• Adverse childhood experience;
  • developmental health;
  • epigenetics;
  • foster care;
  • foster care children;
  • gene–environment interaction;
  • optimal developmental health;
  • vulnerable population

BACKGROUND:  Every day, the United States child welfare system is entrusted with the care of over 400,000 children through foster care. The majority of children entering this social setting are infants, the most developmentally vulnerable.

METHODS: Bronfenbrenner's human health ecology model and Bowlby's attachment theory are used to delineate the social setting of foster care and its impact on developmental health, and elucidates the relationship between childhood experiences and the overall continuum of health. Additionally, the notion of inherited genes and environmental influences or epigenetics toward gene expression will be explored.

RESULTS:  Research points out that what happens in childhood matters; the consequences of not addressing childhood adversity and the associated risk factors of foster care increase a child's risk for poor developmental health and other major illnesses noted later in life such as cardiac disease, depression, and even premature death. Healthcare providers and others charged with caring for this vulnerable population who understand the social setting of foster care and its impact on developmental health may help identify and treat developmental problems earlier, thus potentially reducing long-term effects of abuse and neglect.

CONCLUSION:  Improvement plans that promote best practice for child welfare must include those that directly address the unique developmental needs of all infants and children in foster care itself. Such plans will ensure that foster care as an intervention to protect vulnerable children at risk does not create more harm by reducing the associated risks and maximizing benefits while in foster care, and ensures that those born genetically vulnerable and disproportionately susceptible to poor outcomes in adversity are also protected and provided opportunities that promote optimal developmental health.