Statement Rundown: There is growing evidence that children unable to live with their biological parents fare better when living with extended family rather than nonrelated foster parents. In fact, the number of children who live with relatives other than their biological parents has been increasing over the years, with substance abuse and neglect as top reasons why children are removed from their parents’ care. One key measure of a child’s well-being is the stability of the home environment. Children raised in the kinship of their relatives have fewer moves than children in foster care and are thus more likely to retain relationships with their biological parents and siblings. In addition, their risk of developing behavioral problems is lower than those in nonkin foster care.
Identifying families involved in kinship care is difficult, as many of these arrangements are informal agreements. Thus, it is important for pediatricians to look closely at their patients to see if they notice any patterns consistent with kinship care. Overall, kinship care is more prevalent in the African American community and kinship caregivers tend to be older, have less formal education, are more likely to care for large groups of siblings, and are more likely to report age-related chronic health conditions. These families face challenges that include economic stress, lack of healthcare insurance, and significant physical and behavioral health needs of caregivers themselves.
The rising number of children in kinship arrangements requires pediatricians to be better informed about these families and address their concerns during regular clinic visits. They should identify guardianship arrangements in order to better coordinate care and connect families with the proper resources. In addition, when a child is identified as being in kinship care, more frequent follow-ups and more in-depth evaluation of developmental status are recommended. Pediatricians can also provide guidance to kinship caregivers around the challenges they face raising these children, such as current safety standards for sleep, motor vehicle and injury prevention, and education for older caregivers. The overall goal of pediatricians should be to ensure the well-being of not only the child, but also that of the kin caregiver.
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