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Comprehensive health care for children in foster care

Sandra H Jee, MD, MPH
Moira A Szilagyi, MD, PhD
Section Editors
Jan E Drutz, MD
Marilyn Augustyn, MD
Deputy Editor
Mary M Torchia, MD


Children and adolescents who spend time in foster care have usually endured multiple adverse childhood experiences, including child maltreatment and family disruption. Studies indicate that children involved with child welfare and living away from their parents in informal placements with relatives have had similar life experiences. Thus, providing health care for children involved with child welfare, and especially those in foster care, requires an understanding of childhood trauma and its potential negative impact on the developing brain; the unique health, mental health, developmental, and educational problems of children and adolescents in foster care; and the structure, goals, and mandates of the foster care system as this will facilitate provision of appropriate comprehensive care to this vulnerable population [1,2].

Comprehensive health care for children and adolescents in foster care will be discussed here. The epidemiology of foster care and an overview of the foster care system in the United States are presented separately. (See "Epidemiology of foster care placement and overview of the foster care system in the United States".)


Overview — Children in foster care are a uniquely vulnerable population. They are classified as children with special health care needs by the American Academy of Pediatrics (AAP) because of the high prevalence of chronic medical, developmental, and mental health problems, most of which predate placement in foster care [3-5]. Most children in foster care have at least one chronic medical problem (table 1) and one-fourth have three or more [2,4,6-10]. (See "Children with special health care needs".)

Throughout this topic, the concept of health encompasses physical (including dental), mental, behavioral, developmental, educational, and psychosocial health. Some of the most commonly identified health problems of children in foster care include, but are not limited to [2,4,6-9,11,12]:

Exposure to childhood adversity and trauma resulting in toxic or traumatic stress

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Literature review current through: Nov 2017. | This topic last updated: May 17, 2017.
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