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PEDIATRICS Vol. 106 No. 1 July 2000, pp. 59-66

Specialized Assessments for Children in Foster Care

Received Mar 8, 1999; accepted Sep 10, 1999.

Sarah McCue Horwitz*, Dagger , §, Pamela OwensDagger , and Mark D. Simmsparallel

From the * Department of Epidemiology and Public Health and Dagger  Child Study Center, Yale University School of Medicine, New Haven, Connecticut; § Institution for Social and Policy Studies, Yale University, New Haven, Connecticut; and parallel  Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin.

Objective.  To investigate the differences in health problems identified and health services received by children newly entering foster care who participated in a comprehensive multidisciplinary program, compared with children newly entering foster care who received customary community-based services.

Methods.  Using a 2-group quasiexperimental design, 120 young children entering foster care were enrolled in a multidisciplinary intervention program (n = 62) or were followed by customary care providers (n = 58). An interview with the foster parent; a complete medical examination; and a battery of developmental, psychological, speech/language, and motor assessments were completed for each child at baseline. Children in both groups participated in follow-up assessments at 6 and 12 months.

Results.  No significant differences between the 2 groups existed in medical, educational, developmental, or mental health problems identified by foster mothers. However, children in the intervention group were more likely to be identified with developmental (56.5% vs 8.6%) and mental health problems (37.1% vs 13.8%) by providers than children in the comparison group. Children in the intervention group were also more likely to be referred for health services at baseline (71.0% vs 43.1%) and receive follow-up care at 6 and 12 months of age than children in the comparison group.

Conclusions.  Findings indicate that community providers identify medical and educational needs but do not recognize developmental and mental health needs of young children newly entering foster care. The discrepancies in the number of recommended services and follow-up care between the 2 groups make a case for the establishment of specialized services for children entering out-of-home care.  Key words:  foster care, health services.


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