Do children in the child welfare system experience medical treatment in the same ways that children in the general population do? To some degree, yes, they do. At the same time, there are notable differences in the life experiences and family circumstances of children in foster care compared to their peers outside the child welfare system. It's important to understand what these differences are and how they may influence responses to medical events among children in foster care. Three main issues affect how children in foster care experience medical treatment:
- Level of medical and developmental need
- How medical services are delivered
- Experiences before and during treatment
Children in foster care are a medically vulnerable group. On average, they have greater healthcare needs than most kids yet they usually received inconsistent health care before entering placement. As a result, children often enter placement with unidentified and unmet health problems. Even after placement many do not receive adequate and timely healthcare.
According to "Improving Child Well-Being: Strengthening Collaboration Between Child Welfare and Health Care Systems", a new report from the Children's Hospital of Philadelphia Policy Lab and Safe Place, "Trauma exposure (i.e., adverse childhood experiences) can compound physical and mental health challenges long-term, and may inalterably change a child’s brain structure. The mounting research about the effect of maltreatment on well-being has contributed to an increasing recognition that children’s social, emotional, and health needs should be addressed in all stages of their involvement with the child welfare system." To address this, the report calls for more collaboration between child welfare and health care systems.
For doctors and nurses, providing trauma informed care for children in the child welfare system doesn't have to be complicated. For child welfare professionals, there's no need to be a physician or psychologist to help children feel more comfortable with medical care. Multiple opportunities exists for collaboration between the child welfare and health care systems to positively impact children's well-being, from the beginning of the CPS investigative stage, through ongoing child welfare services stage, and even as the child transitions out of the system. Most interventions fit into activities that doctors, nurses, child welfare caseworkers and other team members do on a routine basis. The key is to understand how the circumstances of children in foster care (e.g., removal from their biological parents, past histories of abuse or neglect, or moving among multiple foster homes) may affect how they cope with medical treatment.