IN THEIR OWN WORDS

Children and teens have often received only fragmentary and sporadic health care prior to entering foster care. Typically they enter foster care with a high prevalence of undiagnosed or under-treated chronic medical problems, often due to being without necessary medications or equipment. Fractures, infections, burns, bruises, and other acute illnesses are also prominent and often a result of abuse. Of the children and teens entering foster care:

• About 50% have chronic physical problems (eg, asthma, anemia, visual loss, hearing loss, and neurological disorders)
• About 10% are medically fragile or complex
• Many have a history of prenatal (maternal) substance exposure and/or premature birth

Some physical health issues may worsen during times of distress for children.  For example, children or teens with asthma may experience more frequent flare-ups during times of transition or when there is increased chaos and unpredictability.  When a child with a chronic health problem has a worsening course, the pediatric clinician should inquire about changes or stressors in the child’s or family’s life that may be impacting the course of an illness.  

Even after entering foster care, children and teens may not receive all necessary health care because of a variety of barriers to good care. To assist in this effort, the American Academy of Pediatrics and Child Welfare League of America have published standards for health care for children and teens in foster care. These standards are designed to help professionals from all disciplines understand the complexity of health problems of this population, specifying the parameters for high-quality health care.

The information, tools, and resources provided here aim to educate professionals and others about the physical health issues and needs of children and teens in foster care.