Building a Healthy Foundation for Children in Foster Care
Children’s Mercy has established the Foundations Foster Care Clinic to provide a new, healthy start for children placed in foster care.
Claire Hickey, MD, Director-Foster Care Medical Clinic, said the clinic’s name and its tagline, “Building a healthy foundation for children in foster care,” were conceived in recognition of the fact that “A lot of these kids have not had a healthy foundation, so when they enter foster care we want to build that support.”
Dr. Hickey said the American Academy of Pediatrics recommends that children in foster care be seen within 72 hours after being placed in state custody to have a basic medical screening for communicable diseases, signs of abuse or any chronic illnesses that need to be addressed. The Foster Care Clinic provides those hour-long initial exams, which also include hearing and vision screening and discussions with caregivers about the child’s history. Follow-up exams lasting about 30 minutes are then conducted within 30 to 45 days.
Dr. Claire Hickey, Director-Foster Care Medical Clinic, conducts exams of children entering foster care and counsels foster parents on raising a foster child. “A lot of these kids have not had a healthy foundation, so when they enter foster care we want to build that support,” she says.
The Foster Care Clinic is part of the SCAN (Child Abuse and Neglect) Division.
“That’s important, because these children often come from high-risk homes where we find signs of abuse or neglect. The SCAN Clinic is there if I need help determining whether something I’ve found during an exam could be abuse. I usually can diagnose physical abuse or neglect, but if there is a disclosure of something like sexual abuse, we can consult a child abuse pediatrician who can do the specific exam that’s required.”
Dr. Hickey added, “I also think it’s important to be part of a clinic with nursing and staff trained specifically for children who have experienced trauma.”
Dr. Hickey’s time is devoted exclusively to see foster children when they go into care. She is assisted by Sharon Stimatze, BSN, RN, Foster Care Coordinator, Nursing Program, who “works tirelessly to track down vaccine records and other medical information to help guide our appointments,” Dr. Hickey said.
The follow-up exams are focused on developmental issues. The clinic uses “ages and stages” screening, a developmental evaluation tool that helps caregivers determine whether the foster children need referrals to subspecialties, or if they have developmental concerns that can be addressed by early intervention.
“About 70 percent of kids in foster care are found to have some kind of behavioral issue, and that’s probably understated,” Dr. Hickey said, adding that both visits put a great deal of emphasis on preventive health, much like a well-child check.
“At that point, [the follow-up visit] we make sure they’re seeing a dentist and are established with a therapist,” Dr. Hickey said. “I’m a strong believer that these kids should be in therapy—even if it’s play therapy when they’re little—because of the changes they’re experiencing. If there weren’t obvious signs of abuse, there is still the trauma of leaving their home and their parent. Even if the parent wasn’t providing for them, it’s still their parent, and that can be traumatic.”
Parental education
Education of foster parents is another point of emphasis.
“Whether it’s a new foster parent who has never fostered before, or a ‘kinship’ placement with a grandmother, aunt or other relative who hasn’t cared for a child in 20 years, it’s important for us to educate and update them on current safety and medical guidelines for the age group of the child being fostered, especially at the beginning of being placed in a new home,” Dr. Hickey said. “We help foster parents address specific behaviors we see among children in foster care, including ways to discipline that are beneficial for that child.”After the two Foster Care Clinic visits, patients, who range in age from newborn to 18, are referred to a primary care doctor.
“Our goal is to provide the best possible care to foster children and to help foster parents get the proper care and teaching information these children need,” Dr. Hickey said.
Learn more about the Foundations Foster Care Clinic at Children's Mercy.