Foster Care Clinical Pathway — Outpatient Specialty Care

Provider Resources

General information about health of children in foster care

AAP Healthy foster care America  
Links to a broad array of resources for professionals and families, including an overview of health issues related to foster care, tips for creating a foster care friendly practice, clinical forms, insurance information, and advocacy opportunities.

Fostering Health: Healthcare for children and adolescents in foster care  
A manual developed by the AAP Task Force on Foster Care detailing standards of healthcare for children and adolescents in foster care. Includes specific chapters for primary care, mental health, and child abuse professionals.

AAP policy statement - Healthcare issues for children and adolescents in foster care and kinship care:  
Council on Foster Care, Adoption, and Kinship Care, Committee on Adolescence, and Council on Early Childhood. Healthcare issues for children and adolescents in foster care and kinship care. Pediatrics 2015;136(4):e1131-e1140.
This AAP policy statement outlines healthcare needs of children in foster care, barriers to adequate care, and approaches to healthcare service delivery. Trauma-informed care and care coordination are discussed. Recommendations for the healthcare of children in foster care are made on individual, pediatric practice and system levels.

AAP technical report – Healthcare issues for children and adolescents in foster care and kinship care:  
Szilagyi MA et al. Healthcare issues for children and adolescents in foster care and kinship care. Pediatrics 2015;136(4):e1142-e1166.
This report supports the AAP policy statement, providing information on topics including the foster care system, health problems of children in foster care, the impact of trauma on health and the need for trauma-informed care, barriers to care, as well as consent and confidentiality issues. The role of the pediatrician is discussed. Healthcare guidelines for children in foster care are reviewed.

Current problems in pediatric and adolescent healthcare. Foster care and Health in the U.S. 2015;10(45):381-322.
This journal issue reviews healthcare status of children in foster care, trauma-informed care, aging out of foster care, and national policies related to foster care.

AAP Clinical Report - Children exposed to maltreatment: Assessment and the role of psychotropic medication.  
Keeshin B et al. Pediatrics 2020; 145(2):e20193751
This clinical report focuses on the topic of appropriate use of psychotropic medication among children involved with the child welfare system. The discussion includes child welfare systems, assessment of traumatic experiences and principles for prescribing or discontinuing psychotropic medications.

Laboratory screening for children entering foster care  
Greiner MV et al. Pediatrics 2017;140.
This study evaluates the prevalence of illness detected by routine screening laboratory tests among children entering foster care.

Toxic stress and trauma-informed care

SAMHSA National Center for Trauma-informed Care  
A program that provides technical assistance and training on trauma-informed care to service providers. The website also contains links to trauma-related resources such as helplines and a behavioral health treatment locator.

Center on Developing Child at Harvard University  
Harvard portal for scientific research and public policy related to early childhood adversity. Includes brief overviews of key concepts in the field as well as numerous reports and multimedia.

Child Trauma Academy  
A nonprofit organization offering online courses on scientifically-informed methods for working with at-risk children, as well as a library of articles related to child trauma.

Helping Foster and Adoptive Families Cope with Trauma.  
A guide for pediatricians to identify traumatized children in foster and adoptive families and to support their families by sharing knowledge about the manifestations of trauma and offering coping strategies. Includes helpful handouts that may be printed out for families.

Safe and Sound: Responding to the Experiences of Children Adopted or in Foster Care  
In addition to the guide for pediatricians, the American Academy of Pediatrics developed resources for parents, caseworkers, teachers, and childcare providers to help children who have experienced trauma. These guides are available for download.

From this page you can download a series of resources to help adults understand how to recognize and respond to the effects of trauma. There guides for parents, other adults involved in children’s lives such as coaches, pediatricians, caseworkers, early education/childcare providers, and teachers.

Sexual abuse:

AAP Clinical report: The evaluation of children in the primary care setting when sexual abuse is suspected.  
AAP recommendations for evaluating children for possible sexual abuse, including responding to a parent’s concerns, interviewing children, performing the physical exam, testing for STIs, and counseling families to decrease the adverse effects of sexual abuse.

AAP Clinical report – the evaluation of sexual behaviors in children  
AAP guide to evaluating sexual behaviors in children, including differentiating between normal and abnormal behaviors, environmental factors affecting sexual behaviors, assessment, treatment, and parental guidance.

Adams et al. Updated guidelines for the medical assessment and care of children who may have been sexually abused  
Guidelines for the medical evaluation suspected child sexual abuse, with an emphasis on the interpretation of laboratory and physical exam findings based on a review of recent literature.

CHOP sexual abuse pathway

Physical Abuse

AAP clinical report on the evaluation of suspected child abuse  
AAP guide to the evaluation of suspected child physical abuse. Outlines risk factors, challenges in identifying abuse, histories and physical examination findings suggestive of abuse, diagnostic testing, treatment, reporting and prevention.

CHOP physical abuse pathway

Developmental Resources

Elwyn Philadelphia Special Needs Resource Guide
Contains information about an array of services such as Early Intervention, after school programs, and camps.

ASERT (Autism Services, Education, Resources and Training).  
A Pennsylvania collaborative designed to bring together resources locally, regionally and statewide.

CHOP Physical Therapy

CHOP Occupational Therapy

CHOP Speech-Language Pathology