Protection and Participation: The Role of Children's Voices in Collecting and Maintaining Foster Care Vital Records

Background/Purpose: Children in foster care often have complex health (physical, mental, developmental) and educational needs.  To meet these needs, children’s families of origin, foster parents, case managers and other adult stakeholders work together to collect and maintain health and education records.  Children in foster care are sometimes asked to provide health or education information about themselves or their siblings.  This study aims to better understand when and how foster parents and case managers give consideration to children’s voices and perspectives in obtaining critical health and well-being information.

Methods: Data was collected from current, experienced foster parents (FPs) and case managers (CMs) across one southeastern U.S. state through four semi-structured focus groups with child protective services CMs and twenty semi-structured telephone interviews with FPs (n=36).  All respondents were at least eighteen years old.  CMs were mean 30 years old (median=27.5), racially/ethnically diverse (50% white, 38% Black/African American, 6% biracial, 6% Hispanic) and primarily identified as female (94%).  FPs were mean 52 years old (median= 51.5), were predominately white (70% white, 25% Black/African American, 5% other), primarily identified as female (80%) and had mean 10.65 years foster parenting experience (median=6.5). Separate codebooks were developed for CM focus groups and FP interviews using inductive thematic analysis. The qualitative team analyzed each transcript, revising codebooks thematically. Though analyzed separately, similar themes independently emerged in both codebooks.  Coding was conducted in NVivo 10.

Findings:  Three themes emerged related to child involvement in vital record collection: 1) Main source, 2) Supplemental information and 3) Appropriateness.  In main source, CMs and FPs shared examples of reasons to involve children as primary information sources, such as to provide simple information (e.g. name of school), urgent necessary information (e.g. allergies or medication) or for well-being information (e.g. special interests). In supplemental information, CMs and FPs describe involving children as a secondary information source when unable to find vital information elsewhere.  The appropriateness theme describes how CMs and FPs determine when it is in children’s best interest to be included in vital record collection.  Aspects of this appropriateness decision include empowerment, reliability, age and sharing information on another sibling.

Conclusions/Implications: This study finds a central tension between child participation and child protection.  On one hand, foster parents and case managers seek to empower and involve children, particularly older children, in providing information and filling in information gaps in their own health and educational records, and in those of their siblings.  On the other hand, foster parents and case managers prioritize child protection by avoiding child involvement in vital record collection due to unreliability or unnecessary burden.  Primary considerations for involving children in vital record collection included: the availability of the information elsewhere, the type of information being collected, the age of the child and the potential for harm if the information is not urgently collected.  Findings may inform the creation of best practices or tools to assess when and how to involve children in foster care vital record collection.