Girls in foster care: a vulnerable and high-risk group.

PURPOSE: To describe the characteristics of girls in foster care who have exhibited sexually abusive behavior.

STUDY DESIGN AND METHODS: This was a chart review and a descriptive, exploratory study of 155 female children and adolescents (age 4-17 years) who were in foster care and had been evaluated for their sexual abusive and aggressive behaviors.

RESULTS: Findings indicated that these girls had significant histories of maltreatment, chronic health issues, and foster care placement instability; 84% of the girls had been physically abused; 95% were victims of ongoing abuse by the biological parents (78%). Sexual abuse was reported by 81%, and 68% were sexually abused by more than one individual. Ninety-five percent were neglected; 51% of the neglect was classified as severe and chronic. All of the girls (100%) had been shown to exhibit sexually abusive and inappropriate behaviors toward other children, including exposing themselves to age-mates, violation of body space, sexually aggressive remarks, sexual touching without permission, and sexual touching of much younger children. Ninety-two percent of the girls had two or more changes in caregivers by age 16 years. Over one-third of the girls (39.2%) experienced four or more different living situations that lasted less than 1 month.

CLINICAL IMPLICATIONS: These girls demonstrated a variety of behavior problems that place them at high risk for multiple foster care placements, which can negatively impact upon their well-being and health. Whether in healthcare settings, schools, the workplace, community, in-patient, or psychiatric settings, nurses and other healthcare providers have access to children and their foster care caregivers. Nurses and other healthcare clinicians are in an ideal position to provide a safe clinical environment contributing to the health, education, and support to these girls.