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Family Life

Children in foster care have special health care needs. Before foster care, most of these children lived with families that suffered from:

The experience of living in out-of-home placement usually brings with it feelings of confusion, worry, fear, sadness, and loss of control. While it is impossible to predict all of the health concerns that these children might have, we know they have many more physical, mental, dental, and developmental health concerns than children who are not in foster care.

Ideally, when children enter foster care, they will remain with their familiar child care provider. However, this may not be possible. Sometimes, children enter child care for the first time when they enter foster care. Also, foster parents or kin may have to enroll children in child care almost immediately after placement.

Common Issues for a Child Transitioning (Changing) into Child Care Include:

  • Increased difficulty transitioning into child care due to the child also having to adjust to foster care placement and being away from the birth parent(s)
  • Lack of knowledge by early education and child care professionals about how to help a child with a history of trauma
  • Difficulty enrolling a child in child care because a lack of health information, sometimes resulting in a change of placement or use of unlicensed child care providers
  • Behavior problems resulting in the child not being allowed to go back to child care
  • Behavior issues that often lead to suspension or expulsion from child care are based on childhood trauma and include:
    • Acting out toward staff or other children
    • Stealing
    • Ruining property
    • Not following rules
    • Not listening to the child care provider

Advice for Foster Parents or Kin

Here are some steps foster parents or kin can take to help the child make a successful transition into the child care program:
 
  • Visit the program with the child, before she begins attending.
  • Inform early education and child care professionals about the need for extra support because the child is getting used to both your home and to child care.
  • Send a transitional object, such as a blanket or stuffed animal, with the child every day; you can even let the child pick what to bring by offering a few choices. Note: To reduce the risk of Sudden Infant Death Syndrome, children under 1-year should not have any soft bedding or objects in the crib.
  • Let the child know who will be there to pick him up at end of the day.
  • Let the child know that she will be returning to your home at the end of the day.

Advice for Early Education and Child Care Providers

Here are some steps early education and child care professionals can take to help the child make a successful transition into the child care program:
 
  • Ensure that appropriate permission is in place, each time, when a child is picked up for a visit with the birth parent(s). Often the person picking up the child changes week to week, or the birth parent(s) drops in for a visit. The child care program needs to ensure that the child is only being visited or taken by permission.
  • Ensure confidentiality about the fact that a particular child is in foster care. Early education and child care professionals should not reference that a child is in foster care in front of other parents or other children.
  • Encourage awareness that children in foster care are often very sensitive to transitions and separation. In addition, the times right before and/or after visits can be very stressful for the child.

Tips for Easing the Transition:

  • Have a consistent caregiver each day.
  • Allow the child to have pictures of key people in his life handy.
  • Prepare the child for visits with family (some happen during the day and when the child is picked up and/or returned to the child care program). Assist in the transition when the child is being picked up for a visit, especially if the person is unknown to the child (eg, a driver).
  • After a visit, allow the child to spend time with a familiar and caring adult to transition back to the child care setting.
  • Be aware that behaviors may increase before and/or after a visit and/or if the visit is canceled or the parent does not show up.
  • Encourage awareness that severe tantrums or other behavior issues also need to be handled sensitively.
  • Isolating a child (eg, using a “time out”) who already feels “abandoned” can be very damaging.
  • Encourage awareness about common mental health issues for children in foster care (and how to respond to them) such as:
  • Engage the assistance of a mental health consultant if the child’s behaviors are problematic and/or if the child is having chronic difficulty with transitions and/or separations.
  • Encourage sensitivity regarding things like Mother’s and Father’s Day projects (eg, make 2 sets of gifts, one for the foster parent and one for the birth parent).

 

Last Updated
10/3/2013
Source
Helping Children in Foster Care Make Successful Transitions into Child Care (Copyright © 2011 American Academy of Pediatrics)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.