Foster care often fails kids with disabilities.
asserted
care → fail → disabilities
Consider these cases
The woman who calls 911 says there's a diabetic teen boy in distress, but when police and paramedics arrive at the house in Mesa, Arizona she comes outside to say he's just "pretending that he's dead on the floor" because he wants attention.
When those first responders go inside, they find something tragically different.
asserted
they → consider → something
Fifteen-year-old Christian Williams isn't breathing.
asserted
Williams → breathe → ?
His lips are blue and his heart has stopped.
asserted
heart → stop → ?
The small ranch house — lit up from inside in the dark, desert night — is a residential treatment facility for seven young men in foster care.
asserted
house → light → care
The facility provided specialized mental health care for Christian, who, in the one month since he'd come to the group home, was in and out of the hospital for complications from his Type 1 diabetes.
asserted
he → provide → diabetes
"I've never even dealt with a diabetic.
asserted
I → deal → diabetic
I don't know anything about that," the woman who called the police, a staffer at the foster care home, tells an officer, recorded on the officer's body camera.
asserted
who → know → camera
Paramedics begin CPR, steadily pushing on Christian's chest, in an attempt to revive him.
asserted
Paramedics → begin → him
An NPR investigation — including an analysis of federal data on hundreds of thousands of children — shows that kids with disabilities are the largest group that go into foster care.
asserted
that → include → care
More significantly, they suffer the worst outcomes in foster care — getting trapped in the system longer than children without disabilities and dealing with lifelong harm.
asserted
they → suffer → harm
One reason, NPR found, is the extreme complexity of the system.
asserted
NPR → find → system
"Caring for children with disabilities in foster care involves much more than meeting their medical needs," explained Bobbi Andrew-Green, an Alaska foster parent to children with complex medical needs.
asserted
Green → care → needs
She navigates child welfare, mental health, Medicaid, special education, home nursing and other service systems.
asserted
She → navigate → welfare
"It is beyond complex to the point where some days, I'm dizzy," she said.
asserted
she → say → point
Disability encompasses a wide range of conditions.
asserted
Disability → encompass → conditions
In our reporting, we came across children who used wheelchairs, were blind or deaf, had intellectual disabilities or used ventilators and sometimes were sent to foster homes that weren't accessible for them.
asserted
that → come → them
"Up to 80% of children in foster care enter with a significant mental health need," according to a report from the American Academy of Pediatrics that cites multiple research studies.
uncertain
that → enter → studies
"This is the group that everybody gives up on and it's because they have disabilities," said Nancy Thaler, who leads a federally-funded program to understand how to better care for "children with complex behavioral health conditions."
asserted
who → give → conditions
These kids "are so hard to understand and, frankly, take some sophistication to treat," said Thaler.
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Thaler → understand → sophistication
Often, they're diagnosed with mental health issues, trauma, brain injuries, Fetal Alcohol Spectrum Disorders, intellectual disabilities and autism and would have lived in state institutions years ago, she said.
asserted
she → diagnose → institutions
They end up in child welfare in large numbers, often in the most institutional settings — including therapeutic group homes and residential treatment centers — because of their "behaviors that are off-putting or scary," according to Thaler.
uncertain
that → end → Thaler
"It's hurting other people, hurting themselves, damaging property.
asserted
It → hurt → property
That's the range of things that they do," Thaler said.
asserted
Thaler → do → that
"These kids can recover and be very successful," Thaler said, "This is doable."
But there's one big roadblock: Child welfare programs largely depend on 100-year-old models of therapy that, Thaler said, don't work with these disabled children.
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Thaler → recover → children
Instead, that treatment often makes their behaviors worse.
Missing numbers, worse outcomes.
asserted
behaviors → make → numbers
There aren't even clear numbers on how many children and youth in foster care have disabilities.
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children → be → disabilities
Researchers use a broad range: From 25 to 80%.
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Researchers → use → %
The lower percentage reflects how disability is counted in federal foster care data.
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disability → reflect → data
The higher one reflects research suggesting that the vast majority of children and youth in foster care have some mental health issue — either one that contributed to them going into care, or one that resulted from the trauma of being removed from family and going to a foster home.
asserted
that → reflect → home
The federal government keeps and analyzes extensive data on foster care demographics and knows a lot about other populations.
asserted
government → keep → populations
Black children make up 24% of the foster care population, according to NPR's analysis.
uncertain
children → make → analysis
(Add biracial ones, according to the research group Child Trends, and it's 35%.)
uncertain
it → add → group
Hispanic kids represent 21%.
asserted
kids → represent → %
These numbers have helped researchers and policymakers understand how children from these groups, especially from poor families, are disproportionately represented in foster care, and the harm that often results for them and their families.
asserted
that → help → them
One research study, for example, shows that 53%of Black children in America will be the subject of a child protective services investigation by the time they turn 18.
asserted
they → show → 18
But the numbers that could give clarity on disabled kids in foster care are harder to come by — partly because of the sometimes hazy definitions of disability but also because of the failure of child welfare providers to even count them.
uncertain
that → give → them
NPR obtained data from the government's mandated data collection system, the Adoption and Foster Care Analysis and Reporting System (AFCARS).
asserted
NPR → obtain → system
But our analysis found there was too much missing data to get a statistically valid count of kids with the label "emotionally disturbed," the one category of foster youth with mental health conditions.
asserted
analysis → find → conditions
NPR analyzed the federal data on 505,591 children in foster care in 2025 and quickly found limitations to those numbers.
asserted
NPR → analyze → numbers
…and 296 more, not listed.
The Aporia
