Whenever I talk to someone about the realities of foster care, I find myself walking a fine line. There is a misconception, often perpetuated by the media, that kids in foster care are “bad,” or that they are in foster care because of their own actions. That’s absolutely not true, and I don’t want to ever communicate that. But at the same time, foster children very often have behavior challenges as a result of the trauma they’ve experienced. This is not their fault, and it is not a matter of choice or willpower. Abuse and neglect, particularly when suffered for a long time, affects brain development. Our kids deserve a loving adult to parent them and help them handle these challenges, but we also do a disservice to potential foster parents if we aren’t honest and realistic about some of the things they may face.

But what kind of behavior challenges are we talking about? Below is a list of some of the more common issues, presented with the hope that it will help prospective foster parents to be less afraid of the unknown and current foster parents to know that they are not alone and that these things can be managed. This is not intended to be an exhaustive list, but rather a summary of the most common themes.

Hygiene Issues

Many kids who enter foster care have not been taught how to take care of their bodies. This can include brushing their teeth, brushing or combing their hair, bathing, and even wiping themselves properly after using the bathroom. In some cases, this is just a matter of teaching, but for some who have experienced abuse, the issues can be much deeper than that. A child who has been sexually abused, for example, may not feel safe taking their clothes off to bathe and may avoid it or rush through a shower without properly washing. A child who has experienced rejection may, consciously or subconsciously, avoid bathing in order to prevent others from getting too close to them.

Potty Issues

Potty issues are often related to hygiene issues, but they deserve their own special mention. Kids in foster care may regress in terms of toilet training, avoid changing soiled diapers or underwear, and wet the bed. There can be a lot of root causes for these issues from sexual abuse, to a desire to control whatever they can, to find comfort in the sounds and smells that are familiar. And in addition to this, kids may have gastrointestinal issues due to changes in diet (switching from highly processed foods to good nutrition, for example), stress, or even medications.

Sleep Issues

Many kids who have experienced trauma struggle with sleep. There is a loss of control that’s required to fall asleep, and this can be terrifying for some kids. Many of them may also experience nightmares. And for some kids, their brains may always keep them at least partially awake in order for them to protect themselves.

Food Issues

Many kids are picky or opinionated eaters (for example, nearly every toddler I have ever met), but sometimes kids in foster care struggle with food issues that go far beyond the typical. This can be about control or rebellion against a sudden change in diet. Kids may also struggle with certain textures, especially if they are already prone to sensory issues.


Foster kids live in a perpetual state of limbo, so it’s no wonder they struggle with anxiety. At some point, they were removed from their parents’ care, likely without any warning. There is very little that we can promise them will always be true, and experience has taught them that promises don’t mean that much anyway. Many kids in foster care need plenty of time to prepare for new experiences and thrive best in as much structure as we can manage. Anxiety can be difficult to identify, as a perceived threat for a child can yield a fight, flight, or freeze response. Even more difficult is pinpointing the triggers. This takes a lot of study of the child’s behavior and surroundings, both before or after that stress response kicks in.

This list can be overwhelming and, for some prospective foster parents, maybe even paralyzing. Please remember that every child is different as is their story, and there are a lot of factors that impact kids and the way their brains work. Our foster children may struggle with one or more of these issues, and we may need to adjust the way we care for them as a result. But with time and the right support system, we can learn how to do this, and we can help give our kids the skills they need to manage themselves. They deserve that.