Foster care is defined as 24-hour substitute care for children outside of their own homes. It is generally conceived of as a time-limited living arrangement in which a child whose family is unable to maintain a sufficient child-rearing environment is placed with licensed caregivers until reunification with birth parents, adoption, or emancipation occurs. Foster care is a legally binding arrangement in which the state temporarily assumes custody of the child. Reasons for placement into foster care are diverse and include but are not limited to child abuse, neglect, parental substance dependency, mental or physical illness, and incarceration. In the past decade, there has been an increase in the number of reports of child abuse and neglect to child welfare agencies in addition to higher numbers of mothers and pregnant women with substance abuse problems. Consequently, foster placements are involving younger children and infants more often than in the past, and these children are likely to stay in foster care longer than children placed at older ages.
The number of children in foster care has expanded in recent years, with estimates exceeding 550,000 at any given point in time. Further, it has been reported in numerous studies that these children are experiencing high levels of emotional, behavioral, and medical difficulties. Behavioral and psychological problems among foster children may persist because of caregiver instability, the effects of early maladaptive caregiving, attachment disruption, and insults to developing brain systems. In light of these alarming findings, there has been a movement toward identifying the most effective placements for children who cannot be maintained in the homes of birth parents. The promotion of the child’s growth and development through a safe and nurturing atmosphere has become a primary goal of most child welfare agencies. Recent social and political trends reflect our society’s efforts to create a foster care system that maximizes children’s opportunity for nurturing care in the context of stability.
Social And Political Trends In Foster Care
The emergence of foster care in the United States can be traced back to the efforts of Charles Loring Brace, who in 1853 founded the Children’s Aid Society of New York, an organization that established modern methods in child welfare. In the late 1800s, Brace spearheaded efforts to place children from New York City with families from the Midwest and other rural locations, where they were adopted, obliged to work on farms, or both. The system improved many lives, but some of the children were exploited as free labor. Following several scandals, it became evident that more supervision was required by state agencies to ensure that children were not being mistreated. In 1909 at the White House Conference on Dependent Children, Theodore Roosevelt established the first legislation supporting the use of foster families for destitute and neglected children. This helped pave the way for a federal agency devoted to the promotion of child welfare. The Children’s Bureau was started in 1912 and has remained as part of the U.S. Department of Health and Human Services, focusing on foster care, adoption, and child care standards.
Several other landmark political actions have contributed to the development of the modern foster care system. In 1935, the Social Security Act contained provisions for aid to dependent children. Funds were allocated for low-income children and children who were abused, neglected, or abandoned. It was not until 1961, however, that the federal government developed a formal method for disseminating funds for foster care. The Aid to Families with Dependent Children provided financial incentive to qualified individuals to serve as foster parents. An unintended consequence of this measure was that increasing numbers of children were removed from the homes of troubled families without first attempting any sort of intervention with these birth families. In response to the burgeoning numbers of children (nearly 500,000) in foster care and the movement toward family preservation, the Adoption Assistance and Child Welfare Act (AACWA) was implemented in 1980. This legislation provided financial incentives to encourage states to prevent unnecessary foster placements by offering preventative services and programs to reunite foster children with birth families. Initially, there was a dramatic decrease in the number of children in out-of home placements to about 250,000 in the early 1980s. This law helped to propel the movement toward “permanency planning” by providing set time frames for placement decisions in order to reduce the number of extended foster placements.
Social and political initiatives favoring permanency planning continued throughout the 1990s. In particular, two laws were passed to reduce barriers to expeditious, long-term placements. The Multiethnic Placement Act (1994) responded to concerns about extended placements and poor outcomes for minority children in foster care. The Multiethnic Placement Act prohibited discriminatory placement practices and forbade the delay or denial of foster or adoptive placements because of race, color, or national origin. Another initiative, the Adoption and Safe Families Act (1997), continued to make placement permanency a priority by federally mandating efforts to reduce children’s time spent in foster care. Child welfare agencies were commissioned to locate a permanent placement for children within the first 12 to 15 months following admission into foster care. The purpose was to reduce the number of children in long-term foster placements and to promote the adoption of children unable to return to a safe home environment. The Adoption and Safe Families Act emphasized the safety of children first and foremost, but it also clearly established a timeline for permanency planning.
It is evident that certain aspects of the foster care system remain problematic despite the laudable efforts of our legal and social institutions. As of 2003, the U.S. Department of Health and Human Services reported that the number of children in foster care at any given time is greater than one-half million as a result of neglect, abuse, and other maladaptive parenting practices. Moreover, these children are being identified as having a range of behavioral and emotional disturbances that are more serious than in the past. It is unlikely that political initiatives will completely remedy problems associated with out-of-home placements, and it is equally clear that no simple solution exists. There will likely be continued debate regarding those conditions in which a child benefits from remaining with his or her biological family and those situations in which a child is best served by a temporary or permanent out-of-home placement. Recent initiatives that have placed a priority on children’s safety and emotional security while advocating for the permanency of such placements are likely to lead to positive outcomes for many children.
Types Of Foster Care
Foster placements differ on a number of characteristics based on the needs of the individual child and the resources available to meet those needs. Four basic types of out-of-home placement are most prominent: family foster care, kinship care, treatment/ specialized foster care, and group foster homes.
Family Foster Care
Family foster care refers to continuous 24-hour childcare and supervision by a licensed or approved nonrelative caregiver. These foster parents are typically monitored by private or public child welfare agencies. Although some foster parents eventually choose to adopt, most family foster care placements are temporary. The role of nonrelative foster parents includes providing care, supervision, guidance, and a safe environment for a foster child. Even within this type of foster care, there are different kinds of arrangements. Some families serve as emergency foster families and take children into their homes on very short notice, often in the midst of a crisis. This emergency placement may last only a short period while another, more stable placement is sought. The most common form is short-term foster care in which foster parents provide a temporary home for children who are ultimately expected to return to their birth homes. Finally, there are some placements that are referred to as long-term foster care because children are not expected to return to their birth families, yet there are also no prospects for adoption. This may occur when an older child does not wish to be adopted. Long-term foster placements are not typical with very young children, especially in light of the push for permanency planning discussed in the previous section.
Kinship Care
Kinship care is another primary type of foster care in which a relative of the child (e.g., grandparent, aunt) or someone with a close emotional tie (e.g., godparent, family friend) assumes the caregiving responsibilities for a child. Kinship care is similar to family foster care in that caregivers are licensed and monitored by child welfare agencies. Children in kinship care differ from children placed in family foster care in that they are more likely to have been removed from their parents’ homes because of abuse or neglect. The parents of children in kinship care are more likely to have a drug or alcohol problem and are more likely to be young and never married. Kinship care can be divided into two main categories: formal and informal kinship care. Formal kinship care refers to arrangements in which kin act as foster parents for children in state custody. Informal kinship care refers to caregiving arrangements that occur without the involvement of a child welfare agency. Kinship care has increased in recent years because it is thought to give children a better opportunity to maintain a sense of family identity, self-esteem, and continuity of family relationships. Moreover, the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 changed the federal law to grant relatives priority when determining with whom foster children should live.
Therapeutic Foster Care
Therapeutic foster care refers to foster family homes that provide specific supportive services that are designed to remediate the behavioral and social problems of challenging foster children who might otherwise be placed in residential treatment settings. Therapeutic foster parents are licensed to provide specialized services to behaviorally or seriously emotionally disturbed foster children. Therapeutic foster care combines the benefits of a family-centered environment with an array of specialized supportive services. These foster parents are part of a professional care team that provides additional clinical services to the child. Therapeutic foster parents often receive financial incentives for their services that are more substantial than the subsidies of family foster care as compensation for specialized care and training. It is often the case that these foster parents are trained by agencies that provide treatment foster care and subsequently receive contracts to care for children with support from the agency. Specialized foster care is similar to therapeutic foster care in that foster parents are licensed to care for foster children with a variety of unique challenges. A distinction that can be made, however, is that specialized foster care usually involves parenting of foster children with certain characteristics (i.e., children with human immunodeficiency virus [HIV] or other medical conditions, drug-addicted infants). It is often the case that specialized foster parents have specific training for dealing with the medical, psychological, or behavioral complications associated with a particular population.
Group Foster Care
Group homes and residential facilities are out-of home placements in group settings or institutions in which multiple service providers are responsible for the supervision and treatment of foster children. Residential treatment centers or group foster homes are often utilized when severely emotionally or behaviorally disturbed children cannot be maintained in less restrictive settings. Of all foster placements, group settings tend to be reserved for the children with the highest level of problematic behaviors. In many cases, multiple failed placements occur before a child is placed in a residential setting for a long duration. Other times, a residential setting is temporary until a foster or adoptive placement can be arranged.
Foster Care Outcomes
Research evidence about the effectiveness of the different types of foster care placement is limited. Few well-designed studies exist that compare the different types of foster care with one another as well as control for various confounding influences. Some evidence suggests that children placed in group residential care were more inattentive and hyperactive than those children in the foster family care homes, according to observational and teacher measures collected a year after placement. Other researchers have found that children raised in residential group homes experienced difficulties managing and organizing their lives as adults. Evidence consistently supports the conclusion that children who are adopted generally fare better than children in long-term foster care, who in turn fare better than children reared in group settings or institutions. However, more carefully designed longitudinal research projects need to be conducted to investigate the long-term impact of the different types of foster care on children’s later social, emotional, cognitive, and behavioral development.
Entry Into Foster Care
A child can enter the foster care system through two main routes: voluntary or involuntary placement. Voluntary placement occurs when a biological parent or legal guardian voluntarily agrees to grant the state temporary custody of his or her child. A parent may choose to place his or her child in foster care for a variety of reasons, including lack of housing, incarceration, rehabilitation for a substance abuse problem, or poverty. The parent legally agrees to surrender custody of his or her child for a specified period of time, so that the parent can complete or achieve the stipulated activity for which he or she placed the child in foster care.
A child may also enter foster care through an involuntary placement. An involuntary placement occurs when a report of suspected child abuse or child neglect is filed against a parent or legal guardian. Once a report of child abuse or child neglect is filed with the local department of family services, a social worker must investigate the claim within 24 hours. The social worker will remove a child if evidence of abuse or neglect is found or if the environment is deemed an “imminent danger to life or health.” The social worker will then remove the child from the home. The state will assume temporary custody of the child, and the child will be placed with a foster family. Preliminary hearings, fact-finding trials, dispositional hearings, and extension of placement decisions will be conducted to secure the child’s safety upon return to the parent.
Exiting Foster Care
Upon the parent’s completion of the stipulated activity, the child exits foster care and returns to the custody of the parent. If the parent is unable to complete the stipulated activity, he or she may ask the court for an extension of time to achieve the stipulated activity. Parents may also decide to terminate their parental rights to the child, which will free the child for adoption. Parental rights must be legally terminated in court before a child can be freed for adoption. The parental rights must be terminated by both biological parents to free a child for adoption. Legal attempts must be exhausted to locate biological parents and inform them or their rights to the child before a child can be freed. If all legal avenues have been exhausted, after a specified time that may vary, the court will terminate a biological parent’s rights to a child and free the child for adoption.
Social workers frequently assist parents in their efforts to complete the stipulated activity to support the return of their children. However, many social service agencies are limited in the resources and services that they can provide to families in need. Additional resources exist in some states (e.g., New York, Pennsylvania) to support parents’ efforts to achieve their goals, such as Court Appointed Special Advocates (CASAs). CASAs are typically volunteers who work to ensure that a child’s stay in the foster care system is as brief as possible.
Although reunification with the biological family is often the goal of foster care, it often does not ensure the future healthy development of children. Children originally placed in foster care as infants and toddlers and then reunified with their biological families are at a high risk to endure future maltreatment and physical and sexual abuse. The U.S. Department of Health and Human Services Administration for Children and Families (2002) found that 77% of children who died from abuse or neglect were younger than 4 years of age. Reunification also threatens the child’s attachment relationships with his or her current foster caregivers.
Foster Parent Selection
Individuals who are interested in becoming foster parents usually make contact with a local child welfare agency to apply or are recruited through recruiting drives by these agencies. To become a foster parent, applicants generally first have a telephone interview and then a personal interview with an agency recruiter. This is often followed by a home study to assess the current living situation, a child abuse and criminal clearance, and training sessions. However, specific requirements vary widely by state. If the state-specific requirements are met, the foster home is licensed and continually monitored by either a public or private child welfare agency.
Currently, there is a shortage of available foster parents. While the number of children in need of foster care placements has risen over the past two decades, the number of available foster families has dropped significantly. Changing family dynamics and women entering the workforce in greater numbers have had a large effect on the decline of available surrogate caregivers. In addition, a number of factors have caused increased dissatisfaction among parents providing foster care services. Because agencies are interested in keeping biological families intact, only children from the most troubled families and those children who have the most severe behavior problems are being placed into foster care. This trend, in combination with changing family dynamics, has led to fewer nonrelative caregivers willing to provide foster care.
On the other hand, there seems to be an increase in the number of kinship foster placements. More relatives of families in need are volunteering to help care for their relatives’ children. Interestingly, kinship foster parents often receive fewer services and less frequent home monitoring by social workers than nonkinship parents. Kinship foster parents may be perceived as less in need of attention and assistance than nonkinship parents. However, data do not currently exist to support the claim that kinship foster parents actually require fewer services than nonkinship parents.
Characteristics Of Foster Parents
Foster families vary widely in terms of structure, ethnicity, and socioeconomic status (SES). National information about specific characteristics of foster parents is not available because no national reporting system regarding foster parents exists. However, several recent, large-scale studies examining foster care in the United States provide some general characteristics of foster care providers. They found that most foster families (about 60%) are headed by two parents, and most others are headed by single mothers. Foster parents are generally between 35 and 55 years of age. Most foster parents have obtained a high school degree or have attended some college. About one half of foster families would be considered of middle SES based on family income, 15% would be considered of upper-middle SES, and about 35% would be considered low-income families. Additionally, religion appears to be an important factor for many individuals who decide to become foster parents.
Individuals choose to become foster parents for a number of different reasons. Some of the most commonly given reasons for wanting to become a foster parent include the desire to help a child in need, a wish to do something for one’s community or society, or an interest in having children, or more children. For most foster parents, money is not a key motivator for becoming a foster care provider. In fact, the stipends that foster parents receive often do not entirely cover the costs of raising the child, and the parents must subsidize the cost of providing care to the child.
Role Of Foster Parents
Foster parents are commissioned to provide a safe, nurturing home for a child who cannot be maintained in his of her home environment. This is typically a temporary arrangement, although adoption can result if the child’s birth parents terminate parental rights and the foster family is inclined to adopt. The role of a foster parent can be emotionally challenging. Foster parents are often faced with dilemmas about what their role is in their foster child’s upbringing. Foster parents are responsible for the child’s well-being, but also need to work within the constraints of the child welfare agency charged with the child’s care. Foster parents and agencies may have different views on what is in the best interest of the child. Foster parents face the prospect of assuming responsibility for a child and not always having the authority to accomplish what is necessary in a given situation. Foster parents must also deal with decisions about reunification and permanency planning, over which they have limited control. To improve recruitment, training, and retention of foster families, unambiguous and consistent guidelines for foster parents’ role responsibilities should be established and clearly communicated.
Effectiveness Of Foster Care
Children in foster care are presented with a unique set of obstacles to overcome as they mature. They must adjust to disruptions that they experience as they enter and exit foster care. Some children are placed with foster parents for a brief amount of time and then return home to their biological families. Other children are initially placed with foster care parents who adopt them, whereas other children experience multiple disruptions in care as they move from birth families to foster care families. These disruptions in care disturb the stability and security that caregivers provide to infants as they are shifted from one home to another. Disruptions in care and early inadequate care place the child at risk for developing future emotional, behavioral, and psychological problems. Unfortunately, many of the medical, social, emotional, and cognitive needs of children in foster care are jeopardized by the instability in care that they experience. Furthermore, it is believed that prolonged or unpredictable separations from caregivers are problematic, leading to permanent changes in biological stress systems and adverse influences on brain development. Therefore, it is important to identify children at an early age who are at risk for developing problem behaviors so that interventions can target their specific needs.
Placements into foster care, kinship care, or group foster homes have been associated with high levels of psychological and behavioral problems in comparison to children who are adopted. In response to placements with substitute caregivers, children often demonstrate developmental outcomes that are impaired across a range of social, emotional, and behavioral domains. Evidence suggests that in comparison to children exposed to similar levels of risk, children who experience out-of-home placements demonstrate significantly higher levels of behavioral difficulties associated with impulse control problems, aggression, and attentional deficits. Children experiencing disruptions in care have a higher rate of referral to mental health settings and have more severe attentional and externalizing symptoms than similar children who have not been placed with alternate caregivers.
Such sobering research evidence raises the question, How effective is foster care as an intervention? Many would argue based on research evidence previously cited that the prognosis for foster children’s healthy development is grim. “Foster care drift,” or the idea that many children remain in foster care even after they are eligible for adoption, is an unfortunate reality. Many policy makers and researchers argue that the foster care system is neither temporary nor effective. Alternatives to the current foster care system, such as keeping parents and children together while providing services to the biological parents or expediting adoptions, may be more effective in the long term.
Despite the limitations of foster care as a permanent solution for children in need of out-of-home placement, there is evidence that foster care can be delivered therapeutically to enhance children’s self-esteem, sense of identity, and personal worth. A number of studies have suggested that many foster parent attributes and service delivery characteristics lead to positive placement outcomes for foster children. Foster parent qualities such as warmth and acceptance, an authoritarian parenting style defined by clear structure and appropriate limit setting, and adequate social support have been associated with positive foster placements.
Studies have also found that foster parent training reduces the number of unsuccessful placements and increases retention of foster parents. Foster parent training ensures that parents possess the skills necessary to deal with children having behavioral and emotional problems. Providing foster parents the tools to handle situations effectively can reduce inappropriate responses and decrease feelings of frustration. Training to help foster parents appropriately interpret foster child behaviors, avoid stress and burnout, and cope with difficult times is important in promoting sustained placements. Respite times, ongoing responsive supervision from child welfare agencies, and social support have also been shown to enhance placement effectiveness.
In general, factors that increase foster parents’ efficacy also improve their ability to provide an adequate rearing environment for their foster child. To deal with the unique challenges that foster children present, unique caregiving skills are necessary to provide optimal levels of care. Parents who are warm, are realistic in their expectations, and can manage emotionally and behaviorally demanding behaviors likely provide a foster child with the best chance for a stable and nurturing placement.
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