§4 ch14: Foster Care for Youth with Elevated Needs
14.7 Youth Who May Not be Appropriate for Level A
Youth who may not be appropriate for Level A include:
- Youth under the age of three (3) who cannot be treated effectively through the behavior modification treatment model;
- Youth who exhibit severe psychiatric behavior, as diagnosed by a psychiatrist/psychologist, such as an obvious lack of emotional contact, affect disturbances, and/or severe thought distortions;
- Youth with a recent history of extreme or dangerous physical aggression;
- Youth with a recent history of fire setting;
- Youth who have recently attempted suicide and continue to have suicidal ideations;
- Youth with an IQ below 65(should also look at functioning);
- Youth who are medically diagnosed as chemically dependent and whether they have had treatment;
- Youth with severe medical or physical handicaps which present barriers that the child cannot or will not overcome;
- Youth whose primary presenting problem, as diagnosed by a psychiatrist/psychologist is sexual addiction and who need extremely structured treatment and unusually close supervision; or
- Youth with personality disorders, as diagnosed by a psychiatrist/psychologist, who have severe problems forming attachments with caretakers and significant others.
14.7.1 Youth Who May Not be Appropriate for Level B
- Actively suicidal;
- Compulsive fire setter;
- Sexual abuse offender which might endanger other family members;
- Require around-the-clock awake supervision; and
- Unable to function in public school and alternative program (day treatment) is not available.
Working With Youth With Developmental Delays
Youth with developmental delays may, or may not, be appropriate for Level B Foster Care. Appropriateness for Level B Foster Care should be based on the Selection/Screening Team and/or the FST team evaluation of all the circumstances surrounding that particular youth. Youth should not be ruled out for Level B based solely on the singular characteristic of an IQ score falling below 65. Instead, the team should consider a variety of information, including the following:
- Youth’s functioning level;
- Severity of developmental delays;
- Ability for self-care;
- Type of behavior problems;
- Level of physical aggressions;
- Need for supervision;
- Strengths; and
The Department of Mental Health/Division of Developmental Disabilities can be very valuable in providing expertise about and support for these youth and their resource parents or caregivers. If a referral for services to the Division of Developmental Disabilities has not been made in these instances, the case manager should do so immediately by contacting the appropriate Regional Center.
Another key factor in considering a youth with developmental delays for Level B care is the match with the resource parent(s). Some youth with developmental delays require a lot of patience and structure and may do better in families that have set routines. Likewise, some youth may require a high level of resource parent supervision. Respite care may be especially important for families caring for youth with delays. Level B resource parents may benefit from training and/or specialized services geared to the particular youth. While behavior modification techniques were originally developed with developmentally delayed populations, specific Level A strategies may have to be adjusted to fit the youth. For example, youth with developmental delays may be slower to learn new behaviors and slower to generalize the learning. The youth’s participation in determining the consequences may have to be geared to that youth’s ability and level of understanding.
In conclusion, Level B foster care may be appropriate for some youth with developmental delays, with decision making that takes into consideration the youth as a unique individual with a unique mix of characteristics, strengths and challenges.