Foster Care : Health Concerns of Children in Foster Care

Children in foster care are among the most medically vulnerable. Many have had inadequate prenatal care, maternal substance use, inconsistent medical attention, or significant trauma. Early identification and intervention are critical to improving health and well-being.

Common Medical and Psychosocial Concerns

Children Entering Foster Care May Present with:
Chronic/untreated conditions
Asthma
Dental disease
Vision/hearing problems
Developmental delays
Cognitive
Speech
Motor (40–60%)
Mental health disorders
Anxiety
Depression
PTSD
Attachment disorders (60–70%)
History of trauma
Abuse
Neglect
Prenatal substance exposure
Educational challenges
Learning disabilities
School failure
Preventive care gaps
Incomplete immunizations
Poor health screening history

For a more detailed list of possible ongoing medical problems, see the Possible Medical Problems Table below.

Medical Evaluation Guidelines

Children in foster care need to be reassessed within one month and as soon as the previous medical records, including immunizations, have been received. Documentation of visits, needs, and concerns should be provided to the local Department of Social Services.

Initial Evaluation
(within 7 days)
Comprehensive Follow-Up
(within 30 days)
Comprehensive physical exam, including injury/abuse screening
Assess for active illnesses, injuries, disabilities
Review prior medical records and reassess/manage prior issues
Update immunizations
Review available medical, family, and birth history, including current medications
Vision and hearing screening
Growth, nutrition, allergy, and immunization assessment
Detailed developmental and psychosocial assessment (may need to be repeated)
Tuberculosis risk assessment and testing (as indicated)
HIV risk assessment/testing per state law
Laboratory screening (lead, anemia, STIs, Hepatitis B & C, and other testing as appropriate)
Substance abuse evaluation (as indicated)
Developmental and mental health screening/referrals
Specialist referrals (dental, ophthalmology, mental health therapy)
Immediate evaluation of urgent medical or psychiatric needs and medical equipment needs, such as nebulizers, eyeglasses, or hearing aids
Ongoing problem list and treatment plan

Ongoing Care

More frequent medical visits, usually every three to six months, may be necessary to evaluate the child's on-going health needs and to assess the foster parents’ and caseworker’s needs and responsibilities. Ongoing developmental assessments may also be necessary. Routine, periodic, health care visits should take place as recommended by American Academy of Pediatrics. For more information, see American Academy of Pediatrics/Bright Futures Guidelines for Health Supervision of Infants, Children, and Adolescents.

Possible Medical Problems in Children in Foster Care
Medical/ Developmental
Mental Health/ Behavioral
Trauma/ Exposure
Preventive Care Gaps
Asthma
Genetic syndromes
Chronic illness
Anxiety
Depression
Attachment disorders
Abuse injuries
Shaken baby syndrome
Fractures
Incomplete immunizations
Failure to thrive
Hyperphagia
Polydipsia
Emotional/behavioral problems
Sleep disorders
Prenatal drug/alcohol exposure
STIs
Poor dental health
Developmental delay
Encopresis
Enuresis
PTSD
HIV infection
Vision/hearing problems

Health Concerns of Children in Foster Care