Abuse of children in foster and residential care

Objective: There have recently been many debates in the UK about how to pro vide good care for children placed away from home. Professionals have reali zed that the level of child abuse in foster care and children's homes is hi gh. This research examines the characteristics of physical and sexual abuse of children in foster and residential care in a city in England. The numbe r of cases of abuse reported by pediatricians in this group was compared to the number reported by the same pediatricians for the population of Leeds as a whole. Method: This is a retrospective study of 158 children, fostered or in resid ential care who were involved in 191 episodes of alleged physical and/or se xual abuse assessed and reported by pediatricians over a 6 year period from 1990 to 1995 in Leeds, England. Details of the child including the reason for placement in care, their physical and mental health, abuse characterist ics, including perpetrator and case management were studied. Results (see Table 1): 158 incidents of abuse in 133 children in foster/res idential care are described. In foster care, 42 children were physically abused 76 were sexually abused, and 15 experienced both forms of abuse. In residential care, 12 children were physically abused, 6 were sexually ab used, and 6 experienced both forms of abuse. In foster care 60% of sexual abuse involved girls and 60% of physical abuse involved boys. In residential care almost twice as many boys as girls were reported to be abused. Foster carers perpetrated the abuse for 41%, natural parents on contact for 23%, and children 20% of incidents. A significant proportion of abuse was severe with I death, 8 children with burns, 18 with genital, and 34 with anal penetration. Long-standing emotional, behavioral and learning difficulties were common. Most children (80%) had been abused prior to entry into care. Foster children were 7-8 times and children in residential care 6 times mor e likely to be assessed by a pediatrician for abuse than a child in the gen eral population. Conclusions: Children in foster or residential care form an at risk group f or maltreatment. Their special needs include additional measures to protect them from abuse. (C) 1999 Elsevier Science Ltd.