title: Foster care: an update.
abstract: OBJECTIVE
  To inform child and adolescent psychiatrists about the almost 500,000 children now residing in the American foster care system. This overview surveys the pediatric, developmental, and psychiatric needs of these children.
  
  
  METHODS
  Child and adolescent psychiatrists, pediatricians, a child welfare researcher, a social worker, and a psychologist developed a consensus paper from their experience with child welfare and a review of the literature in their respective fields.
  
  
  RESULTS
  Being in foster care is a defining experience in these children's lives. They are at risk in myriad ways: for instance, being poor, having chronic health deficits, experiencing the trauma of abuse and neglect, and suffering from a gamut of emotional challenges. Evolutionary developments in foster care such as therapeutic foster homes, kinship care, and changes in Medicaid funding will continue to alter the system.
  
  
  CONCLUSIONS
  Foster children are a huge reservoir of unmet pediatric and psychiatric needs; research on them is spotty at best. It is hoped that child and adolescent psychiatrists will meet the challenges these youngsters present and will advocate for them.
authors.affiliation: Johns Hopkins University Medical School, Baltimore, USA.
authors.forename: A A
authors.initials: AA
authors.lastname: Rosenfeld
authors.forename: D J
authors.initials: DJ
authors.lastname: Pilowsky
authors.forename: P
authors.initials: P
authors.lastname: Fine
authors.forename: M
authors.initials: M
authors.lastname: Thorpe
authors.forename: E
authors.initials: E
authors.lastname: Fein
authors.forename: M D
authors.initials: MD
authors.lastname: Simms
authors.forename: N
authors.initials: N
authors.lastname: Halfon
authors.forename: M
authors.initials: M
authors.lastname: Irwin
authors.forename: J
authors.initials: J
authors.lastname: Alfaro
authors.forename: R
authors.initials: R
authors.lastname: Saletsky
authors.forename: S
authors.initials: S
authors.lastname: Nickman
mesh_terms: D000293:Adolescent; D002648:Child; D002662:Child Health Services / Q000458:organization & administration*; D002665:Child Psychiatry / Q000592:standards; D002669:Child Welfare / Q000639:trends*; D002675:Child, Preschool; D005581:Foster Home Care / Q000639:trends; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006801:Humans; D008605:Mental Health Services / Q000458:organization & administration*; D014481:United States