Hidden Risks of Foster Care

For many children, one diagnosis keeps popping up

After years of trying to have their own children, John and Cinnamon Norton of Kearns, Utah, decided to become foster parents. At the time, John Norton was working in sales and Cinnamon Norton worked as an accountant. They felt they could provide a good, stable home for their kids.

“Why pay thousands of dollars for infertility treatments when I can help out children who need it?” Cinnamon Norton told LifeZette.

But being a foster parent didn’t turn out to be as easy as it at first seemed. Over the course of several years, the Nortons took in five foster children and adopted two of them.

Norton says that almost all of these children came from homes in which they had faced abandonment and witnessed hard drug use.

She felt unprepared for the extent of their challenges. Despite taking preparatory parenting classes, creating carefully regulated routines for the kids, and building a safe home environment, the foster children often experienced night terrors. Several were later diagnosed with ADHD and oppositional defiant disorder.

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“It was a first-time exposure to ADHD, and I’m still wondering what I’m supposed to do,” Norton said. “It’s not something that just goes away. You have to take it a day at a time.”

“These kids are under stress almost from the time they’re born.”

But foster parents like the Nortons can find some comfort in knowing they’re not alone in these challenges. A new study from the Centers for Disease Control and Prevention used comprehensive statistical data from 12 states to show that foster kids are three times more likely to be diagnosed with ADHD.

Researchers found that 1 in 4 foster children has an ADHD diagnosis, compared to just 1 in 14 of children not in foster care. And close to half the children in foster care also had some other psychological disorder, such as oppositional defiant disorder, anxiety, or depression.

‘Surprised the Numbers Aren’t Higher’
The reasons for this wide discrepancy aren’t immediately clear. But Stephanie Donaldson-Pressman, a licensed clinical social worker at the New England Center for Pediatric Psychology, said she’s surprised the numbers aren’t higher.

“By the time these children enter the foster system, they have been exposed minimally to neglect and maximally to abuse or lack of nutrition and basic levels of care,” she told LifeZette. “These kids are under stress almost from the time they’re born.”

Related: Why a Sick Child Made Me Grateful

As a defense mechanism, they develop hypervigilance, they distrust adults, and they often experience extreme separation anxiety.

“You can’t multitask when you’re stressed and afraid,” Donaldson-Pressman said.

Foster kids may be misdiagnosed in some cases.

So while the children are often diagnosed with learning disabilities, they may be operating under a sense of fear. They may be resistant to developing new skills because they’re afraid their foster parents will return them to the system if they don’t perform well.

“Most foster kids have been deprived of dedicated nurturing,” Donaldson-Pressman said. “Their cries weren’t attended to, and they had to compete for adults’ attention. Children need dedicated time — and a child in foster care is very unlikely to have had those experiences. This usually translates into an inability to focus.”

Robert Pressman, a psychologist at the New England Center for Pediatric Psychology, said that, at least in some cases, these foster kids may be misdiagnosed.

The ADHD diagnosis depends entirely on two questionnaires that are filled out by parents and teachers, rating the prevalence of certain behaviors. In Pressman’s view, this form of diagnosis is somewhat subjective and depends on the “tolerance and sensitivity of the person filling out the form.”

Medication may be needed to help some children with ADHD, Pressman also said, but he has found that developing consistent bedtime routines, eliminating co-sleeping, and providing a predictable schedule for children can also drastically reduce ADHD symptoms.

The good news is that help is readily available for foster parents whose children struggle with these disorders.

Melissa Danielson, a statistician and lead author on the CDC study, told LifeZette that foster children were more likely to be receiving psychological and behavioral treatments for these disorders, according to the data. The percentage of foster children receiving medication treatments was also higher than for those children not in foster care.

Foster children face challenges for sure, but at least many of them are being given the tools they need to combat their challenges. That’s hopeful news for foster families across the nation.

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