Children in Foster Care: Adverse Childhood Experiences and Psychiatric Diagnoses

Abstract

This study examined psychiatric diagnoses and adverse childhood experiences in a matched sample (n = 144) of children enrolled in standard or treatment foster care programs and their associations with discharge placement restrictiveness for children (n = 90) in treatment foster care. Medical record data were extracted on psychiatric diagnoses, adverse childhood experiences, and discharge placement restrictiveness. Children in treatment versus standard foster care had significantly more psychiatric diagnoses and adverse childhood experiences. The presence of bipolar and oppositional defiant disorder was associated with a more restrictive discharge placement. Even without standardized screening, children with more severe presentations are found in treatment versus standard foster care. These findings support the need for coordinated mental health services in treatment foster care.

Keywords:

• treatment foster care
• adverse childhood experiences
• child maltreatment

Acknowledgments

This work was supported by National Institute of Mental Health grant 5 K23 MH001822-05 and 5 U79 SM56215-02. Data from this article were presented in part at the 2007 and 2008 American Public Health Association meeting. The authors would like to thank Megan Rogers for her administrative support and Lisa Ashton, RN, for her assistance with data collection. The authors also thank Sydney Royes, MSW, for her participation in the data analysis of an earlier version of this project. Most especially the writers would like to acknowledge the clinicians, children, and families participating in treatment foster care.