1. Catherine Karr, MD, MS* 2. Susan Kline, MN† 1. *Senior Research Fellow, Department of Pediatrics, University of Washington 2. †Pediatric Nurse Practitioner, Health Care for the Homeless Network, Seattle/King County Public Health, Seattle. WA After completing this article, readers should be able to: 1. Recognize homelessness and the risk of becoming homeless for children who reside with their families. 2. Describe the specific health problems that affect homeless children. 3. Determine how to modify health care plans and prevention strategies appropriately for homeless children. 4. Find additional resources for homeless patients and their families. Most clinicians who care for children encounter patients who are homeless or at risk of becoming homeless. This reflects the growing number of homeless families that include children and that homelessness increases the risk of a number of health problems. This article helps the clinician to recognize patient homelessness and create effective, appropriate health care plans. Of note, the information provided relates to homeless children who are part of families and does not address unaccompanied youth who have somewhat different and unique issues. Approximately 2% of American children are homeless in the course of 1 year, and trends suggest that the number of homeless children will increase. Homeless families are the fastest growing segment of people experiencing homelessness and currently represent 40% of the homeless population. The numbers of families requesting emergency shelter increased by 15% from 2002 to 2003. Homeless children tend to be young (41% younger than age 5 y) and in families headed by single mothers (85%). Homelessness is dynamic; 25% of homeless children are homeless more than once during their childhood, and their average period of homelessness is 10 months. Definitions of homelessness can be found in federal legislation such as the Stewart B. McKinney Act and in the missions and goals of local and nonprofit agencies. These different definitions are designed to determine the types and distribution of specific services. For clinicians, an operational definition includes a continuum of living situations from living on the street to staying temporarily …