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Children in foster care have a high prevalence of developmental delay. A program for developmental screening was designed to address the increased risk of developmental delay among children in foster care. Fifty-two children birth to 18 months were evaluated using the Denver Developmental Screening Test-II (DDST-II), Early Language Milestone Scale-2 (ELM-2), and the HOME Scale. Fortynine children were screened with the Infant Neurological International Battery. Thirty five percent of the children failed DDST-II screening. Language assessment with the ELM-2 resulted in a mean global ELM-2 standard score of 89. Sixty-one percent of children had abnormal neurologic INFANIB screening exams. HOME scores reflected foster care environments that provided adequate developmental and emotional stimulation for the children. Implications for future interventions should move from developmental screening to comprehensive developmental testing and expansion of foster parent education regarding the growth and development of the foster children in their care.
In the United States there are more than 500,000 children in the foster care system. Between 1985 and 1988, the number of children in foster care grew by an estimated 23%, with the proportion of children under the age of 6 years rising 40% (Ruff, Blank, & Barnett, 1990). The present national trends of increasing numbers of children within the foster care system is linked to multiple factors which include increasing numbers of children being abused and neglected, persistent poverty, homelessness, family violence, and substance and alcohol abuse within the biologic families. Some authors have suggested that change to a nonabusive and supportive home environment is associated with better development, emotional health, and medical health for these children (American Academy of Pediatrics [AAP], 1994; Simms, 1991).
Children are placed within the foster care system because legal action has been taken on their behalf to provide out of home care. Most children entering this system have suffered combinations of physical, emotional, or sexual abuse or have been neglected in having their physical, emotional, or medical needs met. Children in foster care suffer from a cluster of health problems directly related to abuse and neglect (AAP, 1994; Blatt et al., 1997; Chernoff, Coombs-Orme, RisbyCurtiss, & Heisler, 1994). A profile of their health status shows that 40-95% experience emotional and behavioral disturbances, 60% have developmental delays, 35-45% have chronic medical problems,...