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Foster care is care provided for children whose families are temporarily unable to care for them. The local government determines the process of arranging foster care. Foster care is surprisingly common in the United States—about 750,000 children are in the foster care system each year.
The foster parent assumes day-to-day care for the child. However, the birth parents usually remain the child's legal guardians. This means that the birth parents still make legal decisions for the child. For example, if the child needs an operation, only the birth parents can provide consent.
Most children in foster care are from poor families. About 70% of the children in foster care are put there by child protective services because the child has been abused or neglected. Most of the remaining 30% are adolescents placed in care by the juvenile justice system. Very few children are placed voluntarily by their parents. Most children in foster care live with foster families, although many live with extended family and adolescents are likely to live in group homes or residential treatment facilities.
Removal from their family is enormously painful to children. In foster care, children may have frequent visits with their families or only limited, supervised visits. Children in foster care leave behind their neighborhoods, communities, schools, and most of their belongings. Many children and adolescents in foster care feel anxious, uncertain, and helpless to control their lives. Many feel angry, rejected, and pained by the separation or they develop a profound sense of loss. Some feel guilty, believing that they caused the disruption of their birth family. Peers often tease children about being in foster care, reinforcing perceptions that they are somehow different or unworthy. Children in foster care have more chronic illnesses and behavioral, emotional, and developmental problems than do other children. Yet, most children in foster care adjust well as long as the placement is stable and the foster family is skilled in nurturing the child's emotional needs. Most children in foster care benefit from counseling.
Over half of the children eventually return to their birth families. About 20% of children in foster care are eventually adopted, most often by their foster family. Other children return to a relative or become too old for foster care. A small number of children are later transferred to another foster care agency. Tragically, 18% of youth in foster care eventually age out of the system without a sense of belonging in any family.
Last full review/revision July 2007 by Moira Szilagyi, MD, PhD
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