Unique Issues of Children in Foster Care

Unique Needs of Children in Foster Care
Objectives
~	Explore some unique stressors for the child as well as caregivers 
Intro
~	According to 2014 AFCARS data, approximately 53 percent of foster children remain in care for  12 months or more
~	Eighty percent of youth involved with the child welfare system require mental health intervention and services due to developmental, behavioral or emotional issues
~	Excessive amounts of cortisol and chronic HPA-Axis activation disrupts developing brain circuits and increases the risk for stress related disease and cognitive impairment well into the adult years (ACEs)
~	Providing supportive, responsive relationships as early in life as possible can prevent or reverse the damaging effects of toxic stress
ACES
~	Abuse
~	Addiction or mental health issues in the family of origin
~	Abandonment
~	Parent leaving or dying
~	Frequent placement transitions
~	No opportunity to develop a secure attachment
~	Changing schools and friends (can lead to attachment disorders)
~	May be a particular issue for children of substance abusing parents because of repeated unification and separation
~	Loyalty to parents
~	Disempowerment due to failure to consider child’s perspective in agency decisions – May not be a good environment, but in some cases it is at least predictable
Other Potential Factors
~	Low self-esteem
~	Parental/caregiver rejection
~	Stigma
~	Prenatal substance exposure
~	Malnutrition
~	Automatic placement in special education or biased differential diagnosis
~	Cultural differences
~	Cultural variability in child socialization practices – How we want children to behave – How we teach children to behave according to cultural norms
~	School assignments (such as family trees, autobiographies, or baby picture contests) and language (“natural” or “real” instead of “birth” parent; “children of their own and an adopted child”) that isolates them and affects their school experience.
Other Factors
~	Birth family visits
~	Inconsistency
~	Re-awakening the grief process
~	Anger/guilt of being taken away
~	Depression and sadness with departure (or no-show)
~	Confusing/conflicting messages between foster and birth parents
~	Saying goodbye to foster family for reunification
~	Fears about reunification

Disrupted Attachment
~	Problems with affect regulation and dissociation 
~	Lack of impulse control and attentional problems
~	Controlling stance used in peer and caregiving relationships (role inappropriate parent child interactive behavior)
~	Cognitive impairments
~	High Risk for Oppositional Defiant Disorder and aggression in middle childhood and low self esteem and dissociation in adolescence
~	Tend to repeat the cycle
~	When the child is developing a new attachment, particularly after disruption, setbacks can occur rapidly and have serious consequences because it represents a current loss and re-ignites the prior unresolved losses.
Special Issues in Kinship Care
~	Interrupt relative caregivers’ plans, priorities, space and privacy—and how this can contribute to their feelings of loss (grief) and ambivalence
~	Relative caregivers may also have feelings of guilt about and anger toward the biological parent
~	Biological parents trying to fudge the rules or take advantage of the relative caregiver
ADDRESS
~	People hold preconceived notions about others based on
~	Age
~	Disability
~	Dress and Presentation
~	Religion and Spirituality
~	Ethnicity and Culture
~	Social Class
~	Sexual Orientation
~	How might this impact foster parent’s expectations?
~	How might this influence foster children’s expectations?
~	How can we promote a more culturally sensitive and welcoming environment?
ADDRESS cont…
~	Personal, family and cultural history shape schema
~	Can I trust you?
~	Will you help or harm me (or both)?
~	Do you understand me?
~	How might each of your assumptions affect current interactions?
~	How might the way your system is organized and the role you play in your system, contribute to or disconfirm this person’s assumptions about “you”?
~	Behavior is communication.  What behaviors might a child exhibit who 
~	Believes they cannot trust?
~	Believes they may be harmed?
~	Does not feel they are understood?
Attachment Intervention: CRAVES
~	Consistency: Be the go-to person that responds in an attentive, predictable manner
~	Responsiveness: Provide developmentally appropriate physical, emotional and cognitive support including learning to label feelings, triggers and warning signs and developing coping and distress tolerance skills
~	Attention (Proactive)
~	Validation/Empathy: Try to see the situation from the child’s perspective
~	Encouragement to explore and attempt new things
~	Support when things go wrong or through scaffolding

Summary
~	Young traumatized children’s reactions and behaviors are best understood in the context of relationship.
~	Foster care is an active intervention with the goal of helping the young child to recover from their traumatic experience, not just a “place to stay.” 
~	The foster/resource parent is an essential partner in the recovery of the young child. 
~	Transitions for young children should be carefully planned