What happens when a child with a disability enters the foster care system?

In this episode of Special Ed Rising: No Parent Left Behind, Mark Ingrassia explores the unique challenges children with disabilities can face in foster care, including longer stays, multiple placement changes, and increased use of group homes or institutional settings.

Inspired by NPR reporting by Joseph Shapiro, Mark looks at the impact of trauma, autism, intellectual disabilities, complex medical needs, and behavioral-health challenges—and asks whether the system is equipped to truly understand and support these children.

The conversation also examines how families can reach a crisis point when they cannot access the respite, behavioral, medical, and community supports their child needs. Sometimes, “I can't do this anymore” really means, “I've been doing this alone for years, and I desperately need help.”

Mark discusses the story of Christian Williams, a 15-year-old with Type 1 diabetes and behavioral-health challenges who died while living in a therapeutic group home, raising important questions about whether children with complex needs are being placed in settings equipped to care for them.

The episode explores the importance of family connections, kinship care, better coordination between schools, medical providers, caregivers, and child-welfare agencies, and listening to former foster youth about what children actually experience.

Most importantly, this is a conversation about changing the way we think about children with disabilities in foster care.

Maybe the goal shouldn't be to make children fit the system. Maybe the goal is to build a system that can fit the child.

Because every child deserves to be understood before they're judged, supported before they're punished, and connected before they're corrected.

In This Episode:

• Children with disabilities in foster care
• Placement instability and trauma
• Behavioral-health and complex medical needs
• Families reaching crisis without adequate support
• Custody relinquishment and disability-related needs
• Christian Williams' story
• Kinship and family connections
• Coordination across schools, healthcare, and child welfare
• Listening to former foster youth
• Building a foster-care system that fits the child

Reporting Discussed: Joseph Shapiro, NPR

specialedrising.com

Ray's Respite Care: What happens when a child with a disability enters the foster care system?

In this episode of Special Ed Rising: No Parent Left Behind, Mark Ingrassia explores the unique challenges children with disabilities can face in foster care, including longer stays, multiple placement changes, and increased use of group homes or institutional settings.

Inspired by NPR reporting by Joseph Shapiro, Mark looks at the impact of trauma, autism, intellectual disabilities, complex medical needs, and behavioral-health challenges—and asks whether the system is equipped to truly understand and support these children.

The conversation also examines how families can reach a crisis point when they cannot access the respite, behavioral, medical, and community supports their child needs. Sometimes, “I can't do this anymore” really means, “I've been doing this alone for years, and I desperately need help.”

Mark discusses the story of Christian Williams, a 15-year-old with Type 1 diabetes and behavioral-health challenges who died while living in a therapeutic group home, raising important questions about whether children with complex needs are being placed in settings equipped to care for them.

The episode explores the importance of family connections, kinship care, better coordination between schools, medical providers, caregivers, and child-welfare agencies, and listening to former foster youth about what children actually experience.

Most importantly, this is a conversation about changing the way we think about children with disabilities in foster care.

Maybe the goal shouldn't be to make children fit the system. Maybe the goal is to build a system that can fit the child.

Because every child deserves to be understood before they're judged, supported before they're punished, and connected before they're corrected.

In This Episode:

• Children with disabilities in foster care
• Placement instability and trauma
• Behavioral-health and complex medical needs
• Families reaching crisis without adequate support
• Custody relinquishment and disability-related needs
• Christian Williams' story
• Kinship and family connections
• Coordination across schools, healthcare, and child welfare
• Listening to former foster youth
• Building a foster-care system that fits the child

Reporting Discussed: Joseph Shapiro, NPR

specialedrising.com

Ray's Respite Care: What happens when a child with a disability enters the foster care system?

In this episode of Special Ed Rising: No Parent Left Behind, Mark Ingrassia explores the unique challenges children with disabilities can face in foster care, including longer stays, multiple placement changes, and increased use of group homes or institutional settings.

Inspired by NPR reporting by Joseph Shapiro, Mark looks at the impact of trauma, autism, intellectual disabilities, complex medical needs, and behavioral-health challenges—and asks whether the system is equipped to truly understand and support these children.

The conversation also examines how families can reach a crisis point when they cannot access the respite, behavioral, medical, and community supports their child needs. Sometimes, “I can't do this anymore” really means, “I've been doing this alone for years, and I desperately need help.”

Mark discusses the story of Christian Williams, a 15-year-old with Type 1 diabetes and behavioral-health challenges who died while living in a therapeutic group home, raising important questions about whether children with complex needs are being placed in settings equipped to care for them.

The episode explores the importance of family connections, kinship care, better coordination between schools, medical providers, caregivers, and child-welfare agencies, and listening to former foster youth about what children actually experience.

Most importantly, this is a conversation about changing the way we think about children with disabilities in foster care.

Maybe the goal shouldn't be to make children fit the system. Maybe the goal is to build a system that can fit the child.

Because every child deserves to be understood before they're judged, supported before they're punished, and connected before they're corrected.

In This Episode:

• Children with disabilities in foster care
• Placement instability and trauma
• Behavioral-health and complex medical needs
• Families reaching crisis without adequate support
• Custody relinquishment and disability-related needs
• Christian Williams' story
• Kinship and family connections
• Coordination across schools, healthcare, and child welfare
• Listening to former foster youth
• Building a foster-care system that fits the child

Reporting Discussed: Joseph Shapiro, NPR

specialedrising.com

Ray's Respite Care: https://www.gofundme.com/f/join-rays-respite-care-mission

Episode 194: When Foster Care Fails Children With Disabilities: Who Is Protecting the Kids Who Need Us Most?

Welcome to Special Ed Rising: No Parent Left Behind.

I’m Mark Ingrassia. For nearly 40 years, I’ve worked with kids and families in the disability community—as a teacher, adjunct professor, parent trainer, advocate, and parent coach.

And I’m here to help you feel a little less overwhelmed and a lot more prepared.

Every week, we bring you real conversations, expert advice, and practical strategies for navigating parenting, school, behavior, advocacy, and everyday life; people who care deeply and want to make things better, together.

If you’re raising, teaching, or supporting someone with disabilities, you’re warmly welcome here.

And if this episode hits home for you, do me a favor. Go drop a 5-star review. That’s how we get this message to more families who need it.

And if you want more than a podcast—if you want personalized support for your family—visit specialedrising.com to learn about my parent coaching and practical resources. Because you don't have to figure this out alone.

Take a breath—you’re in the right place. Let’s get to work.

Today, I want to take a closer look at an issue that doesn't get nearly enough attention: what happens to children with disabilities when they enter the foster care system? I recently came across a series of reports from NPR by Joseph Shapiro that really made me curious about this issue. We hear a lot about the challenges facing children in foster care, but we don't always talk about the additional challenges faced by children with disabilities. And when you start looking at the numbers and, more importantly, the stories of these children, there are some very important questions we need to ask about whether the system is really meeting their needs.

Children with disabilities are among the most vulnerable children entering foster care. We're talking about children with autism, intellectual disabilities, physical disabilities, complex medical needs, mental-health challenges, and children who may have difficulty communicating what they're feeling or what they need. NPR's recent investigation found that children with disabilities tend to remain in foster care longer, experience more placement changes, and are more likely to end up in group homes or institutional settings than children without disabilities. That matters because every placement change means another disruption in a child's life — a new caregiver, a new school, new therapists, new rules, new expectations, and often another loss of relationships that may have been important to that child.

For a child who already struggles with communication, emotional regulation, sensory processing, or trusting adults, those changes can be particularly difficult. And this is where I think we need to look beyond behavior. A child who is hitting, running away, refusing, shutting down, or becoming aggressive may not simply be a "difficult" child. That behavior may be communicating fear, frustration, confusion, sensory overload, trauma, or an unmet need. One of the things I talk about often in my work with parents is that behavior is communication. Before we ask, "How do we stop this behavior?" we should be asking, "What is this child trying to tell us?"

That's especially important in foster care because many children entering the system have already experienced trauma. Now imagine adding repeated moves, unfamiliar adults, new schools, new environments, and new expectations on top of that. For some children, the very system that's supposed to provide stability can actually become another source of instability.

NPR's reporting included the stories of former foster youth who described what it was like to move from one placement to another. One of the things that stood out was how important family connection remained to these young people. They wanted their parents. They wanted people to fight for them. They wanted someone who knew them and understood them. And I think that's an important reminder that even when a child cannot safely remain in their home, that doesn't mean their relationships suddenly stop mattering.

Another part of NPR's investigation looked at the tragic story of Christian Williams, a 15-year-old with Type 1 diabetes and behavioral-health challenges who died while living in a therapeutic group home. According to the reporting, Christian required insulin and regular blood-glucose monitoring, but the facility wasn't adequately prepared to manage the combination of his medical and behavioral needs. When his health deteriorated, staff reportedly failed to recognize the seriousness of what was happening. Christian eventually collapsed and died.

I don't bring up Christian's story to sensationalize what happened. I think it's important because it raises a fundamental question: If we're going to place a child with complex medical and behavioral needs into a specialized setting, are we making sure that the people caring for that child actually have the training, resources, and information they need?

And there's another issue that is easy to overlook: we don't even have complete information about how many children with disabilities are in foster care. NPR found significant gaps in federal disability data. And that creates a problem because you can't effectively plan for a population that you're not accurately counting. How many foster families do we need who are trained to care for medically complex children? How many need expertise in autism or intellectual disabilities? How many need to understand communication systems, sensory needs, mobility issues, or behavioral-health challenges? How many children are being placed far away from their families because there simply aren't enough appropriate homes available?

These are questions we need better data to answer.

But I think there's also an opportunity here to rethink how we approach foster care for children with disabilities. When a child has to be removed from their home, maybe our first question shouldn't simply be, "Where can we place this child?" Maybe the first question should be, "Who does this child know?"

Is there a grandparent? An aunt or uncle? An adult sibling? A family friend? A trusted teacher? Someone who already understands the child? Because familiarity can be incredibly important for a child with a disability. Someone who already knows how that child communicates, what calms them, what overwhelms them, what their routines are, what they enjoy, and what scares them may be able to provide something that an unfamiliar placement simply can't.

But before we talk about what happens to children once they're in foster care, I think it's important to understand how they get there in the first place. A foster child isn't necessarily a child who was abused by their parents. Children enter foster care for many reasons, including abuse or neglect, unsafe living situations, parental substance use, domestic violence, or circumstances where a parent can no longer safely care for a child. And for some children with significant disabilities or behavioral-health needs, there's another pathway that doesn't get talked about nearly enough. Sometimes parents reach a point where they're simply overwhelmed and the supports they need either don't exist or aren't accessible. They may be saying, "I love my child, but I can't keep everyone safe without help." They may need respite, behavioral support, home-based services, medical assistance, crisis intervention, or simply someone who understands their child's disability. Federal research has found that thousands of children enter foster care each year under circumstances resembling what's called custody relinquishment, where parents effectively surrender custody because they cannot access or manage the services their child needs. Recent NPR reporting gives us a heartbreaking example with Christian Williams, whose parents agreed to his removal after struggling with his increasingly serious behavioral needs; NPR reported that a court document found no abuse or neglect by his parents. And I think that's an important distinction. Sometimes a parent isn't saying, "I don't want my child." They're saying, "I don't know how to do this anymore, and I need help." That's why preventing unnecessary foster-care placement has to include supporting families before they reach that crisis point. Greater access to respite, behavioral-health services, home-based supports, caregiver training, medical care, care coordination, and crisis intervention could make an enormous difference and, in some cases, allow children to remain safely with their families. At the same time, we have to recognize that some children have needs so complex that specialized residential treatment may be necessary. The goal shouldn't be to eliminate those settings, but to make sure they aren't becoming the default simply because we haven't invested enough in family and community-based alternatives. Because sometimes what looks like a child-welfare problem is really a family-support problem, and we shouldn't confuse parental exhaustion with parental indifference. A parent saying, "I can't do this anymore" may actually be saying, "I've been doing this alone for years, and I desperately need somebody to help me."

And wherever a child is placed, we have to make sure the adults and systems around that child are actually working together. That means the school, the medical team, the therapist, the foster or kinship caregiver, and the child-welfare agency aren't each working from a different piece of the puzzle. The caregiver needs to understand the child's IEP and communication needs. The medical team needs access to the child's health history, medications, and developmental information. The school needs to understand what's happening in the child's life, and the caseworker needs to understand the child's disability and what supports are actually required. Research from the American Academy of Pediatrics has found that information gaps and fragmented care are common for children in foster care, sometimes resulting in medication problems, delays in care, and difficulty managing chronic conditions. Federal child-welfare guidance also emphasizes multidisciplinary teams and cross-agency collaboration for children with disabilities. And I think that's really the key: we shouldn't expect a parent, foster parent, or caseworker to navigate all of these systems alone. There needs to be someone whose job is to bring the pieces together, make sure information follows the child, and keep everyone focused on the same question: What does this particular child need to be safe, healthy, supported, and successful?

And perhaps one of the most important things we can do is listen to people who have actually lived through foster care. If we're going to talk about reform, former foster youth need to be part of that conversation. They know what worked. They know what didn't. They know what it feels like to be moved from one placement to another. They know what it feels like when adults don't listen. And they know how much difference one caring adult can make.

So what should the future look like?

I think it should be a system where children with disabilities aren't viewed as the children who are too difficult to place. A system where families receive meaningful support before they reach a crisis. Where relatives and trusted adults are actively sought out. Where foster families receive the training and resources they need. Where schools, medical providers, child-welfare agencies, and families communicate with one another. And where behavior is understood before it is punished.

Ultimately, I think the larger story is bigger than simply saying, "foster care is failing children with disabilities." What this reporting really reveals is a system struggling to care for a population of children with increasingly complex disabilities and behavioral-health needs. And perhaps one of the most important things to understand is who these children are. We're not talking only about children with physical or medical disabilities. A very large proportion have behavioral-health disabilities and complex behavioral needs, including children experiencing trauma, autism, intellectual disabilities, brain injuries, fetal alcohol spectrum disorders, and other mental-health challenges. NPR cites research suggesting that as many as 80 percent of children entering foster care have a significant mental-health need. These are children who may need far more than a safe bed and a new placement. They need specialized support, stability, connection, medical and behavioral-health care, educational support, and adults who understand what their behavior is communicating. And when those supports aren't available in the community, foster care, residential treatment, or institutional settings can end up filling a role they were never really designed to fill. That's where I think the real crisis lies. Families may not have the support they need before a child enters care, and once a child is in the system, the different agencies and professionals around that child don't always have the coordination or resources to meet all of those needs. But I don't think the answer is to simply say that foster care doesn't work. There are foster families and programs doing this work incredibly well, and there are children who thrive when they have the right people and the right supports around them. The question is whether we're willing to build a system that recognizes what these children actually need. Maybe the goal shouldn't be to make children fit into the system. Maybe the goal is to build a system that can fit the child. Because every child deserves more than a placement. They deserve stability, connection, understanding, and adults who are willing to see the child behind the disability and never stop advocating for them.

This is an issue that deserves more attention, more research, and frankly, more conversation. Because when we're talking about children with disabilities in foster care, we're talking about some of the children who need us to get the system right the most.

And as always, remember: every child deserves to be understood before they're judged, supported before they're punished, and connected before they're corrected.