The following frequently asked questions were developed by members, liaisons, and consultants of the AAP Task Force on Foster Care. These questions will be updated according to the latest information posted on the Web site. Check back for updates! Click on the arrows to the left to reveal the answers. FAQs for parents can be found on HealthyChildren.org.
This Web site will help to provide you with the latest health information related to children and teens in foster care. Children and teens enter foster care with a rate of health problems that is higher than that for other children, due to issues such as poor pre-natal care, neglect, abuse, and other care issues. They also experience higher than normal rates of physical problems, mental and behavioral issues, developmental and educational delays, immunization delays, untreated illness, and even dental ailments.
See the Health Issues and Needs section of this site to learn about health of children and teens in foster care.
Every year, the federal government compiles "point-in-time" data on the foster care system, meaning that they take a census of sorts on a particular date (in September, the end of the fiscal year) to count the number of children and teens in care. From this data, they gather demographic and other information, such as age, race, and amount of time in the foster care system. The information is compiled into what is known as the Adoption and Foster Care Analysis and Reporting System (AFCARS).
Because it gathers a significant amount of data that must be compiled and analyzed, the AFCARS report is usually not published until a year or 2 after the point-in-time data is collected. Access the latest AFCARS data. Learn about data from other studies.
The department that oversees adoption and foster care in your state is often known as the Department of Child and Family Services or Department of Human Services, though there are a number of names used throughout the country.
Compare demographic information about children and teens in foster care across states.
The average stay in foster care is 33 months, or nearly 3 years. The stay is often longer if the child or teen has developmental or behavioral issues, is part of a large sibling group, or is a member of an ethnic/minority group.
The Administration for Children and Families (ACF) of the United States Department of Health and Human Services (USDHHS) maintains statistics about trends in foster care and adoption. Statistics from September 30, 2007, indicate that approximately 496,000 children were in foster care on that day. During fiscal year 2007, 293,000 children entered foster care, 287,000 children exited foster care, and the parental rights of 84,000 children had been terminated. While 130,000 children were considered "waiting" for adoption (defined as those with a goal of adoption as determined by their child welfare agency and/or whose parents' rights had been terminated), only 51,000 were adopted during that year.
Whether a teenager has turned 18 and "aged out" of care, or a toddler has left foster care to be reunited with her family, the experience often leaves scars. The scars are not only the result of being removed from the family, but also come from the adversity the child experienced prior to entering foster care - often the very events that led the child to foster care - such as neglect, abuse, or having an incarcerated, substance-abusing or mentally ill parent, to name a few.
Read about foster care success stories. Go to the Foster Care Alumni of America Web site for a wealth of resources for foster care alumni.
Owing to poor pre-natal care, neglect, abuse, and other family issues, children and teens often enter foster care with a variety of health problems, including physical problems, mental and behavioral issues, developmental and educational delays, and even dental ailments. For example, they experience problems such as cavities, untreated illness, and immunization delays at higher rates than other children. In fact, a 1995 Government Accounting Office report found that children in foster care are "sicker than homeless children and children living in the poorest sections of inner cities."
- The rate of Post-traumatic Stress Disorder (PTSD) among foster care alumni (21.5%) is 5 times that of the general population and higher than that of American war veterans.
- An estimated 12% of young children in foster care receive no routine health care, 34% receive no immunizations, and 32% have some identified health needs that are not met.
- An estimated 78% of young children in foster care are at high risk for HIV as a result of parental drug abuse, yet only about 9% are tested for HIV.
The AAP, with the support of the Child Welfare League of America (CWLA) and many state child welfare agencies, recommends that all children in foster care have a health screening visit within 72 hours of placement into foster care.
Ideally all past relevant medical records would be available for this visit. In practice, however, many children may be placed without these records - and should be seen despite the incomplete past medical history. In the absence of actual records, often some history can be pieced together from the child's social worker, from the child's child care or school, and often from the child himself.
Following this screening visit, all children should be scheduled to return for a comprehensive evaluation within 30 days of placement. During the time between the 2 visits, medical records can be obtained and reviewed. Caseworkers and medical offices should work together to obtain the necessary consents. The important components of the comprehensive visit include:
- All important information from these visits should be shared with the child welfare agency, juvenile court judge, parents (birth and foster) and kin, and the child, as appropriate. If evaluation is not done in the child's medical home, all relevant data should be communicated with the primary care pediatrician who will follow the child while in foster care.
- After the evaluation period, the child should have health maintenance visits according to the AAP recommendations for preventive health care. Because of the prevalence of significant medical, social, and mental health issues affecting children in foster care, additional visits are often advisable.
Learn more about the health care standards for children and teens in foster care.
There are several kinds of foster care, including:
- Straight or family foster care refers to the scenario where the state or local government places a child with certified foster parents, who are not related to the child.
- In kinship foster care, a child is placed with a relative. This kind of foster care isn't always reported to an agency for oversight, because in many families, relatives step in to take care of a child (or a parent gives a child to her grandparents or other family members) without going through the court system. In some areas, close family friends can also be considered as kinship caregivers.
- With pre-adoptive foster care, a child is placed with the family who will adopt her.
Learn about the other kinds of foster care.
There are many resources - both locally and nationally - where you can find information about adoption and foster care in your area. Local and state governments, private agencies, faith communities, and other organizations provide a wealth of information.
Find resources in your area. Enter your state and criteria, and find information lines, government agencies, and even photos of children waiting to be adopted. View a comprehensive list of foster care organizations.
American Academy of Pediatrics