When children are abused by foster parents

I click open the x-ray viewer.  After 4 years in emergency pediatrics, I am not really surprised that a tibia fracture underlies the bruised ankle I unexpectedly encountered on physical exam.  Yet I audibly gasp as the chest x-ray loads.  The torso in question belongs to a chubby little cherub of a 3-month-old in room 11, brought in for red eyes.  I begin to count the fractured ribs — 1, 2, 3, 4, 5.  I pause.  That’s just the left side.

His 17-year-old mother sobs as the caseworker takes her son from her arms.

“He smiles when you kiss his face,” she calls as she’s escorted out of the ED, “and he likes it when you read him books.  Someone has to read him books.”  She looks towards me.  I look down.

She admits to the social worker that she gets overwhelmed.  His father, also 17, has a short temper.  He works third shift, she works days.  They pass the baby off.  I don’t ask when they sleep.

“Having a baby,” she whispers, “is harder than I thought.”

I want to tell her not to worry.  I want to tell her he’s in good hands, that he’s safe now, that someone will read to him and kiss his face and make him smile.

I don’t tell her about the toddler twins I admitted last week, profoundly dehydrated after days of not being fed by their foster parents.

I don’t tell her about the preteen I saw just hours ago, pushed out a second story window by her foster mother during an argument.

I don’t tell her that, on average, a child will spend 3 years in the foster care system and traverse through three placements before reuniting with their family.  That he may be walking, talking, and calling someone else “mommy” by the time she’s able to navigate the court system and regain custody.

Statistics on abuse within the foster care system are nearly impossible to find, though anecdotes abound.  This month, an 11-year-old foster child was found handcuffed on his front porch with a dead chicken hung around his neck.  In 2003, a Pennsylvania foster mother was arrested after her foster daughter died of asphyxiation when duct tape was used to enforce a time-out.   An inquiry into the Trenton, New Jersey foster care system that year found that up to 1 in 5 children within their foster system were abused at a foster home.

In Indianapolis, where I practice, the Department of Child Services (DCS) has undergone budget cut after budget cut over the past decade, $100 million in 2011, $16 million in 2012, and,  most recently $10 million in 2013.  The national turnover rate for DCS caseworkers is above 20%, with low salary, inadequate support, and excessive workload cited as the most common reasons for leaving.   In my own encounters with DCS as a prospective adoptive parent, my caseworker changed three times over a 12 month period, with our final caseworker never responding to our emails.  The social worker teaching our parenting course readily admitted at the start of our class that she had no experience with children, but had taken the job to cover until the position was filled.

I see extraordinary foster parents at my job every single day and have the honor of working with caseworkers who commit their lives to caring for and protecting children.  I also witness the consequences when the system fails the very children it is charged with protecting.

So I don’t tell the young mother that her son is safe, that he’ll be cared for, that he’ll be back with her soon.  “I’ll read to him,” I promise her.

S. Terez Malka is a pediatrics resident.


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  • querywoman

    Foster parents are supposed to be more abusive to children than their biological parents. There isn’t a Child Protective Services unit anywhere in this country with enough staff to properly monitor them.
    A lot of them do it for the foster subsidies.

    Maybe we need more quality orphanages with adequate staffing and monitoring.
    I have a relative, an inlaw to me, who is over 80 now. He was raised in a church home for children because his parents died of scarlet fever when he was five. His home was a good one.

    • SarahJ89

      Sadly, he was lucky. The underlying problem is a simple lack of concern for anyone helpless in our society. An underfunded institution won’t be any better than an underfunded foster care system. Foster parents are given traumatized children and little or no training or supervision. If you ever want to see people who know they’ve been thrown on the scrap heap, talk to teen agers in foster care.

      • querywoman

        I stopped working in public welfare in 2001. Before I left, there was a new regulation that mothers under 18 had to be living with a responsible relative like a parent or a grandmother or else living in a “second chance home” or explain why they were not in a second chance home.
        The problem was that second chance homes were almost nonexistent. I knew of two small church ones, that had a family like environment for young expectant mothers.
        Newt Gingrich advocated quality orphanages. I’d like to see them.
        After I worked for welfare, I worked briefly for the IRS. I had foster parents calling in all of the time and asking if they could claim their foster children on their taxes. I’m sure foster subsidies are more than $600 per month. The foster parents could not claim the children unless they were paying more than half of their support, more than $7200 per year.
        I’ll have to look up the IRS regulations.
        I read an article online by a woman who had five or six foster children. She said she bought them mostly thrift store clothes and some new ones. She also hand-washed the laundry. I wanted to know what she was doing with the foster care subsidies.
        I discussed this with my relative, knowing he had been raised in a quality church home. He said it worked for him. He said when he started dating his wife, my blood relative, that someone at the children’s home told her she would never have inlaw problems with him.
        He bonded into my blood family. I met his brother once.
        Orphanages have to be monitored regularly, and they could use plenty of outside help, volunteering to love the kids.
        I’ve heard horror stories of another church orphan’s home near where I live.
        What goes on in foster families makes me want to puke! I’d rather have quality orphanages.

  • Halona Black

    These kinds of stories break my heart. Are there any resources to help make parenting more manageable for the parents?

  • meyati

    This is something that I can’t handle. I was a cook at an emergency shelter for abused children. Most of them were foster children. There was a boy whose face and head was covered with knots and bruises. He was fostered by a family that wanted a slave to clean their corrals, clean the house, etc. He was out in the icy wind, cleaning the corrals on his birthday. He went in and they had a new chocolate cake. He asked them if it was his birthday cake. When he went to school a few days later, the teacher called the cops.

    When there weren’t very many children there, I’d ask them how they wanted their eggs and how many eggs. For many of the children this would be the only times they had a fried egg-sunny side up or a soft-boiled egg. It’s pitiful for a 10 year-old child to cry because he never had a fried egg before.

    In this state we can’t figure out the criteria for an investigation about child abuse. Neighbors complain about filthy, half-naked children playing in the snow-and there isn’t any investigation. Yet, they want to go after military families. These children have their own doctors, social workers and counselors, besides supportive neighbors.

    When we got our security clearance, the principal (we lived off base) had the sheriff come out and interrogate my children. My husband was deployed. My 8 year old son was terrified and became hysterical. The head of social services filed a complaint against the principal. As she said, we lived a public life in the community, and my children were always well-fed, healthy, and wearing appropriate clothes.

    Later I became a HS teacher, and the school counselors, other teachers often talked about how upside down childrens protective services were. They’d file a complaint for a child-and it would be ignored. A happy healthy child would be yanked into protective services. One 15 year-old girl was yanked from her parents, because she sat out in the car with her friends after she came home from a movie or something. They sat and talked-a retired cop across the street decided that was neglect. She was assaulted while in protective services. She wasn’t the same. This family wasn’t a military family.

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