Foster care is a system in which a
minor
Minor may refer to:
Common meanings
* Minor (law), a person not under the age of certain legal activities.
* Academic minor, a secondary field of study in undergraduate education
Mathematics
* Minor (graph theory), a relation of one graph to an ...
has been placed into a
ward
Ward may refer to:
Division or unit
* Hospital ward, a hospital division, floor, or room set aside for a particular class or group of patients, for example the psychiatric ward
* Prison ward, a division of a penal institution such as a pris ...
,
group home
A group home, congregate living facility, care home (the latter especially in British English and Australian English), adult family home, etc., is a structured and supervised residence model that provides assisted living as well as medical car ...
(
residential child care community
Residential child care communities or children's homes are a type of residential care, which refers to long-term care given to children who cannot stay in their birth family home. There are two different approaches towards residential care: The fa ...
or treatment centre), or private home of a state-
certified
Certification is part of testing, inspection and certification and the provision by an independent body of written assurance (a certificate) that the product, service or system in question meets specific requirements. It is the formal attestatio ...
caregiver, referred to as a "foster parent", or with a family member approved by the state. The placement of a "foster child" is normally arranged through the government or a social service agency. The institution, group home, or foster parent is compensated for expenses unless with a family member. Any adult who has spent time in care can be described as a "care leaver", especially in European countries.
The state, via the
family court
Family courts were originally created to be a Court of Equity convened to decide matters and make orders in relation to family law, including custody of children, and could disregard certain legal requirements as long as the petitioner/plaintif ...
and
child protective services agency, stand ''
in loco parentis
The term ''in loco parentis'', Contemporary Latin, Latin for "in the place of a parent", refers to the legal responsibility of a person or organization to take on some of the functions and responsibilities of a parent.
Originally derived from ...
'' to the minor, making all legal decisions while the foster parent is responsible for the day-to-day care of the minor.
Scholars and activists have expressed concerns about the efficacy of foster care services provided by non-government organisations.
Specifically, this pertains to poor retention rates of social workers. Poor retention rates are attributed to being overworked in an emotionally draining field that offers minimal monetary compensation.
The lack of professionals pursuing a degree in social work coupled with poor retention rates in the field has led to a shortage of social workers and created large caseloads for those who choose to work and stay in the field.
The efficacy of caseworker retention also affects the overall ability to care for clients. Low staffing leads to data limitations that infringe on caseworkers' ability to adequately serve clients and their families.
Foster care is correlated with a range of negative outcomes compared to the general population. Children in foster care have a high rate of ill health, particularly psychiatric conditions such as anxiety, depression, and eating disorders. One third of foster children in a US study reported abuse from a foster parent or other adult in the foster home. Nearly half of foster children in the US become homeless when they reach the age of 18, and the poverty rate is three times higher among foster care alumni than in the general population.
By country
Australia
In Australia foster care was known as "boarding-out". Foster care had its early stages in
South Australia
South Australia (commonly abbreviated as SA) is a States and territories of Australia, state in the southern central part of Australia. With a total land area of , it is the fourth-largest of Australia's states and territories by area, which in ...
in 1867 and stretched to the second half of the 19th century. It is said that the system was mostly run by women until the early 20th century. Then the control was centered in many state children's departments. "Although boarding-out was also implemented by non-government
lchild rescue organizations, many large institutions remained. These institutions assumed an increasing importance from the late 1920s when the system went into decline." The system was re-energized in the postwar era, and in the 1970s. The system is still the main structure for "out-of-home care". The system took care of both local and foreign children. "The first adoption legislation was passed in
Western Australia
Western Australia (WA) is the westernmost state of Australia. It is bounded by the Indian Ocean to the north and west, the Southern Ocean to the south, the Northern Territory to the north-east, and South Australia to the south-east. Western Aust ...
in 1896, but the remaining states did not act until the 1920s, introducing the beginnings of the closed adoption that reached it peak in the period 1940–1975. New baby adoption dropped dramatically from the mid-1970s, with the greater tolerance of and support for single mothers".
Cambodia
Foster care in
Cambodia
Cambodia, officially the Kingdom of Cambodia, is a country in Southeast Asia on the Mainland Southeast Asia, Indochinese Peninsula. It is bordered by Thailand to the northwest, Laos to the north, and Vietnam to the east, and has a coastline ...
is relatively new as an official practice within the government. However, despite a later start, the practice is currently making great strides within the country. Left with a large number of official and unofficial
orphanage
An orphanage is a residential institution, total institution or group home, devoted to the care of orphans and children who, for various reasons, cannot be cared by their biological families. The parents may be deceased, absent, or abusi ...
s from the 1990s, the Cambodian government conducted several research projects in 2006 and 2008, pointing to the overuse of orphanages as a solution for caring for vulnerable children within the country. Most notably, the studies found that the percentage of children within orphanages that had parents approached 80%. At the same time, local NGOs like "Children In Families" began offering limited foster care services within the country. In the subsequent years, the Cambodian government began implementing policies that required the closure of some orphanages and the implementation of minimum standards for
residential care
Residential care refers to long-term care given to adults or children who stay in a residential setting rather than in their own home or family home.
There are various residential care options available, depending on the needs of the individual. ...
institutions. These actions lead to an increase in the number of NGOs providing foster care placements and helped to set the course for care reform around the country. As of 2015, the Cambodian government is working with UNICEF, USAID, several governments, and many local NGOs in continuing to build the capacity for child protection and foster care within the Kingdom.
Canada
Foster children in Canada are known as permanent wards (crown wards in Ontario).
[Anne Tweddle]
"Youth Leaving Care Report"
, September 2005 A
ward
Ward may refer to:
Division or unit
* Hospital ward, a hospital division, floor, or room set aside for a particular class or group of patients, for example the psychiatric ward
* Prison ward, a division of a penal institution such as a pris ...
is someone, in this case a child, placed under protection of a
legal guardian
A legal guardian is a person who has been appointed by a court or otherwise has the legal authority (and the corresponding duty) to make decisions relevant to the personal and property interests of another person who is deemed incompetent, ca ...
and are the legal responsibility of the
government
A government is the system or group of people governing an organized community, generally a State (polity), state.
In the case of its broad associative definition, government normally consists of legislature, executive (government), execu ...
. Census data from 2011 counted children in foster care for the first time, counting 47,885 children in care. The majority of foster children – 29,590, or about 62 per cent – were aged 14 and under.
[National Pos]
"Census 2011: Canada's foster children counted for first time"
September 19, 2012 The wards remain under the care of the government until they "age out of care". All ties are severed from the government and there is no longer any legal responsibility toward the youth. This age is different depending on the province.
Israel
In December 2013, the Israeli
Knesset
The Knesset ( , ) is the Unicameralism, unicameral legislature of Israel.
The Knesset passes all laws, elects the President of Israel, president and Prime Minister of Israel, prime minister, approves the Cabinet of Israel, cabinet, and supe ...
approved a bill co-drafted by the
Israel National Council for the Child to regulate the rights and obligations of participants in the foster care system in Israel.
Japan
The idea of foster care or taking in abandoned children actually came about around 1392–1490s in Japan. The foster care system in Japan is similar to the Orphan Trains system of the US, thinking the children would do better on farms rather than living in the "dusty city". The families would often send their children to a farm family outside the village and only keep their oldest son. The farm families served as the foster parents and they were financially rewarded for taking in the younger siblings. "It was considered an honor to be chosen as foster parents, and selection greatly depended on the family's reputation and status within the village". Around 1895 the foster care program became more like the system used in the United States because the
Tokyo Metropolitan Police
The , known locally as simply the Metropolitan Police Department (MPD), is the prefectural police of Tokyo Metropolis, Japan. Founded in 1874, the TMPD is the largest police force in Japan by number of officers, with a staff of more than 40,000 p ...
sent children to a hospital where they would be "settled". Problems emerged in this system, such as
child abuse
Child abuse (also called child endangerment or child maltreatment) is physical abuse, physical, child sexual abuse, sexual, emotional and/or psychological abuse, psychological maltreatment or Child neglect, neglect of a child, especially by a p ...
, so the government started phasing it out and "began increasing institutional facilities". In 1948 the Child Welfare Law was passed, increasing official oversight, and creating better conditions for the children to grow up in.
United Kingdom
In the United Kingdom, foster care and adoption has always been an option, "in the sense of taking other people's children into their homes and looking after them on a permanent or temporary basis." However, nothing about it had a legal foundation until the 20th century. The UK had "wardship", the family taking in the child had custody by the
Chancery Court
The Court of Chancery was a court of equity in England and Wales that followed a set of loose rules to avoid a slow pace of change and possible harshness (or "inequity") of the common law. The Chancery had jurisdiction over all matters of eq ...
. Wardship was not used very often because it did not give the guardian "parental rights". In the 19th century came a "series of baby farming scandals". At the end of the 19th century they started calling it "boarding-out" like they did in Australia. They started placing the children in
orphanage
An orphanage is a residential institution, total institution or group home, devoted to the care of orphans and children who, for various reasons, cannot be cared by their biological families. The parents may be deceased, absent, or abusi ...
s and
workhouse
In Britain and Ireland, a workhouse (, lit. "poor-house") was a total institution where those unable to support themselves financially were offered accommodation and employment. In Scotland, they were usually known as Scottish poorhouse, poorh ...
s as well. "The First World War saw an increase in organized adoption through adoption societies and child rescue organizations, and pressure grew for adoption to be given legal status." The first laws based on adoption and foster care were passed in 1926. "The peak number of adoptions was in 1968, since then there has been an enormous decline in adoption in the United Kingdom. The main reasons for children being adopted in the United Kingdom had been unmarried mothers giving up their children for adoption and stepparents adopting their new partner's children".
United States
Historians of foster care in America emphasize biases of race and class status that shaped divergent experiences for children. In particular, the United States welfare system has reckoned with a longer history of Black children taken away from their families during
slavery
Slavery is the ownership of a person as property, especially in regards to their labour. Slavery typically involves compulsory work, with the slave's location of work and residence dictated by the party that holds them in bondage. Enslavemen ...
. Scholars have also documented the negative conditions faced by often impoverished children during the creation of early orphanages. Prior to protections of Tribes and the right of Indigenous children to remain within their tribal communities such as the 1978
Indian Child Welfare Act
The Indian Child Welfare Act of 1978 (ICWA, enacted November 8, 1978 and codified at Indian Child Welfare Act, (, )) is a United States Code, United States federal law that governs jurisdiction over the removal of Native Americans in the United ...
, child welfare concerns were cited as reasoning to remove 35% of Indigenous children from their families and tribes.
In the United States, formal foster care started as a result of the efforts of
Charles Loring Brace
Charles Loring Brace (June 19, 1826 – August 11, 1890) was an American philanthropist who contributed to the field of social reform. He is considered a father of the modern foster care movement and was most renowned for starting the Orphan T ...
, who founded the Children's Aid Society. Taking note that nearly 30,000 homeless or neglected children lived in New York City alone,
["Foster Care History & Accomplishments." The Children's Aid Society. N.p., n.d. Web. 05 Oct. 2013.] Brace took these children off the streets and placed them with families around the United States, particularly Christian families living on farms, in an attempt to improve their quality of life.
[Nordmark, Oliver. "Orphan Train History.": REVEREND CHARLES LORING BRACE. N.p., 09 Feb. 2010. Web. 19 Oct. 2013.] Between 1853 and his death in 1890, Brace transported over 120,000 children by train, giving name to the
Orphan Train
The Orphan Train Movement was a supervised welfare program that transported children from crowded Eastern cities of the United States to foster homes located largely in rural areas of the Midwestern United States, Midwest short on farming Child ...
Movement. When Brace died in 1890, his sons took over his work of the Children's Aid Society until they retired.
The foster care approach pioneered by Brace and the Children's Aid Society became the basis for Concurrent Planning, which was the basis of the federal
Adoption and Safe Families Act
The Adoption and Safe Families Act (ASFA, Public Law 105–89) was signed into law by President Bill Clinton on November 19, 1997, after having been approved by the United States Congress earlier in the month.
Background
ASFA was enacted in a ...
of 1997.
From August 1999 to August 2019, over 9 million American children were removed from their families and placed in foster homes.
As of August 2022 there were 368,530 children nationally located in foster homes. On average, an American child in foster care spends two birthdays in the system.
In order to create a safe environment for the child long term, children in American foster care have both a case plan and a case plan goal. A case plan is a clear statement about why the child needs protection and the roles and responsibilities of all participants (case worker, foster parents, etc.) in addressing the child's needs and their protection. The case plan goal is the end goal for the child that ends their stay in foster care. 52% of foster children in America have the goal to reunify with their parent(s) or primary caretaker(s).
France
In France, foster families are called (literally "welcome families"). Foster homes must obtain an official approval from the government in order to welcome a minor or an elderly person. In order to receive this approval they must follow a training and their home is inspected to be sure it is safe and healthy. In 2017, 344,000 minors and 15,000 elderly persons were welcomed in foster homes.
The Foundling Hospital in
Paris
Paris () is the Capital city, capital and List of communes in France with over 20,000 inhabitants, largest city of France. With an estimated population of 2,048,472 residents in January 2025 in an area of more than , Paris is the List of ci ...
is often considered the first state efforts to assist children, founded in 1670 by
Saint Vincent de Paul
Vincent de Paul, CM (24 April 1581 – 27 September 1660), commonly known as Saint Vincent de Paul, was an Occitan French Catholic priest who dedicated himself to serving the poor.
In 1622, Vincent was appointed as chaplain to the galleys. ...
. Mothers had the option of anonymously depositing their infant children at the gate, a practice that was unique across much of Europe.
Simple adoption, a form of additional parentage, was first codified into French law through the
Civil Code of 1804 and allowed only adults over fifty without any legitimate children to adopt. The specificity of a lack of legitimate children hoped to reduce interference with inheritance.
Traditionally, there is an emphasis on keeping families in contact as much as possible as parents often keep parental responsibility . The majority of social services for these children relies on both local authorities and Judicial Juvenile Protection, which includes laws outlining protections allowed to the children. Current laws limit families to three children in foster care, but exceptions may be made by the president of the
Departmental Council in certain cases.
Italy
Although the numbers have greatly decreased since post
World War II
World War II or the Second World War (1 September 1939 – 2 September 1945) was a World war, global conflict between two coalitions: the Allies of World War II, Allies and the Axis powers. World War II by country, Nearly all of the wo ...
, over 27,000 children in Italy are in alternative care. Under 40% of children are able to return to their birth families, which is the ultimate goal of foster care.
Italian law considers familial relationships to be pivotal to a child's developments and gives primary relevance to the original family and offer home based support. However, if neglect or abuse is present, the judicial system may intervene to remove involved children. In 2001, all institution based facilities for displaced children were closed and replaced with
residential homes in order to provide a more familial feeling.
Placement
Family-based foster care is generally preferred to other forms of out of home care. Foster care is intended to be a short-term solution until a permanent placement can be made.
[Dorsey et Al. ''Current status and evidence base of training for foster and treatment foster parents''] In most states, the primary objective is to reconcile children with the biological parents. However, if the parents are unable or unwilling to care for the child, or if the child is an
orphan
An orphan is a child whose parents have died, are unknown, or have permanently abandoned them. It can also refer to a child who has lost only one parent, as the Hebrew language, Hebrew translation, for example, is "fatherless". In some languages ...
, then the first choice of adoptive parents is a relative such as an
aunt
An aunt is a woman who is a sibling of a parent or married to a sibling of a parent. Aunts who are related by birth are second-degree relatives. Alternate terms include auntie or aunty.
Aunt, auntie, and aunty also may be titles bestowed b ...
,
uncle
An uncle is usually defined as a male relative who is a sibling of a parent or married to a sibling of a parent, as well as the parent of the cousins. Uncles who are related by birth are second-degree relatives. The female counterpart of an un ...
or
grandparent
Grandparents, individually known as grandmother and grandfather, or Grandma and Grandpa, are the parents of a person's father or mother – paternal or maternal. Every sexually reproducing living organism who is not a genetic chimera has a maxi ...
, known as
kinship care
Kinship care is a term used in the United States and Great Britain for the raising of children by grandparents, other extended family members, and unrelated adults with whom they have a close family-like relationship such as godparents and close ...
. Most
kinship care
Kinship care is a term used in the United States and Great Britain for the raising of children by grandparents, other extended family members, and unrelated adults with whom they have a close family-like relationship such as godparents and close ...
is done informally, without the involvement of a court or public organization. However, in the United States, formal kinship care is increasingly common. In 2012, a quarter of all children in formal foster care were placed with relatives instead of being placed into the system.
If no related family member is willing or able to adopt, the next preference is for the child to be adopted by the foster parents or by someone else involved in the child's life (such as a
teacher
A teacher, also called a schoolteacher or formally an educator, is a person who helps students to acquire knowledge, competence, or virtue, via the practice of teaching.
''Informally'' the role of teacher may be taken on by anyone (e.g. w ...
or
coach
Coach may refer to:
Guidance/instruction
* Coach (sport), a director of Athletes' training and activities
* Coaching, the practice of guiding an individual through a process
** Acting coach, a teacher who trains performers
Transportation
* Coac ...
). This is to maintain continuity in the child's life. If neither above option are available, the child may be adopted by someone who is a stranger to the child.
If none of these options are viable, the plan for the minor may be to enter OPPLA (Other Planned Permanent Living Arrangement). This option allows the child to stay in custody of the state and the child can stay placed in a foster home, with a relative or a long-term care facility, such as a
residential child care community
Residential child care communities or children's homes are a type of residential care, which refers to long-term care given to children who cannot stay in their birth family home. There are two different approaches towards residential care: The fa ...
or, for children with development disabilities, physical disabilities or mental disabilities, a
treatment center.
671,000 children were served by the foster care system in the United States in 2015.
"After declining more than 20 percent between FY 2006 and FY 2012 to a low of 397,000, the number of children in foster care on the last day of the fiscal year increased to 428,000 in FY 2015, with a slightly higher percent change from 2014 to 2015 (3.3%) than observed from 2013 to 2014 (3.2%)." Since FY 2012, the number of children in foster care at the end of each FY has steadily increased.
The median amount of time a child spent in foster care in the U.S. in 2015 was 13.5 months. That year, 74% of children spent less than two years in foster care, while 13% were in care for three or more years.
[Id.] Of the estimated 427,910 children in foster care on September 30, 2015: 43 percent were White, 24 percent were African-American, 21 percent were Hispanic (of any race), 10 percent were other races or multiracial, and 2 percent were unknown or unable to be determined.
Children may enter foster care voluntarily or involuntarily. Voluntary placement may occur when a biological parent or lawful guardian is unable to care for a child. Involuntary placement occurs when a child is removed from their biological parent or lawful guardian due to the risk or actual occurrence of physical or psychological harm, or if the child has been orphaned. In the US, most children enter foster care due to neglect. If a biological parent or
legal guardian
A legal guardian is a person who has been appointed by a court or otherwise has the legal authority (and the corresponding duty) to make decisions relevant to the personal and property interests of another person who is deemed incompetent, ca ...
is unwilling to care for a child, the child is deemed to be dependent and is placed under the care of the child protection agency. The policies regarding foster care as well as the criteria to be met in order to become a foster parent vary according to legal jurisdiction.
Especially egregious failures of child protective services often serve as a catalyst for increased removal of children from the homes of biological parents. An example is the brutal torture and murder of 17-month-old
Peter Connelly
Peter Connelly is a British video game composer and sound designer known for his work on the action-adventure ''Tomb Raider'' series. He has been part of several video game releases working mainly with Core Design, Eutechnyx and Ubisoft.
Car ...
, a British toddler who died in
London Borough of Haringey
The London Borough of Haringey ( , same as Harringay) is a London boroughs, London borough in north London, classified by some definitions as part of Inner London, and by others as part of Outer London. It was created in 1965 by the amalgamation ...
, North London after suffering more than 50 severe injuries over an eight-month period, including eight broken ribs and a broken back. Throughout the period of time in which he was being tortured, he was repeatedly seen by Haringey Children's services and
NHS
The National Health Service (NHS) is the term for the publicly funded health care, publicly funded healthcare systems of the United Kingdom: the National Health Service (England), NHS Scotland, NHS Wales, and Health and Social Care (Northern ...
health professionals. Haringey Children's services already failed ten years earlier in the case of
Victoria Climbié
Victoria most commonly refers to:
* Queen Victoria (1819–1901), Queen of the United Kingdom and Empress of India
* Victoria (state), a state of Australia
* Victoria, British Columbia, Canada, a provincial capital
* Victoria, Seychelles, the capi ...
.
In the time since his death, in 2007, cases have reached a record rate in England surpassing 10,000 in the reporting year ending in March 2012.
Abuse and negligence
Although the majority of children in the foster care system are not abused or neglected, children in foster care do experience higher rates of
child abuse
Child abuse (also called child endangerment or child maltreatment) is physical abuse, physical, child sexual abuse, sexual, emotional and/or psychological abuse, psychological maltreatment or Child neglect, neglect of a child, especially by a p ...
, emotional deprivation, and physical
neglect
In the context of caregiving, neglect is a form of abuse where the perpetrator, who is responsible for caring for someone who is unable to care for themselves, fails to do so. It can be a result of carelessness, indifference, or unwillingness and ...
than those not in care. In one study in the United Kingdom, "foster children were 7–8 times, and children in residential care 6 times more likely to be assessed by a pediatrician for
abuse
Abuse is the act of improper usage or treatment of a person or thing, often to unfairly or improperly gain benefit. Abuse can come in many forms, such as: physical or verbal maltreatment, injury, assault, violation, rape, unjust practices, ...
than a child in the general population". A study of foster children in Oregon and Washington State in the US found that nearly one-third reported being abused by a foster parent or another adult in a foster home.
Although caregivers are put through a through and intense screening before being allowed to take in any children, the foster care system often lacks any safeguards to reevaluate families once they have taken in children. The death of a child in foster care may not be investigated as throughly in order to not further displace other children in the same foster home. Organizations such as Child Abuse Prevention Services, located in Long Island, New York, suggest regular home visits and monitoring in order to ensure early intervention in the case of any avoidable issues or clearly unsafe conditions.
In a 2023 study, 66% of the 143 youth currently in foster care who had reached out for help were victims of
sexual abuse
Sexual abuse or sex abuse is abusive sexual behavior by one person upon another. It is often perpetrated using physical force, or by taking advantage of another. It often consists of a persistent pattern of sexual assaults. The offender is re ...
by a foster family member. These youth may encounter different barriers than their peers not in foster care such as concerns for safety, a lack of trust in the foster care system, previous negative reception to disclosure of sexual abuse, or not wanting to move placements.
The race, sex, age, and sibling status all significantly influence potential instability of a placement. Non-white children, males, older children, and those who are only children were the most at risk of an unsafe or unstable foster care placement. In general, older children in foster care are more likely to experience behavioral and mental health issues, which have been correlated with less likely success of adoption and fostering.
Development
As of 2019, in the US, the majority of children in the foster care system were under eight years of age.
These early years are quite important for the physical and mental development of children. More specifically, these early years are most important for brain development. Stressful and traumatic experiences have been found to have long-term negative consequences for the brain development in children whereas talking, singing, and playing can help encourage brain growth. Since the majority of children are removed from their homes due to neglect, this means that many of these children did not experience stable and stimulating environments to help promote this necessary growth.
In a research study conducted at the University of Minnesota, researchers found that children placed in non-parental homes, such as foster homes, showed significant behavior problems and higher levels of internalizing problems in comparison to children in traditional families, even those who were mistreated by caregivers. A child who has lived in an orphanage or a home for multiple children may have learned survival skills but lack family skills due to a lack of permanency.
Medical and psychiatric disorders
A higher prevalence of physical, psychological, cognitive and epigenetic disorders for children in foster care has been established in studies in various countries. The Casey Family Programs Northwest Foster Care Alumni Study was a fairly extensive study of various aspects of children who had been in foster care.
Individuals who were in foster care experience higher rates of physical and psychiatric morbidity than the general population and suffer from not being able to trust and that can lead to placements breaking down.
In the Casey study of foster children in
Oregon
Oregon ( , ) is a U.S. state, state in the Pacific Northwest region of the United States. It is a part of the Western U.S., with the Columbia River delineating much of Oregon's northern boundary with Washington (state), Washington, while t ...
and
Washington state
Washington, officially the State of Washington, is a state in the Pacific Northwest region of the United States. It is often referred to as Washington State to distinguish it from the national capital, both named after George Washington ...
, they were found to have double the incidence of
depression, 20% as compared to 10% and were found to have a higher rate of
post-traumatic stress disorder
Post-traumatic stress disorder (PTSD) is a mental disorder that develops from experiencing a Psychological trauma, traumatic event, such as sexual assault, domestic violence, child abuse, warfare and its associated traumas, natural disaster ...
(PTSD) than combat veterans with 25% of those studied having PTSD. Children in foster care have a higher probability of having
attention deficit hyperactivity disorder
Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterised by symptoms of inattention, hyperactivity, impulsivity, and emotional dysregulation that are excessive and pervasive, impairing in multiple con ...
(ADHD), and deficits in
executive functioning
In cognitive science and neuropsychology, executive functions (collectively referred to as executive function and cognitive control) are a set of cognitive processes that support goal-directed behavior, by regulating thoughts and actions thro ...
,
anxiety
Anxiety is an emotion characterised by an unpleasant state of inner wikt:turmoil, turmoil and includes feelings of dread over Anticipation, anticipated events. Anxiety is different from fear in that fear is defined as the emotional response ...
as well as other developmental problems.
These children experience higher degrees of
incarceration
Imprisonment or incarceration is the restraint of a person's liberty for any cause whatsoever, whether by authority of the government, or by a person acting without such authority. In the latter case it is considered " false imprisonment". Impri ...
,
poverty
Poverty is a state or condition in which an individual lacks the financial resources and essentials for a basic standard of living. Poverty can have diverse Biophysical environmen ...
,
homelessness
Homelessness, also known as houselessness or being unhoused or unsheltered, is the condition of lacking stable, safe, and functional housing. It includes living on the streets, moving between temporary accommodation with family or friends, liv ...
, and
suicide
Suicide is the act of intentionally causing one's own death.
Risk factors for suicide include mental disorders, physical disorders, and substance abuse. Some suicides are impulsive acts driven by stress (such as from financial or ac ...
. Studies in the U.S. have suggested that some foster care placements may be more detrimental to children than remaining in a troubled home, but a more recent study suggested that these findings may have been affected by
selection bias
Selection bias is the bias introduced by the selection of individuals, groups, or data for analysis in such a way that proper randomization is not achieved, thereby failing to ensure that the sample obtained is representative of the population inte ...
, and that foster care has little effect on behavioral problems.
Neurodevelopment
Foster children have elevated levels of
cortisol
Cortisol is a steroid hormone in the glucocorticoid class of hormones and a stress hormone. When used as medication, it is known as hydrocortisone.
Cortisol is produced in many animals, mainly by the ''zona fasciculata'' of the adrenal corte ...
, a
stress hormone
A hormone (from the Ancient Greek, Greek participle , "setting in motion") is a class of cell signaling, signaling molecules in multicellular organisms that are sent to distant organs or tissues by complex biological processes to regulate physio ...
, in comparison to children raised by their biological parents. Elevated cortisol levels can compromise the immune system. (Harden BJ, 2004). Most of the processes involved in typical neurodevelopment are predicated upon the establishment of close nurturing relationships and environmental stimulation. Negative environmental influences during this critical period of brain development can have lifelong consequences.
Post-traumatic stress disorder
Children in foster care have a higher incidence of
post-traumatic stress disorder
Post-traumatic stress disorder (PTSD) is a mental disorder that develops from experiencing a Psychological trauma, traumatic event, such as sexual assault, domestic violence, child abuse, warfare and its associated traumas, natural disaster ...
(PTSD). In one study,
60% of children in foster care who had experienced sexual abuse had PTSD, and 42% of those who had been physically abused met the PTSD criteria. PTSD was also found in 18% of the children who were not abused. These children may have developed PTSD due to witnessing violence in the home. (Marsenich, 2002).
In order to figure out if a child has developed PTSD, there is a PTSD module, the 'anxiety disorder interview'. This is considered a reliable resource for establishing if a child has developed post traumatic stress disorder due to physical, sexual, or mental abuse.
In a study conducted in Oregon and Washington state, the rate of PTSD in adults who were in foster care for one year between the ages of 14 and 18 was found to be higher than that of combat veterans, with 25% of those in the study meeting the diagnostic criteria as compared to 12–13% of Iraq war veterans and 15% of Vietnam war veterans, and a rate of 4% in the general population. The recovery rate for foster home alumni was 28.2% as opposed to 47% in the general population.
"More than half the study participants reported clinical levels of mental illness, compared to less than a quarter of the general population".
Eating disorders
Foster children are at increased risk for a variety of
eating disorders
An eating disorder is a mental disorder defined by abnormal eating behaviors that adversely affect a person's health, physical or mental health, mental health. These behaviors may include eating too much food or too little food. Types of eatin ...
in comparison to the general population. In a study done in the United Kingdom, 35% of foster children experienced an increase in
Body Mass Index
Body mass index (BMI) is a value derived from the mass (Mass versus weight, weight) and height of a person. The BMI is defined as the human body weight, body mass divided by the square (algebra), square of the human height, body height, and is ...
(BMI) once in care. Food Maintenance Syndrome is characterized by a set of aberrant eating behaviors of children in foster care. It is "a pattern of excessive eating and food acquisition and maintenance behaviors without concurrent obesity"; it resembles "the behavioral correlates of Hyperphagic Short Stature". It is hypothesized that this syndrome is triggered by the stress and maltreatment foster children are subjected to, it was prevalent amongst 25 percent of the study group in New Zealand.
Bulimia nervosa
Bulimia nervosa, also known simply as bulimia, is an eating disorder characterized by binge eating (eating large quantities of food in a short period of time, often feeling out of control) followed by compensatory behaviors, such as self-indu ...
is seven times more prevalent among former foster children than in the general population.
Poverty and homelessness

Nearly half of foster children in the U.S. become homeless when they turn 18. One of every 10 foster children stays in foster care longer than seven years, and each year about 15,000 reach the age of majority and leave foster care without a permanent family—many to join the ranks of the homeless or to commit crimes and be imprisoned.
Three out of 10 of the
United States homeless are former foster children. According to the results of the Casey Family Study of Foster Care Alumni, up to 80 percent are doing poorly—with a quarter to a third of former foster children at or below the
poverty line
The poverty threshold, poverty limit, poverty line, or breadline is the minimum level of income deemed adequate in a particular country. The poverty line is usually calculated by estimating the total cost of one year's worth of necessities for ...
, three times the national poverty rate. Very frequently, people who are homeless had multiple placements as children: some were in foster care, but others experienced "unofficial" placements in the homes of family or friends.
Individuals with a history of foster care tend to become homeless at an earlier age than those who were not in foster care. The length of time a person remains homeless is longer in individuals who were in foster care.
Suicide-death rate
Children in foster care are at a greater risk of suicide. The increased risk of suicide is still prevalent after leaving foster care. In a small study of twenty-two
Texan
Texas ( , ; or ) is the most populous state in the South Central region of the United States. It borders Louisiana to the east, Arkansas to the northeast, Oklahoma to the north, New Mexico to the west, and has an international border wit ...
youths who aged out of the system, 23 percent had a history of suicide attempts.
A
Swedish study utilizing the data of almost one million people including 22,305 former foster children who had been in care prior to their teens, concluded:
Death rate
Children in foster care have an overall higher mortality rate than children in the general population. A study conducted in Finland among current and former foster children up to age 24 found a higher mortality rate due to substance abuse, accidents, suicide and illness. The deaths due to illness were attributed to an increased incidence of
acute and
chronic medical conditions and
developmental delays
Global developmental delay is an umbrella term used when children are significantly delayed in two or more areas of development. It can be diagnosed when a child is delayed in one or more milestones, categorised into motor skills, speech, cognitive ...
among children in foster care.
Georgia Senator
Nancy Schaefer published a report "The Corrupt Business of Child Protective Services"
stating:
Academic prospects
Educational outcomes of ex-foster children in the Northwest Alumni Study:
* 56% completed high school compared to 82% of the general population, although an additional 29% of former foster children received a
G.E.D. compared to an additional 5% of the general population.
* 42.7% completed some education beyond
high school
A secondary school, high school, or senior school, is an institution that provides secondary education. Some secondary schools provide both ''lower secondary education'' (ages 11 to 14) and ''upper secondary education'' (ages 14 to 18), i.e., ...
.
* 20.6% completed any degree or certificate beyond high school
* 16.1% completed a
vocational degree
Vocational education is education that prepares people for a skilled craft. Vocational education can also be seen as that type of education given to an individual to prepare that individual to be gainfully employed or self employed with req ...
; 21.9% for those over 25.
* 1.8% complete a
bachelor's degree
A bachelor's degree (from Medieval Latin ''baccalaureus'') or baccalaureate (from Modern Latin ''baccalaureatus'') is an undergraduate degree awarded by colleges and universities upon completion of a course of study lasting three to six years ...
, 2.7% for over 25, the completion rate for the general population in the same age group is 24%, a sizable difference.
The study reviewed case records for 659 foster care alumni in Northwest USA, and interviewed 479 of them
between September 2000 and January 2002.
Higher Education
Approximately 10% of foster youth make it to college and of those 10%, only about 3% actually graduate and obtain a 4-year degree. Although the number of foster youth who are starting at a 4-year university after high school has increased over the years, the number of youth who graduate from college continues to remain stable. A study of 712 youth in California, the results revealed that foster care youth are fives times less likely to attend college than youth who do not go through foster care.
There are different resources that offer both financial and emotional support for foster youth to continue their education. Simultaneously, there are also many barriers that make getting to a college or university difficult.
Borton describes some of the barriers youth face in her article, ''Barriers to Post-Secondary Enrollment for Former Foster Youth''. A few of those barriers include financial hurdles, navigating through the application process with little to no support, and lack of housing.
Many studies have shown that there are a few factors that have seemingly played a role in the success of foster youth making it to and graduating from a college or university. While having financial resources for foster youth is a huge help, there are other components to look at. Beginning with having support for these youth at the high school level. In order for foster youth to obtain a college degree, they must enroll at a university first.
Out of the different factors that play in increasing college enrollment such as youth participating in extended foster care, reading ability, etc., youth who received assistance or had supportive relationships from adults, were more likely than youth who did not have supportive relationships, to enroll at a university.
At colleges across the nation, there are programs that are specifically put in place to help youth who have aged out of the foster care system and continued into higher education. These programs often help youth financially by giving them supplemental funds and providing support through peer mentor programs or academic counseling services. While funding is an important key in helping get through college, it has not been found as the only crucial component in aiding a youth's success.
A study done by Jay and colleagues provides insight on what youth view as important in helping them thrive on a college campus. The study, which had a sample of 51 foster youth, used Conceptual Mapping to break down the different components of support that may be important for youth to receive on a college campus. It is important to take in the different factors that can be helpful for youth at a university and to look beyond providing financial support.
Psychotropic medication use
Studies have revealed that youth in foster care covered by
Medicaid
Medicaid is a government program in the United States that provides health insurance for adults and children with limited income and resources. The program is partially funded and primarily managed by U.S. state, state governments, which also h ...
insurance receive
psychotropic medication
A psychoactive drug, psychopharmaceutical, mind-altering drug, consciousness-altering drug, psychoactive substance, or psychotropic substance is a chemical substance that alters psychological functioning by modulating central nervous system acti ...
at a rate that was 3 times higher than that of Medicaid-insured youth who qualify by low family income. In a review (September 2003 to August 2004) of the medical records of 32,135 Texas foster care 0–19 years old, 12,189 were prescribed psychotropic medication, resulting in an annual prevalence of 37.9% of these children being prescribed medication. 41.3% received 3 different classes of these drugs during July 2004, and 15.9% received 4 different classes. The most frequently used medications were
antidepressants
Antidepressants are a class of medications used to treat major depressive disorder, anxiety disorders, chronic pain, and addiction.
Common side effects of antidepressants include dry mouth, weight gain, dizziness, headaches, akathisia, sexu ...
(56.8%), attention-deficit/hyperactivity disorder drugs (55.9%), and antipsychotic agents (53.2%). The study also showed that youth in foster care are frequently treated with
concomitant
Concomitance is the condition of accompanying or coexisting. A concomitant is something that accompanies something else.
Concomitant or concomitance may refer to:
* Concomitance (doctrine)
The Doctrine of Concomitance is a Eucharistic theologica ...
psychotropic
A psychoactive drug, psychopharmaceutical, mind-altering drug, consciousness-altering drug, psychoactive substance, or psychotropic substance is a chemical substance that alters psychological functioning by modulating central nervous system acti ...
medication, for which sufficient evidence regarding safety and effectiveness is not available.
The use of expensive, brand name, patent protected medication was prevalent. In the case of
SSRI
Selective serotonin reuptake inhibitors (SSRIs) are a class of drugs that are typically used as antidepressants in the treatment of major depressive disorder, anxiety disorders, and other psychological conditions.
SSRIs primarily work by ...
s the use of the most expensive medications was noted to be 74%; in the general market only 28% are for brand name SSRI's vs generics. The average out-of-pocket expense per prescription was $34.75 for generics and $90.17 for branded products, a $55.42, difference.
Therapeutic intervention
Children in the child welfare system have often experienced significant and repeated traumas and having a background in foster homes—especially in instances of sexual abuse—can be the precipitating factor in a wide variety of psychological and cognitive deficits it may also serve to obfuscate the true cause of underlying issues. The foster care experience may have nothing to do with the symptoms, or on the other hand, a disorder may be exacerbated by having a history of foster care and attendant abuses. The human brain however has been shown to have a fair degree of
neuroplasticity
Neuroplasticity, also known as neural plasticity or just plasticity, is the ability of neural networks in the brain to change through neurogenesis, growth and reorganization. Neuroplasticity refers to the brain's ability to reorganize and rewir ...
. and adult
neurogenesis
Neurogenesis is the process by which nervous system cells, the neurons, are produced by neural stem cells (NSCs). This occurs in all species of animals except the porifera (sponges) and placozoans. Types of NSCs include neuroepithelial cells ( ...
has been shown to be an ongoing process.
Multidimensional Treatment Foster Care (MTFC), also referred to as Treatment Foster Care Oregon (TFCO) and Treatment Foster Care (TFC) is a community-based intervention that was created in 1983 by Dr. Patricia Chamberlain and her associated colleagues with the initial design intended to offer a replacement for group facilities.
MTFC has differing approaches for different age groups. Preschoolers receive “a behavior-management approach and intensively trains, supervises, and supports foster caregivers to provide positive adult support and consistent limit setting” coupled with “coordinated interventions with the child’s biological parents.”
MTFC for adolescence consists of individual placement with an intensely trained foster family providing “coordinated interventions in the home, with peers,
ndin educational settings.”
MTFC has been shown to provide better results than group facilities
and proves to be more cost effective.
Reports show that Multidimensional treatment has effective results in reducing depression, arrest rates, deviant peer affiliations, placement disruption, and pregnancy rates while having positive replication trials.
It is one method that attempts to incorporate
trauma informed care into its design.
Researchers have faced difficulty when it comes to accurately assessing what makes MTFC and other similar programs that involve multiple levels of intervention successful. It seems to remain in a "black box" scenario where it is unsure what aspect of the treatment plan is actually producing positive effects.
Multiple peer-reviewed research articles on foster care programs point out a lack of research effectively evaluating the outcomes of specific foster care programs,
calling for more complete assessments to be conducted in order to properly compare outcomes between treatment plans and evaluate what practices in MTFC are most effective.
Ethical concerns have also been raised by Therese Åström and other associated researchers when conducting a systematic review on behalf of the Swedish Agency for Health Technology Assessment and Assessment of Social Services in 2018, noting that on the one hand MTFC is evaluated as effective, however, it tends to be implemented in a way that diminishes the child's agency.
The L.Y.G.H.T. program is a peer grief support program that has been shown to increase perceived social support and hope while decreasing perceived problems.
Cross-cultural adoption policies
George Shanti, Nico Van Oudenhoven, and Rekha Wazir, co-authors of ''Foster Care Beyond the Crossroads: Lessons from an International Comparative Analysis'', say that there are four types of Government foster care systems. The first one is that of developing countries. These countries do not have policies implemented to take care of the basic needs of these children and these children mostly receive assistance from relatives. The second system is that of former socialist governments. The historical context of these states has not allowed for the evolution of their foster care system. NGO's have urged them to evolve; however the traditional system of institutionalizing these children is still in place. Thirdly, liberal democracies do not have the support from its political system in order to take care of these children, even though they have the resources. Finally, social democracies are the most advanced governments in regards to their foster care system. These governments have a massive infrastructure, funding, and support system in order to help foster care children.
Adoption
Foster care adoption is a type of domestic adoption where the child is initially placed into a foster care system and is subsequently placed for adoption.
Children may be placed into foster care for a variety of reasons; including, removal from the home by a governmental agency because of maltreatment. In some jurisdictions, adoptive parents are licensed as and technically considered foster parents while the adoption is being finalized. According to the U.S. Department of Health and Human Services Children's Bureau, there were approximately 408,425 children in foster care in 2010. Of those children, twenty-five percent had a goal of adoption. In 2015, 243,060 children exited foster care and twenty-two percent were adopted. Nationwide, there are more than one hundred thousand children in the U.S. foster care system waiting for permanent families.
Adoptive parenting can have an impact on children, recent research has shown that warm adoptive parenting reduces internalizing and externalizing problems of the adoptive children over time.
Outcomes
Youth who are aging out of foster care often face difficulties in transitioning into adulthood, especially in terms of finding stable housing, employment, finances, and educational opportunities.
The suspected reason for these difficulties involves a lack of stability experienced while in the foster care system, and the reported abuse and/or neglect in their childhood, which may affect their ability to cope with significant life changes.
In the United States, there are independent living programs designed with the intent to serve the needs of transitioning foster youth.
However, youth aging out of foster care have indicated that these programs are failing to fully address the needs of young adults without familial assistance.
Nearly half reported that they were unprepared for independent living and cited a lack of concrete needs such as safe housing, money and bus passes after aging out.
In a study conducted by Gypen et al. (2017),
involving a cross-database analysis of research articles relevant to the outcomes of former foster youth, they found that the educational, mental health, employment, income, stable housing, criminal involvement and substance abuse issues outcomes for youth who have aged out of the foster care system are substantially poorer than their peers. For example, Gypen et al. (2017),
indicated that only 45% of former foster youth received a high school diploma, which is 23% lower than the general population. There are also significantly poorer outcomes for children who were formerly in foster care than children from low-income households and racial minorities.
African American former foster youth graduate high school at a much lower rate then their white counterparts.
The likelihood for secondary degree obtainment, whether a two or four year degree, is significantly decreased compared to the general population in every survey. A 2011 study found that between 8-13% of former foster youth obtained either a 2 or 4 year college degree compared to 34-44% of the general population. Children who are eventually adopted by their placement family show greater outcomes, in terms of finding stable housing, employment, finances and education opportunities, than those who aged out of the foster care system without a permanent placement.
Economically, former foster youth also fall behind their non-foster youth peers. Annually, former foster youth make about $7550 less than their peers.
After aging out about 17%-33% are dependent on public assistance (such as food stamps).
Of those who age out of the family services system and move in with a partner, 32% don't have any sort of income compared to 3% of the general population.
The mental health of those that age out of foster care also suffers more than the general population.
Around 62% of former foster youth will be diagnosed with at least 1 psychiatric illness in their life time with a much higher rate of women getting such a diagnosis.
Former foster youth also experience higher levels of substance abuse and alcohol dependency. Between 40% and 49% of former foster youth will abuse alcohol and 3% to 13% will become dependent on it. 39% of former foster youth smoke compared to 20% of youth in general and 16% use cannabis compared to 6.5%.
Former foster youth who identify as male are 3 times more likely to abuse substances than females.
It has also been reported that former foster youth have a higher chance of ending up in
prostitution
Prostitution is a type of sex work that involves engaging in sexual activity in exchange for payment. The definition of "sexual activity" varies, and is often defined as an activity requiring physical contact (e.g., sexual intercourse, no ...
, and even fall prey to
sex trafficking
Sex trafficking is human trafficking for the purpose of sexual exploitation. Perpetrators of the crime are called sex traffickers or pimps—people who manipulate victims to engage in various forms of commercial sex with paying customers. Se ...
. This has also been called the "foster care to prostitution pipeline". a 2012 study in Los Angeles found that 59% of juveniles arrested for prostitution were or had been in foster care, but the generalizability of these findings has been disputed.
See also
*
Assisted living
An assisted living residence or assisted living facility (ALF) is a housing facility for people with disabilities or for adults who cannot or who choose not to live independently. The term is popular in the United States. Still, the setting i ...
*
Attachment theory
Attachment theory is a psychological and evolutionary framework, concerning the relationships between humans, particularly the importance of early bonds between infants and their primary caregivers. Developed by psychiatrist and psychoanalys ...
*
Child abandonment
A child () is a human being between the stages of birth and puberty, or between the developmental period of infancy and puberty. The term may also refer to an unborn human being. In English-speaking countries, the legal definition of ''chi ...
*
Child and family services
Child and family services (CFS) is a government or non-profit organisation designed to better the well being of individuals who come from unfortunate situations, ''environmental'' or ''biological''. People who seek or are sought after to participa ...
*
Child and youth care
Child and Youth Care (CYC) is a profession which focuses on the developmental needs of children and families within the space and time of their daily lives.Adapted from Stuart, C. (2013). Foundations of child and youth care. Dubuque: Kendall Hunt. ...
*
Community-based care {{Unreferenced, date=January 2023
Community-based care serves as a "bridge" between orphanage and settlement house. Adolescents are placed in a family in their community. The guardians will provide individual care and nurture in the context of a f ...
*
Community integration
Community integration, while diversely defined, is a term encompassing the full participation of all people in community life. It has specifically referred to the integration of people with disabilities into US society from the local to the nationa ...
*
Complex post-traumatic stress disorder
Complex post-traumatic stress disorder (CPTSD, cPTSD, or hyphenated C-PTSD) is a stress-related mental disorder generally occurring in response to complex traumas (i.e., commonly prolonged (or repetitive) exposure to a traumatic event (or trau ...
*
Congregate Care
*
Cottage Homes
*
Independent living
Independent living (IL), as seen by its advocates, is a philosophy, a way of looking at society and disability, and a worldwide movement of disabled people working for Equal opportunity, equal opportunities, self-determination, and self-respect. ...
*
Orphan train
The Orphan Train Movement was a supervised welfare program that transported children from crowded Eastern cities of the United States to foster homes located largely in rural areas of the Midwestern United States, Midwest short on farming Child ...
*
Orphanage
An orphanage is a residential institution, total institution or group home, devoted to the care of orphans and children who, for various reasons, cannot be cared by their biological families. The parents may be deceased, absent, or abusi ...
*
Reactive attachment disorder
Reactive attachment disorder (RAD) is described in clinical literature as a severe attachment disorder, disorder that can affect children, although these issues do occasionally persist into adulthood.DSM-IV-TR (2000) American Psychiatric Asso ...
*
Residential education
Residential education, broadly defined, is a pre-college education provided in an environment where students both live and learn outside their family homes. Some typical forms of residential education include boarding schools, preparatory schools ...
*
Substance dependence
Substance dependence, also known as drug dependence, is a biopsychological situation whereby an individual's functionality is dependent on the necessitated re-consumption of a psychoactive substance because of an adaptive state that has develop ...
*
Supported living
Supported living or supportive living refers to a range of services and community living arrangements (CLAs) designed with individuals with disabilities and their families to support citizens with disabilities to attain or retain their independen ...
*
Supported housing
Supportive housing is a combination of housing and services intended as a cost-effective way to help people live more stable, productive lives, and is an active "community services and funding" stream across the United States. It was developed by ...
*
Teaching-family model
The Teaching-Family Model (TFM) is a model of care for persons in need of services and care necessary to support an improved quality of life and increase opportunities to live to their potential. The TFM is used internationally in residential home ...
*
Family support
Family support is the support of families with a member with a disability, which may include a child, an adult, or even the parent in the family. In the United States, family support includes "unpaid" or "informal" support by neighbors, families, ...
*
Wraparound (childcare)
The wraparound process is an intensive, individualized care management process for youths with serious or complex needs. Wraparound was initially developed in the 1980s as a means for maintaining youth with the most serious emotional and behavior ...
References
Further reading
* Bald, Anthony, Joseph J. Doyle Jr., Max Gross, and Brian A. Jacob. 2022. "Economics of Foster Care." Journal of Economic Perspectives, 36 (2): 223–46.
* Hurley, Kendra (2002)
"Almost Home"Retrieved June 27, 2006.
*
* Knowlton, Paul E. (2001). "The Original Foster Care Survival Guide"; A first person account directed to successfully aging out of foster care.
* McCutcheon, James, 2010. "Historical Analysis and Contemporary Assessment of Foster Care in Texas: Perceptions of Social Workers in a Private, Non-Profit Foster Care Agency". Applied Research Projects.
Texas State University
Texas State University (TXST) is a public university, public research university with its main campus in San Marcos, Texas, United States, and another campus in Round Rock, Texas, Round Rock. Since its establishment in 1899, the university has ...
br>
Paper 332.
Forever Homeis a novel that can give insights into becoming a foster parent.
External links
The Mental Health of Children in Out-of-Home Care: Scale and Complexity of Mental Health ProblemsEffects of Enhanced Foster Care on the Long-term Physical and Mental Health of Foster Care AlumniThe impact of foster care on developmentEnduring neurobehavioral effects of early life trauma mediated through learning and corticosterone suppression *
{{Authority control
Adoption forms and related practices
Adoption, fostering, orphan care and displacement
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