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Pediatr Clin North Am. 2014 Oct;61(5):1059-72. doi: 10.1016/j.pcl.2014.06.015. Epub 2014 Jul 24.

Foster care and healing from complex childhood trauma.

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Foster Children Evaluation Service (FaCES), UMass Children's Medical Center, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA. Electronic address:
Division of General Pediatrics, Department of Pediatrics, University of Rochester, 601 Elmwood Avenue, Box 777, Rochester, NY 14642, USA.


Children enter foster care with many forms of adversity and trauma beyond maltreatment that impact their short- and long-term physical, mental, and developmental health and their adaptation to their new care environment. Applying an understanding of the impact of toxic stress on the developing brain and body allows the health care provider to understand findings in this vulnerable population. Complex trauma alters immune response, neurodevelopment, and the genome, resulting in predictable and significant cognitive, behavioral, and physical consequences. Pediatric care of children in foster care must be trauma informed to meet their medical, mental health, and developmental needs.


Adverse childhood experiences; Childhood trauma; Complex trauma; Foster care; Kinship care; Maltreatment; Resilience; Toxic stress

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