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This paper examines psychiatric symptoms and disorders in children in the care of a Children's Aid Society. Youth, caretaker and teacher scores on the Standardized Clinical Information System questionnaire were correlated with demographic and maltreatment data gathered from the files of children from a Children's Aid Society. Mean externalizing and internalizing scores for the study group were significantly elevated above the norm on the youth, caretaker and teacher reports; externalizing more so than internalizing. Forty-one percent to 63% of the children studied scored in the pathological range for one or more disorders. Conduct disorder was the most common disorder (30% to 50%). Within the study sample, temporary wards and children with a history of having been abused had more elevated scores. The authors conclude that children in foster care have significant psychiatric morbidity reflective of the extreme adversity and maltreatment they have experienced.

The high symptom burden of children in care is substantially attributable to their high-risk histories, and treatment should be designed with this in mind.

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