Pediatric patients come from all walks of life.  Health care professionals may encounter children who have been abused and/or neglected more often than expected.  Did you know that in 2010, child protective services agencies received reports of the alleged maltreatment of nearly 6 million children in the United States?  This means that for 2 out of every 25 children in this country there were serious concerns about their safety.  As a result, more than 408,000 children spent time in foster care during 2010.  Chances are, one of these children visited your health care setting.  You probably noticed that compared to their peers in the general population, kids in foster care have more medical and dental conditions.  They also have higher rates of developmental delays, neurodevelopmental disorders, and emotional and behavioral problems.

To help medical professionals address these needs, the American Academy of Pediatrics (AAP) issued Fostering Health: Health Care for Children and Adolescents in Foster Care, 2nd edition. Implementing these AAP standards of health care is a great place to start when addressing medical traumatic stress among children in the child welfare system.  For example, establishing a “medical home” that remains consistent even when a child changes foster care placements allows that child to form a bond with the health care provider, which may decrease the child’s anxiety during medical visits.

What recommendations in the AAP standards have helped you create a less stressful medical experience for children in foster care?