Spring Hill foster mom gets 16 years for abuse

FRANKLIN — Shelley Blair will serve a total of 16 years for starving, binding with duct tape and imprisoning two children in her Spring Hill home.

Before reading her sentence, Judge Robbie Beal told Blair that in jail, “comparatively, you will be held in the very lap of luxury as to what you provided for those kids.”

Blair pleaded guilty in October to four felony counts: two of aggravated assault and one each of attempted especially aggravated kidnapping and kidnapping.

Spring Hill Police found the boy, then 12, and girl, 13, on Main Street running away from home on Oct. 20, 2008.

Police detective Geoff Betts displayed a piece of wallboard from the basement room to illustrate how small of a hole the malnourished boy was able to fit through and the desperation of his escape.

The children were extremely malnourished: The girl weighed 55 pounds and the boy 61 pounds. In executing a search warrant, police found that the children had been locked in separate, empty rooms and forced to use a bucket as a toilet.

The girl, now 16, testified that Blair would restrain them with duct tape. She said Blair would leave them with sandwiches or oatmeal and a bottle of water.

Blair admits she treated the children badly but said she was overwhelmed by their behavioral problems, violence and sexual behavior.

At one point, Blair sent the girl, her adopted daughter, to a treatment facility in Iowa. She took the boy in as a foster child through a private arrangement before the girl was kicked out of the treatment facility.

Beal said Blair was entrusted with providing these children refuge and failed to get the help she needed before resorting to the “exceptional cruelty” she employed.

Working against Blair was a 2003 conviction for child abuse involving the same adopted girl. Beal said Blair was in duress of her own making by not seeking the proper help.

“You simply didn’t learn your lesson,” he said.

Contact Jill Cecil Wiersma at 615-790-7207, jwiersma@tennessean.com or on Twitter @Jill_WAM.


Foster-care supervisor charged in child porn case

A Lac La Biche foster care supervisor is in legal trouble after FBI in Connecticut tipped Alberta police about someone distributing child pornography over the Internet.

The Alberta Law Enforcement Response Team’s Internet Child Exploitation (ICE) unit says they were tipped off by FBI Agents in August that someone was distributing child pornography through the World Wide Web from a home in Lac La Biche, a small town 221 km north of Edmonton.

And after a lengthy investigation, the team obtained a search warrant and seized a number of computers and external hard drives from the home Thursday.

A 62-year-old man, who was not at the home, was later arrested by Mounties in Bonnyville.

Daniel Quiring Stoesz has been charged with possessing and making available child pornography. He is scheduled to appear in a Lac La Biche provincial courtroom on Monday.

Police also later seized computer equipment from Stoesz’s workplace after making the arrest.

Kathy Telfer, a spokeswoman with Alberta Children and Youth Services, said the man was not working closely with children.

He was working for the last 10 years in the regional foster services in St. Paul for roughly 10 years, said Telfer.

Stoesz is responsible for supervising a group of foster support workers, said Telfer.

“In cases like this, the policy is the employee would be relieved of their duties pending the outcome of the investigation,” said Telfer, who wouldn’t say if Stoesz has been suspended with or without pay.

Sgt. Mike Lokken with the child exploitation unit, says the case still requires further investigation as members are still unclear on how much child pornography was allegedly contained in the seized computer equipment.

“To what degree he is involved in this, that is to be determined,” said Lokken.

But he says the incident should not raise alarms for foster parents and those concerned about the province’s foster care system.

“This is one allegation among thousands of good people (in foster care),” said Lokken.

When asked by the Edmonton Sun if the tip from the FBI is part of a much larger investigation, Lokken declined to comment.

Alberta’s ICE units have investigated 426 cases and laid a total of 247 charges against 201 people from April 2010 to March 21, 2011.

jeff.cummings@sunmedia.ca

@SUNJeffCummings


Foster parent facing child porn charges

By Trish Audette And Brent Wittmeier, Edmonton JournalDecember 3, 2011

An Alberta foster parent and foster care supervisor is facing criminal charges in connection to possessing and distributing child pornography.

The province's Internet Child Exploitation (ICE) team was tipped off by the FBI in Connecticut. They had flagged online distribution of child pornography that seemed to be coming from a home in Lac La Biche, about 230 kilometres northeast of Edmonton.

ICE and Lac La Biche RCMP officers searched a home Thursday and seized computer equipment and electronic storage devices. An arrest was made by Bonnyville RCMP.

Daniel Quiring Stoesz, 62, appeared Friday in Lac La Biche court and was remanded. He is expected to appear in court again Monday.

A further search of the suspect's workplace at Alberta's Ministry of Human Services in Lac La Biche led to police seizing more computer equipment on Thursday.

An FBI spokesman would not comment on the organization's involvement in the case, since it is now in the hands of Canadian authorities. ICE was tipped off in August, said Sgt. Mike Lokken, who declined to describe the nature of the FBI tip.

"These investigations take time," Lokken said. "There are certain processes, investigative process and different things we have to do to do things properly."

Forensic technicians will examine "every nook and cranny" of the seized equipment, Lokken said. But there's nothing at this point to indicate Stoesz was manufacturing child pornography.

An Alberta Human Services spokeswoman, Kathy Telfer, said Friday that Stoesz had worked for regional foster services in St. Paul for more than 10 years. Stoesz is also a foster parent himself.

Telfer said the foster children formerly in his care are safe and with a responsible adult.

Alberta Foster Parent Association executive director Katherine Jones said the charges were shocking.

"All we can do is wait and let the police do their job," she said. "This isn't something that should ever happen. . . . It just puts a real cloud over everybody when these things come out in the media."

© Copyright (c) The Calgary Herald

Former foster parent’s sexual abuse trial set for fall of 2012

By Daryl Slade, Calgary Herald


A trial has been set for nearly a year down the road for a former foster parent accused of sexually abusing three boys in his care.

Court of Queen’s Bench Justice Suzanne Bensler set the eight-day trial to begin next Oct. 15 for Garry Dale Prokopishin, 52, charged with three counts of having sexual contact with a youth by a person in authority.

Crown prosecutor Gary Cornfield and defence lawyers Bina Border and Ian McKay will also argue for two days starting Oct. 1 on the admissibility of evidence.

Prokopishin originally faced 13 charges relating to six alleged victims, but several of those charges were withdrawn following a two-day preliminary hearing in October.

Police have said the assaults occurred at the accused’s Calgary home and at locations outside the city between 2001 and 2008, when the complainants were in their mid-teens.

Prokopishin, a former director of the Calgary and District Foster Parents Association, was named Foster Family of the Year in 2007.

He will be back in court on Jan. 20 to confirm details of the trial.

dslade@calgaryherald.com


Resource Guide: Children in Foster Care

Resource Guide: Children in Foster Care

The federal government has not done enough to protect America's foster children from being over-medicated with powerful mind-altering drugs, according to recent report by the Government Accountability Office (GAO). Thousands of children in the states the GAO investigated -- Florida, Massachusetts, Michigan, Oregan and Texas – were being prescribed psychiatric medications at doses higher than the maximum levels approved by the Food and Drug Administration (FDA).

Here is a resource guide of organizations that help the country's nearly 425,000 foster children.

AACAP: American Academy of Child and Adolescent Psychiatry:The AACAP is composed of over 7,500 child and adolescent psychiatrists and physicians who research, evaluate, diagnose and treat psychiatric disorders. The organization provides up to date findings on disorders that effect up to 80 percent of foster children.

CASA: Court Appointed Special Advocate Association: An association of 955 programs that recruit, train and support volunteers to advocated abused and neglected children in court and during other legal proceedings. Last year, the judge-appointed volunteers helped 240,000 children find safe, permanent homes.

Able Child: Parents for Label and Drug Free Education:A non-profit that supports caregivers and parents and helps them make informed decisions when faced with children who may or may not need prescription drugs or psychiatric treatment.


Maryhurst: Established in 1843, Mary Hurst is a non-profit child welfare agency based in Kentucky that provides residential in-home and community-based treatment programs for girls who suffered physical, emotional, and sexual abuse as well as homelessness. A fully licensed childcare, child placement and adoption service provider in Kentucky, serving more than 600 children and families each year.

Florida's Children First: Founded by child advocate attorneys, Florida's Children First protects the rights of at-risk children in Florida by providing legal advocacy and assistance. The organization also works to implement public policy that ensures that all children in Florida have food, clothing, housing, education and medical care.

Annie E. Casey Foundation: The primary mission of the foundation is to foster public policies, human service reforms and community supports that more effectively meet the needs of today's vulnerable children and families.

AdoptUSKids: A project of the Children's Bureau, part of the federal Department of Health and Human Services, the organization encourages families to adopt U.S. children.

Casey Family Programs: Casey Family Programs' mission is to provide and improve -- and ultimately to eliminate the need for -- foster care by providing direct services and promoting advances in child-welfare practice and policy.

Dave Thomas Foundation: Wendy's founder Dave Thomas created the nonprofit organization dedicated to increasing the adoption of the more than 150,000 children in North America's foster care system.

North American Council on Adoptable Children: NACAC promotes and supports permanent families for children and youth in the United States and Canada who have been in care, especially those in foster care and those with special needs.

Pew Commission of Children in Foster Care: Part of the Pew Charitable Trust, the Pew Commission on Children in Foster Care has been established to develop recommendations to improve outcomes for children in the foster care system.

Children's Rights: One of the country's foremost advocacy organizations for children. Uses the power of the courts, policy analysis and public education to ensure that children who are abused and neglected receive the care and services they need, and that they grow up in permanent and loving homes.

The Kinship Center: The California-based Kinship Center helps create and support families for thousands of children who can no longer remain safely with their birth parents.

Adoption.About.com: A clearinghouse of information on adoption and foster care.

The Urban Institute: A nonpartisan economic and social policy research institute.

National Foster Parents Association: The National Foster Parent Association is the only national organization that strives to support foster parents, and remains a consistently strong voice on behalf of all children.

Child Welfare League of America: An association of more than 900 public and private nonprofit agencies that assist more than 3.5 million abused and neglected children and their families each year with a range of services.


Jim Casey Youth Opportunities Initiative: A national foundation whose mission is to help youth in foster care make successful transitions to adulthood by connecting them with opportunities in education, employment, health care, housing and supportive personal and community relationships.

National Court Appointed Special Advocate Association: Together with its state and local members, the association supports and promotes court-appointed volunteer advocacy for abused and neglected children so that they can thrive in safe, permanent homes.

National Council of Juvenile and Court Judges: Founded in 1937 by a group of judges dedicated to improving the effectiveness of the nation's juvenile courts, the council has pursued a mission to improve courts and systems practice, and to raise awareness of the core issues that touch the lives of many of our nation's children and families.

American Humane: American Humane supports the development and implementation of effective community, state, tribal and national systems to protect children and strengthen families through consultation, training, research and evaluation, advocacy, and information dissemination.

New Yorkers for Children: The mission is to improve the lives of children and families served by the Administration for Children's Services by providing the private resources needed to assist Children's Services and by increasing the private sector's awareness of child welfare issues.

Chapin Hall Center for Children at the Univ. of Chicago: Chapin Hall is a research and development center that brings their research and scholarship to the real-world challenges of policymakers and service providers dealing with children.

Children's Rights: One of the country's foremost advocacy organizations for children. Uses the power of the courts, policy analysis and public education to ensure that children who are abused and neglected receive the care and services they need, and that they grow up in permanent and loving homes.

The Kinship Center: The California-based Kinship Center helps create and support families for thousands of children who can no longer remain safely with their birth parents.

Adoption.About.com: A clearinghouse of information on adoption and foster care.

The Urban Institute: A nonpartisan economic and social policy research institute.

National Foster Parents Association: The National Foster Parent Association is the only national organization that strives to support foster parents, and remains a consistently strong voice on behalf of all children.

Child Welfare League of America: An association of more than 900 public and private nonprofit agencies that assist more than 3.5 million abused and neglected children and their families each year with a range of services.


Jim Casey Youth Opportunities Initiative: A national foundation whose mission is to help youth in foster care make successful transitions to adulthood by connecting them with opportunities in education, employment, health care, housing and supportive personal and community relationships.

National Court Appointed Special Advocate Association: Together with its state and local members, the association supports and promotes court-appointed volunteer advocacy for abused and neglected children so that they can thrive in safe, permanent homes.

National Council of Juvenile and Court Judges: Founded in 1937 by a group of judges dedicated to improving the effectiveness of the nation's juvenile courts, the council has pursued a mission to improve courts and systems practice, and to raise awareness of the core issues that touch the lives of many of our nation's children and families.

American Humane: American Humane supports the development and implementation of effective community, state, tribal and national systems to protect children and strengthen families through consultation, training, research and evaluation, advocacy, and information dissemination.

New Yorkers for Children: The mission is to improve the lives of children and families served by the Administration for Children's Services by providing the private resources needed to assist Children's Services and by increasing the private sector's awareness of child welfare issues.

Chapin Hall Center for Children at the Univ. of Chicago: Chapin Hall is a research and development center that brings their research and scholarship to the real-world challenges of policymakers and service providers dealing with children.

Generations United: A national membership organization focused solely on improving the lives of children, youth and older people through intergenerational strategies, programs and public policies.

Youth Communication: Youth Communication publishes Represent, a magazine by teens in foster care for kids in foster care. The group's mission is to help teenagers develop their skills in reading, writing, thinking, and reflection, so they can acquire the information they need to make thoughtful choices about their lives.




Baby died after he was left in hot car by foster mother

A BABY boy who was on holidays with his foster parents died after he was left for three hours in a parked car.

Nathan Ryan was 14 months old when he died at a caravan park near Spanish Point beach in west Clare on July 29, 2010.

The child was on holidays with his foster parents, Fiona and Liam Doheny of Toureen, Ballysimon, Limerick at the time.

Fiona's mother Maureen Burke told an inquest yesterday Nathan's death wasn't due to neglect.

In her deposition, Mrs Burke said: "It wasn't out of neglect. Nathan was well taken care of by my daughter, Fiona."

She said that Nathan was a 'delicate child'. Recalling the events of the day, Ms Doheny told the inquest that Nathan was unsettled and she decided to bring him for a drive and placed him in the car seat in the back of the car at the caravan park.

However, when she saw that Nathan was fast asleep, Ms Doheny said she decided to sit out with her mother, Mrs Burke on two deck chairs 10ft from the car and watch Nathan from there.

She said: "I left the driver's door open with the window of the door slightly open. I checked Nathan three times while he was in the car."

Mother-of-two Ms Doheny said: "At 4pm, I went into the mobile home to heat a saucepan of milk for him and when I checked Nathan in the car, he wasn't right. He was still and I tried to wake him, but he remained still. I called Liam twice and screamed. I dialled 999."

Frantic

Two local doctors and a paramedic made frantic efforts to revive Nathan using CPR over the next 90 minutes before he was pronounced dead at 5.30pm.

Montessori teacher Ms Doheny told the inquest that she and Liam had fostered children on behalf of the HSE for the last five or six years and that Nathan was in their full-time care since January 1, 2010.

Nathan's biological mother, Limerick woman Deirdre Byrnes (pictured), also attended the inquest.

In her evidence, State pathologist Dr Marie Cassidy said that the child was very well cared for and that there was no evidence of trauma.

Dr Cassidy said that where the child was found must be taken into account when considering the most probable cause of death.

She said that at 14 months, Nathan was at the outer range of cot death, however, he was a small child and therefore may have increased risk of death due to sudden infant death syndrome.

She said: "However, he was found collapsed in the back of a car on a hot day, which raises the possibility of potential lethal hyperthermia in a vulnerable individual...

"In a young and undeveloped individual, whose central temperature regulation is not fully developed, a child may be less able to cope with a sudden rise in temperature."

Dr Cassidy confirmed that Gardai had reconstructed the temperatures in the car on the day. They found that they would not have risen to a lethal level and would have been only a few degrees above the outside temperature.

Clare County Coroner Isobel O'Dea concluded that heat was a factor in the tragedy. She recorded that the cause of death was sudden unexplained death in an infant with hyperthermia as a contributory factor.

jlast@herald.ie


Study: Federal Government Not Overseeing Use of Mind-Altering Drugs in Foster Children

The federal government has not done enough to oversee the treatment of America's foster children with powerful mind-altering drugs, according to a Government Accountability Office (GAO) report to be released Thursday. ABC News was given exclusive access to the GAO report, which capped off a nationwide yearlong investigation by ABC News on the overuse of the most powerful mind-altering drugs on many of the country's nearly 425,000 foster children.
The GAO's report, based on a two-year-long investigation, looked at five states -- Florida, Massachusetts, Michigan, Oregon and Texas. Thousands of foster children were being prescribed psychiatric medications at doses higher than the maximum levels approved by the Food and Drug Administration (FDA) in these five states alone. And hundreds of foster children received five or more psychiatric drugs at the same time despite absolutely no evidence supporting the simultaneous use or safety of this number of psychiatric drugs taken together.

GAO Key Findings
Overall, the GAO looked at nearly 100,000 foster children in the five states and found that nearly one-third of foster children were prescribed at least one psychiatric drug.
The GAO found foster children were prescribed psychotropic drugs at rates up to nearly five times higher than non-foster children, with foster children in Texas being the most likely to receive the medications compared to foster children in the other four states.
Although the actual percentages of children who received five or more psychiatric drugs at the same time were low in the five states included in the GAO report, the chances of a foster child compared to a non-foster child being given five or more psychiatric drugs at the same time were alarming.
In Texas, foster children were 53 times more likely to be prescribed five or more psychiatric medications at the same time than non-foster children. In Massachusetts, they were 19 times more likely. In Michigan, the number was 15 times. It was 13 times in Oregon. And in Florida, foster children were nearly four times as likely to be given five or more psychotropic medications at the same time compared to non-foster children.
Initially part of GAO's investigation, Maryland was later excluded from GAO's analysis "due to the unreliability of their foster care data" according to the report, a problem ABC News learned many states face.
Foster children were also more than nine times more likely than non-foster children to be prescribed drugs for which there was no FDA-recommended dose for their age.
For the most vulnerable foster children, those less than 1 year old, foster children were nearly twice as likely to be prescribed a psychiatric drug compared to non-foster children.
When Sen. Thomas Carper, D-Del., lead requestor of the GAO report, first learned of the report's findings, he said, "I was almost despondent to believe that the kids under the age of one, babies under the age of one were receiving this kind of medication."
ABC News has reviewed dozens of medical studies published in recent years that echo GAO's findings -- research showing foster children receive psychiatric medications up to 13 times more often than kids in the general population. In some parts of the country, as many as half of foster kids are on one or more psychiatric medications. This, compared to just 4 percent of kids in the general population.
Dr. George Fouras, a child psychiatrist and co-chairman of the Adoption and Foster Care Committee of the American Academy of Child and Adolescent Psychiatry (AACAP), said, "There is an incredible push to use medications to solve these problems as if it is a magic wand."
The stories include kids like 11-year-old Ke'onte from Texas, whose journey was documented by ABC News over the past year and who will be testifying before Congress on Thursday about the overuse of psychiatric medications in foster children.
Neglected and often left home alone with his 1-year old sister, Ke'onte became a ward of the state at the tender age of four. Ke'onte was placed with a relative who, he said, beat him with belts, switches, and extension cords -- which not only left him with the physical scars on his body he showed ABC News, but, understandably, with anger and despair. Simply too much for the relative, the state of Texas bounced Ke'onte between six foster homes and hospitals over just four years.
Along the way, Ke'onte's trauma was treated with an onslaught of psychotropic drugs -- powerful mind-altering medicines like the mood-stabilizer Depakote, the stimulant Vyvanse, the antidepressant Lexapro, clonidine for ADHD and the antipsychotic Seroquel.
"I was put on bipolar meds. I am not bipolar at all," Ke'onte told ABC News' Diane Sawyer.
Ke'onte was on at least 12 psychiatric medications while in foster care, up to four of them at the same time. "I was on a whole lot of medicines that I should have not been on," Ke'onte told ABC News.
But Ke'onte is lucky -- a member of a select group of foster kids, about one in 10, who leave state custody to enjoy the security and stability of being adopted by a loving family, according to the latest data from the Administration for Children and Families.
And his new family, Carol and Scott Cook, were on a mission to get Ke'onte off drugs; he is now in therapy, beginning to heal. Additionally, his doctor now says Ke'onte doesn't have ADHD and he's not bipolar.

Meds Aren't Always the Answer
While almost all experts acknowledge children in foster care have more emotional and behavioral issues, experts ABC News spoke to do not believe this alone justifies the magnitude of the overuse of psychiatric medications in this vulnerable population.
"The general consensus is that when you're treating young children, you always try behavioral intervention before you go to medication," said Dr. Charles Zeanah, director of child and adolescent psychiatry at Tulane University.
Experts are also beginning to question the accuracy of diagnoses such as bipolar disorder and other mental illnesses in children, especially in foster children who may not always have access to comprehensive mental health services.
Stephen Crystal, director of the Center for Education and Research on Mental Health Therapeutics at Rutgers University, said while foster kids may be three times as likely to be diagnosed with bipolar disorder, "the validity of these diagnoses is uncertain, and the fact of being in foster care may itself increase the likelihood of psychiatric conditions being diagnosed."
While the National Institute of Mental Health reports schizophrenia affects just 1 percent of the population and bipolar disorder less than 3 percent of the population, antipsychotics have become one of the top-selling classes of medications in the United States, with 2010 prescription sales of $16.2 billion, according to IMS Health.
Concerned about numerous reports of waste and the abuse of psychiatric medications in foster children, Republican and Democratic United States senators, led by Sen. Carper, requested an independent GAO investigation on the growing problem nearly two years ago.
In the five states included in this week's GAO report, more than $375 million was spent on psychiatric drugs in 2008, $200 million of which was spent in Texas alone.
Medicaid spends at least $6 billion a year, nearly 30 percent of its entire drug budget, on psychiatric drugs, more than double what was spent in 1999, according to the Centers for Medicaid and Medicare Services.

GAO Holds HHS Accountable
The GAO report is an indictment on HHS's oversight of the nation's foster care children and asks that "HHS consider endorsing guidance for states on best practices for overseeing psychotropic prescriptions for foster children."
Several factors may be contributing to the increasing number of psychotropic prescriptions for foster children: greater exposure to trauma before entering the foster care system, frequent changes in foster placements and lax oversight policies on the part of states.
"You know, there are a lot of people you need to talk to, to find out as much as you can about what the child's behavior is like in a variety of different situations before you make a determination that you're going to use something like a very powerful medication to treat them," Zeanah said.
The GAO found that Texas, Massachusetts, Michigan, Oregon, and Florida each "falls short of providing comprehensive oversight as defined by the American Academy of Child and Adolescent Psychiatry" with regards to prescribing and overseeing the use of psychotropic drugs.
Currently, HHS simply provides "informational resources for states to consider for their programs" when it comes to psychotropic drugs provided to children in state custody according to the GAO.
States are not obligated to follow consent and oversight best principle guidelines set by the American Academy of Child and Adolescent Psychiatry for medicating foster children.
However, many states are also not following oversight provisions required by law, according to the Child and Family Services Improvement and Innovation Act passed in September 2011 and the Fostering Connections to Success and Increasing Adoptions Act of 2008.
In addition to providing guidance, HHS also has the authority to withhold federal funds from states that do not comply with strengthened oversight measures.
Sen. Carper said Congress has a responsibility, too -- "to try to get to the bottom of this, and armed with that information, to make sure that behavior is changed, that's going to be beneficial to children."

HHS Sends Letter to States the Day Before Thanksgiving
HHS was given an early look at the GAO report and issued a letter to states the day before Thanksgiving regarding the effective use of psychotropic medications among children in foster care.
"Too many states, I'm afraid, just don't know what best practices are," Carper said. But states have been asking for help for years.
One state official told researchers at Tufts, "[We] need guidelines to determine whether medications are needed and, if so, for how long."
HHS said it will "offer expanded opportunities to states and territories to strengthen their systems of prescribing and monitoring psychotropic medication use among children in foster care."
Dr. Christopher Bellonci, a child psychiatrist and author of a 2010 Tufts study that showed nearly 50 percent of states either didn't have, or were still in the process of developing, policies regarding foster care psychotropic drug use, thinks HHS guidance for states on best practices, while good, are not enough.
Bellonci told ABC News the states should have to report pharmacy claims of actual psychotropic drugs given to foster children.
"We need to be able to benchmark states around one another, then at least it is all public record," Bellonci said.
Antidepressants, anti-anxiety medications, antipsychotics, and mood stabilizers are some of the so-called psychotropic drugs -- psychiatric medicines that alter chemical levels in the brain, which impacts mood and behavior. Of the psychotropics, antipsychotics, like Ke'onte's Seroquel and others like Abilify, Risperdal, Zyprexa, Geodon, Invega, Latuda, Fanapt, Clozaril, Saphris and Solian, are among the most powerful.
Of all the psychiatric medications, antipsychotics are, by far, the most prescribed, especially for foster children. Foster children are given antipsychotics at a rate nine times higher than children not in foster care, according to a 2010 16-state analysis by Rutgers University of nearly 300,000 foster children.
While doctors aren't exactly sure how or even why antipsychotics work, most experts believe antipsychotics block specific receptors in the brain, which are thought to be overactive in patients with symptoms of psychoses, such as hallucinations and delusions.
Antipsychotics were initially designed for schizophrenia and bipolar disorder. Only Seroquel, Abilify, Risperdal, and Zyprexa have very limited FDA-approval for use in children.
However, antipsychotics are being widely prescribed off-label, meaning for conditions the FDA has not approved them for, for things like agitation, anxiety, acting out, irritability, behavior issues and even as sleeping aids.
Dr. Jeffrey Thompson, chief medical officer for Medicaid in the state of Washington, said, "Nobody gets up in the morning to overdose kids. It just happens that it's a momentum in the system. Kids get aggressively diagnosed and sometimes we look for the easy solution, which is a pill over psychotherapy or better parenting."
Critics charge that, because of their sedating properties, antipsychotics are actually being used in foster care treatment facilities as chemical restraints.
Dr. Fouras is particularly concerned about the use of these drugs as chemical restraints.
"We are trying to put a nice shiny term that sounds [as if] 'oh, we're just restraining the kid,' [when] really what you are doing is just knocking them out to make them less of a problem for you," Fouras said.
This widespread and frequently unchecked use of antipsychotics is concerning considering the serious side effects of these medications. Antipsychotics change a person's metabolism, frequently cause significant weight gain and can increase the risk of diabetes.
In addition to tremors, muscle spasms and restlessness, antipsychotics can cause tardive dyskinesia, a permanent and irreversible condition where a person has involuntary movements of the tongue, lip, mouth, and arms and legs.
While less common with newer antipsychotics, each year 5 percent of people on antipsychotics will develop tardive dyskinesia, according to the National Institute of Mental Health.
Many experts are also concerned about the prolonged use of antipsychotics in children, given there are absolutely no long-term safety studies for their use in children.
Fouras said, "Some of these medications have only been out for 10 to 15 years, so that is not enough time to know what is going to happen over the long term."