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Dec/Jan 2011Vol. 11, No. 10Social-Emotional Problems in Children in Foster Care

Many children and youth in foster care exhibit social-emotional problems due to childhood trauma and unmet mental health care needs. In an effort to improve screening for social-emotional problems, researchers at the University of Rochester Medical Center and Starlight Pediatrics, a pediatric medical home practice for foster children with special health care needs, conducted a retrospective study of young children. The results were recently published in The Journal of Child Psychology and Psychiatry.

The researchers attempted to determine:

  • Whether the systematic use of an objective social-emotional screening tool improves the detection rate of social-emotional problems in foster children, compared to reliance on subjective clinical judgment
  • The relative effectiveness of two validated tools for detecting social-emotional problems
  • The patterns of social-emotional problems among children in foster care

Researchers reviewed the medical charts of children in foster care between the ages of 6 months and 5 and a half years. At baseline, children were assessed for social-emotional problems by pediatricians relying on their clinical judgment. Later, the Ages and Stages Questionnaire (ASQ), which identifies general developmental delays, and the more specific Ages and Stages Questionnaire: Social Emotional (ASQ-SE) were used for screening. Results show that:

  • A validated mental health screening tool significantly increased the detection of potential social-emotional problems in foster care children when compared to diagnoses based on practitioner surveillance alone.
  • The more specific ASQ-SE detected more children at risk for mental health problems than did the more general ASQ.
  • Toddlers and preschoolers presented with more social-emotional problems than infants, and the prevalence of these problems appeared to increase with age.

Despite initial assumptions, there was no difference in the detection rate of social-emotional problems for children new to the foster care system and those who had been in foster care for longer time periods.

"Identification of Social-Emotional Problems Among Young Children in Foster Care," by Sandra H. Jee et al., was published in The Journal of Child Psychology and Psychiatry and is available for purchase online: