The American Academy of Pediatrics (AAP) just released a policy statement, recommending better health care for children in kinship care and foster care placements. The "Health Care Issues for Children and Adolescents in Foster Care and Kinship Care" calls for more intensive care due to the additional challenges a child placed in foster care faces.
Children are placed into foster care to be removed from the abusive or neglectful environment they were experiencing. Federal and state foster care programs exist to be their safety net. So why is the AAP making a call for better health care of foster children? When children get placed in the child welfare system, are they not being taken care of?
Most children will enter foster care or kinship care with preexisting conditions. Post-Traumatic Stress Disorder (PTSD) in foster children is at a rate higher then U.S. war veterans.
70% of foster children have documented history of abuse and/or neglect
80% of foster children have been exposed to significant violence
30% to 80% of children entering foster can have at least 1 untreated medical condition
up to 80% of children entering foster care, enter with a significant mental health need
When a child enters foster care, the need for appropriate, consistent and accurate medical and dental care are evident; however, there are significant challenges in providing such care. The AAP states the following:
"Among the challenges are incomplete health information about the young person (including vaccinations), difficulty identifying somebody to provide consent for treatment, inadequate resources for treatment and medical problems that have gone untreated."
The other issue the AAP policy statement addresses is the overmedication of psychotropic drugs.
"Foster children are prescribed are prescribed psychotropic medications at a rate three times that of other children."
To combat this issue, AAP policy statement recommends that children first and foremost before psychotropic drugs are administered, receive a mental health evaluation conducted by a pediatric mental health professional. Pediatricians should pursue evidence-based trauma therapies and if medication is needed, it should be diagnosis-specific.
The recent recommendations of the AAP policy statement are movements in the right direction. As the Igbo and Yoruba (Nigeria) Proverb states, "It takes a whole village to raise a child." Taking care of children needs to be a communal effort. For foster children, their communities are child welfare system, medical professionals, educators, parents, relatives, supportive adults, and/or peers, among others. We all have a critical role in the well-being of foster children.