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Foster Care in Early Childhood

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Foster Care in Early Childhood CHAPTER 34 Foster Care in Early Childhood Anna T. Smyke Angela S. Breidenstine Both the serious maltreatment that precipitates children. Whenever a decision is made about a a young child’s entry into out-of-home care and young child in foster care, we should be asking the experience of separation from parents and ourselves: “Whose needs are being met here?” family members can impact the child and his or If the answer is not that the child’s needs are her family for years to come. Removal is initiat- being met, but rather that priority is being given ed when it is believed the risks caused by sepa- to the easiest transportation option, or the child rating a child from his or her parents/caregivers protection worker’s schedule, or the biological are secondary to the risks posed to the child’s parents’ lack of resources, or the foster parent’s well-being if allowed to remain in the home. aversion to meeting the biological parents, or Reunifying the family remains the primary any such non-child-centered reason, then we goal for almost all young children brought into must rethink our decision-making process to foster care. Some maltreating parents were fos- prioritize the needs of the child. ter children themselves (Lillas, 2010) and went This chapter is based on the premise that fos- into and out of the system without adequate res- ter care should be understood not only as a safe olution of the factors that brought them to the place for children to reside in out-of-home care attention of child protective services. Involving but also as a systematic means to help young biological parents, foster parents, and child pro- children to recover from the impact of abuse tection workers as a team, in a respectful way, and neglect (Smyke & Breidenstine, 2009). In as they work toward the goal of reunification is this chapter, we review statistics about young an essential element in meeting the young foster children in foster care and examine specific child’s need for love and stability (Lutz, 2005). challenges for caregivers of young children, Notably, when foster and biological parents including those who are interested in family “coparent” young children, that is, work to- building through foster care and relative care- gether in partnership, focused on creating the givers. We also explore interventions aimed at best experience possible for the young child, improving the experience of out-of-home care there is the opportunity for young foster chil- for young children. Throughout, we emphasize dren to thrive (Petcovich, 2010). Maintaining the importance of prioritizing developmen- child-centered foster care, rather than extend- tally informed foster care for young children ed-respite foster care (Smyke & Breidenstine, (Zeanah, Shauffer, & Dozier, 2011) aimed at 2009) or adult/system-centered foster care, strengthening relationships between young fos- Copyright @ 2019. The Guilford Press. All rights reserved. May not be reproduced in any form without permission from the publisher, except fair uses permitted under U.S. or applicable copyright law. keeps the process focused on the needs of young ter children and their caregivers. 553 EBSCO : eBook Collection (EBSCOhost) - printed on 7/2/2019 3:18 PM via TUFTS UNIV AN: 1843598 ; Zeanah, Charles H..; Handbook of Infant Mental Health, Fourth Edition Account: s3579704.main.ehost 554 V. Intervention In addition to protecting the child from fur- (Smyke & Breidenstine, 2009). Subclinical in- ther abuse or neglect, a child’s stay in foster juries that do not result in full-blown shaken care should be an opportunity for maltreating baby syndrome or prenatal exposure to illicit parents to improve their protective capacity substances may cause greater infant distress and learn more empathic, appropriate ways to and crying, thus further stressing parents who interact with their children. There are many in- are ill-equipped to handle their babies’ distress. terventions used with biological parents for this We focus in this chapter on the ways in which purpose, but we note that interventions focused the youngest children in the foster care system on increasing the parents’ understanding of have special needs that are dictated by their age, the child’s attachment needs, such as Circle of their cognitive capabilities, and their develop- Security (COS; Powell & Cooper, 2014), those mental imperative to establish and maintain at- facilitating sensitive parenting for mothers in tachment relationships with their caregivers. substance abuse treatment, such as the Mothers and Toddlers Program (Suchman, DeCoste, & Mayes, 2009), or those that treat parent–child Developmentally Informed Foster Care relationships affected by trauma, such as child– for Young Children parent psychotherapy (CPP; Lieberman, Ghosh Ippen, & Van Horn, 2016; Lieberman & Van A primary developmental task of the young Horn, 2009), may be invaluable for children af- child is to establish an attachment relationship fected by maltreatment and their parents. with a caregiver. It is beyond the scope of this chapter to go into depth about the development and maintenance of the parent–child attachment Who Are the Young Children in Foster Care? relationship (see Boris, Aoki, & Zeanah, 1999), although issues of attachment and loss have par- Children under 5 years of age are at increased ticular relevance to the maltreated young child physical risk for maltreatment given their small in foster care (Zeanah, Berlin, & Boris, 2011). size and absolute dependence on adult care to If the child enters foster care before 6 months survive. In the United States, children less than of age, we would expect that he or she has not 4 years of age accounted for 77.7% of those yet reached the stage of forming a focused at- under age 18 who died from child abuse in 2014 tachment with his or her biological parents and (Child Welfare Information Gateway, 2016a). may readily establish one instead with the fos- On September 30, 2014, there were 164,542 chil- ter parents later in the first year. Children who dren ages 5 and younger residing in the U.S. fos- enter state’s custody during the time when they ter care system. They were 39% of the 415,129 are expected to be developing a focused attach- children in foster care in the United States (U.S. ment relationship (ages 7–9 months), or after Department of Health and Human Services, they have already established one, are likely to 2016). Overall, foster children were evenly rep- experience a disruption of that relationship. resented in gender (female 48%) and their me- Visitation with biological parents often oc- dian age was 8 years. Among all foster children, curs on a weekly basis for an hour or two, which 42% were European American, 24% were Af- is insufficient time either to develop or maintain rican American, 22% were of Hispanic origin, an attachment relationship (Smariga, 2007). Be- and 10% were categorized as other/biracial. In cause of their immature cognitive development, fiscal year 2014, the last year for which we have even multiple visits a week are usually insuf- data, 126,091 (46%) of the 264,746 total children ficient for young children to maintain or create entering foster care were 5 and younger when a meaningful attachment relationship, which they entered the child welfare system (U.S. De- depends on repeated, daily caregiving interac- partment of Health and Human Services, 2016). tions over time. Especially objectionable is the Whereas a school-age child can convey to mandated minimum number of visits per week. adults that he or she is being abused and ne- Individualizing recommendations is always glected, this is much more difficult for a young preferable because of myriad factors that must child who may be limited by his or her lan- be considered. guage capabilities, or who may not be around Many factors affect a child’s comfort level other adults capable of providing protection. when he or she visits with his or her biological Injuries to infants and toddlers, such as shaken parents, including the nature of the parent–child Copyright @ 2019. The Guilford Press. All rights reserved. May not be reproduced in any form without permission from the publisher, except fair uses permitted under U.S. or applicable copyright law. baby syndrome, can lead to lifelong disabilities relationship before entry into foster care (e.g., EBSCO : eBook Collection (EBSCOhost) - printed on 7/2/2019 3:18 PM via TUFTS UNIV AN: 1843598 ; Zeanah, Charles H..; Handbook of Infant Mental Health, Fourth Edition Account: s3579704.main.ehost 34. Foster Care in Early Childhood 555 neglectful, role-reversed/inappropriate), as well There are a number of reasons why the fit be- as whether there were traumatic events involv- tween the foster parent and the child protection ing the parents prior to the child’s removal (e.g., worker may not be a good one (e.g., the foster physical abuse, sexual abuse, intimate partner parent is seen as advocating “too much” for the violence). The presence of the foster parent (the child, blocking access to the biological parents child’s attachment figure), with proper prepara- by scheduling appointments during visit times, tion, can make the visit more meaningful for or refusing to transport the child). Consistent both child and biological parent. communication between the foster parent and In our experience, the importance of parents child protection worker is essential to the young making progress in needed interventions while foster child’s well-being. having one or two supported, well-designed weekly visits with their children typically su- Uncertainty persedes the idea that all children and their par- ents should visit multiple times per week, for Foster parents are asked to commit to children long periods of time.
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