Forgotten Children: Children with Disabilities in Foster Care (2006)
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Forgotten Children A Case for Action for Children and Youth with Disabilities in Foster Care A Project of United Cerebral Palsy and Children’s Rights, 2006 Forgotten A Case for Action for Children and Youth with Disabilities in Foster Care Children Table of Contents About United Cerebral Palsy and Children’s Rights.........2 Acknowledgements..............................................................2 A Case for Action.................................................................3 The Kids................................................................................4 Unmet Needs........................................................................5 Systemic Challenges.............................................................6 Identifying the Population ......................................6 Foster Parents ...........................................................6 Health Care...............................................................6 Education..................................................................6 Transition to Adulthood..........................................7 Fragmented Systems and Lack of Information .....7 Promising Approaches.........................................................8 Conclusion............................................................................9 Endnotes.............................................................................10 About United Cerebral Palsy Acknowledgements United Cerebral Palsy is one of the nation’s leading The partnership between United Cerebral Palsy and organizations serving and advocating for the more than 54 Children’s Rights would not be possible without the million Americans with disabilities. Most UCP consumers are commitment of Loreen Arbus, a national Trustee of United people with disabilities other than cerebral palsy. Through its Cerebral Palsy, who saw the need and cared enough to nationwide network, United Cerebral Palsy offers services to initiate and support this effort. individuals, families and communities such as job training and placement, physical therapy, individual and family Children’s Rights and United Cerebral Palsy also would like support, early intervention, social and recreation programs, to thank the diverse group of United Cerebral Palsy affiliates community living, state and local referrals, and instruction on who have added their voices to this collaboration, and to how to use technology to perform everyday tasks. For more recognize Sara Munson at Children’s Rights, the primary information, visit www.ucp.org or call (800) 872-5827. author of this comprehensive literature review. About Children’s Rights Children’s Rights is a national organization advocating on behalf of abused and neglected children in the U.S. Since 1995 we have used legal action and policy initiatives to protect children and create lasting improvements in foster care, adoption and child welfare. For more information, visit www.childrensrights.org or call (212) 683-2210. 2 A Case for Action On any given day, there are more than half a million children and youth in foster care in the United States, and studies suggest that at least one-third have disabilities, ranging from minor developmental delays to significant mental and physical disabilities.1 This population continues to increase as technology enables growing numbers of children to survive disabling medical conditions and as more children are being recognized and identified as having disabilities.2 Evidence suggests, however, that the special needs of this population are not being met in foster care systems across the country, and that these children experience worse outcomes than other children in foster care.3 In 2004, two national organizations committed to improving the lives of vulnerable children, United Cerebral Palsy and Children’s Rights formed an alliance to improve policy and practice for children and youth with disabilities in foster care. Through this partnership, United Cerebral Palsy and Children’s Rights are identifying promising service delivery approaches for meeting the needs of this population and developing policy and legal advocacy strategies to address major systemic problems that negatively affect these children’s safety, well-being and opportunity to grow up in permanent families. The joining of forces of the child welfare and disability service and advocacy communities at the national, state and local levels is a critical step in beginning to address these issues.4 This report provides a summary of the research and other available information regarding children and youth with disabilities in foster care. It documents the critical needs of the children and youth themselves and the status of the systems that serve them, detailing the range of issues that provide the foundation for the partnership between United Cerebral Palsy and Children’s Rights. 3 Forgotten A Case for Action for Children and Youth with Disabilities in Foster Care Children The Kids Of the more than 500,000 children and youth in foster care, There are 119,000 children and youth in foster care who are almost one-third are under age five and one-fifth are over waiting to be adopted. Their average age is eight; more than the age of 16. Almost half are placed with non-relative foster one-third are under the age of five, and more than one-third families, one-fourth live with relatives, and one-fifth are are over the age of 11. They have been in foster care an living in group homes or institutions. Forty percent have average of nearly four years.7 The majority of these children been in foster careA forProfile more than twoof years. Children5 Many of these in Fosterand youth have Care disabilities.8 children and youth have disabilities.6 A Profile of Children in Foster Care Age Average Age = 10 years Placements 21% 6-10 years 46% with non-relative foster families 23% 30% 25% with relatives 11-15 years 1-5 years 19% 18% in group homes 16-18 years or institutions 2% 19 years or more 5% pre-adoptive home 5% under 1 year 4% trial home visit 2% runaway 1% supervised independent living Race 39% White Length of Time in Care 35% Black 40% have been in foster care for more than 2 years 17% Hispanic Gender Slightly more males than females 3% Non-Hispanic 2% Native American Indian 1% Asian 3% Unknown Source: US Department of Health and Human Services, 2005 4 The Unmet Needs A growing body of research has revealed that increasingly, Children and youth with these types of special needs children and youth in foster care have physical, mental experience disproportionately poorer foster care outcomes. health or developmental problems.9 When compared to children and youth without disabilities, those with disabilities in foster care: Although the issues facing children and youth with disabilities in foster care have yet to come to the forefront of • Are less safe, and more likely to be maltreated;26 child welfare planning, service delivery or evaluation,10 there • Are more likely to be on psychotropic medications;27 is a developing body of literature that clearly highlights the critical need for this type of discussion and focus.11 • Have poorer educational experiences and outcomes, including higher rates of school transfer, absenteeism, Most of the children who enter foster care have been tardiness, grade retention, achieving poor grades, exposed to conditions that undermine their chances for dropping-out, performing below grade level, receiving low healthy development.12 Research indicates that children and state testing scores, exemption from state testing, youth in foster care are in worse health than those who are suspension and expulsion, enrollment in vocational homeless or those living in the poorest sections of our inner training, placement in more restrictive classrooms, and cities.13 They have a higher likelihood of chronic medical lower rates of doing homework, receiving help with problems, lifelong psychiatric and behavioral issues, as well schoolwork from caregivers, being enrolled in college as permanent physical, cognitive and developmental preparatory courses, receiving a high school diploma, or disabilities than children in the general population.14 participating in postsecondary education;28 • Are more likely to be institutionalized;29 Whether they experience maltreatment that results in disabilities, or are victims of maltreatment because of their • Experience more placement instability;30 disabilities,15 children who enter foster care with special • Have longer lengths of stay;31 needs, on average, already have experienced more than 14 different environmental, social, biological and psychological • Have lower rates of achieving permanency, including risk factors before coming into care.16 lower probability of reunification with their birth families, guardianship with relatives or adoption,32 and higher rates While there have not been systematic national studies of the of re-entry into care;33 prevalence of disability among children in foster care, • Have fewer opportunities for positive adult functioning, individual studies in various states and localities have including higher rates of homelessness, substance abuse, highlighted a range of potential challenges. These studies unemployment, receiving public assistance, criminal have found the following: justice involvement, non-marital childbearing, being violently or sexually assaulted and having mental health • 40% born low birth weight or premature;17 problems following discharge from foster care.34 • 80% prenatally exposed to substances;18 •