENT CENTERS.
It should be noted that there is still much confusion in the general public about the difference between an adoptive home and a foster home. An adoptive family has the same parental rights and obligations as a birth family does when the child is born to them. A foster family must defer many decisions about a child's welfare to a state or county social worker. Although a child may remain in a foster home for years as a foster child, the state can (and has) removed foster children for a variety of reasons. An adopted child, however, can only be removed for the same reasons as a birth child.
It is also true that some private adoption agencies place children into their own approved "foster care" homes for a period of days, weeks or months, allowing birthparents to make final decisions about adoption and to sign consent forms prior to the time judges sign permanent termination of parental rights. Such families are generally not the families referred to (sometimes in a pejorative manner) when the media discusses foster care, foster children and foster families. Such private agency foster care is usually funded by the agency rather than by the state. The remainder of this essay refers solely to foster children in state care.
Foster care can be very costly to society at large. According to the book, Assessing the Long-Term Effects of Foster Care, as many as 40% of adults who were foster children are receiving welfare benefits or are in jail. Only about half graduate from high school, compared to 78% of the general public. Their homeless rate is at least four times that of the general population and the dismal statistics go on and on.
Reason for Placement in Foster Care
In a 1998 study reported in Pediatrics, researchers examined the primary reasons why children entered foster care and also looked at medical problems of foster children. Researchers studied 749 foster children in the San Francisco area. They found that neglect was the most common reason that children had entered foster care (30%), followed by physical abuse (25%) and "no available caretaker" (24%). Other children entered care because of a failed placement or sexual abuse.
Researchers also looked at the reason for entry into foster care and the age of the child, breaking age into the categories of 0-6 years, 7-12 years and 13-18 years.
Of children who entered foster care in the 0-6 age bracket, more than half were neglected or abandoned. In the case of adolescents age 13-18, a majority were in care because of failed placements. (Reasons were varied for children admitted into the system when they were 7-12 years, with no reason dominating.)
The researchers also looked at characteristics of the biological parents of the foster children. They found that substance abuse was identified in 30% of the cases, followed by incarceration in 9% and psychiatric illness of the parents in 5% of the cases. Also, of parents who had used illegal drugs, 15% had been imprisoned and 4% had psychiatric problems.
Many of the younger children had medical problems, and 62% had more than one problem. The most common medical problem for foster children ages 0-6 was upper respiratory illnesses (27.4%), followed by skin problems at 20.5%. In addition, 22.5% of the younger children were screened and found to have developmental delays. Nearly 10% were anemic. About 9% had poor vision.
One disturbing finding, not seen in other age groups, was that about 12% of the adolescents were positive for tuberculosis. Said the researchers, "The 12.3% tuberculin test positivity rate among adolescents is substantially higher than figures available for healthy adult populations, ranging from 2.5% among U.S. Navy recruits to 6.1% among applicants to a department of corrections. With high rates of parental substance abuse, children placed in foster care are significantly more likely than the general population to be exposed to adults with at least one risk factor for tuberculosis." Most of the children had not been screened for tuberculosis, thus researchers recommended routine screening on entry into foster care.
Another intriguing finding was that children who had been neglected or abandoned or in failed placements had more medical problems and appeared to have worse health than children who were physically or sexually abused. The researchers stated, "Although intense media coverage and public outcry have been associated with incidents of abuse, the increasing proportion of foster placement attributable to other reasons provides additional impetus to explore further the relationship between different types of maltreatment and health outcomes."
According to a study of factors that affect the length of a child's stay in foster care, predictors for a longer time in foster care were the following variables: the child had been abandoned; the child was black; the child was male; the child was physically or mentally impaired; or adoption was being planned. (One possible reason why children with pending adoptions remain longer is the length of time required to terminate parental rights in the court.)
Children tended to spend a shorter than normal time in foster care if the child was in care because of abuse or other problems in the parent-child relationship, the goal of the social services department was reunification, parental contact with the child continued or the social worker had a degree in social work.
Foster care is theoretically a temporary solution, and social workers should determine whether the problem causing the child's removal from the home has been resolved and when the child could be expected to return home or be placed with adoptive parents or guardians. In addition, a court hearing regarding the child's status must be held after a child has been in foster care for 12 of the last 15 months. At this time, the court may decide to return the child to his or her home, retain the child in foster care, recommend the process of terminating parental rights be started or decide to delay action altogether.
Foster care providers must be licensed, and a limit is set on the number of children that may be placed in a home; however, practicality often rules (see FOSTER PARENTS). If there are not enough licensed foster homes for the children coming into care, state social services workers may be forced to place additional children in a foster home on an emergency basis (a problem that may contribute to abuse or neglect by an overwhelmed foster parent).
The Process
The child is removed from the parental or permanent caretaker on an emergency basis after abuse, neglect or abandonment has been substantiated and/or the child is perceived as at risk for being abused. (The process may be different when a parent voluntarily requests the child be placed in foster care, depending on state laws.)
The social worker will then request a court date, at which time the court will decide the conditions under which the child should return home or stay in foster care.
Rules on foster care vary from state to state, but federal regulations also apply; for example, the federal government requires that "reasonable efforts" be made to prevent a removal from the home. New federal law, the ADOPTION AND SAFE FAMILIES ACT, also provides specific instances when "reasonable efforts" are not required.
Expenses of Caring for Foster Children
Foster parents usually receive a monthly stipend to cover the child's expenses, and this amount varies from state to state.
Most foster parents consider this amount highly inadequate to cover all the child's expenses and often spend their own money to cover basic expenses for food and clothes.
In many cases, the child may arrive in a foster home with the clothes on her back and nothing else because of the hurried nature of the move. Foster parents often are not equipped with the child's family medical/genetic history. This can be a serious problem, and physicians such as Burton Sokoloff urge that adequate medical records, including immunizations, be maintained. According to Sokoloff, good records are essential, especially in medical emergency situations (for example, when there is a scar on a child with a "suspicious abdomen"). He also urges that two medical records be kept: one by the foster parents and one by social worker.
Foster children are usually on MEDICAID, and foster parents may use the Medicaid card to obtain health care for the child.
Behavior and Development Problems in Foster Care
Often ungrateful about being "saved" and resentful of the social worker, foster children will sometimes act out: ACADEMIC PROGRESS may plummet, the child may over- or undereat, behave aggressively, withdraw and so forth. If possible, siblings are placed together in a foster home to reduce the stress of the move as much as possible. If there are many children in the family, the probability they will stay together in the same foster home is low.
Children from newborns to age 18 are foster children, and increasing numbers of infants are entering the system because of drug and crack cocaine use, HIV/AIDS in the birthparent and other reasons. (See ABUSE; DRUG ABUSE)
Visitations with parents are usually arranged by social workers. REUNIFICATION attempts are mandated whenever possible by the federal government as well as by state governments.
As a result, the child's social worker will attempt to arrange visits between the child and parents on a weekly basis or as frequently as is feasible. The child is likely to act out in the foster home after visits, but social workers generally believe that visits with parents are in the child's best interests.
Visits may be supervised visits in the social services office or visits with the child at the foster home, depending on the individual case.
Adoption of Foster Children
If all attempts at reunification with the parents fail, adoption may be considered as the plan for the child. Parental rights will be legally terminated, and the child can then be adopted. Older children who probably could be placed with adoptive families may decide against adoption for themselves. (If a child is over a certain age, for example, 12 years, in some states, he or she has the option of declining adoption. In such a case, a legal guardianship of extended foster case may be feasible.
In an increasing number of cases, foster children are adopted by their foster parents or placed in a legal risk situation with a family interested in adoption at the beginning of foster care or placed with extended family, and thus there is no need to relocate the child to another home, another school, new parents or new friends.
If the foster parents do not wish to adopt the child or are inappropriate for some reason, the caseworker will seek an adoptive home for the child. With the passage of the ADOPTION AND SAFE FAMILIES ACT in 1997, it is hoped that many more children will either return quickly to their biological families or be adopted and thus not entrapped in the foster care quagmire for many years. (Study after study shows that the older the child is, the less likely he or she is to be adopted.)
Recruitment for adoptive parents is achieved through MEDIA advertising, photolisting books and listings on state and national computer databanks. Many state social service agencies also offer picnics, bringing WAITING CHILDREN to the picnic in the hope the child and prospective parents may meet. In addition, the caseworker may already know a family who appears a good match for the child.
Most social workers seek to find a same-race match for a child and use TRANSRACIAL ADOPTION as a last resort. See the MULTIETHNIC PLACEMENT ACT.
Increasingly, older children and children with SPECIAL NEEDS are successfully placed with adoptive parents who may be older parents, single parents or parents with children in the home already. (See also DISRUPTION; FOSTER PARENTS; FOSTER PARENT ADOPTIONS; OLDER CHILD; SIBLINGS). Richard P. Barth and associates studied foster children who were adopted and found other salient factors related to a child's likelihood to be adopted. Researchers evaluated data from 1,268 families who had adopted 1,396 children. From this sample, they based their findings on about 500 children who had been in foster care and were then adopted.
Said the researchers, "The items found to be negatively related to timely adoption were exposure to sexual abuse, physical abuse, and neglect; history of multiple foster care placements; severe behavioral problems; greater age at entry into foster care; and the fact that the social worker and foster family did not plan that the child would be adopted by the family at initial placement."
They also found that children who were most likely to stay in foster care for an extended period and not be adopted fell into one or more of the following categories: children who entered foster care after age one; children who had been abused or neglected; children who had experienced multiple placements and children for whom adoption was not planned at the time of placement.
In another study, published in a 1998 issue of Children and Youth Services Review, researchers studied factors that mitigated for or against adoption. The study included 150 children in foster care. The average age was 11 years.
They found three variables that were significant. First was age, and this had the strongest correlation of the variables. Next was the number of siblings placed together, and last was a genetic or family history. They found that an adolescent in foster care was 33 times more likely to remain in foster care than a preschool child.
Children not placed with siblings were more likely to stay in foster care, contrary to what most people might think. (Although it is not clear if this was because of social workers' desire to keep families together or because of another reason.)
Another intriguing finding was that children with a genetic or family history indicating possible problems were more likely to be placed, which seems to fly in the face of what one would expect. The researchers said it was "surprising that what may be considered a deficiency would sway the permanency plan towards adoption. Perhaps when considered with other factors such as age, the presence of a risk which has not yet blossomed does not emerge as a prohibiting factor in the workers' or adoptive parents' estimations of adoptability."
One factor found significant was race, with nonwhite children more likely to remain in foster care. Another was developmental disabilities, with disabled children more likely to remain in care.
How Children Feel About Foster Care
In the book The Heart Knows Something Different: Teenage Voices from the Foster Care System, a poignant work that shares first-person stories from foster children, one can gain a feeling for how foster care feels from the inside. This revealing book only deepens the sense of urgency to help so many children who are lost in a complex system.
Wrote a 17-year-old girl, "My biological mother used to beat me for no reason, just because she was angry. She told me to keep the bruises on my body a secret from everyone, but if she was in a good mood she'd be very nice to me and say, 'I'll be there for you.'
"My foster mother doesn't know about my past. She doesn't know that everything I once owned has been taken away from me.
"My brother has been adopted and I haven't seen him in years. Perhaps he wouldn't have been adopted if I could have shown him I loved him.
"My mother abused me and I take some of the blame. I just wish I could have been a better child."
http://encyclopedia.adoption.com/entry/foster-care/144/1.html
The Definition of Foster Care that Social Wrecker's Do Not Follow
Foster care
From Wikipedia, the free encyclopedia
This article is about the modern child welfare system of placing children in state custody in the homes of temporary caregivers. For the social practice of children being raised by families not their own, see Fosterage.
Foster care is the term used for a system in which a minor who has been made a ward is placed in the private home of a state certified caregiver referred to as a "foster parent".
The state via the family court and child protection agency stand in loco parentis to the minor, making all legal decisions while the foster parent is responsible for the day to day care of said minor. The foster parent is remunerated by the state for their services.
Foster care is intended to be a short term situation until a permanent placement can be made:[1]
Reunification with the biological parent(s)
When it is deemed in the child's best interest. This is generally the first choice.
Adoption
Preferably by a biological family member such as an aunt or grand parent.
If no biological 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 or coach). 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.
Permanent transfer of guardianship
Foster care placement
Children may enter foster care via voluntary or involuntary means. Voluntary placement may occur when a biological parent or lawful guardian is unable or unwilling 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. In the US, most children enter foster care due to neglect.[2]
[edit]Policy
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.
[edit]United States
[edit]Children in Foster Care
547,415 children were in publicly supported foster care in the United States in September of 2000.[3] "There are about 123,000 children waiting for adoptive families [in 2009] in the United States foster care system." [4] African American children represented 41% of children in foster care, white children represented 40% and Hispanic children represented 15% in the year 2000.[5]
[edit]Foster Parents
The foster parent licensing process is often similar to or the same as the process to become licensed to adopt. It requires preparation classes as well as an application process. The application varies but may include: a minimum age, verification that your income allows you to meet your expenses, a criminal record check at local, state and federal levels including finger printing and no prior record of child abuse or neglect; a reference from a doctor to ensure that all household members are free from diseases that a child could catch and in sufficient health to parent a child and; letters of reference from an employer and others who know you.
[edit]Regulation, administration, and oversight
In the United States, foster home licensing requirements vary from state to state but are generally overseen by each state's Department of Social Services or Human Services. In some states, counties have this responsibility. Each state's services are monitored by the federal Department of Health and Human Services through reviews such as Child and Family Services Reviews, Title IV-E Foster Care Eligibility Reviews, Adoption and Foster Care Analysis and Reporting System and Statewide Automated Child Welfare Information System Assessment Reviews.[6]
Children found to be unable to function in a foster home may be placed in Residential Treatment Centers (RTCs) or other such group homes. In theory, the focus of treatment in such facilities is to prepare the child for a return to a foster home, to an adoptive home, or to the birth parents when applicable. But two major reviews of the scholarly literature have questioned these facilities' effectiveness.[7]
[edit]Funding and system incentives
A law passed by Congress in 1961 allowed AFDC (welfare) payments to pay for foster care which was previously made only to children in their own homes. This made aided funding foster care for states and localities, facilitating rapid growth. In some cases, the state of Texas paid mental treatment centers as much as $101,105 a year per child. Observers of the growth trend note that a county will only continue to receive funding while it keeps the child in its care. This may create a "perverse financial incentive" to place and retain children in foster care rather than leave them with their parents, and incentives are sometimes set up for maximum intervention. A National Coalition for Child Protection Reform issue paper states "children often are removed from their families `prematurely or unnecessarily' because federal aid formulas give states `a strong financial incentive' to do so rather than provide services to keep families together."[8]
Findings of a grand jury investigation in Santa Clara, California;
"The Grand Jury heard from staff members of the DFCS and others outside the department that the department puts too much money into "back-end services," i.e., therapists and attorneys, and not enough money into "front-end" or basic services. The county does not receive as much in federal funds for "front-end" services, which could help solve the problems causing family inadequacies, as it receives for out-of-home placements or foster care services. In other words, the Agency benefits, financially, from placing children in foster homes.[9]
There are some children in foster care who are difficult to place in permanent homes through the normal adoption process. These children are often said to require “special-needs adoption.” In this context, "special needs" can include situations where children have specific chronic medical problems, mental health issues, behavioral problems, and learning disabilities. In some cases, sibling groups, older children, and children of color qualify as "special needs."[10] Governments offer a variety of incentives and services to facilitate this class of adoptions.[11]
[edit]Recent United States foster care legislation
Average length of stay in foster care in the U.S.
In 1997, President Bill Clinton signed a new foster care law, the Adoption and Safe Families Act (ASFA),[12]) which reduced the time children are allowed to remain in foster care before being available for adoption. The new law requires state child welfare agencies to identify cases where "aggravated circumstances" make permanent separation of child from the birth family the best option for the safety and well-being of the child. One of the main components of ASFA is the imposition of stricter time limits on reunification efforts. Proponents of ASFA claimed that before the law was passed, the lack of such legislation was the reason it was common for children to languish in care for years with no permanent living situation identified. They often were moved from placement to placement with no real plan for a permanent home.
Opponents of ASFA argued that the real reason children languished in foster care was that too many were taken needlessly from their parents in the first place. Since ASFA did not address this, opponents said, it would not accomplish its goals, and would only slow a decline in the foster care population that should have occurred anyway because of a decline in reported child abuse.[13]
Ten years after ASFA became law, the number of children in foster care on any given day is only about 7,000 fewer than when ASFA was passed[14]
The Foster Care Independence Act of 1999, helps foster youth who are aging out of care to achieve self-sufficiency. The U.S. government has also funded the Education and Training Voucher Program in recent years in order to help youth who age out of care to obtain college or vocational training at a free or reduced cost. Chafee and ETV money is administered by each state as they see fit.
The Fostering Connection to Success and Increasing Adoptions Act of 2008 is the most recent piece of major federal legislation addressing the foster care system. This bill extended various benefits and funding for foster children between the age of 18 and 21 and for Indian children in tribal areas. The legislation also strengthens requirements for states in their treatment of siblings and introduces mechanisms to provide financial incentives for guardianship and adoption.[15][16]
[edit]Australia
Home-based care, which includes foster care, is provided to children who are in need of care and protection. Children and young people are provided with alternative accommodation while they are unable to live with their parents. As well as foster care, this can include placements with relatives or kin, and residential care. In most cases, children in home-based care are also on a care and protection order.[17]
In some cases children are placed in home-based care following a child protection substantiation and where they are found to be in need of a safer and more stable environment. In other situations parents may be incapable of providing adequate care for the child, or accommodation may be needed during times of family conflict or crisis.[17] In the significant number of cases substance abuse is a major contributing factor.
Respite care is a type of foster care that is used to provide short-term (and often regular) accommodation for children whose parents are ill or unable to care for them on a temporary basis.[17] It is also used to provide a break for the parent or primary carer to hopefully decrease the chances of the situation escalating to one which would lead to the removal of the child(ren).
As with the majority of child protection services, states and territories are responsible for funding home-based care. Non-government organizations are widely used, however, to provide these services.[17]
[edit]Current policy
There is strong emphasis in current Australian policy and practice to keep children with their families wherever possible. In the event that children are placed in home-based care, every effort is made to reunite children with their families wherever possible.[17]
In the case of Aboriginal and Torres Strait Islander children in particular, but not exclusively, placing the child within the wider family or community is preferred[17] This is consistent with the Aboriginal Child Placement Principle.[18]
[edit]The negative effects of foster care
Individuals who were in foster care experience higher rates of physical and psychiatric morbidity than the general population.[19] In a study of adults who were in foster care in Oregon and Washington state, they were found to have double the incidence of Depression ,20% as compared to 10% and were found to have a higher rate of Post Traumatic Stress Disorder (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, and deficits in executive functioning, anxiety as well other developmental problems.[20][21][22][23] These children experience higher degrees of incarceration, poverty, homelessness, and suicide. Recent studies in the U.S., suggests that, foster care placements are more detrimental to children than remaining in a troubled home.[24][25][26]
[edit]Neurodevelopment
Negative environmental influences affect various aspects of neurodevelopment, such the formation of neurons and dendrites.
Foster care has been shown in various studies, to have deleterious consequences on the physical health and mental wellbeing of those who were in foster care. Many children enter foster care at a very young age. The human brain doesn't fully develop until approximately the age of twenty, one of the most critical periods of brain development occurs in the first 3–4 years.
The processes that govern the development of personality traits, stress response and cognitive skills are formed during this period. The developing brain is directly influenced by negative environmental factors including lack of stimulation due to emotional neglect, poor nutrition, exposure to violence in the home environment and child abuse.
Negative environmental influences have a direct effect on all areas of neurodevelopment, neurogenesis (creation of new neurons), apoptosis (death and reabsorption of neurons), migration (of neurons to different regions of the brain), synaptogenesis (creation of synapses), synaptic sculpturing (determining the make-up of the synapse), arborization (the growth of dendritic connections , myelinzation (protective covering of neurons), an enlargement of the brain's ventricles and can cause cortical atrophy. Most of the processes involved in healthy neurodevelopment are predicated upon the establishment of close nurturing relationships and environmental stimulation. Foster children have elevated levels of cortisol, a stress hormone in comparison to children raised by their biological parents, elevated cortisol levels can compromise the immune system. (Harden BJ, 2004).[27] Negative environmental influences during this critical period of brain development can have lifelong consequences.[28][29][30][31]
[edit]Epigenetic effects of environmental stress
epigentic mechanisms
Epigenetics is the effect environmental factors have on gene expression. Negative environmental influences such as maternal deprivation, child abuse and stress[32][33] have been shown to have a profound effect on gene expression including transgenerational epigenetic effects in which physiological and behavioral (intellectual) transfer of information across generations not yet conceived is effected. In the Överkalix study in Sweden the effects of epigentic inheritance were shown to have a direct correlation to the environmental influences faced by the parents and grandparents. [34] Many physiological and behavioral characteristics ascribed to Mendelian inheritance is due in fact to transgenerational epigenetic inheritance. The implications in terms of foster care and the cost to society as a whole is that the stress, deprivation and other negative environmetal factors many foster children are subjected to has a detrimental effect not only their physical, emotional and cognitive well-being but the damage can transcend generations.[35][36][37]
In studies of the adult offspring of Holocaust survivors, parental PTSD was risk factor for the development of PTSD in adult offspring in comparison to those whose parents went through the Holocaust without developing PTSD. The offspring of survivors with PTSD had lower levels urinary cortisol excretion, salivary cortisol and enhanced plasma cortisol suppression in response to low dose dexamethasone administration than offspring of survivors without PTSD. Low cortisol levels are associated with parental, particularly maternal, PTSD. This is in contrast to the normal stress response in which cortisol levels are elevated after exposure to a stressor. The results of the study point to the involvement of epigenetic mechanisms.[38][39]
Epigenetic Effects of Abuse;
"In addition, the effects of abuse may extend beyond the immediate victim into subsequent generations as a consequence of epigenetic effects transmitted directly to offspring and/or behavioral changes in affected individuals. (Neighh GN et al. 2009)[40]
It has been suggested in various studies that the deleterious epigentic effects may be somewhat ameliorated through pharmacological manipulations in adulthood via the administration of nerve growth factor-inducible protein A,[41] and through the inhibition of a class of enzymes known as the histone deacetylases (HDACs). "HDAC inhibitors (HDACIs) such as Trichostatin A (TSA); "TSA can be used to alter gene expression by interfering with the removal of acetyl groups from histones", and L-methionine an essential amino acid, have been developed for the treatment of a variety of malignancies and neurodegenerative disorders. Drug combination approaches have also shown promise for the treatment of mood disorders including bipolar disorder, anxiety and depression."[42][43]
[edit]Post Traumatic Stress Disorder
Regions of the brain associated with stress and post traumatic stress disorder[44]
Children in foster care have a higher incidence of Post traumatic stress disorder (PTSD).In one study (Dubner and Motta, 1999)[45] 60% of children in foster care who had experienced sexual abuse had PTSD, and 42% of those who had been physically abused fulfilled 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 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".[46][47]
[edit]Eating disorders
Foster children are at increased risk for a variety of eating disorders, in comparison to the general population.
Obesity children in foster care are more prone to becoming overweight and obese, and in a study done in the United Kingdom, 35% of foster children experienced an increase in Body Mass Index (BMI) once in care.[48]
Hyperphagic Short Stature syndrome (HSS) is a condition characterized by short stature due to insufficient growth hormone production , an excessive appetite (hyperphagia) and mild learning disabilities. While it is believed to have genetic component, HSS is triggered by being exposed to an environment of high psychosocial stress, it is not uncommon in children in foster homes or other stressful environments. HSS improves upon removal from the stressful environment.[49][50][51]
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". (Tarren-Sweeney M. 2006). It is hypothesised 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.[52]
Bulimia Nervosa is seven times more prevalent among former foster children than in the general population. [53]
[edit]Disorganized attachment
A study by Dante Cicchetti found that 80% of abused and maltreated infants in his study exhibited symptoms of disorganized attachment.[54][55] Children with histories of maltreatment, such as physical and psychological neglect, physical abuse, and sexual abuse, are at risk of developing psychiatric problems.[56][57][58][59] These children may be described as experiencing trauma as the result of abuse or neglect, inflicted by a primary caregiver, which disrupts the normal development of secure attachment. Such children are at risk of developing a disorganized attachment.[58][60][61] Disorganized attachment is associated with a number of developmental problems, including dissociative symptoms,[62] as well as depressive, anxiety, and acting-out symptoms.[63][64]
[edit]Child abuse
Children in foster care experience high rates of child abuse, emotional and physical neglect. 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 than a child in the general population".[65]
[edit]Poverty and homelessness
New York street children; Jacob Riis, 1890
Nearly half of foster kids in the U.S. become homeless when they turn 18.[66][67] Most foster care children should be placed in adoptive homes. "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.[68][69]
Three out of ten of the United States homeless are former foster children.[70] 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, three times the national poverty rate.[71] Very frequently, people who are homeless had multiple placements as children: some were in foster care, but others were "unofficial" placements in the homes of family or friends. Individuals with a history foster care tend to become homeless at an earlier age than those who were not in foster care and Caucasians who become homeless are more likely to have a history of foster care than Hispanics or African Americans. The length of time a person remains homeless is prolonged in indiviuals who were in foster care.[72]
[edit]Suicide rate
Children in foster care are at a greater risk of suicide,[73] the increased risk of suicide is still prevalent after leaving foster care and occurs at a higher rate than the general population. In a study of Texas youths who aged out of the system 23 percent had a history of suicide attempts.[74]
A Swedish study utilizing the data of almost one million people including 22,305 former foster children who had been in care prior to their teens;
"Former child welfare clients were in year of birth and sex standardised risk ratios (RRs) four to five times more likely than peers in the general population to have been hospitalised for suicide attempts....Individuals who had been in long-term foster care tended to have the most dismal outcome...former child welfare/protection clients should be considered a high-risk group for suicide attempts and severe psychiatric morbidity."[75]
[edit]Death rate
Children in foster care have an overall higher mortality rate than children in the general population.[76] 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 and chronic medical conditions and developmental delays among children in foster care.[77]
[edit]Poor academic prospects
Foster care has been proven in innumerable studies to not be conducive to academic performance. In a study conducted in Philadelphia by John Hopkins University it was found that; among high school students who are in foster care, have been abused and neglected, or receive out of home placement by the courts, the probability of dropping out of school is greater than 75%.[78]
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. and an additional 5% of the general population.
42.7% completed some education beyond high school.
20.6% completed any degree or certificate beyond high school
16.1% completed a vocational degree; 21.9% for those over 25.
1.8% complete a bachelors degree , 2.7% for over 25, the completion rate for the general population in the same age group is 24%, a sizable difference.
[edit]State abuses
[edit]Drug testing
Throughout the 1990s, experimental HIV drugs were tested on HIV-positive foster children at Incarnation Children’s Center in Harlem. The agency has also been accused of racism, some comparing the trials to the Tuskegee syphilis experiment, as 98 percent of children in foster care in New York City belong to ethnic minorities.[79]
[edit]Unnecessary/Over Medication
Studies"[80] have revealed that youth in foster care covered by Medicaid insurance receive psychotropic medication 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 (56.8%), attention-deficit/hyperactivity disorder drugs (55.9%), and antipsychotic agents (53.2%).
Psychiatrists prescribed 93% of the psychotropic medication, and it was noted in the review of these cases that the use of expensive, brand name, patent protected medication was prevalent. In the case of SSRIs 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.[81]
Medicating Foster Kids For Profit
CONCLUSIONS. "Concomitant psychotropic medication treatment is frequent for youth in foster care and lacks substantive evidence as to its effectiveness and safety".[80]
[edit]The lost children
Children victimized by the United Kingdom's Childrens Migrant Programme
An estimated 150,000 British children were sent to overseas colonies and countries in the commonwealth such as Australia. This practice was in effect from the beginning of the nineteenth century until 1967. Many of these children were sent to orphanages, foster homes and religious institutions, where they were used as a free source of labor and many were severely abused and neglected. These children were classified as orphans although most were not. In the period after World War II the policy was dubbed the "Child Migrants Programme". The prime consideration was money as it was cheaper to care for children in commonwealth countries than it was in the United Kingdom. This program was carried out with the complicity of the Methodist Church, the Catholic Church and the Salvation Army among others. At least 10,000 children some as young as 3 were shipped to Australia after the war,[82][83], most to join the ranks of the "Forgotten Australians", the term given for those who experienced care in foster homes and institutions in the 20th century. Among these Forgotten Australians were members of the "Stolen Generation", the children of Australian Aborigines, forcibly removed from their homes and raised in white institutions. In 2009 Australian Prime Minister, Kevin Rudd apologised to the approximately 500,000 "forgotten Australians" and in 2010 British Prime Minister Gordon Brown issued a similar apology to those who were victimised by the Child Migrants Programme.[84][85][86]
[edit]Therapeutic Intervention
The negative physical, psychological, cognitive and epigenetic effects of foster care have been established in innumerable studies in various countries. The Casey Family Programs Northwest Foster Care Alumni Study was a fairly extensive study into various aspects of the psychosocial effects of foster care noted that 80% of ex-foster children are doing "poorly".
[edit]Neuroplasticity
The human brain however has been shown to have a fair degree of neuroplasticity.[87][88][89] Adult Neurogenesis, has been shown to be an ongoing process.[90]
"... all those experiences are of much significance which show how the judgment of the senses may be modified by experience and by training derived under various circumstances, and may be adapted to the new conditions..." - Hermann von Helmholtz, 1866
While 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 such as ADHD,[91] and PTSD[92][93] it may also serve to obfuscate the true cause of any underlying issues, there should be no automatic assumptions, it may have nothing to do with, or may be exacerbated by having a history of foster care and the attendant abuses.
http://en.wikipedia.org/wiki/Foster_care
From Wikipedia, the free encyclopedia
This article is about the modern child welfare system of placing children in state custody in the homes of temporary caregivers. For the social practice of children being raised by families not their own, see Fosterage.
Foster care is the term used for a system in which a minor who has been made a ward is placed in the private home of a state certified caregiver referred to as a "foster parent".
The state via the family court and child protection agency stand in loco parentis to the minor, making all legal decisions while the foster parent is responsible for the day to day care of said minor. The foster parent is remunerated by the state for their services.
Foster care is intended to be a short term situation until a permanent placement can be made:[1]
Reunification with the biological parent(s)
When it is deemed in the child's best interest. This is generally the first choice.
Adoption
Preferably by a biological family member such as an aunt or grand parent.
If no biological 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 or coach). 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.
Permanent transfer of guardianship
Foster care placement
Children may enter foster care via voluntary or involuntary means. Voluntary placement may occur when a biological parent or lawful guardian is unable or unwilling 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. In the US, most children enter foster care due to neglect.[2]
[edit]Policy
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.
[edit]United States
[edit]Children in Foster Care
547,415 children were in publicly supported foster care in the United States in September of 2000.[3] "There are about 123,000 children waiting for adoptive families [in 2009] in the United States foster care system." [4] African American children represented 41% of children in foster care, white children represented 40% and Hispanic children represented 15% in the year 2000.[5]
[edit]Foster Parents
The foster parent licensing process is often similar to or the same as the process to become licensed to adopt. It requires preparation classes as well as an application process. The application varies but may include: a minimum age, verification that your income allows you to meet your expenses, a criminal record check at local, state and federal levels including finger printing and no prior record of child abuse or neglect; a reference from a doctor to ensure that all household members are free from diseases that a child could catch and in sufficient health to parent a child and; letters of reference from an employer and others who know you.
[edit]Regulation, administration, and oversight
In the United States, foster home licensing requirements vary from state to state but are generally overseen by each state's Department of Social Services or Human Services. In some states, counties have this responsibility. Each state's services are monitored by the federal Department of Health and Human Services through reviews such as Child and Family Services Reviews, Title IV-E Foster Care Eligibility Reviews, Adoption and Foster Care Analysis and Reporting System and Statewide Automated Child Welfare Information System Assessment Reviews.[6]
Children found to be unable to function in a foster home may be placed in Residential Treatment Centers (RTCs) or other such group homes. In theory, the focus of treatment in such facilities is to prepare the child for a return to a foster home, to an adoptive home, or to the birth parents when applicable. But two major reviews of the scholarly literature have questioned these facilities' effectiveness.[7]
[edit]Funding and system incentives
A law passed by Congress in 1961 allowed AFDC (welfare) payments to pay for foster care which was previously made only to children in their own homes. This made aided funding foster care for states and localities, facilitating rapid growth. In some cases, the state of Texas paid mental treatment centers as much as $101,105 a year per child. Observers of the growth trend note that a county will only continue to receive funding while it keeps the child in its care. This may create a "perverse financial incentive" to place and retain children in foster care rather than leave them with their parents, and incentives are sometimes set up for maximum intervention. A National Coalition for Child Protection Reform issue paper states "children often are removed from their families `prematurely or unnecessarily' because federal aid formulas give states `a strong financial incentive' to do so rather than provide services to keep families together."[8]
Findings of a grand jury investigation in Santa Clara, California;
"The Grand Jury heard from staff members of the DFCS and others outside the department that the department puts too much money into "back-end services," i.e., therapists and attorneys, and not enough money into "front-end" or basic services. The county does not receive as much in federal funds for "front-end" services, which could help solve the problems causing family inadequacies, as it receives for out-of-home placements or foster care services. In other words, the Agency benefits, financially, from placing children in foster homes.[9]
There are some children in foster care who are difficult to place in permanent homes through the normal adoption process. These children are often said to require “special-needs adoption.” In this context, "special needs" can include situations where children have specific chronic medical problems, mental health issues, behavioral problems, and learning disabilities. In some cases, sibling groups, older children, and children of color qualify as "special needs."[10] Governments offer a variety of incentives and services to facilitate this class of adoptions.[11]
[edit]Recent United States foster care legislation
Average length of stay in foster care in the U.S.
In 1997, President Bill Clinton signed a new foster care law, the Adoption and Safe Families Act (ASFA),[12]) which reduced the time children are allowed to remain in foster care before being available for adoption. The new law requires state child welfare agencies to identify cases where "aggravated circumstances" make permanent separation of child from the birth family the best option for the safety and well-being of the child. One of the main components of ASFA is the imposition of stricter time limits on reunification efforts. Proponents of ASFA claimed that before the law was passed, the lack of such legislation was the reason it was common for children to languish in care for years with no permanent living situation identified. They often were moved from placement to placement with no real plan for a permanent home.
Opponents of ASFA argued that the real reason children languished in foster care was that too many were taken needlessly from their parents in the first place. Since ASFA did not address this, opponents said, it would not accomplish its goals, and would only slow a decline in the foster care population that should have occurred anyway because of a decline in reported child abuse.[13]
Ten years after ASFA became law, the number of children in foster care on any given day is only about 7,000 fewer than when ASFA was passed[14]
The Foster Care Independence Act of 1999, helps foster youth who are aging out of care to achieve self-sufficiency. The U.S. government has also funded the Education and Training Voucher Program in recent years in order to help youth who age out of care to obtain college or vocational training at a free or reduced cost. Chafee and ETV money is administered by each state as they see fit.
The Fostering Connection to Success and Increasing Adoptions Act of 2008 is the most recent piece of major federal legislation addressing the foster care system. This bill extended various benefits and funding for foster children between the age of 18 and 21 and for Indian children in tribal areas. The legislation also strengthens requirements for states in their treatment of siblings and introduces mechanisms to provide financial incentives for guardianship and adoption.[15][16]
[edit]Australia
Home-based care, which includes foster care, is provided to children who are in need of care and protection. Children and young people are provided with alternative accommodation while they are unable to live with their parents. As well as foster care, this can include placements with relatives or kin, and residential care. In most cases, children in home-based care are also on a care and protection order.[17]
In some cases children are placed in home-based care following a child protection substantiation and where they are found to be in need of a safer and more stable environment. In other situations parents may be incapable of providing adequate care for the child, or accommodation may be needed during times of family conflict or crisis.[17] In the significant number of cases substance abuse is a major contributing factor.
Respite care is a type of foster care that is used to provide short-term (and often regular) accommodation for children whose parents are ill or unable to care for them on a temporary basis.[17] It is also used to provide a break for the parent or primary carer to hopefully decrease the chances of the situation escalating to one which would lead to the removal of the child(ren).
As with the majority of child protection services, states and territories are responsible for funding home-based care. Non-government organizations are widely used, however, to provide these services.[17]
[edit]Current policy
There is strong emphasis in current Australian policy and practice to keep children with their families wherever possible. In the event that children are placed in home-based care, every effort is made to reunite children with their families wherever possible.[17]
In the case of Aboriginal and Torres Strait Islander children in particular, but not exclusively, placing the child within the wider family or community is preferred[17] This is consistent with the Aboriginal Child Placement Principle.[18]
[edit]The negative effects of foster care
Individuals who were in foster care experience higher rates of physical and psychiatric morbidity than the general population.[19] In a study of adults who were in foster care in Oregon and Washington state, they were found to have double the incidence of Depression ,20% as compared to 10% and were found to have a higher rate of Post Traumatic Stress Disorder (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, and deficits in executive functioning, anxiety as well other developmental problems.[20][21][22][23] These children experience higher degrees of incarceration, poverty, homelessness, and suicide. Recent studies in the U.S., suggests that, foster care placements are more detrimental to children than remaining in a troubled home.[24][25][26]
[edit]Neurodevelopment
Negative environmental influences affect various aspects of neurodevelopment, such the formation of neurons and dendrites.
Foster care has been shown in various studies, to have deleterious consequences on the physical health and mental wellbeing of those who were in foster care. Many children enter foster care at a very young age. The human brain doesn't fully develop until approximately the age of twenty, one of the most critical periods of brain development occurs in the first 3–4 years.
The processes that govern the development of personality traits, stress response and cognitive skills are formed during this period. The developing brain is directly influenced by negative environmental factors including lack of stimulation due to emotional neglect, poor nutrition, exposure to violence in the home environment and child abuse.
Negative environmental influences have a direct effect on all areas of neurodevelopment, neurogenesis (creation of new neurons), apoptosis (death and reabsorption of neurons), migration (of neurons to different regions of the brain), synaptogenesis (creation of synapses), synaptic sculpturing (determining the make-up of the synapse), arborization (the growth of dendritic connections , myelinzation (protective covering of neurons), an enlargement of the brain's ventricles and can cause cortical atrophy. Most of the processes involved in healthy neurodevelopment are predicated upon the establishment of close nurturing relationships and environmental stimulation. Foster children have elevated levels of cortisol, a stress hormone in comparison to children raised by their biological parents, elevated cortisol levels can compromise the immune system. (Harden BJ, 2004).[27] Negative environmental influences during this critical period of brain development can have lifelong consequences.[28][29][30][31]
[edit]Epigenetic effects of environmental stress
epigentic mechanisms
Epigenetics is the effect environmental factors have on gene expression. Negative environmental influences such as maternal deprivation, child abuse and stress[32][33] have been shown to have a profound effect on gene expression including transgenerational epigenetic effects in which physiological and behavioral (intellectual) transfer of information across generations not yet conceived is effected. In the Överkalix study in Sweden the effects of epigentic inheritance were shown to have a direct correlation to the environmental influences faced by the parents and grandparents. [34] Many physiological and behavioral characteristics ascribed to Mendelian inheritance is due in fact to transgenerational epigenetic inheritance. The implications in terms of foster care and the cost to society as a whole is that the stress, deprivation and other negative environmetal factors many foster children are subjected to has a detrimental effect not only their physical, emotional and cognitive well-being but the damage can transcend generations.[35][36][37]
In studies of the adult offspring of Holocaust survivors, parental PTSD was risk factor for the development of PTSD in adult offspring in comparison to those whose parents went through the Holocaust without developing PTSD. The offspring of survivors with PTSD had lower levels urinary cortisol excretion, salivary cortisol and enhanced plasma cortisol suppression in response to low dose dexamethasone administration than offspring of survivors without PTSD. Low cortisol levels are associated with parental, particularly maternal, PTSD. This is in contrast to the normal stress response in which cortisol levels are elevated after exposure to a stressor. The results of the study point to the involvement of epigenetic mechanisms.[38][39]
Epigenetic Effects of Abuse;
"In addition, the effects of abuse may extend beyond the immediate victim into subsequent generations as a consequence of epigenetic effects transmitted directly to offspring and/or behavioral changes in affected individuals. (Neighh GN et al. 2009)[40]
It has been suggested in various studies that the deleterious epigentic effects may be somewhat ameliorated through pharmacological manipulations in adulthood via the administration of nerve growth factor-inducible protein A,[41] and through the inhibition of a class of enzymes known as the histone deacetylases (HDACs). "HDAC inhibitors (HDACIs) such as Trichostatin A (TSA); "TSA can be used to alter gene expression by interfering with the removal of acetyl groups from histones", and L-methionine an essential amino acid, have been developed for the treatment of a variety of malignancies and neurodegenerative disorders. Drug combination approaches have also shown promise for the treatment of mood disorders including bipolar disorder, anxiety and depression."[42][43]
[edit]Post Traumatic Stress Disorder
Regions of the brain associated with stress and post traumatic stress disorder[44]
Children in foster care have a higher incidence of Post traumatic stress disorder (PTSD).In one study (Dubner and Motta, 1999)[45] 60% of children in foster care who had experienced sexual abuse had PTSD, and 42% of those who had been physically abused fulfilled 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 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".[46][47]
[edit]Eating disorders
Foster children are at increased risk for a variety of eating disorders, in comparison to the general population.
Obesity children in foster care are more prone to becoming overweight and obese, and in a study done in the United Kingdom, 35% of foster children experienced an increase in Body Mass Index (BMI) once in care.[48]
Hyperphagic Short Stature syndrome (HSS) is a condition characterized by short stature due to insufficient growth hormone production , an excessive appetite (hyperphagia) and mild learning disabilities. While it is believed to have genetic component, HSS is triggered by being exposed to an environment of high psychosocial stress, it is not uncommon in children in foster homes or other stressful environments. HSS improves upon removal from the stressful environment.[49][50][51]
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". (Tarren-Sweeney M. 2006). It is hypothesised 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.[52]
Bulimia Nervosa is seven times more prevalent among former foster children than in the general population. [53]
[edit]Disorganized attachment
A study by Dante Cicchetti found that 80% of abused and maltreated infants in his study exhibited symptoms of disorganized attachment.[54][55] Children with histories of maltreatment, such as physical and psychological neglect, physical abuse, and sexual abuse, are at risk of developing psychiatric problems.[56][57][58][59] These children may be described as experiencing trauma as the result of abuse or neglect, inflicted by a primary caregiver, which disrupts the normal development of secure attachment. Such children are at risk of developing a disorganized attachment.[58][60][61] Disorganized attachment is associated with a number of developmental problems, including dissociative symptoms,[62] as well as depressive, anxiety, and acting-out symptoms.[63][64]
[edit]Child abuse
Children in foster care experience high rates of child abuse, emotional and physical neglect. 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 than a child in the general population".[65]
[edit]Poverty and homelessness
New York street children; Jacob Riis, 1890
Nearly half of foster kids in the U.S. become homeless when they turn 18.[66][67] Most foster care children should be placed in adoptive homes. "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.[68][69]
Three out of ten of the United States homeless are former foster children.[70] 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, three times the national poverty rate.[71] Very frequently, people who are homeless had multiple placements as children: some were in foster care, but others were "unofficial" placements in the homes of family or friends. Individuals with a history foster care tend to become homeless at an earlier age than those who were not in foster care and Caucasians who become homeless are more likely to have a history of foster care than Hispanics or African Americans. The length of time a person remains homeless is prolonged in indiviuals who were in foster care.[72]
[edit]Suicide rate
Children in foster care are at a greater risk of suicide,[73] the increased risk of suicide is still prevalent after leaving foster care and occurs at a higher rate than the general population. In a study of Texas youths who aged out of the system 23 percent had a history of suicide attempts.[74]
A Swedish study utilizing the data of almost one million people including 22,305 former foster children who had been in care prior to their teens;
"Former child welfare clients were in year of birth and sex standardised risk ratios (RRs) four to five times more likely than peers in the general population to have been hospitalised for suicide attempts....Individuals who had been in long-term foster care tended to have the most dismal outcome...former child welfare/protection clients should be considered a high-risk group for suicide attempts and severe psychiatric morbidity."[75]
[edit]Death rate
Children in foster care have an overall higher mortality rate than children in the general population.[76] 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 and chronic medical conditions and developmental delays among children in foster care.[77]
[edit]Poor academic prospects
Foster care has been proven in innumerable studies to not be conducive to academic performance. In a study conducted in Philadelphia by John Hopkins University it was found that; among high school students who are in foster care, have been abused and neglected, or receive out of home placement by the courts, the probability of dropping out of school is greater than 75%.[78]
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. and an additional 5% of the general population.
42.7% completed some education beyond high school.
20.6% completed any degree or certificate beyond high school
16.1% completed a vocational degree; 21.9% for those over 25.
1.8% complete a bachelors degree , 2.7% for over 25, the completion rate for the general population in the same age group is 24%, a sizable difference.
[edit]State abuses
[edit]Drug testing
Throughout the 1990s, experimental HIV drugs were tested on HIV-positive foster children at Incarnation Children’s Center in Harlem. The agency has also been accused of racism, some comparing the trials to the Tuskegee syphilis experiment, as 98 percent of children in foster care in New York City belong to ethnic minorities.[79]
[edit]Unnecessary/Over Medication
Studies"[80] have revealed that youth in foster care covered by Medicaid insurance receive psychotropic medication 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 (56.8%), attention-deficit/hyperactivity disorder drugs (55.9%), and antipsychotic agents (53.2%).
Psychiatrists prescribed 93% of the psychotropic medication, and it was noted in the review of these cases that the use of expensive, brand name, patent protected medication was prevalent. In the case of SSRIs 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.[81]
Medicating Foster Kids For Profit
CONCLUSIONS. "Concomitant psychotropic medication treatment is frequent for youth in foster care and lacks substantive evidence as to its effectiveness and safety".[80]
[edit]The lost children
Children victimized by the United Kingdom's Childrens Migrant Programme
An estimated 150,000 British children were sent to overseas colonies and countries in the commonwealth such as Australia. This practice was in effect from the beginning of the nineteenth century until 1967. Many of these children were sent to orphanages, foster homes and religious institutions, where they were used as a free source of labor and many were severely abused and neglected. These children were classified as orphans although most were not. In the period after World War II the policy was dubbed the "Child Migrants Programme". The prime consideration was money as it was cheaper to care for children in commonwealth countries than it was in the United Kingdom. This program was carried out with the complicity of the Methodist Church, the Catholic Church and the Salvation Army among others. At least 10,000 children some as young as 3 were shipped to Australia after the war,[82][83], most to join the ranks of the "Forgotten Australians", the term given for those who experienced care in foster homes and institutions in the 20th century. Among these Forgotten Australians were members of the "Stolen Generation", the children of Australian Aborigines, forcibly removed from their homes and raised in white institutions. In 2009 Australian Prime Minister, Kevin Rudd apologised to the approximately 500,000 "forgotten Australians" and in 2010 British Prime Minister Gordon Brown issued a similar apology to those who were victimised by the Child Migrants Programme.[84][85][86]
[edit]Therapeutic Intervention
The negative physical, psychological, cognitive and epigenetic effects of foster care have been established in innumerable studies in various countries. The Casey Family Programs Northwest Foster Care Alumni Study was a fairly extensive study into various aspects of the psychosocial effects of foster care noted that 80% of ex-foster children are doing "poorly".
[edit]Neuroplasticity
The human brain however has been shown to have a fair degree of neuroplasticity.[87][88][89] Adult Neurogenesis, has been shown to be an ongoing process.[90]
"... all those experiences are of much significance which show how the judgment of the senses may be modified by experience and by training derived under various circumstances, and may be adapted to the new conditions..." - Hermann von Helmholtz, 1866
While 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 such as ADHD,[91] and PTSD[92][93] it may also serve to obfuscate the true cause of any underlying issues, there should be no automatic assumptions, it may have nothing to do with, or may be exacerbated by having a history of foster care and the attendant abuses.
http://en.wikipedia.org/wiki/Foster_care
Developmental Impact of Foster Care
Foster Child Health and Development: Developmental Impact of Foster Care
Authors and Disclosures
Abstract and Introduction
Physical Health Status of Children in Foster Care
Mental Health Status
Developmental Impact of Foster Care
Implications for Primary Care
Developmental Impact of Foster Care
It has been estimated that up to 60% of children in foster care experience some type of developmental delay, including language delays (57%), cognitive problems (33%), gross motor difficulties (31%), and growth problems (10%) (Silver et al., 1999; Simms & Halfon, 1994). Children who enter care with developmental problems are more likely to remain in care long-term (Horowitz, Simms, & Farrington, 1994). Table 1 summarizes common developmental problems experienced by children in foster care at different developmental stages.
Due to the nature of the traumatic experiences that typically precede a child's foster care placement, such as family violence and instability, problems with attachment and developing trusting interpersonal relationships are quite common (Milan & Pinderhughes, 2000). These experiences, coupled with a trajectory of multiple placement transitions, serve to maintain attachment difficulties as the hallmark of a child's development in foster care. An early foundation of insecure attachments and developmental discontinuity in significant relationships has been shown to be related to increased time in care, further placement disruptions, and increased mental health problems in children in foster care (Marcus, 1991). With placement and relationship instability, a pattern of emotional detachment from foster caregivers often develops; the lack of emotional reciprocity between child and caregiver is often too emotionally challenging for foster parents to endure, thus perpetuating a cycle of placement failure (Simms et al., 2000). Adolescents in long-term foster care reported unwillingness to make continued attempts to form attachments with new caregivers. To shield themselves from interpersonal loss, they described self-protective strategies including keeping relationships superficial and maintaining interpersonal distance from others (Kools, 1997, 1999).
Instability and difficulties in interpersonal relationships extend from the foster home context to the peer network. Multiple placements make it logistically difficult for the young person to maintain friendships (Marcus, 1991). Adolescents also reported feeling stigmatized by peers for their diminished status of foster child, resulting in social isolation. Likewise, these experiences have an impact on the adolescent's identity development, with the young person at risk for internalizing the negative views of others (Kools, 1997).
For school-aged children and adolescents, school is a major context for growth and development. Within this important environment, the foundation is set for interpersonal and life skills that contribute to healthy functioning across the life span (Carnegie Council on Adolescent Development, 1995). Frequent school disruption and discontinuity in education are other consequences of multiple foster care placements. Moving from home to home often results in changing school settings. There may be a delay in school enrollment and educational records transmission after each move, resulting in a child's pattern of getting behind in school and increasing the risk for academic failure (Zima et al., 2000).
Finally, independent living skills training has been federally mandated for adolescents in foster care. However, those adolescents with the personal skills, emotional maturity, and financial stability to live independently after aging out of the system at age 18 are the rare exception (GAO, 1999). Premature launching into independent living generally occurs before the adolescent is developmentally ready for this system-imposed milestone (Kools, 1997). This is evidenced in former foster youths' failure to complete high school education and failure to secure affordable housing and stable employment at a living wage (Courtney & Piliavan, 1998). Many foster care "graduates" face serious problems such as homelessness, incarceration, victimization, and early pregnancy and parenting (GAO, 1999; Westat, 1991). In terms of health care, a recent study documented that young people discharged from foster care had extreme difficulty obtaining affordable health care. The majority had no health insurance. They were even less likely to receive mental health services despite clear evidence of ongoing psychological distress (Courtney & Piliavan, 1998).
http://www.medscape.com/viewarticle/449673_4
Authors and Disclosures
Abstract and Introduction
Physical Health Status of Children in Foster Care
Mental Health Status
Developmental Impact of Foster Care
Implications for Primary Care
Developmental Impact of Foster Care
It has been estimated that up to 60% of children in foster care experience some type of developmental delay, including language delays (57%), cognitive problems (33%), gross motor difficulties (31%), and growth problems (10%) (Silver et al., 1999; Simms & Halfon, 1994). Children who enter care with developmental problems are more likely to remain in care long-term (Horowitz, Simms, & Farrington, 1994). Table 1 summarizes common developmental problems experienced by children in foster care at different developmental stages.
Due to the nature of the traumatic experiences that typically precede a child's foster care placement, such as family violence and instability, problems with attachment and developing trusting interpersonal relationships are quite common (Milan & Pinderhughes, 2000). These experiences, coupled with a trajectory of multiple placement transitions, serve to maintain attachment difficulties as the hallmark of a child's development in foster care. An early foundation of insecure attachments and developmental discontinuity in significant relationships has been shown to be related to increased time in care, further placement disruptions, and increased mental health problems in children in foster care (Marcus, 1991). With placement and relationship instability, a pattern of emotional detachment from foster caregivers often develops; the lack of emotional reciprocity between child and caregiver is often too emotionally challenging for foster parents to endure, thus perpetuating a cycle of placement failure (Simms et al., 2000). Adolescents in long-term foster care reported unwillingness to make continued attempts to form attachments with new caregivers. To shield themselves from interpersonal loss, they described self-protective strategies including keeping relationships superficial and maintaining interpersonal distance from others (Kools, 1997, 1999).
Instability and difficulties in interpersonal relationships extend from the foster home context to the peer network. Multiple placements make it logistically difficult for the young person to maintain friendships (Marcus, 1991). Adolescents also reported feeling stigmatized by peers for their diminished status of foster child, resulting in social isolation. Likewise, these experiences have an impact on the adolescent's identity development, with the young person at risk for internalizing the negative views of others (Kools, 1997).
For school-aged children and adolescents, school is a major context for growth and development. Within this important environment, the foundation is set for interpersonal and life skills that contribute to healthy functioning across the life span (Carnegie Council on Adolescent Development, 1995). Frequent school disruption and discontinuity in education are other consequences of multiple foster care placements. Moving from home to home often results in changing school settings. There may be a delay in school enrollment and educational records transmission after each move, resulting in a child's pattern of getting behind in school and increasing the risk for academic failure (Zima et al., 2000).
Finally, independent living skills training has been federally mandated for adolescents in foster care. However, those adolescents with the personal skills, emotional maturity, and financial stability to live independently after aging out of the system at age 18 are the rare exception (GAO, 1999). Premature launching into independent living generally occurs before the adolescent is developmentally ready for this system-imposed milestone (Kools, 1997). This is evidenced in former foster youths' failure to complete high school education and failure to secure affordable housing and stable employment at a living wage (Courtney & Piliavan, 1998). Many foster care "graduates" face serious problems such as homelessness, incarceration, victimization, and early pregnancy and parenting (GAO, 1999; Westat, 1991). In terms of health care, a recent study documented that young people discharged from foster care had extreme difficulty obtaining affordable health care. The majority had no health insurance. They were even less likely to receive mental health services despite clear evidence of ongoing psychological distress (Courtney & Piliavan, 1998).
http://www.medscape.com/viewarticle/449673_4
NEGATIVE EFFECTS OF FOSTER CARE ON EMOTIONAL, INTELLECTUAL & PSYCHOLOGICAL DEVELOPMENT
Rhawn Joseph, Ph.D.
NEGATIVE EFFECTS OF FOSTER CARE ON EMOTIONAL, INTELLECTUAL & PSYCHOLOGICAL DEVELOPMENT
Rhawn Joseph, Ph.D.
Brain Research Laboratory
Despite the protests of her father, and although there was no evidence of paternal or maternal abuse or neglect, Angela was placed among strangers, i.e. Foster Care, for a period of at least 7 months, during a critical stage of social and emotional development and neurological immaturity.
It is now well established that Foster Care can be profoundly injurious to a child's mental health (Harden, 2004; Pediatrics 2000), and that "children in foster care have more compromised developmental outcomes than children who do not experience placement in foster care (Harden, 2004).
In fact, children in foster care are more likely to develop behavioral, educational, and emotional problems than children who are raised by abusive and high-risk parents (Bass et al., 2004; Harden, 2004; Kortenkamp, K., and Ehrle, 2002; Lawrence et al. 2006 NSCAW 2004). In Angela's case, there was no evidence of abuse in the parental home.
Children in foster care are also more likely to suffer from health problems, even though, ostensibly they have better access to health care (Bass et al., 2004; Horowitz, 2000).
Children between the ages of 1 month to 3 years are particularly susceptible to emotional harm from foster care, as they are the most fragile (Bass et al., 2004; Perry, 2002).
Foster care can injure a child's emotional development and can lead to negative development outcomes due to inconsistent nurturing and maternal contact (Cassidy et al. 1996). When placed in Foster Care, and if maternal care or care provided by the primary caretaker is inconsistent or inadequate, such as in the case of Angela, children become more insecurely attached and develop abnormal attachments (Cassidy & Berlin 1994; Zeanah et al. 2001).
As detailed by Harden (2004) children placed in Foster Care and who received inconsistent nurturing care from the primary caretaker, and who "have disrupted attachments to their caregivers, display overly vigilant or overly compliant behaviors, show indiscriminate connection to every adult, or do not demonstrate attachment behaviors to any adult. Children with insecure, “disordered” or “disorganized” attachments may also have many other adverse outcomes that persist throughout childhood, such as poor peer relationships, behavioral problems, or other mental health difficulties." Similar findings have been presented by other scientists (Carlson 1998, Lyons-Ruth, 1996).
Children placed in Foster Homes also exhibit "elevated levels of cortisol compared to children reared by their biological parents" (Harden, 2004). Cortisol is secreted in response to stress, and cortisol not only effects the brain but can injure the immune system.
As detailed earlier in this report, children who are removed from their mothers also have a tendency to become ill, and even to die. Likewise, according to Harden (2004) "Many studies have pointed to the deleterious impact of foster care on children's physical health, cognitive and academic functioning, and social-emotional wellbeing. In the area of physical health, pediatric and public health scholars have documented that foster children have a higher level of morbidity throughout childhood than do children not involved in the foster care system."
Likewise, according to the NSCAW, a significant proportion of children placed in Foster Care, suffer from compromised cognitive, intellectual, and academic functioning (National survey of child and adolescent well-being NSCAW, 2001). Specifically, the NSCAW found that over 1/3 of infants and toddlers and 1/2 of pre-school age children scored in the delayed range of development. Similar findings have been presented by other scientists (Konekamp & Ehrle, 2002, Pears & Fisher, 2005; Swayer & Dubowitz, 1994).
Children placed in Foster Care have higher rates of depression, abnormal social skills, are more impulsive, become more aggressive, and are more insecurely attached and have insecure and disordered attachment behaviors (Clausen et al., 1998; Stein et al., 1996).
Children placed in Foster Care do more poorly than children who are left in high-risk homes where parents are neglectful or abusive (Lawrence et al. 2006) Likewise, behavior problems are worse as compared to those raised by maltreating care givers(Lawrence et al. 2006). Likewise, according to a NSCAW (2003) study, children placed in Foster Care show more compromised social-emotional functioning than children raised in a high risk environment. However, in this case, Angela was not being abused or neglected by her parents. In this regard, and given these findings and the research reviewed above it is thus clear that Angela developed these problems precisely because was placed in foster care.
In fact, in a study released on April 6, 2005, by the Casey Family Programs, Harvard Medical School, the State of Washington Office of Children’s Administration Research, and the State of Oregon Department of Human Services,it was reported that children raised in Foster Homes are highly likely to develop PTSD and that the rates of PTSD among adults who were formerly placed in foster care was twice as high as among U.S. war veterans.
As detailed in the Casey Family study, in addition to the PTSD, 54.4% of adults formerly in foster care were found to be suffering from depression, social phobia, panic syndrome, and anxiety. Moreover, it was found that 80% of adults who had been placed in Foster Care as children, were doing poorly, with a quarter to one third becoming homeless or living below the poverty level.
ABUSE WHILE IN FOSTER CARE:
In states from California to New York, and in counties and cities from Santa Clara County and San Jose, to New York City and Maryland, it has been reported that over 20% of children placed in Foster Care are sexually and physically abused or suffer from profound neglect while in Foster Care (United States District Court, D. Maryland, L.J. By and Through Darr v. Massinga, decision, Civ. No. JH-84-4409, September 27, 1988. F.Supp. 508 (D.Md. 1988); Testimony of Stephen P. Berzon, Foster Care: Problems and Issues, hearing, Subcommittee on Select Education, Committee on Education and Labor, U.S. House of Representatives, September 8, 1976; Casereading conducted by Theodore J. Stein in conjunction with Del A. v. Edwin Edwards, (1988); David Kaplovitz and Louis Genevie, Foster Children in Jackson County, Missouri: A Statistical Analysis of Files Maintained by the Division of Family Services, (1981); Testimony of Marcia Robinson Lowry, Foster Care, Child Welfare, and Adoption Reforms, Joint Hearings before the Subcommittee on Public Assistance and Unemployment Compensation of the Committee on Ways and Means and the Select Committee on Children, Youth and Families, U.S. House of Representatives, April 13 and 28, May 12, 1988; Superior Court of Arizona, Maricopa County, Bogutz v. Arizona, 2nd amended civil complaint, No. CV94-04159. July 1994.)
In a Maryland study, substantiated allegations of sexual abuse have been reported to be four times higher than found among the general population (Mary I. Benedict and Susan Zuravin, Factors Associated With Child Maltreatment By Family Foster Care Providers (Baltimore: John Hopkins University School of Hygiene and Public Health, 1992).
Likewise, in a study conducted by the National Foster Care Education Project (1986) and the American Civil Liberties Union's Children's Rights Project (1993) it was found that Foster Children are 10 times more likely to be abused than children from the general population (Farber, 1993; Maier, 1997).
Children placed in Foster Care in California are also typically "subjected to inadequate supervision, substandard conditions and inadequate health care and education" (Gunnison, 1996); a conclusion also reached by the Santa Clara County Grand Jury (1993) and by members of the 1998-1999, Santa Clara County Grand Jury.
As concluded by the California-based Little Hoover Commission (1992) regarding children placed in Foster Care: "children can come to harm--and even die--while supposedly under the protection of foster care."
http://brainmind.com/FosterCareInfancyChildhood.html
NEGATIVE EFFECTS OF FOSTER CARE ON EMOTIONAL, INTELLECTUAL & PSYCHOLOGICAL DEVELOPMENT
Rhawn Joseph, Ph.D.
Brain Research Laboratory
Despite the protests of her father, and although there was no evidence of paternal or maternal abuse or neglect, Angela was placed among strangers, i.e. Foster Care, for a period of at least 7 months, during a critical stage of social and emotional development and neurological immaturity.
It is now well established that Foster Care can be profoundly injurious to a child's mental health (Harden, 2004; Pediatrics 2000), and that "children in foster care have more compromised developmental outcomes than children who do not experience placement in foster care (Harden, 2004).
In fact, children in foster care are more likely to develop behavioral, educational, and emotional problems than children who are raised by abusive and high-risk parents (Bass et al., 2004; Harden, 2004; Kortenkamp, K., and Ehrle, 2002; Lawrence et al. 2006 NSCAW 2004). In Angela's case, there was no evidence of abuse in the parental home.
Children in foster care are also more likely to suffer from health problems, even though, ostensibly they have better access to health care (Bass et al., 2004; Horowitz, 2000).
Children between the ages of 1 month to 3 years are particularly susceptible to emotional harm from foster care, as they are the most fragile (Bass et al., 2004; Perry, 2002).
Foster care can injure a child's emotional development and can lead to negative development outcomes due to inconsistent nurturing and maternal contact (Cassidy et al. 1996). When placed in Foster Care, and if maternal care or care provided by the primary caretaker is inconsistent or inadequate, such as in the case of Angela, children become more insecurely attached and develop abnormal attachments (Cassidy & Berlin 1994; Zeanah et al. 2001).
As detailed by Harden (2004) children placed in Foster Care and who received inconsistent nurturing care from the primary caretaker, and who "have disrupted attachments to their caregivers, display overly vigilant or overly compliant behaviors, show indiscriminate connection to every adult, or do not demonstrate attachment behaviors to any adult. Children with insecure, “disordered” or “disorganized” attachments may also have many other adverse outcomes that persist throughout childhood, such as poor peer relationships, behavioral problems, or other mental health difficulties." Similar findings have been presented by other scientists (Carlson 1998, Lyons-Ruth, 1996).
Children placed in Foster Homes also exhibit "elevated levels of cortisol compared to children reared by their biological parents" (Harden, 2004). Cortisol is secreted in response to stress, and cortisol not only effects the brain but can injure the immune system.
As detailed earlier in this report, children who are removed from their mothers also have a tendency to become ill, and even to die. Likewise, according to Harden (2004) "Many studies have pointed to the deleterious impact of foster care on children's physical health, cognitive and academic functioning, and social-emotional wellbeing. In the area of physical health, pediatric and public health scholars have documented that foster children have a higher level of morbidity throughout childhood than do children not involved in the foster care system."
Likewise, according to the NSCAW, a significant proportion of children placed in Foster Care, suffer from compromised cognitive, intellectual, and academic functioning (National survey of child and adolescent well-being NSCAW, 2001). Specifically, the NSCAW found that over 1/3 of infants and toddlers and 1/2 of pre-school age children scored in the delayed range of development. Similar findings have been presented by other scientists (Konekamp & Ehrle, 2002, Pears & Fisher, 2005; Swayer & Dubowitz, 1994).
Children placed in Foster Care have higher rates of depression, abnormal social skills, are more impulsive, become more aggressive, and are more insecurely attached and have insecure and disordered attachment behaviors (Clausen et al., 1998; Stein et al., 1996).
Children placed in Foster Care do more poorly than children who are left in high-risk homes where parents are neglectful or abusive (Lawrence et al. 2006) Likewise, behavior problems are worse as compared to those raised by maltreating care givers(Lawrence et al. 2006). Likewise, according to a NSCAW (2003) study, children placed in Foster Care show more compromised social-emotional functioning than children raised in a high risk environment. However, in this case, Angela was not being abused or neglected by her parents. In this regard, and given these findings and the research reviewed above it is thus clear that Angela developed these problems precisely because was placed in foster care.
In fact, in a study released on April 6, 2005, by the Casey Family Programs, Harvard Medical School, the State of Washington Office of Children’s Administration Research, and the State of Oregon Department of Human Services,it was reported that children raised in Foster Homes are highly likely to develop PTSD and that the rates of PTSD among adults who were formerly placed in foster care was twice as high as among U.S. war veterans.
As detailed in the Casey Family study, in addition to the PTSD, 54.4% of adults formerly in foster care were found to be suffering from depression, social phobia, panic syndrome, and anxiety. Moreover, it was found that 80% of adults who had been placed in Foster Care as children, were doing poorly, with a quarter to one third becoming homeless or living below the poverty level.
ABUSE WHILE IN FOSTER CARE:
In states from California to New York, and in counties and cities from Santa Clara County and San Jose, to New York City and Maryland, it has been reported that over 20% of children placed in Foster Care are sexually and physically abused or suffer from profound neglect while in Foster Care (United States District Court, D. Maryland, L.J. By and Through Darr v. Massinga, decision, Civ. No. JH-84-4409, September 27, 1988. F.Supp. 508 (D.Md. 1988); Testimony of Stephen P. Berzon, Foster Care: Problems and Issues, hearing, Subcommittee on Select Education, Committee on Education and Labor, U.S. House of Representatives, September 8, 1976; Casereading conducted by Theodore J. Stein in conjunction with Del A. v. Edwin Edwards, (1988); David Kaplovitz and Louis Genevie, Foster Children in Jackson County, Missouri: A Statistical Analysis of Files Maintained by the Division of Family Services, (1981); Testimony of Marcia Robinson Lowry, Foster Care, Child Welfare, and Adoption Reforms, Joint Hearings before the Subcommittee on Public Assistance and Unemployment Compensation of the Committee on Ways and Means and the Select Committee on Children, Youth and Families, U.S. House of Representatives, April 13 and 28, May 12, 1988; Superior Court of Arizona, Maricopa County, Bogutz v. Arizona, 2nd amended civil complaint, No. CV94-04159. July 1994.)
In a Maryland study, substantiated allegations of sexual abuse have been reported to be four times higher than found among the general population (Mary I. Benedict and Susan Zuravin, Factors Associated With Child Maltreatment By Family Foster Care Providers (Baltimore: John Hopkins University School of Hygiene and Public Health, 1992).
Likewise, in a study conducted by the National Foster Care Education Project (1986) and the American Civil Liberties Union's Children's Rights Project (1993) it was found that Foster Children are 10 times more likely to be abused than children from the general population (Farber, 1993; Maier, 1997).
Children placed in Foster Care in California are also typically "subjected to inadequate supervision, substandard conditions and inadequate health care and education" (Gunnison, 1996); a conclusion also reached by the Santa Clara County Grand Jury (1993) and by members of the 1998-1999, Santa Clara County Grand Jury.
As concluded by the California-based Little Hoover Commission (1992) regarding children placed in Foster Care: "children can come to harm--and even die--while supposedly under the protection of foster care."
http://brainmind.com/FosterCareInfancyChildhood.html
How Children and Adolescents React to Trauma(Trauma from being stolen from their families)
How Children and Adolescents React to Trauma
The following are typical reactions to a traumatic event and are not necessarily indicative of PTSD or another disorder. Source of the following: NIMH, 2001
Ages 5 and younger: may fear being separated from parent, crying, whimpering, screaming, immobility and/or aimless motion, trembling, frightened facial expressions, and excessive clinging. May regress—return to behaviors exhibited at earlier ages (e.g., bed-wetting, fear of darkness). Children of this age are strongly affected by the parents’ reactions to the traumatic event.
Ages 6 to 11: may show extreme withdrawal, disruptive behavior, and/or inability to pay attention. Regressive behaviors, nightmares, sleep problems, irrational fears, irritability, refusal to attend school, outbursts of anger and fighting are common. Child may complain of stomachaches or other bodily symptoms that have no medical basis. Schoolwork often suffers. Depression, anxiety, feelings of guilt, and emotional numbing or “flatness” are often present as well.
Ages 12 to 17: may exhibit responses similar to those of adults, including flashbacks, nightmares, emotional numbing, avoidance of reminders of traumatic event, depression, substance abuse, problems with peers, and antisocial behavior. Also common are withdrawal and isolation, physical complaints, suicidal thoughts, school avoidance, academic decline, sleep disturbances, and confusion. May feel extreme guilt over his or her failure to prevent injury or loss of life, and may harbor revenge fantasies that interfere with recovery.
http://www.practicenotes.org/vol10_n3/react.htm
The following are typical reactions to a traumatic event and are not necessarily indicative of PTSD or another disorder. Source of the following: NIMH, 2001
Ages 5 and younger: may fear being separated from parent, crying, whimpering, screaming, immobility and/or aimless motion, trembling, frightened facial expressions, and excessive clinging. May regress—return to behaviors exhibited at earlier ages (e.g., bed-wetting, fear of darkness). Children of this age are strongly affected by the parents’ reactions to the traumatic event.
Ages 6 to 11: may show extreme withdrawal, disruptive behavior, and/or inability to pay attention. Regressive behaviors, nightmares, sleep problems, irrational fears, irritability, refusal to attend school, outbursts of anger and fighting are common. Child may complain of stomachaches or other bodily symptoms that have no medical basis. Schoolwork often suffers. Depression, anxiety, feelings of guilt, and emotional numbing or “flatness” are often present as well.
Ages 12 to 17: may exhibit responses similar to those of adults, including flashbacks, nightmares, emotional numbing, avoidance of reminders of traumatic event, depression, substance abuse, problems with peers, and antisocial behavior. Also common are withdrawal and isolation, physical complaints, suicidal thoughts, school avoidance, academic decline, sleep disturbances, and confusion. May feel extreme guilt over his or her failure to prevent injury or loss of life, and may harbor revenge fantasies that interfere with recovery.
http://www.practicenotes.org/vol10_n3/react.htm
Effects of Attachment and Separation
Effects of Attachment and Separation
Attachment and separation: these elemental forces drive the behaviors and decisions that shape every stage of practice. Assessment, removal, placement, reunification, adoption—no aspect of child welfare social work is untouched by their influence. This article will describe these forces and provide suggestions for helping children and families understand and cope with them.
Attachment
Attachment is the social and emotional relationship children develop with the significant people in their lives. An infant's first attachment is usually formed with its mother, although in some circumstances another adult can become the primary attachment figure. This may be a father, a grandparent, or an unrelated adult (Caye, et al., 1996).
Attachment is a process made up of interactions between a child and his or her primary caregiver. This process begins at birth, helping the child develop intellectually, organize perceptions, think logically, develop a conscience, become self-reliant, develop coping mechanisms (for stress, frustration, fear, and worry), and form healthy and intimate relationships (Allen, et al., 1983).
In her 1982 article on parent-child attachment, published in the journal Social Casework, Peg Hess states that three conditions must be present for optimal parent-child attachment to occur: continuity, stability, and mutuality. Continuity involves the caregiver's constancy and repetition of the parent-child interactions. Stability requires a safe environment where the parent and child can engage in the bonding process. Mutuality refers to the interactions between the parent and child that reinforce their importance to each other.
Research has demonstrated that two primary parenting behaviors are most important in developing an infant's attachment to a caregiver. Optimal attachment occurs when a caregiver recognizes and responds to the infant's signals and cues, meeting the infant's physical and emotional needs; and when the caregiver regularly engages the child in lively social interactions.
Studies of infants raised in institutional settings suggest that neither behavior alone is sufficient for secure attachment. For example, one study found that institutionalized infants failed to form strong attachments to caregivers who readily met their physical needs but did not engage them in social interaction. Conversely, social interactions alone are not enough: infants often form social attachments to brothers, sisters, fathers, and grandparents who engage them in pleasurable social activity. Yet, when they are tired, hungry, or distressed, they often cannot be comforted by anyone other than the caregiver who has historically recognized and responded to their signals of physical and emotional need (Caye, et al. 1996).
Separation
Separation, the removal of children from the caregiver(s) to whom they are attached, has both positive and negative aspects. From a child protection perspective, separation has several benefits, the most obvious being the immediate safety of the child. Through this separation, limits can be established for parental behavior, and the child may get the message that society will protect him or her, even if the parent will not. Separation also temporarily frees parents from the burden of child-rearing, allowing them to focus on making the changes necessary for the child to return home.
Separating a parent and child can also have profoundly negative effects. Even when it is necessary, research indicates that removing children from their homes interferes with their development. The more traumatic the separation, the more likely there will be significant negative developmental consequences.
Repeated separations interfere with the development of healthy attachments and a child's ability and willingness to enter into intimate relationships in the future. Children who have suffered traumatic separations from their parents may also display low self-esteem, a general distrust of others, mood disorders (including depression and anxiety), socio-moral immaturity, and inadequate social skills. Regressive behavior, such as bedwetting, is a common response to separation. Cognitive and language delays are also highly correlated with early traumatic separation.
Social workers in child placement must be continually aware of the magnitude of the changes children experience when they are removed from their families. See "Helping a Child Through a Permanent Separation" for ways to minimize the trauma of separation.
Grief
In most cases of separation, the families involved go through the five stages of grief (shock/denial, anger, bargaining, depression, and resolution), although not necessarily in this order. For example, it is possible for a grieving person to move from anger to depression and back to anger again. "Reactions to the Five Stages of Grief" is a chart that identifies behavioral expression in children and parents during each of these stages.
One of the most common errors made by social workers, foster parents, and parents is to misinterpret a child's compliant and unemotional behavior during the shock/denial stage and judge a placement to be a "success." When a child is thought to have handled the move without distress, later behavioral signs are often not recognized as part of the grieving process. They may be ignored or attributed to emotional or behavioral problems. At times the child may even be punished for them, intensifying the child's distress and depriving him of support and help (Caye, et al., 1996).
References
Allen, J. A., Fahlberg, V., Ellett, A., Montgomery, T. M., Overberger, C., Williams., C., & Swanson, K. (1983). Special needs adoption curriculum: Preparation of children. Tallahassee, FL: Florida Department of Health and Rehabilitative Services.
Caye, J., McMahon, J., Norris, T., & Rahija, L. (1996). Effects of separation and loss on attachment. Chapel Hill: School of Social Work, University of North Carolina at Chapel Hill.
Fahlberg, V. I. (1991). A child's journey through placement. Indianapolis, IN: Perspectives Press.
Hess, P. (1982). Parent-child attachment concept: Crucial for permanency planning. Social Casework, 63(1), 46-57.
Wasserman, S. & Rosenfeld, A. (1986). Decision-making in child abuse and neglect. Child Welfare, 65(6), 515-529.
© 1997 Jordan Institute for Families
http://www.practicenotes.org/vol2_no4/effects_of_separation_and_attachment.htm
Attachment and separation: these elemental forces drive the behaviors and decisions that shape every stage of practice. Assessment, removal, placement, reunification, adoption—no aspect of child welfare social work is untouched by their influence. This article will describe these forces and provide suggestions for helping children and families understand and cope with them.
Attachment
Attachment is the social and emotional relationship children develop with the significant people in their lives. An infant's first attachment is usually formed with its mother, although in some circumstances another adult can become the primary attachment figure. This may be a father, a grandparent, or an unrelated adult (Caye, et al., 1996).
Attachment is a process made up of interactions between a child and his or her primary caregiver. This process begins at birth, helping the child develop intellectually, organize perceptions, think logically, develop a conscience, become self-reliant, develop coping mechanisms (for stress, frustration, fear, and worry), and form healthy and intimate relationships (Allen, et al., 1983).
In her 1982 article on parent-child attachment, published in the journal Social Casework, Peg Hess states that three conditions must be present for optimal parent-child attachment to occur: continuity, stability, and mutuality. Continuity involves the caregiver's constancy and repetition of the parent-child interactions. Stability requires a safe environment where the parent and child can engage in the bonding process. Mutuality refers to the interactions between the parent and child that reinforce their importance to each other.
Research has demonstrated that two primary parenting behaviors are most important in developing an infant's attachment to a caregiver. Optimal attachment occurs when a caregiver recognizes and responds to the infant's signals and cues, meeting the infant's physical and emotional needs; and when the caregiver regularly engages the child in lively social interactions.
Studies of infants raised in institutional settings suggest that neither behavior alone is sufficient for secure attachment. For example, one study found that institutionalized infants failed to form strong attachments to caregivers who readily met their physical needs but did not engage them in social interaction. Conversely, social interactions alone are not enough: infants often form social attachments to brothers, sisters, fathers, and grandparents who engage them in pleasurable social activity. Yet, when they are tired, hungry, or distressed, they often cannot be comforted by anyone other than the caregiver who has historically recognized and responded to their signals of physical and emotional need (Caye, et al. 1996).
Separation
Separation, the removal of children from the caregiver(s) to whom they are attached, has both positive and negative aspects. From a child protection perspective, separation has several benefits, the most obvious being the immediate safety of the child. Through this separation, limits can be established for parental behavior, and the child may get the message that society will protect him or her, even if the parent will not. Separation also temporarily frees parents from the burden of child-rearing, allowing them to focus on making the changes necessary for the child to return home.
Separating a parent and child can also have profoundly negative effects. Even when it is necessary, research indicates that removing children from their homes interferes with their development. The more traumatic the separation, the more likely there will be significant negative developmental consequences.
Repeated separations interfere with the development of healthy attachments and a child's ability and willingness to enter into intimate relationships in the future. Children who have suffered traumatic separations from their parents may also display low self-esteem, a general distrust of others, mood disorders (including depression and anxiety), socio-moral immaturity, and inadequate social skills. Regressive behavior, such as bedwetting, is a common response to separation. Cognitive and language delays are also highly correlated with early traumatic separation.
Social workers in child placement must be continually aware of the magnitude of the changes children experience when they are removed from their families. See "Helping a Child Through a Permanent Separation" for ways to minimize the trauma of separation.
Grief
In most cases of separation, the families involved go through the five stages of grief (shock/denial, anger, bargaining, depression, and resolution), although not necessarily in this order. For example, it is possible for a grieving person to move from anger to depression and back to anger again. "Reactions to the Five Stages of Grief" is a chart that identifies behavioral expression in children and parents during each of these stages.
One of the most common errors made by social workers, foster parents, and parents is to misinterpret a child's compliant and unemotional behavior during the shock/denial stage and judge a placement to be a "success." When a child is thought to have handled the move without distress, later behavioral signs are often not recognized as part of the grieving process. They may be ignored or attributed to emotional or behavioral problems. At times the child may even be punished for them, intensifying the child's distress and depriving him of support and help (Caye, et al., 1996).
References
Allen, J. A., Fahlberg, V., Ellett, A., Montgomery, T. M., Overberger, C., Williams., C., & Swanson, K. (1983). Special needs adoption curriculum: Preparation of children. Tallahassee, FL: Florida Department of Health and Rehabilitative Services.
Caye, J., McMahon, J., Norris, T., & Rahija, L. (1996). Effects of separation and loss on attachment. Chapel Hill: School of Social Work, University of North Carolina at Chapel Hill.
Fahlberg, V. I. (1991). A child's journey through placement. Indianapolis, IN: Perspectives Press.
Hess, P. (1982). Parent-child attachment concept: Crucial for permanency planning. Social Casework, 63(1), 46-57.
Wasserman, S. & Rosenfeld, A. (1986). Decision-making in child abuse and neglect. Child Welfare, 65(6), 515-529.
© 1997 Jordan Institute for Families
http://www.practicenotes.org/vol2_no4/effects_of_separation_and_attachment.htm
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