Paul Fine

Foster care: an update.

OBJECTIVE To inform child and adolescent psychiatrists about the almost 500,000 children now residing in the American foster care system. This overview surveys the pediatric, developmental, and psychiatric needs of these children. METHOD Child and adolescent psychiatrists, pediatricians, a child welfare researcher, a social worker, and a psychologist developed a consensus paper from their experience with child welfare and a review of the literature in their respective fields. RESULTS Being in foster care is a defining experience in these childrens lives. They are at risk in myriad ways: for instance, being poor, having chronic health deficits, experiencing the trauma of abuse and neglect, and suffering from a gamut of emotional challenges. Evolutionary developments in foster care such as therapeutic foster homes, kinship care, and changes in Medicaid funding will continue to alter the system. CONCLUSIONS Foster children are a huge reservoir of unmet pediatric and psychiatric needs; research on them is spotty at best. It is hoped that child and adolescent psychiatrists will meet the challenges these youngsters present and will advocate for them.

Corrective socialization in foster care of children.

While the phrase, “interminable foster care” is becoming a damning cliché in the dialogues of juvenile courts and child welfare organizations, many children are growing up in foster homes. Human love must move us to approve and enrich these foster families; childhood is too brief and important to be knowingly allowed disapproved or impoverished experience. This paper describes the foster situation: families, children, and the involved professionals. It then presents a teachable developmental theory weaved from threads of numerous known theories, and describes a process whereby “interminable” foster experience was used therapeutically for a group of handicapped homeless children.

Play and family therapy as core skills for child psychiatry: Some implications of Piaget's theory for integrations in training and practice

Training determines the quality and content for long-range professional integrations. Core experiences with play therapy and family therapy enable child psychiatrists to apply the entire spectrum of modern treatment modalities in ways that are developmentally and socially appropriate. Piagets genetic system of psychology provides guidelines for integrating disparate skills toward meaningful practice.

Diagnosis and Treatment of a Child With X-polysomy

Abstract The identification of previously undetected X-polysomy in a 12-year-old Caucasian girl is described. For this patient, identification of the chromosomal abnormality followed by supportive psychotherapy was moderately successful in improving her self-esteem, affect, academic performance, self-care, and interpersonal skills. Psychological gains were found to be stable 16 months after termination. The importance of a high index of suspicion for X chromosome polysemy is highlighted for children presenting with a combination of cognitive impairment, emotional immaturity, abnormal facial features, history of recurrent urinary tract infection, enuresis, skin abnormalities, and hematological abnormalities.