Fractured, Not Broken: How to Repair the Foster Care System to Better Serve Children with Disabilities

Early Childhood Interventions December 11, 2015

The purpose of foster care is “to provide a safe temporary placement for children who cannot remain safely in the home of their parent(s)”. Their main goal for foster care is to eventually “implement a plan for permanency for each child” (https://dss.sc.gov/content/customers/protection/fcs/index.aspx). Over half of the children in the foster care system have some sort of mental, emotional, or physical disability that requires more than just a stable home:

  • 40% of all children in foster care were born low birth weight or premature
  • 80% were prenatally exposed to substances
  • 30-80% have at least one chronic medical condition (ie: asthma, HIV, tuberculosis)
  • 25% have three or more chronic health problems
  • 30-50% are experiencing dental decay
  • 30-60% have developmental delays
  • 50-80% have mental and behavioral health problems
  • 20% are fully handicapped
  • 30-40% receive special education services
  • The rate of Post-Traumatic Stress Disorder (PTSD) for children in foster care is nearly double that of U.S. combat veterans. (American Psychological Association’s Children Youth and Families Office, 2012)

Studies show that this population of children experiences higher rates of maltreatment, especially physical or emotional neglect and sexual or physical abuse. They experience more placement instability with lower rates of adoption or permanency than their non-disabled peers in the foster care system. This placement instability results in a fractured educational experience with little consistency. The children are more likely to be on psychotropic medications and have a higher risk of institutionalization than children with disabilities outside the foster care system. The negative outcomes for this population are not limited merely to childhood; they also extend into adulthood, as outcome studies of disabled children in the foster care system later in life reveal higher rates of homelessness, substance abuse, unemployment, criminality, and mental health problems.

I believe that these disconcerting outcomes for children with disabilities are indications not of bad foster parents, but more of a fractured system. Perhaps the most profound issue with the system is the apparent lack of communication between the different service providers who serve children with disabilities in the foster care system. Schools, families, social workers, foster care case managers, disability advocacy groups, and other related services must communicate regularly to provide children with the support they need. This lack of communication is exacerbated by the fact that the social workers, foster care caseworkers, and child protection investigators are not typically trained to identify or support children with disabilities. They, therefore, underreport the number of children in their caseloads who have disabilities, resulting in poor placement decisions for the children.

Because the social service providers lack training, the foster and adoptive parents do not in turn receive appropriate training to support children with disabilities. Additionally, the social service providers are unaware of training programs available through other agencies, universities, or community colleges. Often when children with disabilities are placed with a family the parents are not aware of their disabling conditions, special needs, or of how to care for the children. Feeling underequipped to support the children; the families often return them back into the system, contributing to even more placement instability for the children. Even when families are aware that the child has a disability, the foster and adoptive parents have many misconceptions about what parenting a child with a disability is like, and, are thus unprepared to care for the child, although their intentions may be admirable.

While the foster care system for children with disabilities is fractured, it is not irreparably broken. The mending of the system will be difficult, but it is not impossible. It will take the dedication and collaboration of the child welfare services, disability services, and advocacy groups, first and foremost to educate the child welfare workers, foster care providers, and judicial personnel about children with disabilities and their rights. Many states are beginning to offer scholarships for those obtaining degrees in social work to focus their studies on developmental and intellectual disabilities, so that we have a foster care workforce that is more aware. (http://www.collegescholarships.org/scholarships/social-worker.htm)With members of the team trained in disabilities, children in the system will receive more intentional placement and the services they deserve. Training cannot end with the social workers, though; social workers need to apply what they have learned about disabilities by teaching future foster and adoptive families about how to care for this population of vulnerable children. One type of foster care program and clinical intervention that is already doing this is the Therapeutic Foster Care Program. http://www.childwelfaresparc.files.wordpress.com/2013/07/therapeutic-foster-care-exceptional-care-for-complex-trauma-impacted-youth-in-foster-care.pdf

Therapeutic Foster Care provides foster parents with twice the amount of training, so that they are prepared to care for children with emotional disabilities. The departments of social services or child welfare agencies need to partner with more advocacy groups that can provide specialized trainings like these on a broader scale for all the providers involved.

Lastly, to improve adult outcomes for the disabled individuals in the foster care system, social serves need to ensure that the children receive vocational and life skills training before they transfer out of the system. This would necessitate very intentional transition planning on the part of the caseworkers to ensure that, despite possible placement instability, these children are prepared for life outside of the system. Many advocacy groups have created resources to help professionals with this type of transition planning. One very useful free online guide comes from the Juvenile Law Center and the Pennsylvania Developmental Disabilities Council. http://www.jlc.org/sites/default/files/topic_related_docs/Transition%20Planning%20for%20Youth%20with%20Disabilities%20-%20A%20Guide%20for%20Professionals%20-%20November%202013.pdf.

The lives of disabled children in the foster care system could be improved by implementing a few key programs:

  • Training of social service providers to identify children who may have a disability;
  • Implement programs of intense training to all foster care parents on identifying children with disabilities, behavior management, and advocacy;
  • Transition planning; and
  • Interagency communication.

 Additionally, the programs that provide early intervention or special education services need to reach out to social service, provide cross training, and support the child welfare workers in supporting foster families and other community based programs for the children. 

References 

American Psychological Association’s Children Youth and Families Office. (2012). Systems of Mental Health Care for Youth in Foster Care. http://www.apa.org/pi/families/resources/newsletter/2012/01/winter.pdf

Hill, K.M, LaLiberte, T., & Lightfoot, E. (2011). Prevalence of children with disabilities in the child welfare system and out of home placement: An examination of administrative records. Social Work Faculty Publications. School of Social Work, University of St. Thomas, Minnesota.

Jee, S.H. et al. (2010). Improved Detection of Developmental Delays Among Young Chidlren in Foster Care. Journal of the American Academy of Pediatrics.http://pediatrics.aappublications.org/content/125/2/282.full.html.

Juvenile Law Center and the Pennsylvania Developmental Disabilities Council’s Guide for Professionals on Transition Planning for Youth with Disabilities from the Child Welfare System to Adulthood http://www.jlc.org/sites/default/files/topic_related_docs/Transition%20Planning%20for%20Youth%20with%20Disabilities%20-%20A%20Guide%20for%20Professionals%20-%20November%202013.pdf 

Scholarships for Social Workers:

http://www.collegescholarships.org/scholarships/social-worker.htm 

Therapeutic Foster Care: http://www.childwelfaresparc.files.wordpress.com/2013/07/therapeutic-foster-care-exceptional-care-for-complex-trauma-impacted-youth-in-foster-care.pdf

United Cerebral Palsy’s Project. (2006). A Case for Action for Children and Youth with Disabilities in Foster Care.

Katerina Maylock
GU’16