Published Online: December 13, 2000
Published in Print: December 13, 2000, as Early Years

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Better Foster Care: A growing number of children who are 4 years old or younger are entering foster care with "serious physical, mental, and developmental health problems" that need better treatment, concludes a new policy from the American Academy of Pediatrics.

For More Information

The policy report "Developmental Issues for Young Children in Foster Care," November 2000, is now available from the American Academy of Pediatrics.

The AAP statement— which appeared in the November issue of Pediatrics, the group's journal recommends steps the nation should take to help those children.

To begin with, foster-care youngsters need to stay with fewer families. Otherwise, the policy statement says, the children will not receive the consistent nurturing they need to develop their young brains.

In fact, children in foster care are six times more likely than children not in foster care to have emotional, behavioral, and developmental problems, according to the Washington-based Child Welfare League of America. That reality is, in part, why the AAP policy focuses on the early years, a time when developmental milestones are occurring in the brain, such as learning how to cope with stress and regulate emotions.

"I'm glad to see the pediatricians have finally seen the needs of children in foster care," said Millicent Williams, director of foster-care services for the Child Welfare League. "The recommendations are good social-work practice."

However, Ms. Williams said the bigger issue—not addressed in the policy statement—is the problem of finding money to pay for more services for young children in foster care.

The policy statement also recommends that children in foster care have periodic assessments of their strengths and needs. As it is, studies show foster children often do not get routine health screenings and checkups. And they frequently are assigned to special education when they don't need to be—or are not receiving special education services when they should.

In addition, the pediatricians' statement recommends that the foster system "not disrupt established psychological ties except when safety or emotional well-being are in jeopardy." This recommendation pays homage to the importance of "kinship" ties, cases where children can live with grandparents or other relatives.

Dr. Susan E. Levitzky, a New York City pediatrician who helped craft the policy statement, said the AAP had previously never gone on record addressing foster- care issues. She hopes the recommendations raise the awareness of pediatricians and others who work with foster children.

—Linda Jacobson

Vol. 20, Issue 15, Page 5

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