1. www.postersession.com
The Department of Health and Human
Services defines foster care as “24-hour substitute
care for children placed away from their parents or
guardians and for whom the state agency has
placement and care responsibility” (HHS; 2000). In
addition to the familiar single foster family home
model, placements also include, but are not limited
to, group homes, emergency shelters, large
residential facilities, and homes of relatives. By
nature, the foster care system has many layers
which were created to raise the accountability
among service providers in order to promote the
success of those transitioning out of foster care in
areas such as independence, educational
achievement, and employment attainment.
However, research suggests that this has not been
the case (Ward, 2016).
In the United States, adolescents
transitioning into adulthood are expected to
complete school, become independent, and
become a contributor to society. “Aging out” is the
term used to describe adolescents aged 18 years
or older who are no longer to eligible to remain in
foster care, however this age differs from state to
state. In particular, the process of aging out poses
many problems to those leaving foster care (Ward,
2016).
Significance and Key
Concepts For OT
Foster the Future:
Independence Among Youth Aging Out of Foster Care
Patrick Martinucci, OTS & Sean McDonald, OTS
The need has been identified for the development
of programs that address the challenges faced by
youth transitioning out of foster care. Specifically,
client-centered occupation-based programs that
increase the chances of equipping this population
with the necessary skills to live independently,
seek employment, and maintain health and well-
being would be of value to the population (Ward,
2016). Programs like these would help empower
those aging out of foster care and effect positive
social change (AOTA, 2007).
The foster care system, by its nature, tends to
marginalize its “members” by labeling them different
than other children. Some studies have shown that a
child in foster care can average up to 15 different
placements throughout their youth, which ultimately
disrupts occupation as they move from placement to
placement (Ward, 2009). Kronenberg and Pollard
(2005) base the notion of occupational apartheid on
the idea that some people in society are deemed of
different economic and social value than others,
which leads to groups of people being pushed to the
outskirts of mainstream society, thus affecting their
social and occupational participation. This is
uniquely true for foster children, made more relevant
by the fact that large numbers of children in the
foster care system are burdened with a variety of
stigmas, including their minority status and physical
and emotional impairments. These stigmas in turn,
often isolate them from the community as a whole.
Abuse and neglect, such as those found in
many foster care settings, over long periods of time
can impact biological stress systems that lead to
alterations in brain maturation and result in
maladaptive outcomes. Childhood stress and
trauma have also been found to alter the
development of the limbic system, thus affecting
emotion and memory (Avery & Freundlich, 2009).
These negative outcomes, coupled with the fact that
most youth at age 18 are not developmentally
prepared to live independently, contribute to the
occupational injustice this group endures.
The barriers to the development of independent
living have been identified, however to date there
has been “no individualized, occupation-based,
client-centered” treatment approaches to fill this
need. Data on this issue has indicated that youth
preparing to exit foster care not only lack the
knowledge of available services, but also the
motivation to seek out services available to them,
the confidence to ask about these services, or find
that the services they do know about are not
meaningful to them. Occupational therapists are
well suited to meet these needs, but traditionally
have not been a part of foster care systems
(Ward, 2016).
According to the Occupational Therapy
Practice Framework, occupational therapists have
been trained to provide interventions at an
individual level, targeting highly relevant “client
factors such as emotional regulation and self-
concept; performance skills, such as process and
social interaction skills… activities of daily living,
instrumental activities of daily living, education,
and work” (Ward, 2016). Occupational therapists
are well equipped to design more attractive and
meaningful programs that will allow these youths
to gain the skills necessary that will ultimately lead
to a greater quality of life as they transition into
adulthood and living independently.
Introduction
Significance and Key
Concepts For
Disability Studies
Background
Each year, more than 250,000 new children in
the United States are placed in foster care (Ward,
2016.) Research suggests that approximately 50%
of children in foster care have at least one
psychiatric disorder, and 33% have three or more
psychiatric disorders. Examples of these disorders
are oppositional defiance, anxiety, depression,
ADD/ADHD, PTSD, learning disorders, and many
other disorders that require medications and
continued management in order to be effective.
Most youth aging out of foster care lack financial
resources as well as other familial supports. This in
turn places them at higher risk for negative
outcomes such as low education attainment,
homelessness, unemployment, and financial
difficulties, as well as the mental and physical
health issues mentioned before. Research shows
youth in the foster care system have increased
absenteeism, disciplinary referrals, and behavioral
problems, in addition to lower grades than
compared to the general K-12 population (Ward,
2016).
A Michigan Alumni study examining
demographics and foster care youth revealed that
foster care alumni are more likely to complete high
school by means of a general equivalency diploma
(GED) rather than a typical diploma. This study also
found that only one third of the alumni (32.2%)
reported having a household income greater than
the Federal Poverty Level (White et. al, 2012).
Furthermore, lack of independence, mental health,
and vocational skills have led to a steep increase
in foster care alumni receiving services as adults
though the criminal justice system (Ward, 2016).
Conclusion
0%
10%
20%
30%
40%
50%
60%
Developmental
Delays
Language
Delays
Cognitive
Problems
Gross Motor
Difficulties
Growth
Problems
Figure 3
Disabilities Displayed by Children in Foster Care
Figure 1
Figure 2
Source: http://www.cnn.com/2014/04/16/opinion/soronen-foster-children/
Source: http://www.theoilyfosterparent.com/2015/09/20/why-are-we-letting-children-age-out-orphans/