KEY MESSAGES:
Children, youth, and young adults with Fetal Alcohol Spectrum Disorder (FASD) are a key population in the child welfare system. Responding to FASD requires skills and knowledge in the many areas that intersect with FASD. Social workers and other professionals who work in the child welfare system require increased education, training, and support to address the needs of individuals with FASD and their families.
Issue:
In Canada, there are an estimated 47,885 children in foster care, 29,590 of which are under the age of 15 [1]. More recent estimates of the number of children in care in Canada also suggest that these numbers may be even higher, with an estimated 62,428 children in out of home care in Canada [2].
Children with Fetal Alcohol Spectrum Disorder (FASD) are known to be overrepresented in the child welfare system, both in Canada and internationally [3]. In Canada, researchers have conservatively estimated the prevalence of FASD among Canadian children in care to be at least 3-11% [4-6]. Most children with FASD in care are not formally diagnosed, particularly when they enter the child welfare system. Children, youth, and young adults with FASD are a key population in the child welfare system.
The goals of the public and private services that make up the child welfare system are to safeguard children from abuse and neglect and to promote the well-being of children, youth, and young adults by ensuring their safety and strengthening families [7]. However, youth with FASD represent a particularly vulnerable population within the child welfare system and often experience poor outcomes.
Outcomes for children in care in general are often poor in comparison to the general population, and may include homelessness, drug and alcohol use, mental health issues, and lower educational attainment [8, 9]. Children and youth in care may also experience early life abuse and neglect, among other adverse childhood experiences. Children with FASD are often placed in the care of child protection service agencies and frequently end up in permanent foster care waiting to be adopted [10].
Individuals with FASD and their families may also seek services from social workers and human service professionals across various settings, including health, corrections, disability, education, mental health, and social services [11]. Therefore, social workers and social service providers who encounter individuals with FASD must be knowledgeable about the disability [11], yet the limited research on social workers indicates that while they report feeling knowledgeable about the consequences of alcohol consumption during pregnancy, they are less familiar with the characteristics of FASD or existing diagnostic guidelines [12].
Given the significant proportion of children with FASD in care, as well as the complex nature of their needs, it is imperative to understand the best practices and key areas of challenge facing the child welfare system and to understand the relationship of this population to child welfare agencies. The purpose of this issue paper is to provide a brief background on the state of FASD and child welfare in Canada.
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