The Social and Emotional Well-Being of Children in …

1 The Social and Emotional Well-Being of Children in Foster Care By Nina Williams-Mbengue functioning, physical health and development, behavioral/ Emotional function and Social functioning. A. Introduction Child Well-Being is an important focus for states Just over 415,000 Children and youth in the because of its lifelong impact on Children and their currently reside in foster care. While this number is success as productive adults. State policymakers now high, it represents a significant decline in foster care understand that Children and youth in foster care face placements over the past decade, with the number of long-term risks from their exposure to violence, child Children in foster care decreasing by almost a quarter maltreatment and other adverse childhood experiences between 2002 and and are anxious to identify and implement strategies that will minimize the long term consequences for A federal and state-level focus on the safety and Children and the costs to state budgets.

2 Fortunately, permanency of Children in care has been an important there is also an increasing body of evidence-based factor contributing to the decline in caseloads. Despite programs that state child welfare systems can develop such progress, state child welfare systems continue to to significantly improve Children 's Well-Being . struggle with the Social and Emotional Well-Being of Children in care, particularly for Children with complex This extended edition newsletter focuses on the Social behavioral and mental health and Emotional Well-Being of Children and youth in foster care. The newsletter will provide information on the Definition of Child Well-Being . Child Well-Being is Social and Emotional characteristics and needs of described by the federal Administration for Children , Children in care, discuss the impact of child Youth and Families in its April 2012 Information maltreatment and trauma on Children 's development Memorandum (ACYF-CB-IM-12-04) as, and examine state and local policies and practices to address the Well-Being of Children in foster care.

3 Children 's behavioral, Emotional and Social Additionally, the legislative role in improving child well - functioning those skills, capacities and being will be considered. characteristics that enable young people to understand and navigate their world in healthy, B. Why is the Social and Emotional Well-Being of positive ways. 3 Children in Foster Care at Risk? The administration has further identified four primary The Social and Emotional Well-Being of Children in foster domains for measuring Well-Being : cognitive care is jeopardized by the conditions that lead to their removal from home, as well as their experiences once in make a child vulnerable and that may impact the child's care. While the number of Children in placement has Well-Being . been reduced in the last decade from more than 511,000 in 2005 to 415,000 in 2014, little data exists In addition to abuse and neglect, Children who enter about the Well-Being of Children in Additionally, foster care may have been exposed to parental effective indicators of Well-Being have not been substance abuse, domestic and community violence and identified or measured routinely.

4 Poverty. The Well-Being of Children Who Enter Foster Care The Impact of a Child's Experiences While in Foster Care Children who are placed in foster care for their protection have experienced many conditions that may The removal from home can be devastating and threaten their safety and Well-Being . As the table below confusing for Children . Once in foster care, Children may indicates, the majority of Children who are confirmed experience prolonged stays in care. According to 2014. for child maltreatment are victims of neglect. AFCARS data, of the 238,230 Children who exited foster care in Fiscal Year 2014, 53 percent had been in care 12. months or Children 's Length of Stay in Foster Care in Fiscal Year 2014. Number of Percent in Length of Stay in Children Care Care 94,358 23% 1 - 5 Months 83,978 20% 6 11 Months 62,447 15% 12 17 Months 39,620 10% 18 23 Months 29,401 7% 24 29 Months 18,833 5% 30 35 Months 36,292 9% 3 4 Years 28,058 7% 5 Years or More Though defined differently from state to state, neglect The longer a child is in placement, the greater the is often a complex combination of conditions that may chance that he or she will move from one foster include: 5 placement to another, placing the child at further risk of negative Social and Emotional outcomes.

5 7,8 Frequent Physical neglect, such as abandonment or moves mean that the child faces continuing disruption failure to provide for a child's nutritional or of relationships with friends, siblings and other other physical needs. relatives, coaches, teachers, classmates, religious Inadequate supervision, such as exposure to leaders and others. Children may move from their hazards or lack of appropriate caregivers; original schools multiple times during the school year. Medical neglect through denial or delay of Frequent changes in caseworkers, judges and legal health care. representation also interfere with child Well-Being and Emotional neglect, such as inadequate achievement of a permanent home. 9. nurturing or affection, Social isolation, chronic or extreme spouse abuse. The Behavioral and Mental Health Needs of Children in Neglect of a child's educational needs. Foster Care Newborns addicted or exposed to drugs. Recent research from the National Survey of Child and After child neglect, the most common reason for Adolescent Well-Being finds that Children and youth in removal is parental substance abuse.

6 Other removal foster care have high levels of mental health needs and reasons include caretaker inability to cope, child that those needs are not being met. Children and youth behavior, physical abuse, and other conditions that in foster care with mental health disorders stay in foster care longer, rely more on expensive residential difficulties they may experience in foster care. Into treatment placement, experience more moves in care, adulthood, Children and youth who have undergone have higher involvement with the criminal justice traumatic experiences may have problems ranging from system and have poorer educational depression and addiction to cancer, diabetes and heart Eighty percent of youth involved with the child welfare system require mental health C. The Costs of Poor Social and Emotional Well-Being intervention and services due to developmental, behavioral or Emotional The Social and Emotional Well-Being of Children who enter foster care has tremendous consequences both on the course of their lives and on the long term costs Children in foster care utilize mental health to taxpayers.

7 Services at five to eight times the rate of other Medicaid-eligible The total annual cost of child abuse and neglect in the in 2012 has been estimated to be Children and youth in residential treatment $ billion. centers (the majority of whom come from the child welfare system) have higher rates of The Pew Center on the States estimates the mental and behavioral health disorders than costs to society to pay for medical and mental Children in the general health services annually is more than $30,000. for each abused For Children in foster Children in foster care are more likely to use care, mental health expenditures are 8 to multiple psychotropic medications than times greater than the expenditures for other Children that are not in the child welfare Medicaid eligible Compared to other Medicaid-eligible youth, In addition to Medicaid costs for direct health Children in foster care have two to eight times services of Children in foster care, such as in- the rates of various psychiatric medication patient treatment or dental services, states spend more than $1 billion in Medicaid for child welfare services.

8 Of the 39 states that Impact of Trauma responded to a recent survey of FY2010 state child welfare expenditures, 27 reported that the It is estimated that 90 percent of Children in foster care number one use of Medicaid dollars by child have been exposed to A comprehensive welfare systems was for rehabilitative services review of Children entering foster care in one state such as residential and behavioral modification revealed that one in four exhibited trauma symptoms treatment, followed by targeted case requiring The term complex trauma management and therapeutic foster care. 22. describes Children 's exposure to multiple or prolonged traumatic events, which are often invasive and Recent research also shows that multiple, negative interpersonal in nature. Complex trauma exposure events in childhood, such as those experienced by many involves the simultaneous or sequential occurrence of Children in foster care, have costly health consequences child maltreatment, including psychological that can impact state budgets for many years.

9 The maltreatment, neglect, exposure to violence and Adverse Childhood Experiences Study (ACES) is a physical and sexual abuse. Trauma can be compounded longitudinal examination of health outcomes for adults by the removal of Children from their families, loved who experienced a variety of multiple, negative events ones, and communities and by adverse experiences in in childhood such as child maltreatment, exposure to foster care. A growing body of research reveals negative domestic violence, living with substance abusing long-term consequences of traumatic stress, especially parents, growing up with a growing up with a mentally repeated exposure to trauma such as might be ill or incarcerated parent or parental abandonment experienced by Children who have been abused or through divorce or death. The study indicates significant neglected, on physical, cognitive, Social and Emotional effects well into adulthood, including:23. functioning. 18 Children 's relationships and attachments to caretakers can be affected, further exacerbating Child Maltreatment Impacts: Brain Function and consequences, repeated, negative childhood Structure experiences contribute to reduced economic productivity.

10 Dr. Robert Anda, co-principal investigator Neuroscience teaches us that the early experiences of of the ACES Study, reported that annual workforce costs young Children have a tremendous influence on their due to adverse childhood experiences included $28. developing brains. Healthy Emotional and cognitive billion for chronic back pain, $40 to $44 billion for development is shaped by responsive, dependable medical costs, reduced productivity, and absenteeism interaction with adults, while chronic or extreme due to depression and $246 billion for substance adversity, such as extreme poverty, caregiver substance abuse or mental illness, exposure to violence or family hardship without appropriate adult support, can cause D. What State Legislators Can Do to Promote the excessive amounts of the cortisol hormone to be Social and Emotional Well-Being of Children in produced resulting in toxic stress, which disrupts Child Welfare Systems developing brain circuits. This kind of prolonged activation of the stress response systems can not only To combat the damaging effects of child disrupt the development of brain architecture and other maltreatment, trauma and adversity, child organ systems, but can also increase the risk for stress- welfare leaders at federal, state and local levels related disease and cognitive impairment well into the are developing policies and financing strategies adult to address Social and Emotional Well-Being .