Adoption, permanent care and foster care: home-based care in and beyond the 1990s

Home-based care in Australia has changed considerably in the past two decades. The majority of children in adoptive, permanent care and foster families are likely to have experienced abuse, neglect and multiple placements. The disruptive behaviours displayed by these children undermine the potential for attachment offered by their new families. While the needs of the child will be obvious, the challenge for paediatricians is to recognize the relative instability of these newly established families and the high levels of stress they experience.