Health, Developmental and Support Needs of Vulnerable Children – Comparing Children in Foster Care and Children in Need

Abstract

Health, Developmental and Support Needs of Vulnerable ChildrenComparing Children in Foster Care and Children in NeedThe health needs of children in foster care (FC) have been well described and pathways to health assessment established. Such pathways for other vulnerable children are scarce. We aimed to describe the health and service needs of children attending community paediatric (CP) clinics specifically set up for children exposed to psychosocial risk factors in South Western Sydney (SWS), and to compare the needs of children in FC to those in parental care. We analysed the clinic records of all children attending CP clinics for vulnerable children in SWS in 2008. Of the 98 children seen, the mean age was 4.6 years, the majority (88%) had abuse documented and 57 per cent were in FC. Family risk factors included parental substance use (65%), domestic violence (57%) and parental mental health disorder (33%). Health needs identified included speech delay (45%), developmental delay (39%) and incomplete immunisation (34%); many children required specialist referral. Behavioural and educational difficulties were encountered in almost one-half of the children. There were no significant differences in health/support needs between those in FC and those in parental care. Pathways to early identification/intervention need to be broadened beyond those established for children in FC, to include those exposed to a range of psychosocial adversities.

The Needs of Foster Children and How to Satisfy Them: A Systematic Review of the Literature

“…A complete list is beyond the scope of this article, so we refer the reader to the above articles and these additional manuscripts (Arora et al 2014 ; Becker and Barth 2000 ; Lauver 2008 ; Ogg et al 2015 ; Rubin et al 2004 ). While many articles report children in foster care have higher rates of medical health problems (e.g., Ringeisen et al 2008 ), a study by Raman and Sahu ( 2014 ) did not find any differences between children in foster care and children at risk living in with their parents. The identified risk factors for developing medical problems are being male, being older, having a longer stay in foster care and having had multiple placements (Ringeisen et al 2008 ; Rubin et al 2004 ; Sullivan and van Zyl 2008 ).…”

“…Based on over 30.000 case files, about 6% of children in foster care have so-called complex needs, which means having co-occurring physical health problems, emotional problems and the need for specialized services (Yampolskaya et al 2014 ). The most common health problems mentioned in the literature are incomplete immunization (Hill and Watkins 2003 ; Kaltner and Rissel 2011 ; Kling et al 2016 ; Nathanson and Tzioumi 2007 ; Raman and Sahu 2014 ; Rodrigues 2004 ), vision problems (Chernoff et al 1994 ; Nathanson and Tzioumi 2007 ; Steele and Buchi 2008 ; Takayama et al 1998 ), and respiratory problems (Nathanson and Tzioumi 2007 ; Ringeisen et al 2008 ; Rodrigues 2004 ; Takayama et al 1998 ). Other medical conditions that are also often encountered in the foster care population are obesity, dental problems, skin conditions, STD’s, infections and allergies.…”

Immunization Coverage of Children in Care of the Child Welfare System in High-Income Countries: A Systematic Review

“…The characteristics of included studies are presented in Appendix Table 1, (available online). The studies primarily came from the United Kingdom (n=15), 18,20,24,26,28,[30][31][32][33]36,38,39,41,43,46 the U.S. (n=9), 19,22,23,29,37,40,42,48,49 and Australia (n=6), 17,27,35,44,45,47 with a smaller number from Italy (n=1), 21 and Sweden (n=2). 25,34 They included 29 peer-reviewed journal publications, three government reports, and one thesis.…”

The role of care coordination and out‐of‐home placement in youth dental and vision care visits

“…Studies from other countries similarly show high rates of health needs among youth in placement. In an Australia‐based study comparing health needs of vulnerable children with those of children in foster care, Raman and Sahu () found that only vision concerns were statistically more common among youth in foster care (at 34%) compared with youth in parental care (14%). Surprisingly, none of the other health areas, including dental problems, showed any significant differences.…”