scholarly journals Do prescribers deprescribe psychotropic medication for children in foster care?

2020 ◽  
Vol 2 (1) ◽  
pp. 3-20 ◽  
Author(s):  
Conor O’Brien ◽  
John T. Rapp ◽  
Erica D. Kierce
Keyword(s):  
Foster Care ◽  
Psychotropic Medication ◽  
Foster Children ◽  
Descriptive Study ◽  
Psychotropic Medications ◽  
Prescribing Patterns ◽  
Future Research ◽  
Foster Care System ◽  
Children In Foster Care ◽  
The Mean

Approximately one third of children in foster care in the U.S. receive psychotropic medication; however, few studies have evaluated the extent to which either the number or dosage of drugs changes across time. We conducted a retrospective descriptive study of Medicaid files for 30 individuals placed in a foster care system that included an analysis of 10 consecutive visits with a prescribing practitioner spanning 8–14 months. Specifically, we evaluated the data for evidence of deprescribing. Results indicate practitioners changed psychotropic medication during 70% of visits and most changes involved removing and adding psychotropic medication within the same class. Results also show 60% of visits across participants involved prescriptions for four or more psychotropic medications, whereas only 0.33% of trials involved no psychotropic medication. Furthermore, results show the mean number of psychotropic medications per foster child at the end of the study ( M = 3.97) did not decrease in comparison to the start of the study ( M = 3.53). Taken together, these results indicate that prescribers do not regularly engage in a clear deprescribing process for psychotropic medication when serving foster youth. We discuss some limitations to the current study and directions for future research on prescribing patterns with foster children.

Predictors of Adoption and Guardianship Dissolution: The Role of Race, Age, and Gender Among Children in Foster Care

2020 ◽  
pp. 107755952095217
Author(s):  
Kierra M. P. Sattler ◽  
Sarah A. Font
Keyword(s):  
Foster Care ◽  
Foster Children ◽  
Cognitive Disability ◽  
Health Issues ◽  
Foster Care System ◽  
Children In Foster Care ◽  
Disability Status ◽  
Entry Cohort ◽  
And Gender

Adoption and guardianship are meant to provide permanency to foster children when reunification is not a viable option. Unfortunately, sometimes adoption and guardianship placements dissolve resulting in children returning to care. Currently, there is limited research on the prevalence and predictors of adoption and guardianship dissolutions. This study investigated rates of guardianship and adoption dissolution using a complete entry cohort from a large state foster care system and the associations between child characteristics and risk factors with dissolution. Drawing on a complete entry cohort of foster children in Texas that exited to either adoption or guardianship placements, results demonstrated that over 2% of adoptive placements and 7% of guardianship placements were dissolved. Compared with White and Hispanic children, Black children had a higher risk of guardianship, but not adoption, dissolution. Older age was associated with a higher risk of adoption dissolution, and females had a higher risk of guardianship dissolution than males. Behavior problems, cognitive disability status, and mental health issues were all associated with a higher risk of dissolution. These findings have important implications for caseworkers and policymakers on permanency for children in adoptive or guardianship placements.

scholarly journals IS FOSTER CARE THE SAFE PLACE WE BELIEVE IT TO BE? IF NOT, WHY NOT?

2021 ◽  
Vol 57 (4) ◽  
pp. 499-515
Author(s):  
Rankwe Reuben Masha ◽  
Petro Botha
Keyword(s):  
Foster Care ◽  
Child Protection ◽  
Foster Children ◽  
Foster Parents ◽  
Small Scale ◽  
Research Approach ◽  
Foster Care System ◽  
Safe Place ◽  
Children In Foster Care ◽  
Abuse And Neglect

Foster care is an important part of the child protection system; however, it seems that some foster children are not protected – they are abused and neglected. The aims of this article are to confirm on a small scale whether children in foster care are indeed being abused and neglected and to develop an understanding of factors contributing to the abuse and neglect of these foster children. A qualitative research approach was applied. Findings confirmed the occurrence of abuse and/or neglect and provided information on factors relating to foster parents and the foster care system itself contributing to this phenomenon.

Foster Care Children

PEDIATRICS ◽  
1983 ◽  
Vol 71 (1) ◽  
pp. 138-138
Author(s):  
JOHN D. MADDEN
Keyword(s):  
Health Care ◽  
Foster Care ◽  
Health Status ◽  
Foster Children ◽  
Foster Child ◽  
Foster Care System ◽  
Children In Foster Care ◽  
Social Pediatrics ◽  
The Family ◽  
Care System

To the Editor.— Schor's article, "The Foster Care System and Health Status of Foster Children" (Pediatrics 1982;69:521) may well prove to be a landmark paper in social pediatrics. The related editorial by Sokoloff (Pediatrics 1982;69:649) provided invaluable advice as to how we, as pediatricians, can better serve children in foster care. One point in Sokoloff's editorial particularly caught my attention. He expressed the hope that pediatricians providing health care to the natural children within the family would also be willing to attend the needs of the foster child and that the fact that in some states Medicaid is responsible financially for these children would not deter the physician from doing so.

Caring for Foster Children

PEDIATRICS ◽  
1982 ◽  
Vol 69 (5) ◽  
pp. 649-650
Author(s):  
Burton Z. Sokoloff
Keyword(s):  
Foster Care ◽  
Foster Children ◽  
Poor Quality ◽  
Pediatric Care ◽  
Foster Care System ◽  
Children In Foster Care ◽  
Health Supervision ◽  
Quality Of Health Services ◽  
Strongly Agree

The poor quality of health services rendered to the half million foster children in this country is well documented elsewhere in this issue.1 This is an area of pediatric care of which we cannot be proud. Schor's "unfortunate discovery that children who have been under the protective and hopefully remedial care of the foster care system continues to demonstrate evidence of inadequate health supervision" must serve as a stimulus for changes. I strongly agree with Schor that the pediatric literatore has contributed to the problem by failing to describe adequately the special problems inherent in children in foster care—a population at high risk.

Foster Care for Child Maltreatment: Impact on Delinquent Behavior

PEDIATRICS ◽  
1985 ◽  
Vol 75 (3) ◽  
pp. 562-568
Author(s):  
Desmond K. Runyan ◽  
Carolyn L. Gould
Keyword(s):  
Foster Care ◽  
Child Maltreatment ◽  
Foster Children ◽  
Maternal Education ◽  
Child Victims ◽  
Foster Home ◽  
Historical Cohort ◽  
Children In Foster Care ◽  
Cohort Differences ◽  
The Impact

Previous reports of child maltreatment Sequelae have not systematically examined the effects of societal intervention. A historical cohort study has been undertaken to examine the impact of one intervention, foster care, on the subsequent development of juvenile delinquency among child victims. One hundred fourteen foster children, aged 11 to 18 years, in foster care for three or more years, and who were in foster care as a result of maltreatment were studied. A comparison cohort was composed of 106 victims of maltreatment who were left in their family home; these children were similar to the children in foster care with regard to age, race, sex, and year of diagnosis. Cohort differences in maternal education, type of abuse, history of prior maltreatment, sex, and race were controlled in the analysis. Foster children committed 0.050 crimes per person-year after age 11 years; home care children committed 0.059 crimes per person-year after age 11 years (P > .2). Foster children were more likely to have committed criminal assault. Among foster children, increased number of foster home placements correlated with increased number of delinquency convictions. Overall, there appears to be no support for the idea that foster care is responsible for a significant portion of later problems encountered by victims of maltreatment.

Psychotropic Medication Patterns for American Indian Children in Foster Care

2018 ◽  
Vol 28 (3) ◽  
pp. 225-231 ◽  
Author(s):  
David Glesener ◽  
Gwendolyn Anderson ◽  
Xuan Li ◽  
Jacob Brown ◽  
James Amell ◽  
...  
Keyword(s):  
Foster Care ◽  
American Indian ◽  
Psychotropic Medication ◽  
Indian Children ◽  
Children In Foster Care

scholarly journals The voices of parents and children in foster care

2020 ◽  
pp. 146801732095861
Author(s):  
Aida Urrea Monclús ◽  
Ainoa Mateos Inchaurrondo ◽  
Laura Fernández-Rodrigo ◽  
M Àngels Balsells Bailón
Keyword(s):  
Foster Care ◽  
Critical Approach ◽  
Parenting Programme ◽  
Foster Care System ◽  
Active Involvement ◽  
Children In Foster Care ◽  
Parents And Children ◽  
The Family ◽  
Realistic View

Summary This article presents the results of a qualitative study whose objective was to collect information on the perceptions of changes in parents and their children who are in the Spanish foster care system after completing a positive parenting programme. Findings The participants in the focus groups included 66 parents and 57 children. Triangulation of the voices of all protagonists identified findings that suggest the need for changes regarding understanding foster care measures and the process of family resilience; the quality and content of visits and contact between parents and children; and the role of professionals involved in the case. Applications The findings indicate the efficacy of the intervention proposed in the ‘Walking family’ programme with the direct and active involvement of children as they become a driver of change for the parents. However, when this does not occur, professionals must work from a critical approach and should provide a realistic view of the family to children.

Pediatrics and the Unwanted Child in History: Foundling Homes, Disease, and the Origins of Foster Care in New York City, 1860 to 1920

PEDIATRICS ◽  
1984 ◽  
Vol 73 (5) ◽  
pp. 699-711
Author(s):  
Peter C. English
Keyword(s):  
Health Care ◽  
New York ◽  
Foster Care ◽  
Medical Attention ◽  
Vulnerable Children ◽  
Foster Care System ◽  
Service Workers ◽  
Professional Groups ◽  
Children In Foster Care ◽  
Emotional Handicaps

In recent years, America's present means of providing for unwanted children, the foster care system, has come under severe criticism from many child-serving professional groups. The Committee on Adoption and Dependent Children of the American Academy of Pediatrics notes that children in foster care are not likely to receive routine health care, such as immunizations and screening for hypertension, dental caries, or vision or hearing problems.1 Yet these vulnerable children frequently have significant health problems, and they may require more medical attention than the average child. In Massachusetts, 33% of the children in foster care have emotional handicaps, 13% suffer from serious physical illnesses, 19% are mentally retarded, and 15% have multiple handicaps.2 Children in foster care often lack a single health provider and they have few health advocates. Despite criticism from pediatricians about the sorry state of health care provided to these children, pediatricians frequently find themselves in the uneasy position of recommending foster care placement to social service workers in intransigent cases of child abuse and neglect. Child psychiatrists, such as Anna Freud and Albert Solnit, have joined pediatricians in criticizing foster care. They point out that a child cannot develop emotionally in a rotating system of foster homes. With each move, the foster child becomes less open, attachments less intense. As a result, children emerge from foster care with significant emotional handicaps.3 Social workers, those professionals who work most closely with unwanted children, have added to the chorus of concern over foster care. They point to the difficulty of early identification of the family in trouble and then successful intervention.

Foster Care Children

PEDIATRICS ◽  
1983 ◽  
Vol 71 (1) ◽  
pp. 137-138
Author(s):  
HOWARD B. DEMB
Keyword(s):  
Foster Care ◽  
Health Status ◽  
Foster Children ◽  
Foster Care System ◽  
High Incidence ◽  
Care System

To the Editor.— After reading Schor's article "The Foster Care System and Health Status of Foster Children" (Pediatrics 1982;69:521) I wished that there was one point he would have made more clearly. Namely, that the population of children coming into foster care has a high incidence of psychopathology, much of it rather severe. A corollary point should also be made, ie, that the quantity and quality of psychopathology produced by the fact of entering foster care is minimal by comparison to the nature and extent of the psychopathology already present in these children when they come into foster care.

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