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On a given day, there are nearly half a million children in the foster care system, and around one-third of those children have special needs. While foster parents are needed throughout the country, foster parents of special needs children are in especially high demand. Those children in the foster care system who have experienced some form of abuse or neglect typically face various emotional attachment disorders as a result.


Caring for children with special needs requires time and commitment and agencies specializing in these cases also provide additional supports. I was a foster parent to a little girl when she was diagnosed with an aggressive form of leukemia. The months of chemotherapy that followed were tough, but among the most rewarding experience I have ever had. I learned a ton about the hospital system, got to know a great team of nurses, and became closer than ever to our foster-daughter’s birth mother. We also were transferred from our initial foster care agency to one specializing in foster children with special needs.


In general, be prepared to advocate for your child’s care, which means learning all you can about the child’s condition, working with their school if necessary and attending meetings and therapies. For children whose special needs involve the creation of an individualized education plan, working closely with the school system is critical to ensure that the child is receiving all the supports identified by health professionals who diagnosed the child’s condition. In particular, parents should be aware of the conditions under which the school system must pay for private schooling when they fail to meet a child’s right to a free and appropriate public education (FAPE). These are based on the Supreme Court Ruling Florence County School District IV v. Shannon Carter, among others.


While most people define “special needs” as someone with a physical or developmental disability, that definition doesn’t always hold true in foster care. Instead, it’s used exactly as it sounds; a child who has special needs. In the foster care system, “special needs” is a much broader term and one that varies state by state. It can mean that the child has mental, physical or behavioral disabilities, was exposed to drugs or alcohol while in the womb, has anti-social behaviors, or is at risk for developing emotional, behavioral, physical or learning disabilities in the future.


Because not every foster parent is willing to care for a child with special needs, some of these children remain in the hospital or emergency shelters instead of living in a loving home. Before a foster parent agrees to take care of a child with special needs, they first need to be aware of what their own limits are. Ask yourself how much you are capable of taking on right now, what resources you have available, and how much time you’ll have to spend caring for the child’s needs. If you don’t feel you have the time or resources to care for a special needs child, then both you and the child will suffer from you taking them in. But if you think you can handle it, there likely is a child in a hospital or shelter who could certainly use your love and affection, having been dealt a tough hand in life from the get go.

In some states, there are different levels of care assigned to a foster child depending on how much specialized care they need to receive. For example, in Texas, there are five different levels, ranging from basic to intense-plus. Typically, a foster parent has to be certified at each level before fostering a child needing that level of care.


In the basic level, the child may have occasional misbehavior and transient difficulties, brief episodes of acting out in response to stress, minimally disturbing behavior typical to their age and that can be corrected, or have intellectual or developmental disabilities with minor to moderate social, conceptual and practical adaptive skills.


A child needing moderate services typically has problems in one or more areas. These can include frequent non-violent, anti-social behaviors; some physical aggression; a child with a current substance abuse problem or a history of substance abuse that requires regular community support; a child with moderate to substantial intellectual or developmental disabilities resulting in a moderate impairment in cognition or communication. It could also refer to a child with primary medical or habilitative needs resulting in limited self-care and daily living skills; intermittent exacerbations or interventions relating to the medical diagnosis; or access to an on-call specialized caregiver.


A child requiring specialized services may have unpredictable anti-social behaviors; frequent physical aggression; major self-injurious actions including suicide attempts; severe impairment due to substance abuse; an intellectual or developmental disability resulting in severe impairment in numerous physical disabilities with sensory impairments, severe communication or cognitive impairments; or severely impaired social, conceptual or practical adaptive skills.


A child needed intense services will exhibit behaviors like extreme physical aggression causing harm; major self-inflicted injuries and suicide attempts; intellectual and developmental disabilities so severe that they require one-on-one supervision for either their own or others safety; or imminent and critical medical needs requiring 24-hour on-site medical supervision and an inability to practice daily self-care and living skills.


The intense-plus service level requires a high degree of structure and is only offered at Residential Treatment Centers. The behaviors of a child needing intense-plus service include, among others, reoccurring and extreme episodes of physical harm; assaultive and destructive behaviors; running away frequently; a human or sex trafficking survivor; frequent criminal behaviors; or an eating disorder causing concern for the child’s wellbeing.


Other states use a one to five scale, with one being little special care needed and five being extreme special care. Often, to take a child on the higher end of the scale, foster parents need to undergo specialized training courses and may need to be a stay-at-home parent in order to provide the child with the needed care. Of course, all of these designations are very different if they concern a toddler or a high school age student.