Foster Care for Young Children: Why It Must Be Developmentally Informed

Dr. Charles H. Zeanah, M.D., MS. Carole Shauffer, J.D., and Dr. Mary Dozier, Ph.D. - Journal of the American Academy of Child and Adolescent Psychiatry

Foster care is a societal intervention for orphaned, abandoned, and maltreated children. In the United States, more than 400,000 children are in foster care, and nearly half of those are younger than 5 years. These children are at substantially increased risk for psychopathology and account for a disproportionate share of public funding for psychiatric services, with spending perhaps 15 to 20 times as much as for low-income non-maltreated children. Although foster care has a social stigma, research clearly shows that high-quality foster care exists and is a far better alternative than other approaches to caring for abandoned or maltreated young children. Nevertheless, there is considerable room for improvement in “business as usual” foster care in the United States, and it is critical that improvements are implemented so that the needs of the youngest and most vulnerable children are met.

We are focusing in this article on a central problem of foster care, which is that it is often not developmentally informed. Our central thesis is that foster care for young children should be a different intervention than for older children. Decades of developmental research on the science of attachment should inform how we design and implement foster care for young children, with young children roughly defined here as younger than 6 years. If foster care is developmentally informed, then crucial features will be more intentionally pursued, as they can and should be. Colleagues in child protection and family courts make complex and difficult decisions daily, and as practitioners and researchers, we must ensure that they have and apply the best available information to inform these decisions.