N. Halfon et al., HEALTH-STATUS OF CHILDREN IN FOSTER-CARE - THE EXPERIENCE OF THE CENTER-FOR-THE-VULNERABLE-CHILD, Archives of pediatrics & adolescent medicine, 149(4), 1995, pp. 386-392
Objectives: To describe the health status and to illustrate the useful
ness of an enhanced primary care model for children in foster care. De
sign: Cross-sectional analysis of a clinical cohort via chart review.
Setting: Foster Care Program of the Center for the Vulnerable Child at
the Children's Hospital, Oakland, Calif. Subjects: Two hundred thirte
en children in foster care assessed between August 1988 and June 1991.
Interventions: None. Methods: A multidisciplinary assessment protocol
was used to collect health and social histories and to conduct develo
pmental, emotional, and behavioral assessments and medical examination
s. Cross-tabulations were used to compare distributions of conditions
and characteristics of the population, including the reasons for, timi
ng of, and number of placements. Results: The population was largely A
frican-American (83.4%), with a mean age of approximately 3 years. At
least 78% of children came from homes where drug use was a primary rea
son for placement. A history of maternal drug use was present in 94% o
f infants. The number of placements ranged from one to eight (mean, 2.
0). Placement changes were common. Over 20% of children had growth abn
ormalities, 30% had neurologic abnormalities, and 16% had asthma. Fewe
r than 20% of children had no medical conditions, while 28.8% had thre
e or more conditions. Over 80% of children had developmental, emotiona
l, or behavioral problems. Emotional, relational, and behavioral probl
ems were more common in children first placed after 2 years of age and
in those with a greater number of placements (chi(2)=12.6, P<.05). Co
nclusion: This comprehensive assessment of children in foster care rev
ealed higher rates of chronic multiple medical and mental health probl
ems than previously reported.