The Pediatric Role in the Care of Children in Foster and Kinship Care

Abstract

1. Moira Szilagyi, MD, PhD* 1. *Starlight Pediatrics, Rochester, NY. In September 2010, 408,425 children and adolescents resided in foster care. Recent legislation highlights an increasing focus on involving pediatricians in supporting children in foster care and defines specific requirements relevant to the role of pediatricians. After completing this article, readers should be able to: 1. Understand the purposes of foster care and the problems associated with pre-placement childhood trauma and foster care placement. 2. Know the basics of how foster care systems work. 3. Recognize that children in foster care are by definition children with special health-care needs. 4. Understand that many children in foster care have behavioral problems that can lead to placement instability that, in turn, can exacerbate those problems. 5. Understand the physician’s role in foster care. Foster care is intended to provide a temporary haven for children during a time of family crisis when children are at imminent risk for harm. The goals of foster care are to promote child health, safety, permanency, and well-being. Foster care also has the mission of building on family strengths and providing birth parents with the services they need to reconnect (reunify) with their children. Because children fare best in stable and nurturing families, there has been an increased emphasis in the past decade on shortening the time to permanency through reunification, placement with relatives, and adoption. Foster care also has the obligation to prepare youth for independent living when none of these permanency options is possible. In some states, more than one third of children in foster care are in court-ordered (formal) kinship placements, arrangements in which the related (kin) caregiver may or may not be a certified foster parent. Even outside the child welfare …