Anticipatory Guidance Ongoing Care with Medical Home

Transition Into Foster Care or Kinship Care

These tips will help the pediatrician guide a patient into foster or kinship care:

Remind caregivers that this is a difficult time for children.
Remind them that there may be an initial honeymoon period followed by acting out behaviors.
Symptoms and behaviors that may be related to prior trauma experiences: tantrums, food hoarding, constipation, or sleep difficulties.
Do not take these behaviors personally.
Provide consistency in access to food, bedtime routines, discipline, and toileting.
Remain calm when children have difficult behaviors, avoid yelling.
Learn to notice and avoid triggers.
Recognize the child's strengths and provide positive reinforcement.
Give messages that the child is safe.
Discuss available resources in the community.
Additional Information: American Academy of Pediatrics Safe and Sound: Responding to the Experiences of Children Adopted or in Foster Care.

Visits with Biological Parents

Before visits with biological parents, the pediatrician should:

Provide a transitional object.
Help the child create an art project to give to their parents.
Reassure children you look forward to seeing them after the visit.

Foster Parents Express Concerns About the Birth Parents

The pediatrician can:

Advise foster parents against making negative comments about the child's birth parents in front of the child.
Instead of voicing concerns in front of the child, the foster parent should discuss as necessary with the appropriate agency representative outside of the child's presence.
Should the foster parent feel the need to express frustration or anger, they should do so with another supportive adult rather than in front of the child.

Resources for the Medical Home Related to Providing Care for Children in Foster Care

Visit the AAP foster care site for primary care resources, including background information, office management information (coding, foster care friendly office tip sheet), and communication.