Health Care Issues for Children and Adolescents in Foster Care and Kinship Care

Rosen, David S.; Rubin, David M.; Zlotnik, Sarah; Szilagyi, Moira; Harmon, David; Jaudes, Paula Kienberger; Jones, V. Faye; Lee, Paul; Nalven, L.; Prock, Lisa Albers; Sagor, Linda Davidson; Schulte, Elaine E.; Springer, Sarah H.; Tonniges, Thomas F.; Braverman, Paula K.; Adelman, William P.; Alderman, Elizabeth M.; Breuner, Cora Collette; Levine, David A.; Marcell, Arik V.; O’Brien, Rebecca; Lieser, Dina; DelConte, Beth; Donoghue, Elaine A; Earls, Marian F.; Glassy, Danette; McFadden, Terri; Mendelsohn, Alan L.; Scholer, Seth J.; Takagishi, Jennifer; Vanderbilt, Douglas; Williams, P. Gail

doi:10.1542/peds.2015-2655

Cited by 64 publications

(5 citation statements)

References 27 publications

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“…The finding that a Medicaid eligibility categorization of blind/disabled individual or foster care child was associated with improved odds of being retained in care might be related to increased health care needs and indications for more frequent medical follow-up in both groups ( 5 , 9 ). The finding that age ≤1 year was associated with decreased odds of retention in care in the commercial claims cohort is surprising, particularly in light of the fact that pediatric HIV treatment guidelines recommend urgent ART and frequent medical follow-up for children < 1 year of age ( 7 ).…”

Section: Discussionmentioning

confidence: 97%

Retention in Medical Care Among Insured Children with Diagnosed HIV Infection — United States, 2010–2014

Tanner¹,

Bush²,

Nesheim³

et al. 2017

MMWR Morb. Mortal. Wkly. Rep.

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Section: Discussionmentioning

confidence: 97%

Retention in Medical Care Among Insured Children with Diagnosed HIV Infection — United States, 2010–2014

Tanner¹,

Bush²,

Nesheim³

et al. 2017

MMWR Morb. Mortal. Wkly. Rep.

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“…The number of children entering and reentering foster care has increased significantly in recent years, placing strain on an already struggling out-of-home care (OOHC) system in Australia (Delfabbro et al, 2010;McKeough et al, 2017;Sammut, 2017). As the health, social, and developmental needs of children in OOHC become more complex, the resources of the foster families are challenged (Braverman et al, 2015). Although foster carers are selected and trained, they face many challenges when children enter their care (Vanschoonlandt et al, 2013).…”

Section: Discussionmentioning

confidence: 99%

Understanding the Parental Stress Scale With a Foster Carer Cohort

et al. 2020

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Objective Using a cohort of foster and kin carers, the research examined the underlying factor structure of the Parental Stress Scale (PSS; Berry & Jones, 1995). A hypothesized underlying two‐dimensional theoretical model was explored. Background With the growing demands on the foster care system, including poor retention and recruitment of foster carers, there is an urgent need to explore the positive and negative factors that may influence carers continued engagement in the role. Method The factor structure of the PSS was examined in a sample of foster and kin carers in Australia (N = 324). The PSS consists of 10 statements addressing stressful aspects of parenting and eight statements addressing satisfying aspects of parenting. Exploratory factor analysis (EFA) explored the underlying theoretical structure of the scale as determined by the developers. Confirmatory factor analysis (CFA) was used to confirm whether four factors would sustain reduction to a two‐dimensional (satisfaction–stress) model. Results EFA and CFA supported a two‐dimensional moderately correlated model measuring parent stress and parent satisfaction. The Parent Stress Index IV Short Form provided concurrent validity for the PSS stress subscale and previous analyses have also identified the strength of these dimensions over time, cohorts, and contexts. Conclusion The current study supports using the subscale scores in research with foster carers and potentially other populations to better capture both stress and rewards and satisfaction related to their parenting role. Implications Application of the PSS subscales can assess interactions or moderating effects of parenting in specific cohorts, making the PSS a valuable instrument to examine the balance between stress and reward for parents, foster parents and others who are “parenting” children.

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“…Specifically, more than 80% of children in foster care are diagnosed with developmental, educational, and emotional problems. 3…”

Section: Kimara Gustafson MD Mphmentioning

confidence: 99%

Importance of Trauma-Informed Practice in Evaluation of Children Diagnosed with Autism Spectrum Disorder

Langenfeld

Kroupina

Palmer

et al. 2021

J Dev Behav Pediatr

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As part of a multidisciplinary adoption support clinic, Erin, a 5-year-old girl, adopted approximately 6 months before the clinic visit, presents for postadoption evaluation. Erin was born at full term. Her birth history was significant for reported maternal treatment for liver failure during pregnancy. Her previous medical history included hospitalization for a viral illness at age 2 months, recurrent ear infections, and a fractured forearm. Family history was significant for a maternal history of bipolar disorder, depression, anxiety, borderline personality disorder, and concern for substance abuse; a paternal history of attentiondeficit/hyperactivity disorder (ADHD) and depression; and full biological brother with a history of ADHD and oppositional defiant disorder. Erin and her brother lived with their parents until she was approximately 3 years old. At that time, there were concerns for poor hygiene, inconsistent medical care, poor school attendance for her brother, financial instability, and significant neglect. Erin was reportedly confined to her crib for hours at a time. She and her older brother were removed from the home because of concerns for significant neglect and placed into foster care. Approximately 3 months after foster placement, Erin underwent testing because of concerns for abnormal behaviors and possible developmental delays. Symptoms included poor sleep, repetitive behaviors such as head banging, delayed speech that primarily involved grunting, and lack of toilet training. She was hyperactive and aggressive and had poor caregiver attachment. On evaluation, she was small for age, poorly groomed, and easily distracted with poor eye contact and did not tolerate interactions with examiners. Neuropsychological testing consisted of symptom checklists and caregiver interview only because she did not tolerate diagnostic testing. She was diagnosed with autism spectrum disorder and global developmental delay with intellectual and language impairments. Over the following year, Erin was transitioned to a second foster family and was subsequently adopted. She received speech, occupational, and physical therapy, along with trauma-informed therapy. She made significant gains in multiple domains and was able to graduate from trauma-informed therapy after 1 year. On examination, Erin greets you with appropriate eye contact and reports that she is feeling "good." She is verbal and interactive with her brother and parents. She looks to parents for support when asked to participate in the physical examination. She does not display any significant repetitive behaviors. Erin's parents are concerned that her initial diagnoses of autism spectrum disorder and global developmental delay do not accurately reflect her current level of functioning and are afraid she may have been misdiagnosed. How would you proceed with next steps to address these diagnoses?

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Health Care Issues for Children and Adolescents in Foster Care and Kinship Care

Cited by 64 publications

References 27 publications

Retention in Medical Care Among Insured Children with Diagnosed HIV Infection — United States, 2010–2014

Retention in Medical Care Among Insured Children with Diagnosed HIV Infection — United States, 2010–2014

Understanding the Parental Stress Scale With a Foster Carer Cohort

Importance of Trauma-Informed Practice in Evaluation of Children Diagnosed with Autism Spectrum Disorder

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