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Caring for Children in Foster Care During COVID-19

​​​​​​By Douglas Waite, MD, FAAP and Anu Partap, MD, MPH, FAAP

Children and youth in foster care have often survived a lifetime of uncertainty and change, both before entering foster care and during foster care. For these children, changes like ​social distancing during COVID-19, can trigger traumatic memories or symptoms.

Specific concerns for children​ in foster care

During the coronavirus pandemic, caring for children in foster care can be even more challenging than the usual day-to-day care given by parents, foster and kinship caregivers, and child welfare professionals. Many of these children have experienced adversity and trauma, leaving them more vulnerable to the changes that come with school closings, lack of daily contact with friends and mentors, and other forms of social distancing​.

Here are some ways you can help your child through this difficult time.

Stay connected. Social distancing can reawaken feelings of loneliness and isolation that many children in foster care have experienced. They may be afraid of being separated from parents, foster parents, and other family members. Help your child feel connected, even if virtually, through video calls or texts with parents, siblings, other relatives, friends, child welfare workers, and other advocates. ​

Note: Media time limits are still important, but they may need to increase to allow for social connection through technology. Just do the best you can to media use from replacing time needed for sleep, physical activity, reading, or family connection. Creating a Family Media Plan​ can help parents set reasonable limits on daily technology use. 

​​​​Look for signs of stress. For some children in foster care, the pandemic may resurface fears and past traumatic experiences. Keep an eye out for the following signs of stress:

  • frequent crying

  • behavior problems

  • difficulty staying still​

  • nightmares

  • social withdrawal

  • changes in mood

  • changes in appetite

  • problems with friends

  • toileting problems

  • problems falling and staying asleep

Children with intellectual disabilities​ or mental illness may need extra support and monitoring during the stress of isolation.

 ​Have routines. Daily routines help children feel safe and secure. Create a daily schedule that includes:

  • regular mealtimes when the family can eat together

  • learning time

  • limited technology use

  • play time

  • naps and bedtime

Reassure them. Limit what your children see and hear on the news about the pandemic. Talk about the situation in a way that your child can understand. Remind them that staying home or following precautions like wearing a cloth face covering​ in public is how we keep everyone safe. 

Watch for regression. If your child starts to regress, or act like a younger child, this may be their way of coping with stress. Help your child feel safe and secure by reassuring them that the pandemic will pass. Help them look forward to the day they can return to their favorite activities.

Seek extra help if needed. If your child shows signs of serious emotional or behavioral problems (such as excessive worry or anxiety, increased aggression or disruptive regressive behaviors), professional help may be needed. This is especially important if your child has any self-harming behavior. Many mental health providers are doing virtual visits by phone or video. You can also reach out to your foster care agency for help and support.

Have a back-up plan. Have a plan in place for who will take care of your child in the event of illness, quarantine, or isolation. Be sure to also communicate with your foster care agency to make sure the designated back-ups are able to serve in that emergency role. If the back up plan needs to be used, explain what will happen in simple terms your child will understand.

Ensure safety and security. An increase in family stress and isolation places children at risk for child abuse and exposure to violence or parental substance use. Stay in touch with supportive friends and family. There are 24-hour hotlines available if you need help or support. You can also reach out to your agency or pediatrician. ​

Maintain family connections. For children in foster care, continued visitation with family, including parents and siblings, is critical. It promotes well-being, secure attachments, and the successful reuniting of families.​ Whenever possible, in-person visitation is preferable. ​A combination of in-person and virtual visits can increase how often children, parents and siblings can interact.

Outdoor visits are best. The best location for a visit is outside whenever possible. When a visit takes place inside, follow current Centers for Disease Control and Prevention guidelines and local protocols for physical ​distancing, ​hand hygiene and testing. When in-person visits cannot be done safely, ensure that children can have virtual visits that are developmentally appropriate for them.

When visits aren't an option. If family visits are not possible during the pandemic, reach out to other foster parents, child welfare advocates or your pediatrician for other ways families can engage. Talk with the child about why visits aren't possib​le right now. Have photographs available or let children draw pictures of their family.  You can also create a memory box or life book to help them through the separation. Talk to your child about why visits are not possible right now. Be the supportive, caring adult you have always been for your child or the child in your foster home. Your empathy will help your child feel safe, secure, and positive about the present and the future.

Weigh the risks. Check the latest guidance from the CDC and your local or state public health authority to assess the risks of COVID-19 transmission before a visit with families.  Factors to consider include known exposure, positive test results or symptoms of COVID-19. Everyone (child, caregiver and household members, birth family, and child welfare professionals) should be screened for COVID-19 exposure or symptoms the day before the planned in-person visit. Visits should not be canceled because of inability to wear a maskFurther safe visitations practice recommendations can be found here​.   

Ensure safety and security. An increase in family stress and isolation places children at risk for child abuse and exposure to violence or parental substance use. Stay in touch with supportive friends and family. There are 24-hour hotlines available if you need help or support. You can also reach out to your agency or pediatrician. ​​

Take care of yourself. It is normal and expected for you to feel stressed. Replace activities you have lost with new ones, and celebrate even small successes each day. Remember, what is good for your well-being will help relieve the stress of your children, who recognize when you feel stress and worry about you. The care you are providing each day will last a lifetime. ​

Additional Information:

Last Updated
American Academy of Pediatrics (Copyright © 2020)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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