Developmental health and wellbeing of Australian Aboriginal children in foster care: Are we making a difference?

Objectives: Children in foster care (FC) have well documented health and developmental needs. Aboriginal children are placed in care at 10 times the rate of non-indigenous children in Australia. In metropolitan Sydney, KARI an... [ view full abstract ]

Objectives: Children in foster care (FC) have well documented health and developmental needs. Aboriginal children are placed in care at 10 times the rate of non-indigenous children in Australia. In metropolitan Sydney, KARI an Aboriginal community organisation provides culturally respectful scaffolding and support to indigenous children in FC; including multi-disciplinary clinical assessment and intervention. Our aims were to determine the health and developmental needs of a subset of children in FC with who had been in stable care for at least a year. We wanted to identify child, carer, and intervention characteristics that contributed to children doing well. We also wanted to identify enablers and barriers to providing culturally competent intervention.

Methods: We identified children who had been in stable care with KARI for >12 months. We compared clinical measures and outcomes for these children with results from previous audits. We identified risk and resilience factors in home and school functioning for each child as well as enablers and barriers to culturally competent intervention by interviewing therapists and caseworkers. Simple descriptive analysis was done on the quantitative data, qualitative data was analysed thematically.

Results: We identified 26 children who had been in stable care with KARI, at entry their developmental profile was similar to that of previous audits. Most children got speech therapy; a third got occupational therapy and psychological intervention, most attended cultural programs. The majority of children (25/26) improved in their developmental health. Risk and resilience factors relating to child, carer/ home, and service intervention type were identified; some were not amenable to change. Caseworkers and therapists identified elements of good practice from a trauma-informed and culturally respectful perspective.

Conclusions: Most children in stable care improve, with intervention and support. There are challenges delivering a culturally competent service in a large metropolitan area, but it can be done.