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Foster Care

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foster care

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."


Richard P. Barth, et al., "Timing Is Everything: An Analysis of the Time to Adoption and Legalization," Social Work Research 18, no. 3 (September 1994): 139-148.

Al Desetta, ed., The Heart Knows Something Different: Teenage Voices from the Foster Care System. (New York: Persea Books, 1996).

Florence Lieberman, D.S.W., Thomas K. Kenemore, Ph.D., and Diane Yost, M.S.W., The Foster Care Dilemma (New York: Human Sciences Press, 1987).

Thomas P. McDonald, et al., Assessing the Long-Term Effects of Foster Care: A Research Synthesis. (Washington, D.C.: CWLA Press, 1996).

National Council For Adoption, Adoption Factbook, (Washington, D.C.: National Council For Adoption, 1985).

Ada Schmidt-Tieszen and Thomas P. McDonald, "Children Who Wait: Long-Term Foster Care or Adoption?", Children and Youth Services Review 20, nos. 1-2 (February 1998): 13-28.

J. R. Seaberg and E. S. Tolley, "Predictors of the Length of Stay in Foster Care," Social Work Research and Abstracts 22, 3 (1986): 11-17.

Burton Z. Sokoloff, "Adoption and Foster Care," in Developmental-Behavioral Pediatrics (Philadelphia: Saunders, 1983).

Wladyslaw Sluckin and Martin Herbert, eds., "Substitute Parenting" in Parental Behaviour, (United Kingdom and New York: Basil Blackwell, 1986).

John I. Takayama, M.D., et al., "Relationship Between Reason for Placement and Medical Findings Among Children in Foster Care," Pediatrics 101, no. 2 (February 1998): 201-207.

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Visitor Comments (1)
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terry - 2 months ago
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explain to you about the reason for foster care this is very helpful how foster cares works it let you know why it is important for sibling to stay together I enjoy reading this #1
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