It is critical for children in foster care to get routine developmental screenings and any necessary follow-up. Routine pediatric visits include developmental check-ups, but children may not be seen regularly by a pediatrician while living in foster care. A child’s physical and mental functioning may improve if problems are recognized during routine developmental screenings and necessary treatment is provided.
Given that the life of a child in foster care is often filled with separation and loss it is not surprising that behavioral and psychiatric issues are common in these children.
Anxiety
Generalized anxiety disorder is characterized by excessive, exaggerated anxiety and worry about everyday life events with no obvious reasons for worry. People with symptoms of generalized anxiety disorder tend to always expect disaster and can’t stop worrying. Daily life becomes a constant state of worry, fear, and dread. Eventually, the anxiety so dominates the person’s thinking that it interferes with daily functioning.
Asthma
Asthma is an inflammatory disorder of the airways, which causes attacks of wheezing, shortness of breath, chest tightness, and coughing.
Compulsive water drinking (polydipsia)
Polydipsia is a medical symptom in which the patient displays excessive thirst.
Depression
Depression is a serious medical illness that involves the brain. It’s more than just a feeling of being “down in the dumps” or “blue” for a few days. The feelings do not go away. They persist and interfere with your everyday life. Symptoms can include:
- Sadness
- Loss of interest or pleasure in activities you used to enjoy
- Change in weight
- Difficulty sleeping or oversleeping
- Energy loss
- Feelings of worthlessness
- Thoughts of death or suicide
Developmental delay
Developmental Delay is when your child does not reach their developmental milestones at the expected times. It is an ongoing major or minor delay in the process of development. If your child is temporarily lagging behind, that is not called developmental delay. Delay can occur in one or many areas—for example, gross or fine motor, language, social, or thinking skills.
Emotional or behavioral problems
Encopresis
Encopresis is the voluntary or involuntary passage of stools in a child who has been toilet trained (typically over age 4), which causes the soiling of clothes. Encopresis is frequently is associated with constipation and fecal impaction. Often, hard fecal material remains in the colon and the child only passes a soft or semi-liquid stool around the impacted stool. Leakage of stool may occur during the day or night. There are rarely physical causes other than constipation (sometimes present since infancy). Other causes may be related to:
- A lack of toilet training
- Toilet training at too early an age
- Emotional disturbance such as oppositional defiant disorder
The following may increase the risk for encopresis:
- Being male
- Chronic constipation
- Low socioeconomic status
Conduct disorder
Whatever the cause the child may develop associated shame, guilt, or loss of self-esteem. The child may try to hide the discovery of the problem.
Enuresis
Bedwetting is involuntary urination in children over 5 to 6 years old. It may occur at any time of the day or night.
Excess appetite (hyperphagia)
Excessive hunger describes an abnormally strong desire or need to eat. This can be normal or related to an underlying medical condition.
Failure to thrive
Failure to thrive is a description applied to children whose current weight or rate of weight gain is significantly below that of other children of similar age and sex.
Genetic and birth defect syndromes
HIV infection
HIV infection is a disease caused by the human immunodeficiency virus (HIV). The condition gradually destroys the immune system, which makes it harder for the body to fight infections.
Inadequate immunization
Long bone and rib fractures
Poor dental hygiene or multiple caries
Poorly controlled chronic illness
Prenatal exposure to cocaine, alcohol, narcotics
Reactive Attachment Disorder
Reactive attachment disorder is a rare but serious condition in which infants and young children don’t establish healthy bonds with parents or caregivers. A child with reactive attachment disorder is typically neglected, abused, or moved multiple times from one caregiver to another. Because the child’s basic needs for comfort, affection and nurturing aren’t met, he or she never establishes loving and caring attachments with others. This may permanently alter the child’s growing brain and hurt their ability to establish future relationships. Reactive attachment disorder is a lifelong condition, but with treatment children can develop more stable and healthy relationships with caregivers and others. Safe and proven treatments for reactive attachment disorder include psychological counseling and parent or caregiver education.
Sexually transmitted diseases
Shaken baby syndrome
(SBS) is a form of physical child abuse that occurs when an abuser violently shakes an infant or small child, creating a whiplash-type motion that causes acceleration-deceleration injuries. It is common for there to be no external evidence of trauma.
Sleep disorders
Sleep disorders involve any difficulties related to sleeping, including difficulty falling or staying asleep, falling asleep at inappropriate times, excessive total sleep time, or abnormal behaviors associated with sleep.
Emotional Needs
The children AFFEC serves have been removed from their birth families. due to neglect, and/or abuse, and have varying degrees of emotional needs. Many of these children are slow to trust a new person or family, having suffered past losses and often finding the adults in their lives unreliable or unable to care for them. Emotional difficulties can also result in a child having behavioral difficulties. Hoarding food, withdrawing, having difficulty telling the truth and competing for attention are among the most common behaviors.
It can be especially challenging to deal with a child who has been through a traumatic experience. If a child is unwilling or unable to discuss these experiences, the frustration may be so overwhelming that it affects the child’s ability to function on a day-to-day basis. A sense of security and support services will often help a child make great strides in a new family. Many of the waiting children benefit from counseling and other therapeutic services.
Physical Difficulties
While most of the waiting children are healthy, some do have physical difficulties or disabilities. Some may have asthma, cleft palate, mild forms of bronchitis or allergies or easily treatable medical conditions. Other children have more severe physical disabilities, such as limb deformities, muscular dystrophy, cerebral palsy, cystic fibrosis, congenital heart disease, life-threatening illnesses and various types of developmental disabilities.
Learning Disabilities
Many waiting children have difficulties comprehending, processing or retaining oral and/or written information. Within the general public school population, 10 to 20 percent of children have some form of learning disability. Learning disabilities can manifest themselves in any number of ways. The most common problems are Attention Deficit Disorder (ADD), hyperactivity and dyslexia.
