The subject of foster care has become an increasingly more popular topic of discussion in recent years. Youth who are placed into the foster care system are primarily victims of physical abuse, sexual abuse, and/or neglect. Recently, more studies have been conducted to understand the effects that being placed into the foster care system has on individuals, and how these effects impact an individual throughout different development stages. Placement of individuals into foster care has been linked to behavioral, emotional, and cognitive issues. This paper will discuss recent research that has assessed the effects on infants and toddlers, adolescents, and adults who have been placed into the foster care system.
Infants and Toddlers
The number of infants and toddlers entering the foster care system has increased in recent decades. Approximately 475,000 youth reside in foster care in the United States annually (Braciszewski, & Stout, 2012). The largest group of children entering the foster care system and the most developmentally vulnerable are infants and young children (Bruskas, & Tessin, 2013). Infants and toddlers that enter the foster care system have typically been subjected to some form of abuse or neglect by their birth parents. This type of maltreatment in the early stages of development is especially harmful because this is when children form attachments, learn trust, how to regulate their emotions, and appropriate behaviors. In addition, unlike children with divorced parents, who may lose a parent from the divorce, children in foster care experience family separation that typically include the loss of their entire immediate and extended family, their home, friends, and even their entire community. This type of separation decreases their opportunities to form a attachments to a primary caregivers and develop healthy long-term relationships with other individuals. When conducting research on the effects of foster care on infants and toddlers, Dozier, Zeanah, and Bernard (2013) wrote an article that discussed how children involved in the child welfare system are more susceptible to behavioral and physiological dysregulation.
The article points out that disruption in a child’s relationship with their primary caregiver can negatively affect their ability to regulate their physiology, behavior, and emotions (Dozier, Zeanah, & Bernard, 2013). The research points out that children who are involved in the system and have experienced a disruption in care when they are about one year old, are more likely to turn away from caregivers rather than seek them when they become distressed (Dozier, Zeanah, & Bernard, 2013).
Although this article points out how the child welfare system can negatively affect children in this development stage, it also provides research on how an intervention on the level of the parent and the system can decrease negative outcomes. Attachment and Biobehavioral Catch-up (ABC) is an intervention program that was developed to enhance the synchrony and nurturance of caregivers, while reducing their frightening, intrusive, or threatening behavior (Bernard et al., 2012). When this intervention was tested, researchers found that it enhanced parent’s synchronous behaviors, child attachment, cortisol production, and executive functioning (Bernard et al., 2012). When further researching literature on the topic of the ABC intervention and the effect on children’s cortisol levels, a study by Dozier, Peloso, Lewis, Laurenceau, and Levine (2012) looked at the effects of the attachment-based intervention on the cortisol production of infants and toddlers in foster care.
Various studies have suggested that early separation from caregivers is often associated with changes in the functioning of the hypothalamus-pituitary-adrenal (HPA) axis. Because of this negative development issue, the researchers designed a relational intervention that intended to normalize HPA functioning among children in foster care (Dozier et al., 2012). The research group did find that there were differences in the daytime patterns of cortisol production among preschool children in foster care when compared to children not in foster care. This research shows how the foster care system can negatively affect the development of an infant and toddler by causing non-normative patterns of cortisol levels.
The ABC intervention program was found to affect this cortisol production in foster children by causing more normative patterns (Dozier et al., 2012). Although foster care can impose negative effects on infants and toddlers in this stage of lifespan development, protective factors such as intervention programs can possibly reduce these negative outcomes. Various research has shown how the disruption in relationships caused by foster care can negatively impact the development of infants and toddlers. This type of disruption in the early stages of life has been shown to effect individuals throughout other stages of development across their lifespan.
The adolescent phase of lifespan development is yet another period of significant development in terms of an individual’s ability to regulate their physiology, behavior, and emotions. Adolescents are entering a period of physical change that involves both growth spurts and sexual maturation. Not only is this change physical, but adolescent’s cognitive abilities are changing as well. They are beginning to consider abstract concepts, they have a greater memory capacity, and a greater attention span. Due to these changes that occur in adolescence, things like attachments to caregivers, emotional and behavioral regulation, and their ability to form relationships are crucial for their overall wellbeing. Adolescence involved in the foster care system typically face turmoil which interferes with their ability to achieve these characteristics.
When researching the effects of foster care on individuals in this stage of the lifespan, Greeson et al., (2011) composed research on complex trauma and mental health in children and adolescents placed in foster care. This article points out that many children in the child welfare system (CWS) have a history of recurrent interpersonal trauma perpetrated by caregivers in early life. This is referred to as complex trauma (Greeson et al., 2011). Their study examined complex trauma histories, post-traumatic stress, and related child behavioral and emotional problems in a sample of youth who have recently been involved with the CWS. Their study found that youth with complex trauma histories were at a higher risk for internalizing behavior problems, posttraumatic stress disorder (PTSD), and having at least one clinical diagnosis, in comparison to youth without a history of complex trauma (Greeson et al., 2011). These finding are important in relation to the development of adolescence in the foster care system because it shows how adolescents experiences of interpersonal trauma impacts their cognitive, behavioral, and emotional functioning.
When considering development effects on older adolescents, Salazar, Keller, Gowen, and Courtney (2013) conducted research on trauma exposure and PTSD among older adolescents in foster care. Their research found that the trauma exposure rate for youth in foster care was double that found in the youth from the general population, and the youth in foster care meet diagnostic criteria for PTSD at higher rates than the general youth population (Salazar et al., 2013). Approximately 30% of respondents from this study reported that they experienced their worst trauma at or after the age of 16. With 18 being the age most states require youth to exit the system, many of these adolescents are still dealing with processing their trauma. Many of these adolescents have not yet fully developed the skills to cope with their traumatic experiences, emotions, mental disorders, etc., by the time they have aged out of the system. This creates further development issues that carry into adulthood.
Due to the adversities faced by youth who are in the foster care system, difficulties often continue into their adulthood development. Research on foster care alumni is somewhat more challenging to find because primarily the focus is on children and adolescents who are still in the system. Approximately 30,000 youth exit the system each year in the United States. This often is a difficult transition into adulthood which presents young adults with significant barriers to success and meeting their needs (Braciszewski, & Stout, 2012). Because the population of individuals who have been in foster care are often high-risk, these individuals face many difficulties that persist into adulthood development.
A positive correlation has been found between individuals foster care experiences such as time spent in care, placement history, and school mobility, with the rate of alcohol and substance dependence (Braciszewski, & Stout, 2012). White, O’Brien, Pecora, and Phillips (2008) examined the effects of family foster care on adult substance dependencies. The results of their study showed that rates of alcohol dependence and drug dependence for the Northwest Study alumni exceeded rates of the general population. Their study found that 11.3% of foster care alumni experienced alcohol dependence during their lifetime verses 7.1% among the general population (White et al., 2008). Drug dependencies during the lifetime was 21.0% for foster care alumni verses 4.5% among the general population (White et al., 2008). This shows that substance dependencies are lifetime problems among alumni of foster care and persist into adulthood. This is a developmental issue that foster care imposes on many individuals involved in the system.
Considering the amount of research that has shown that many children in foster care later have psychological problems as adults, Bruskas, and Tessin (2013) conducted further research on adverse childhood experiences and psychological well-being of women who were in foster care as children. A sum of 101 women ages 18 to 71 completed an online survey based on a 10 item Adverse Childhood Experiences (ACEs) Questionnaire, a Sense of Coherence Questionnaire, and the General Health Questionnaire.
The results of this study showed that more than 56% of women responded that they are currently experiencing psychological distress. 97% of respondents reported at least one adverse childhood experience, 70% reported at least five, and 33% reported at least 8 (Bruskas, & Tessin, 2013). In addition, 43% of the women surveyed reported depression, making it the most common mental health diagnosis reported in this study. This is followed by 29% of the women in the study who reported experiencing posttraumatic stress disorder (Bruskas, & Tessin, 2013). This effects development because the number of adverse childhood experiences were found to be associated with the level of psychological distress in women. Because children and adolescents in the foster care system typically experience some type of neglect and/or abuse, these experiences often cause psychological distresses and mental health disorders that carry into into young adulthood and persist into late adulthood.
In a Midwest evaluation of the adult functioning of former foster youth at ages 23 and 24, it was found that young adults from foster care are not faring well compared to their counterparts (Courtney, Dworsky, Lee, & Raap, 2010). This same study found that about 25% of former foster youth had not obtained a high school diploma or equivalent, compared to 7% of young adults from the general population. Only about 25% attended a university compared to 42% of young adults who were not involved in foster care (Courtney, Dworsky, Lee, & Raap, 2010).
In addition to these findings, more young adults who were foster care alumni faced higher conviction rates, incarceration rates, worked less, and earned less per week compared to young adult who were not previously in the foster care system (Courtney, Dworsky, Lee, & Raap, 2010). This shows development issues in adults who are foster care alumni because studies have continuously shown that these adults are behind educationally, economically, and socially in development. These issues, if left unresolved can persist into late adulthood. This information shows that the foster care system can affect the development of individuals across their entire lifespan. Foster care placement disrupts the typical development and attachments that evolve in childhood and adolescents and continues to effect individuals throughout their lives.
In conclusion, foster care placement has been shown to effect development in many aspects across the lifespan. Researchers have studied the effects on development of infants and toddlers, adolescents, and adults. This literature review is selective rather than comprehensive because it does not cover all available research that has been conducted on the topic of foster care and its effects on individuals. A majority of this research conducted focuses on the negative effects that the foster care system causes, and not positive development outcomes that can occur.
This review of literature includes research on the effects on toddler and infant development when placed into foster care, such as negatively affecting their ability to regulate their physiology, behavior, and emotions. The reviews includes research on how adolescents in the foster care system are at a higher risk for internalizing behavior problems, posttraumatic stress disorder, and having at least one clinical diagnosis. Lastly, literature focusing on the effects of the foster care system on adulthood development such as having higher drug and alcohol dependency rates, and higher rates of psychological disorders is discussed in this paper.
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- Braciszewski, J. M., & Stout, R. L. (2012). Substance Use Among Current and Former Foster Youth: A Systematic Review. Children and youth services review, 34(12), 2337-2344.
- Bruskas, D., & Tessin, D. H. (2013). Adverse childhood experiences and psychosocial well-being of women who were in foster care as children. The Permanente journal, 17(3), e131-41.
- Courtney M. E, Dworsky A, Lee J. S, & Raap M. (2010). Midwest evaluation of the adult functioning of former foster youth: outcomes at age 23 and 24. Chicago, IL: Chapin Hall at the University of Chicago.
- Dozier, M., Peloso, E., Lewis, E., Laurenceau, J. P., & Levine, S. (2008). Effects of an attachment-based intervention on the cortisol production of infants and toddlers in foster care. Development and psychopathology, 20(3), 845-59.
- Dozier, M., Zeanah, C. H., & Bernard, K. (2013). Infants and Toddlers in Foster Care. Child development perspectives, 7(3), 166-171.
- Greeson, J. K., Briggs, E. C., Kisiel, C. L., Layne, C. M., Ake III, G. S., Ko, S. J., … & Fairbank, J. A. (2011). Complex trauma and mental health in children and adolescents placed in foster care: Findings from the National Child Traumatic Stress Network. Child welfare, 90(6), 91.
- Salazar, A. M., Keller, T. E., Gowen, L. K., & Courtney, M. E. (2013). Trauma exposure and PTSD among older adolescents in foster care. Social psychiatry and psychiatric epidemiology, 48(4), 545-551.
- White, C. R., O’Brien, K., White, J., Pecora, P. J., & Phillips, C. M. (2008). Alcohol and drug use among alumni of foster care: Decreasing dependency through improvement of foster care experiences. The journal of behavioral health services & research, 35(4), 419-434.