upright=1.35|thumb|Children of the United Kingdom's [[Home Children|Child Migration Programme – many of whom were placed in foster care in Australia]]
Foster care is a system in which a minor has been placed into a ward, group home (residential child care community or treatment centre), or private home of a state-certified caregiver, referred to as a "foster parent", or with a family member approved by the state. The placement of a "foster child" is normally arranged through the government or a social service agency. The institution, group home, or foster parent is compensated for expenses unless with a family member. Any adult who has spent time in care can be described as a "care leaver", especially in European countries.
The state, via the family court and child protective services agency, stand in loco parentis to the minor, making all legal decisions while the foster parent is responsible for the day-to-day care of the minor.
Scholars and activists have expressed concerns about the efficacy of foster care services provided by non-government organisations. Specifically, this pertains to poor retention rates of social workers. Poor retention rates are attributed to being overworked in an emotionally draining field that offers minimal monetary compensation. The efficacy of caseworker retention also affects the overall ability to care for clients. Low staffing leads to data limitations that infringe on caseworkers' ability to adequately serve clients and their families.
Cambodia
Foster care in Cambodia is relatively new as an official practice within the government. However, despite a later start, the practice is currently making great strides within the country. Left with a large number of official and unofficial orphanages from the 1990s, the Cambodian government conducted several research projects in 2006 and 2008, pointing to the overuse of orphanages as a solution for caring for vulnerable children within the country. Most notably, the studies found that the percentage of children within orphanages that had parents approached 80%. At the same time, local NGOs like "Children In Families" began offering limited foster care services within the country. In the subsequent years, the Cambodian government began implementing policies that required the closure of some orphanages and the implementation of minimum standards for residential care institutions. These actions lead to an increase in the number of NGOs providing foster care placements and helped to set the course for care reform around the country. As of 2015, the Cambodian government is working with UNICEF, USAID, several governments, and many local NGOs in continuing to build the capacity for child protection and foster care within the Kingdom.
Canada
Foster children in Canada are known as permanent wards (crown wards in Ontario). A ward is someone, in this case a child, placed under protection of a legal guardian and are the legal responsibility of the government. Census data from 2011 counted children in foster care for the first time, counting 47,885 children in care. The majority of foster children – 29,590, or about 62 per cent – were aged 14 and under. The wards remain under the care of the government until they "age out of care". All ties are severed from the government and there is no longer any legal responsibility toward the youth. This age is different depending on the province.
Israel
In December 2013, the Israeli Knesset approved a bill co-drafted by the Israel National Council for the Child to regulate the rights and obligations of participants in the foster care system in Israel.
Japan
The idea of foster care or taking in abandoned children actually came about around 1392–1490s in Japan. The foster care system in Japan is similar to the Orphan Trains system of the US, thinking the children would do better on farms rather than living in the "dusty city". The families would often send their children to a farm family outside the village and only keep their oldest son. The farm families served as the foster parents and they were financially rewarded for taking in the younger siblings. "It was considered an honor to be chosen as foster parents, and selection greatly depended on the family's reputation and status within the village". Around 1895 the foster care program became more like the system used in the United States because the Tokyo Metropolitan Police sent children to a hospital where they would be "settled". Problems emerged in this system, such as child abuse, so the government started phasing it out and "began increasing institutional facilities". In 1948 the Child Welfare Law was passed, increasing official oversight, and creating better conditions for the children to grow up in.
United Kingdom
In the United Kingdom, foster care and adoption has always been an option, "in the sense of taking other people's children into their homes and looking after them on a permanent or temporary basis." However, nothing about it had a legal foundation until the 20th century. The UK had "wardship", the family taking in the child had custody by the Chancery Court. Wardship was not used very often because it did not give the guardian "parental rights". In the 19th century came a "series of baby farming scandals". At the end of the 19th century they started calling it "boarding-out" like they did in Australia. They started placing the children in orphanages and workhouses as well. "The First World War saw an increase in organized adoption through adoption societies and child rescue organizations, and pressure grew for adoption to be given legal status." The first laws based on adoption and foster care were passed in 1926. "The peak number of adoptions was in 1968, since then there has been an enormous decline in adoption in the United Kingdom. The main reasons for children being adopted in the United Kingdom had been unmarried mothers giving up their children for adoption and stepparents adopting their new partner's children".
United States
Historians of foster care in America emphasize biases of race and class status that shaped divergent experiences for children. In particular, the United States welfare system has reckoned with a longer history of Black children taken away from their families during slavery. Scholars have also documented the negative conditions faced by often impoverished children during the creation of early orphanages. Prior to protections of Tribes and the right of Indigenous children to remain within their tribal communities such as the 1978 Indian Child Welfare Act, child welfare concerns were cited as reasoning to remove 35% of Indigenous children from their families and tribes.
In the United States, formal foster care started as a result of the efforts of Charles Loring Brace, who founded the Children's Aid Society. Taking note that nearly 30,000 homeless or neglected children lived in New York City alone, Brace took these children off the streets and placed them with families around the United States, particularly Christian families living on farms, in an attempt to improve their quality of life. Between 1853 and his death in 1890, Brace transported over 120,000 children by train, giving name to the Orphan Train Movement. When Brace died in 1890, his sons took over his work of the Children's Aid Society until they retired. As of August 2022 there were 368,530 children nationally located in foster homes. On average, an American child in foster care spends two birthdays in the system.
To create a safe environment for the child long term, children in American foster care have both a case plan and a case plan goal. A case plan is a clear statement about why the child needs protection and the roles and responsibilities of all participants (case worker, foster parents, etc.) in addressing the child's needs and their protection. The case plan goal is the end goal for the child that ends their stay in foster care. 52% of foster children in America have the goal to reunify with their parent(s) or primary caretaker(s). from the government in order to welcome a minor or an elderly person. In order to receive this approval they must follow a training and their home is inspected to be sure it is safe and healthy. In 2017, 344,000 minors and 15,000 elderly persons were welcomed in foster homes.
The Foundling Hospital in Paris is often considered the first state efforts to assist children, founded in 1670 by Saint Vincent de Paul. Mothers had the option of anonymously depositing their infant children at the gate, a practice that was unique across much of Europe. Simple adoption, a form of additional parentage, was first codified into French law through the Civil Code of 1804 and allowed only adults over fifty without any legitimate children to adopt. The specificity of a lack of legitimate children hoped to reduce interference with inheritance.
Traditionally, there is an emphasis on keeping families in contact as much as possible as parents often keep parental responsibility . The majority of social services for these children relies on both local authorities and Judicial Juvenile Protection, which includes laws outlining protections allowed to the children. Current laws limit families to three children in foster care, but exceptions may be made by the president of the Departmental Council in certain cases.
Italy
Although the numbers have greatly decreased since post World War II, over 27,000 children in Italy are in alternative care. Under 40% of children are able to return to their birth families, which is the ultimate goal of foster care.
Italian law considers familial relationships to be pivotal to a child's developments and gives primary relevance to the original family and offer home based support. However, if neglect or abuse is present, the judicial system may intervene to remove involved children. In 2001, all institution based facilities for displaced children were closed and replaced with residential homes in order to provide a more familial feeling.
Placement
Family-based foster care is generally preferred to other forms of out of home care. Foster care is intended to be a short-term solution until a permanent placement can be made. In most states, the primary objective is to reconcile children with the biological parents. However, if the parents are unable or unwilling to care for the child, or if the child is an orphan, then the first choice of adoptive parents is a relative such as an aunt, uncle or grandparent, known as kinship care. Most kinship care is done informally, without the involvement of a court or public organization. However, in the United States, formal kinship care is increasingly common. In 2012, a quarter of all children in formal foster care were placed with relatives instead of being placed into the system.
If no related family member is willing or able to adopt, the next preference is for the child to be adopted by the foster parents or by someone else involved in the child's life (such as a teacher or coach). This is to maintain continuity in the child's life. If neither above option are available, the child may be adopted by someone who is a stranger to the child.
If none of these options are viable, the plan for the minor may be to enter OPPLA (Other Planned Permanent Living Arrangement). This option allows the child to stay in custody of the state and the child can stay placed in a foster home, with a relative or a long-term care facility, such as a residential child care community or, for children with development disabilities, physical disabilities or mental disabilities, a treatment center.
671,000 children were served by the foster care system in the United States in 2015. "After declining more than 20 percent between FY 2006 and FY 2012 to a low of 397,000, the number of children in foster care on the last day of the fiscal year increased to 428,000 in FY 2015, with a slightly higher percent change from 2014 to 2015 (3.3%) than observed from 2013 to 2014 (3.2%)." Since FY 2012, the number of children in foster care at the end of each FY has steadily increased. That year, 74% of children spent less than two years in foster care, while 13% were in care for three or more years. Of the estimated 427,910 children in foster care on September 30, 2015: 43 percent were White, 24 percent were African-American, 21 percent were Hispanic (of any race), 10 percent were other races or multiracial, and 2 percent were unknown or unable to be determined. If a biological parent or legal guardian is unwilling or unable to care for a child, the child is deemed to be dependent by the Juvenile Court and is placed under the legal care of the child protection agency. The policies regarding foster care as well as the criteria to be met to become a foster parent vary according to legal jurisdiction.
Especially egregious failures of child protective services often serve as a catalyst for increased removal of children from the homes of biological parents. An example is the brutal torture and murder of 17-month-old Peter Connelly, a British toddler who died in London Borough of Haringey, North London after suffering more than 50 severe injuries over an eight-month period, including eight broken ribs and a broken back. Throughout the period of time in which he was being tortured, he was repeatedly seen by Haringey Children's services and NHS health professionals. Haringey Children's services already failed ten years earlier in the case of Victoria Climbié. In the time since his death, in 2007, cases have reached a record rate in England surpassing 10,000 in the reporting year ending in March 2012.
Abuse and negligence
Although the majority of children in the foster care system are not abused or neglected, A study of foster children in Oregon and Washington State in the US found that nearly one-third reported being abused by a foster parent or another adult in a foster home.
Although caregivers are put through a thorough and intense screening before being allowed to take in any children, the foster care system often lacks any safeguards to reevaluate families once they have taken in children. The death of a child in foster care may not be investigated as thoroughly in order to not further displace other children in the same foster home. Organizations such as Child Abuse Prevention Services, located in Long Island, New York, suggest regular home visits and monitoring to ensure early intervention in the case of any avoidable issues or clearly unsafe conditions.
In a 2023 study, 66% of the 143 youth currently in foster care who had reached out for help to the "National Sexual Assault Online Hotline" were victims of sexual abuse by a foster family member. These youth may encounter different barriers than their peers not in foster care such as concerns for safety, a lack of trust in the foster care system, previous negative reception to disclosure of sexual abuse, or not wanting to move placements.
The race, sex, age, and sibling status all significantly influence potential instability of a placement. Non-white children, males, older children, and those who are only children were the most at risk of an unsafe or unstable foster care placement. In general, older children in foster care are more likely to experience behavioral and mental health issues, which have been correlated with less likely success of adoption and fostering. These early years are quite important for the physical and mental development of children. More specifically, these early years are most important for brain development. Stressful and traumatic experiences have been found to have long-term negative consequences for the brain development in children whereas talking, singing, and playing can help encourage brain growth. Since the majority of children are removed from their homes due to neglect, this means that many of these children did not experience stable and stimulating environments to help promote this necessary growth. A child who has lived in an orphanage or a home for multiple children may have learned survival skills but lack family skills due to a lack of permanency.
Medical and psychiatric disorders
A higher prevalence of physical, psychological, cognitive and epigenetic disorders for children in foster care has been established in studies in various countries. The Casey Family Programs Northwest Foster Care Alumni Study was a fairly extensive study of various aspects of children who had been in foster care.
Individuals who were in foster care experience higher rates of physical and psychiatric morbidity than the general population and suffer from not being able to trust and that can lead to placements breaking down.
In the Casey study of foster children in Oregon and Washington state, they were found to have double the incidence of depression, 20% as compared to 10% and were found to have a higher rate of post-traumatic stress disorder (PTSD) than combat veterans with 25% of those studied having PTSD. Children in foster care have a higher probability of having attention deficit hyperactivity disorder (ADHD), and deficits in executive functioning, anxiety as well as other developmental problems.
These children experience higher degrees of incarceration, poverty, homelessness, and suicide. Studies in the U.S. have suggested that some foster care placements may be more detrimental to children than remaining in a troubled home, but a more recent study suggested that these findings may have been affected by selection bias, and that foster care has little effect on behavioral problems.
Neurodevelopment
Foster children have elevated levels of cortisol, a stress hormone, in comparison to children raised by their biological parents. Elevated cortisol levels can compromise the immune system. (Harden BJ, 2004). Most of the processes involved in typical neurodevelopment are predicated upon the establishment of close nurturing relationships and environmental stimulation. Negative environmental influences during this critical period of brain development can have lifelong consequences.
Post-traumatic stress disorder
thumb|Regions of the brain associated with stress and post-traumatic stress disorder
Children in foster care have a higher incidence of post-traumatic stress disorder (PTSD). In one study, 60% of children in foster care who had experienced sexual abuse had PTSD, and 42% of those who had been physically abused met the PTSD criteria. PTSD was also found in 18% of the children who were not abused. These children may have developed PTSD due to witnessing violence in the home. (Marsenich, 2002).
In order to figure out if a child has developed PTSD, there is a PTSD module, the 'anxiety disorder interview'. This is considered a reliable resource for establishing if a child has developed post traumatic stress disorder due to physical, sexual, or mental abuse.
In a study conducted in Oregon and Washington state, the rate of PTSD in adults who were in foster care for one year between the ages of 14 and 18 was found to be higher than that of combat veterans, with 25% of those in the study meeting the diagnostic criteria as compared to 12–13% of Iraq war veterans and 15% of Vietnam war veterans, and a rate of 4% in the general population. The recovery rate for foster home alumni was 28.2% as opposed to 47% in the general population. Understanding the impact of the child's early experience, and the maltreatment that brought the child to child welfare's attention is critical to identifying causation.
"More than half the study participants reported clinical levels of mental illness, compared to less than a quarter of the general population".
Eating disorders
Foster children are at increased risk for a variety of eating disorders in comparison to the general population. In a study done in the United Kingdom, 35% of foster children experienced an increase in Body Mass Index (BMI) once in care. Food Maintenance Syndrome is characterized by a set of aberrant eating behaviors of children in foster care. It is "a pattern of excessive eating and food acquisition and maintenance behaviors without concurrent obesity"; it resembles "the behavioral correlates of Hyperphagic Short Stature". It is hypothesized that this syndrome is triggered by the stress and maltreatment foster children are subjected to, it was prevalent amongst 25 percent of the study group in New Zealand.
Poverty and homelessness
thumb|New York street children in 1890
Nearly half of foster children in the U.S. become homeless when they turn 18. One of every 10 foster children stays in foster care longer than seven years, and each year about 15,000 reach the age of majority and leave foster care without a permanent family—many to join the ranks of the homeless or to commit crimes and be imprisoned.
Three out of 10 of the United States homeless are former foster children. According to the results of the Casey Family Study of Foster Care Alumni, up to 80 percent are doing poorly—with a quarter to a third of former foster children at or below the poverty line, three times the national poverty rate. Very frequently, people who are homeless had multiple placements as children: some were in foster care, but others experienced "unofficial" placements in the homes of family or friends.
Individuals with a history of foster care tend to become homeless at an earlier age than those who were not in foster care. The length of time a person remains homeless is longer in individuals who were in foster care.
Suicide-death rate
Children in foster care are at a greater risk of suicide. The increased risk of suicide is still prevalent after leaving foster care. In a small study of twenty-two Texan youths who aged out of the system, 23 percent had a history of suicide attempts.
A Swedish study utilizing the data of almost one million people including 22,305 former foster children who had been in care prior to their teens, concluded:
Death rate
Children in foster care have an overall higher mortality rate than children in the general population. A study conducted in Finland among current and former foster children up to age 24 found a higher mortality rate due to substance abuse, accidents, suicide and illness. The deaths due to illness were attributed to an increased incidence of acute and
chronic medical conditions and developmental delays among children in foster care.
Georgia Senator Nancy Schaefer published a report "The Corrupt Business of Child Protective Services" stating: