The Impact of Foster Care on Child Development
Demeka F. Gaddy
Liberty University
Abstract
The foster care system was designed to provide a safe temporary placement for children who can no longer stay in the care of their parents or guardian. The overall goal of foster care is for the children to return home to their caregiver. If the caregiver fails to regain custody the child is placed in other living arrangements, to include foster homes. However there is a controversy over the effectiveness of the foster care system in regards to child development. Foster care has been linked to negative impacts in child development to include; physical and sexual abuse, attachment disorders, and behavioral problems that eventually lead to children being placed in multiple placements and in some cases the juvenile justice system,. Children who are in foster care are a vulnerable group due to the being removed from their home, in some cases abruptly. It has been proven that the longer children living in foster care are subject to negative development more than children who do not live in foster care. Based on these factors the foster care system needs to focus more on the needs of the child so that positive development can occur.
Keywords: child welfare, abuse, child development

The Negative Impacts of Foster Care on Child Development
The foster care system was designed to provide a safety net for children and families and to reunite children with their biological parents if possible (Martin, 2014). It is meant to provide children with a temporary living arrangement until permanent living arrangement is found. Children are generally placed in foster care due to adverse environmental conditions to include: neglect, physical and sexual abuse. There are an estimated 399,546 children currently under the protection of the foster care system as a result of abuse or neglect (US Department of Health & Human Services, 2013). Out of those children 12 percent remained in care for 24 to 35 months and 9 percent remained in care for 3 to 4 years (U.S. Department of Health & Human Services, 2013). However, there is controversy over the effectiveness of foster care in regards to child development.
Current foster care literature which suggests removing children from their homes and placing them in foster care is associated with negative developmental consequences (Lawrence, Carlson, & Egeland, 2006). Children and adolescents living in foster care have often experienced adversities such as physical abuse, neglect, sexual abuse, parental psychopathology and family breakdown (Birneanu, 2013). After placement in foster care children are normally subjected to additional adversities causing social, behavioral, academic, psychological and developmental problems (American Academy of Pediatrics, 2000). These adversities can lead to children being placed in multiple placement. Children who are in foster care, kinship care or adoption system and related populations such as children adopted internationally from orphanages also will experience attachment disorder (Chaffin, et al., 2006). This paper examines the negative impact of foster care on children. Addresses these problems in the foster care system and provides a recommendation to propose a more developmental sensitive approach to caring for children when they are placed in out-of-home care.

Reason for Foster Care Placement
The foster care system was created to offer a normal family environment for normal children (Birneanu, 2013). Children are generally placed in foster care in cases of abuse and neglect. However other reasons for foster placement can include severe behavioral problems in the child and/or a variety of parental problems, such as abandonment, illness (physical or emotional), incarceration, AIDS, alcohol/substance abuse, and death (American Academy of Child & Adolescent Psychiatry, 2013).The foster care process is a legal process in which a court decides whether parents or guardians are fit to take care of the child and if it is in the best interest of the child. The option of reunification of children back to the primary caregiver is provided if the parenting situation can be improved. If the courts deem the parents or guardian are not fit then the other options are termination of parental rights (a formal legal procedure) and establishing a permanent out-of-home placement when reunification is impossible (Dozier, Zeanah, & Bernard, 2013). Children are then placed in one of many placements; pre-adoptive home, foster homes which can be relative or non-relative, group homes, institutions, or independent living programs.

Issues in Foster Care
Children in the foster care system represent a vulnerable population who tend to have more serious and complex physical, mental, developmental and behavioral health issues (Dowdell, Cavanaugh, Burgess, & Prentky, 2009). Although foster care is supposed to be a protective measure for children to remove them from an adverse environment, many studies have proven that children in foster care are particularly vulnerable to detrimental outcomes. They often come into state care due to their exposure to maltreatment, family instability, and a number of other risk factors that compromise their healthy development (Jones Harden, 2004). Often children are removed from their homes and schools without warning, placed in foster homes or group residences after being subjected to intrusive interrogations, medical examinations and/or strip searches while the legal system sorts out their future (Reid Mandell, 2006). Removal for most children is a traumatic experience and can lead children to exhibit behavioral problems due to children being unable to adjust to the separation or having to adjust to multiple placements.

Behavioral Problems. Children in foster care who exhibit behavioral problems, normally have prior experiences before entering foster care or from the foster care experience itself. Behavioral problems prior to foster care can be linked to many negative influences including: violence in the home, physical, sexual and emotional abuse, parental drug use and neglect. Many of these children have emotional and behavioral problems upon entering the foster care system and once placed in foster care many of these children experience multiple disruptive placement changes and are at risk for many negative health and social outcomes (Lynch, Dickerson, Saldana, & Fisher, 2014). Children placed in out of home care exhibit and show elevated levels of behavior problems following release from care (Lawrence, Carlson, & Egeland, 2006). Some of these behaviors are mild to include tantrums, bed wetting, or cussing, to more extreme behaviors such as stealing, fighting, or running away. Many of these children have been bounced from home to home, and sometimes to residential institutions, and become more emotionally damaged than they were when they went into the system (Reid Mandell, 2006). Children who experience numerous changes in placement may be a particularly high risk for behavior issues and may become disruptive, aggressive and/or dangerous to others due to the constant changes.
These behavior issues can lead many foster children to become involved in the juvenile justice system. “Crossover” youth – children who are involved in the foster care and juvenile justice system – is common as young people who entered foster care come from unstable or abusive family environments, poverty and other harmful situations (Muller-Ravett & Valentine, 2012). Children who enter the foster care and juvenile system are more likely to be arrested as a result of delinquent acts. It has been found the longer children spend in foster the more likely they will be subject to physical, emotional or sexual abuse. Once this occurs children in foster care are more likely to become involved in criminal behavior; thus increasing the risk of children entering both systems. One study found, more than half (55 percent) of 21-year-olds who had “aged out of foster care” have been arrested at least once between age 18 and 21, compared to only 8 percent of a similar-age group who did not age out of foster care (Courtney & et al 2007).

Attachment Disruptions. Attachment is defined as the positive emotional bond that develops between a child and a particular, special individual, (Feldman, 2014), generally the caregiver. During normal attachment children experience pleasure when they are around the given person and feel comfort by the given person in times of distress. Most children have a secure attachment pattern to their mother. Meaning they use their mother as a home base and are at ease when she is around. However as soon as the mother leaves they become upset and upon her return will go to her. When normal attachment is disrupted, such as when a child is removed from their parents and entered into foster care, attachment disorders are likely to occur.
Reactive Attachment Disorder (RAD) is a psychiatric illness in young children that is characterized as a serious problem in forming emotional attachment to others (American Academy of Child & Adolescent Psychiatry, 2011). It can be displayed in feeding difficulties, unresponsiveness to social overtures from others and a general failure to thrive (Feldman, 2014). Reactive attachment disorder is common in children who have been abused, bounced around in foster care, lived in orphanages, or taken away from their primary caregiver after establishing a bond (Smith, Saisan, & Segal, 2013). Disruptions of attachment (out-of home placement) is typically associated with reactive attachment disorder. When children are initially removed from their primary caregiver and placed in foster care they lose the only source of security and comfort that they had, because some young children have not develop a secondary attachment relationship (Schuengel & Mirjam Oosterman, 2009).
Often foster children develop attachment disorder prior to entering foster care because their needs were not met by their mother or father, but the psychological and environmental characteristics of their foster family can influence the type of attachment they have to their caregiver (Jones Harden, 2004). Once removed and placed into care, children whose needs are additional not met by foster parents will begin to withdrawal themselves away from anyone who tries to become close to them. They will not allow themselves to become emotionally attached to others because they feel the need to protect themselves from further abuse or neglect. In some cases they display overly vigilant or overly compliant behaviors, show indiscriminate connection to every adult, or do not demonstrate attachment behavior to any adult. They may also have other adverse outcomes, such as poor peer relationships, behavioral problems, or other mental health difficulties (Jones Harden, 2004). This behavior often causes foster children to be placed in several foster homes, due to foster parents failing to identify that the child may have attachment issues upon being placed in their home.
Attachment and bonding issues have also been linked to multiple placements for children in foster care. When foster children experience multiple disruptions in placement this can cause children to fail to form a secure attachment to their caregiver and possibly lead to future behavioral issues. Out-of-home placement is the first in a series of placements and disruptions of newly formed attachment relationships for children placed in foster care (Oosterman, Schuengel, Slot, Bullens, & Doreleijers, 2007). When children are separated from their primary caregiver this interrupts the process of a child forming a healthy attachment. It also threatens the future process of a child forming a healthy attachment relationship with caregivers in foster care.

Physical and Sexual Abuse. Foster care is meant to provide protection to children from further neglect or abuse, in some cases some children are further abused after entering foster care in the form of physical and sexual abuse. Physical and sexual abuse occurs in foster homes but are often over looked by child welfare departments because the victims of abuse don’t report it. Failure to report normally occurs because the child is threatened by the perpetrator with the idea that they will be moved away if the child reports the abuse to anyone.
Sexual abuse and physical abuse are more likely to occur in inadequate foster homes, particularly those living in private agencies’ homes. This is not to say that every foster home a child enters that the children will experience abuse or that abuse in foster care will always be done by the foster parents. According to the National Coalition for Child Protection Reform (NCCPR) children are ten times more likely to be physically abused and 28 times more likely to be sexual abused in group homes by other children in group homes (2011). Another study found that out of 50% of substantiated maltreatment reports of sexual abuse, foster fathers or other family members were found to be the perpetrators in over two-thirds of cases and 20% of perpetrators were other foster children in the home.
Sexual and physical abuse can occur in all children who are in foster care but studies have shown that girls in foster care are more vulnerable and a higher-risk group. In a study conducted with 155 female children and adolescents (age 4-17 years) in foster care who had significant histories of maltreatment, chronic health issues and foster care placement instability; 84% of the girls had been physically abused, 81% were sexually abused and 68% were sexually abused by more than one individual (Dowdell, Cavanaugh, Burgess, & Prentky, 2009).
Children with histories of sexual abuse may seek inappropriate, sexual outlets, including demonstrating sexual abusive behaviors, such as rape and sodomy. Children who are victims of sexual abuse often develop a distorted perception of the abuse they received causing them to establish relational connections and fulfill intimacy needs by using abusive behaviors. In the same study conducted on the 155 female children and adolescents; all of the girls (100%) had been shown to exhibit sexually abusive and inappropriate behaviors toward other children, including exposing themselves to age-mates, violation of body space, sexually aggressive remarks, sexual touching without permission, and sexual touching of much younger children (Dowdell, Cavanaugh, Burgess, & Prentky, 2009). Children who enter foster care are supposed to be temporarily moved into a safer placement due to parental abuse or neglect. But for most children physical abuse continues to occur after the children enter foster care. Many states have reported that less than one percent of children are abused in foster care. Much like sexual abuse physical abuse goes unreported by children and is normally discovered after the abuse has occurred for many years. Younger children, children with disabilities and children with prior behavioral and emotional problems are at risk for abuse in foster care.

Multiple Placements. Children who remain in foster care for a longer period of time are more likely to have two or more placement changes. Multiple reasons can play a role in placement failure. These reasons might involve both the actual behavior of the children and the coping strategies of the foster families (James, 2004). Aggressive behaviors and sexually acting out are some of the most common reasons children are asked to leave a placement. However, placement changes may occur for other reasons that are not related to behavior problems. There are times when placement change will occur due to unforeseen life events, unrealistic expectations from the foster family, there is a mismatch between the child and the characteristics of the foster family, to use relative placement, to keep siblings together or to move children to less restrictive settings (James, 2004).
It has been found that every time a child moves to a new placement, to include the first move from their biological family, this causes a loss to one developmental and academic year in the child’s life. Studies have also shown that children with a higher number of placement changes experience a decreased likelihood of reunification, greater severity of behavioral problems and spend more time in residential care (James, 2004). Instability in placement can lead to many issues including: aggression, coping difficulties, low self-esteem, poor development outcomes, education difficulties, increased sense of loss, juvenile delinquency and poor adjustment skills. A study conducted by The University of California, Davis states that children who are removed from their homes and then experience a placement disruption experience profound distress and a sense of not belonging, which can lead to distrust and fear of forming healthy relationships (2008). Children who experienced placement instability in infancy and toddlerhood show poorer inhibitory control abilities and higher caregiver-rated oppositional behavior at the age of 5 or 6 compared with other children (Lewis, Dozier, Ackerman, & Sepulveda-Kozakowski, 2007). They are more likely to experience later placement disruptions due to behavioral issues, including in children who initially did not exhibit behavior problems, thus creating a dysfunctional cycle.

Conclusion Children who are in foster care are a vulnerable group, often facing adverse circumstances prior to removal from their primary caregiver. Because these children have already faced early adverse circumstances in the form of abuse or neglect, they are more subject to experiencing increase developmental issues after entering foster care. Behavioral issues that are often present prior to the child’s removal, are more likely to occur or increase once the children are removed from their primary caregiver. Foster care children often will display behavioral issues that can lead to placement disruption or worse juvenile delinquency. Attachment issues can develop when a child is removed from their primary caregiver and can lead to reactive attachment disorder. A disorder that occurs in young children that makes forming emotional attachment to others difficult. Multiple placements can lead to attachment and bonding issues for children. Multiple placements also have shown to have a negative impact in the behavior of foster care children. Physical and sexual abuse in foster care can also cause children to become aggressive, both physically and sexually and also lead to placement disruption.
The foster care system needs to focus on the needs of the child when placing them in foster homes. Foster parents should assume that children will have attachment issues upon entering their homes and that it is important for them to provide a caring and nurturing environment immediately after the child’s placement. Importance should also be on placing children with families who are trained to handle children who have experienced physical or sexual abuse. Background checks need to be performed on all applicants of the foster home and if any indication of previous criminal activity is present then those homes should not be considered for fostering children. This will help to prevent further abuse or neglect towards foster children. To eliminate or limit numerous placements children should be placed in pre-adoptive homes when possible. The foster care system should be better equipped to provide targeted and effective interventions to bring about more favorable outcomes for foster children (Healey & Fisher, 2011).

References
American Academy of Child & Adolescent Psychiatry. (2011, Mar). Facts for Families: Reactive Attachment Disorder. Retrieved from American Academy of Child & Adolescent Psychiatry: http://www.aacap.org/App_Themes/AACAP/docs/facts_for_families/85_reactive_attachment_disorder.pdf
American Academy of Child & Adolescent Psychiatry. (2013, Feb). Facts for families: Foster care. Retrieved from American Academy of Child & Adolescent Psychiatry: http://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/Facts_for_Families_Pages/Foster_Care_64.aspx
American Academy of Pediatrics. (2000). Developmental Issues for Young Children in Foster Care. Pediatrics, 106(1), 1145-1150. Retrieved from Pediatrics.
Birneanu, A. (2013). Behavior problems in foster care children. Revisa de Asistenta Sociala, 15-23.
Dowdell, E., Cavanaugh, D., Burgess, A., & Prentky, R. (2009). Girls in foster care: a vulnerable and high-risk group. MCN The American Journal of Maternal Child Nursing, 34(3), 172-178.
Dozier, M., Zeanah, C. H., & Bernard, K. (2013). Infants and toddlers in foster care. Child Development Perspectives, 7(3), 166-171.
Feldman, R. S. (2014). Development across the life span. Upper Saddle River, NJ: Pearson Education Inc.
Healey, C. V., & Fisher, P. A. (2011). Children in foster care and the development of favorable outcomes. Children and Youth Services Review, 33(10), 1821-1830.
James, S. (2004). Why do foster placements disrupt? An investigation of placement change in foster care. Social Service Review, 78(4), 601-627. Retrieved Sep 28, 2014, from http://www.jstor.org/stable/10.1086/424546?origin=JSTOR-pdf
Jones Harden, B. (2004). Safety and stability for foster children: A developmental perspective. Children, Families, and Foster Care, 31-47. Retrieved Sep 4, 2014, from http://futureofchildren.org/futureofchildren/publications/docs/14_01_02.pdf
Lawrence, C., Carlson, E., & Egeland, B. (2006). The impact of foster care on development. Development and Psychopathology, 18, 57-76. doi:10.10170S0954579406060044
Lewis, E. E., Dozier, M., Ackerman, J., & Sepulveda-Kozakowski, S. (2007). The effect of placement instability on adopted children's inhibitory control abilities and oppositional behavior. Developmental Psychology, 43(6), 1415-1427. Retrieved from http://www.psych.udel.edu/pdfs/publications/the_effects_of_caregiving.pdf
Lynch, F. L., Dickerson, J. F., Saldana, L., & Fisher, P. A. (2014). Incremental net benefit of early intervention for preschool-aged children with emotional and behavioral problems in foster care. Children and Youth Services Review, 36, 213-219. Retrieved from http://rx9vh3hy4r.search.serialssolutions.com/?ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info:sid/summon.serialssolutions.com&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Incremental+net+benefit+of+early+interven
Martin, M. (2014). Introduction to human services: Through the eyes of practice settings (3rd ed.). Upper Saddle River, NJ: Pearson.
Mendle, J. L. (2011). Associations between early life stress, child maltreatment, and pubertal development among girls in foster care. Journal of Research on Adolescence, 21(4), 871-880.
Muller-Ravett, S., & Valentine, E. J. (2012). After foster care and juvenile justice. A Preview of the Youth Villages Transitional Living Evaluation.
National Coalition for Child Protection Reform . (2011). Foster care vs. family preservation: The track record on safety and well being. Retrieved from http://www.nccpr.org/reports/01SAFETY.pdf
Octoman, O., McLean, S., & Sleep, J. (2014). Children in foster care: What behaviours do carers find challenging? Clinical Psychologist, 18(1), 10-20.
Oosterman, M., Schuengel, C., Slot, N., Bullens, R., & Doreleijers, T. (2007). Disruptions in foster care: A review and meta-analysis. Children and Youth Services Review, 29, 53-76.
Reid Mandell, B. (2006). Foster care. New Politics, 11(1), 18-37.
Schuengel, C., & Mirjam Oosterman, P. S. (2009). Children with disrupted attachment histories: Interventions and psychophysiological indices of effects. Child & Adolescence Psychiatry and Mental Health, 3(26).
Smith, M., Saisan, J., & Segal, J. (2013). Attachment Issues and Reactive Attachment Disorders. Retrieved from HelpGuide.Org: http://www.helpguide.org/articles/secure-attachment/attachment-issues-and-reactive-attachment-disorders.htm
The University of California, Davis, Extension The Center for Human Services. (2008). A literature review of placement stability in child welfare service: Issues, concerns, outcomes and future directions. Davis: The Center for Human Services. Retrieved from http://www.childsworld.ca.gov/res/pdf/PlacementStability.pdf
U.S. Department of Health & Human Services. (2013, September). Adoption and Foster Care Analysis and Reporting System (AFCARS). Retrieved from Childrens Bureau: An Office of the Administration for Children & Families: http://www.acf.hhs.gov/programs/cb/research-data-technology/statistics-research/afcars
US Department of Health & Human Services. (2013, Sept). Data Brief 2013-1: Recent Demographic Trends in Foster Care. Retrieved Sep 23, 2014, from US Department of Health & Human Services: http://www.acf.hhs.gov/sites/default/files/cb/data_brief_foster_care_trends1.pdf