Influence of the Foster Care System

The foster care system, especially the abuse and neglect seen within it, negatively affect the way a child behaves, interprets, and responds to the behavior of their peers. The development of the child's brain is a self-based occurrence that is stimulated by the five senses; light, smell, taste, sound, and touch. When these actions occur the brain reacts based on previous experiences with them. Abuse has the worst effect on a child's brain, such as when a child is taken from their home due to related accusations, their brain becomes structured differently than the average person (Dupree & Stephens, 2002).

In addition to abuse conditions, children that live in a low income home, with parents that are drug addicts or suffer from mental illnesses have a tendency to lack the adult support they need, also leading to an abnormal brain structure. Negative situations lead to larger amounts of the cortisol hormone being produced in a child's brain. This adds unneeded negative stress to the child which ends up disturbing the circuits that help to make the brain function. The stress doesn't just rewire the brain as a child, but also has the potential to increase stress related diseases and cause cognitive impairment in the adult brain (Mbengue, n.d.). Likewise, when children experience more than normal amounts of violence, the brain becomes shaped in ways that will increase its ability to detect threats and signs of violence. This could lead to children developing more appropriate behaviors to react to threatening situations and less appropriate ones for normal situations; such as empathy and nurturing. These experiences, the ones that create pain and sadness within a child, have negative impacts on their intellectual development and relationships with important people. Due to this, children become normalized with fear as a response and in result show an increase in hyperactivity, anxiety, behavioral impulsivity, sleep problems, tachycardia (an abnormally fast heartbeat), and hypertension and a variety of neuroendocrine abnormalities (Dupree & Stephens, 2002).

On average, children in foster care are 60% more likely to develop a mental illness than the average general population child. A foster child's history of trauma makes them more at risk for illnesses such as: post-traumatic stress disorder (PTSD), depression, modified social phobia, panic disorder, generalized anxiety disorder, and alcohol and drug dependency. The increased amount of children being diagnosed with these illnesses has led to an increase in the use of psychotropic medication as a treatment. These types of medication generally include mood stabilizers, antipsychotics, anti-anxiety medications and stimulants. An estimated 13-52 percent of foster children are given psychotropic medication as opposed to the 4 percent of the general population. ("Mental Health," 2016).

The increase in the use of these types of medication puts the blame on state legislatures. A study conducted by the Department of Health and Human Services in 2013 shows that about a third of all children that are on psychotropic medications don't receive the right treatment plan or don't receive accurate medication monitoring (Theobald, 2018). These results show the states are violating The Child and Family Services Improvement and Innovation Act of 2011 which requires states to develop a health oversight plan to identify and respond to the health and mental health care needs of children in foster care (Love, Wehring, & Coulter, 2013). A 6 year old child, who was used in the study, was given four psychotropic medications for ADHD, behavior disorder, and a few other conditions. Concerns that the medication was too much for the diagnoses led to a change in the child's medical treatment plan as a 6 year old should not be taking four different drugs for general behavior issues. The frequency of psychotropics being prescribed to foster care children and the lack of oversight with them can prove that they are only prescribed to control the behavior of the child and not for actual treatment of the medical condition (Theobald, 2018). This results in the overtreatment of the medications.

Other factors that can result in longer durations or higher dosages of the medicine include the lack of understanding of the trauma the kids have been through, not knowing that their outbursts aren't intentional, the lack of pediatric health resources, and the possible misdiagnosis of the illness for something else. Psychotropic medications are more appropriate for children that develop depression or other related health problems, like anxiety. Psychotropics should be used as part of a treatment plan when needed, or suggested for the specific diagnosis, but shouldn't be the only part of the treatment plan. Other medical treatments should be used in addition to psychotropics, but if a child is initially put on one they should be started with the lowest dosage and either the dosage should be watched and increased slowly when needed or if possible, the child should be taken off it an put on a medication with less severe effects (Szilagyi et al., 2015). Emotional and Attachment Issues        

Children start to form attachments around six or seven months of age. If babies are separated from their parents before that and are put in a nurturing home, they can normally recover from it without any long-term effects. It is different for older children though because being taken from someone after an attachment has already been made leaves deep psychological suffering that had the potential to carry into their adult life ("How Does," 2018). Young adults inability to develop longing attachments as children is what leads them to avoid forming relationships and close emotional connections, and is what increases social anxiety and fear in their everyday lives (Guarino, n.d.).        

The presence of adversity in a child without the help of an adult figure can affect the neurobiology of the brain. The toxic stress that leads to mental illnesses in children can also alter the genetic expression of the brain. The areas most affected by this stress are the amygdala, hippocampus, and right prefrontal cortex, (Szilagyi et al., 2015) which are the parts of the brain associated with attention, memory, perception and understanding, and stress and emotional responses. Therefore, when a child experiences trauma, danger, or violence, they go through stages of aggression, inattention, impulsivity, poor emotional responses, and disconnection between emotions and thoughts. This is, for many reasons, why children that are exposed to such negative actions act out. It is also part of the reason for why there aren't enough foster parents or why current ones give up and give the children back. When a child lashes out on their foster parents they think it's because of something they did wrong and they think that things are always going to be like that and that the child will never change. This isn't true, it's just that the children's brains have become structured to handling situations a certain way and it takes a lot of patience and love to break and change the negative reactions to positive ones. This increase in the vulnerability to adversity in a child also shows effects as they become adults. Adverse and negative childhood experiences have shown an increase in mortality and morbidity in adults (Szilagyi et al., 2015). Lack of Skills Needed to Survive in the Real World       

Although some states offer young people to stay in the system until they are 21, most are forced out by age 18. Once age 18 comes, the young adults that are forced out of the system lose their eligibility to receive government help with housing, transportation, and medical care. 18 year olds aging out of foster care are expected to be self-sufficient immediately even though they have an insufficient amount of resources to survive (Fowler, Marcal, Zhang, Day, & Landsverk, 2017). These adolescents come out of the system with limited knowledge of how the real world works or how to make decisions in it. After years and years of relying on services from the system, they become reliant on the people that surround them; their sense of independence is low (Seita & Brown, 2010). Attempts to prevent the issues that arise from aging out of the system have been seen through government legislation. The Foster Care Independence Act (1999) looks to help foster care children and young adults achieve self-sufficiency. The federal government provides funds for states to help the youth manage their health needs by providing temporary care coverage; increased educational and employment opportunities; and improved access to housing, counseling, and financial support ("Foster Care Independence," n.d.).

This act helps promote independence amongst adults that have aged out, but true independence in anyone, is never the case. Most non-foster adults and children have established relationships that they can go back to in times of need, so they are never truly independent. As previously stated, establishing connections with foster youth sometimes isn't the case. Young adults going into the real world for the first time need some type of connection in order to be truly apart of their community. The foster care system strives to make adults that have aged out independent, but what they really should be striving for is making them interdependent. Social workers should help young adults that are on the verge of aging out with developing and seeking connections, in order to ensure that any foster youth isn't exiting the system with no one to come back to. They should focus on helping them establish relationships before helping them with anything else. (Scannapieco, Connell-Carrick, & Painter, 2007). Solutions         The foster care system's failures often overshadow anything positive that comes from it. In 2016, adoption numbers increased when compared to the total number of children still in foster care. In addition, since 2009, the amount of time a child has waited to be adopted has decreased to an average of 31.2 months (Children's Bureau, 2017). A year and a half waiting for a family is still too long, but the progress of the system, although slow, is still improving which is what matters most. There are small changes that the United States government could make that would speed up and make the adoption processes more efficient, a long with seeing an overall improvement in the system all together.        

 In order to reduce the effects that the system creates, policymakers should take into consideration previous foster children's experiences and use their voice when determining where funds should go. When each state makes their yearly budget, they should allow foster care alumni to make an input, as they are experts on the subject and are a resource of high value. Painful stories that are shared by alumni look to provide recommendations to people that have the power to change things. As previous foster children, they want to help as much as possible as they know what the system is like and don't want to see the number of children in foster care continue to grow (Seita & Brown, 2010).

Foster parent background checks should be stricter and adults with any type of abuse record should be eliminated immediately. The last thing any child wants is to be recycled into the same patterns that got them removed from their parents in the first place. In Sweden, once the parents pass the background check, the social workers set up an interview between the parents and the child to make sure the child would feel comfortable living in that house. This is a policy that the U.S. system should attempt because the number of children in foster care in Sweden is similar to the number here. Close numbers would make it simple to start because the government could just base the new tactic on the way Sweden does it. Interviews between parents and children would be a crucial improvement in the system, as they can help reduce the number of children that are moved from home to home (CITE).  

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