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March 2004Vol. 5, No. 2Well-Being of Children in Foster Care

Two recent surveys found that many children in foster care are more vulnerable to poor health and developmental outcomes than other children. This is due not only to the difficulties children in foster care face prior to removal from the home (e.g., abuse, neglect, parental substance abuse), but also to difficulties they face upon entering the system (e.g., separation from parents, adjustment to new caregivers, or multiple placements).

Child Trends analyzed data from the National Survey of Child and Adolescent Well-Being (NSCAW) and the National Survey of America's Families (NSAF) and reported findings in a brief, Children in Foster Homes: How Are They Faring? Results show:

  • More than 50 percent of infants and toddlers in foster care are at high risk for neurological and cognitive development impairments.
  • Nearly one-third of foster children under the age of 15 have a disability.
  • Nearly half of foster children have behavioral or emotional problems.

Despite these problems, foster children also have a number of protective factors in their favor. For example:

  • 95 percent have some form of health insurance.
  • 90 percent of foster children under age 5 have received required immunizations.
  • 76 percent of 11- to 14-year-olds report feeling close to their caregivers.
  • 97 percent of 11- to 14-year-olds have an adult they can rely on for help with a serious problem.

The brief offers a number of implications for policy and practice, including the need to:

  • Increase the economic resources of foster parents or recruit foster parents with higher income levels.
  • Improve the coordination of health care across service providers.
  • Design managed care systems that take into account the special needs of foster children.
  • Offer more resources to foster parents and kinship caregivers, including training, child care, and respite care services.

A copy of this brief can be obtained from Child Trends at (PDF - 384 KB). Additional information on NSCAW can be obtained at the Administration on Children and Families website at Additional information on NSAF can be found on the Urban Institute website at

Related Items

Find more information about NSCAW and NSAF in previous issues of Children's Bureau Express:

  • "Children Cared for by Relatives: What Services Do They Need?" and "Children Cared for by Relatives: What Do We Know about Their Well-Being?" (October 2002)
  • "New Study Looks at the Well-Being of Children in the Child Welfare System" (June 2002)
  • "Surveys Give Snapshot of How Child Welfare Services Are Organized, Delivered" (February/March 2002)