Tyrome Laundersville was 9 years old and he didn't understand what was happening the day his mother and father put him in the family car at their home in Iowa and drove him to foster care.
He was excited, at first. He remembers thinking: "'Oh we're going somewhere fun.'"
Their destination was a psychiatric residential treatment center.
Most children in foster care live with families, with relatives or with other foster parents. But about 10% of disabled kids in foster care live in group homes and institutions, compared to just 4% of those without disabilities.
An NPR investigation found children with disabilities, including physical and behavioral health disabilities, are the largest group that goes into foster care — and they have the worst outcomes.
We obtained federal data on more than 500,000 children and youth in foster care in 2025. We calculated that disabled children stay in foster care 50% longer than kids without disabilities.
They're less likely to return to their parents or to be adopted.
To get past the numbers and better understand the issues of children with disabilities in foster care, NPR interviewed former foster youth about their experiences — like Laundersville.
When Laundersville was 9, his occasional screaming, aggression and property destruction were things his parents just couldn't figure out.
The hope was that he'd get treated at that facility and come home.
What happened was that he kept getting moved from place to place.
"Being a child who's nonstop moved around in a facility in that situation from 9 years old until I was 18, it's really hard," Laundersville told a group of child advocates and researchers in a speech in 2024. "I missed my parents. I'm not going to deny that. And even when I was mad or hurt, I still wanted them there. I still forgave them. I wanted them to fight for me. And I needed that connection. And when it wasn't there, it just left me feeling abandoned."
Laundersville would get lots of labels from doctors: Fetal Alcohol Spectrum Disorder. ADHD. Bipolar Disorder. Oppositional Defiance Disorder.
Going to locked-down residential treatment centers — some where he needed permission just to use the bathroom — only made his problematic behaviors worse, he said.
He'd have meltdowns at one facility and then get sent to another that was bigger, more restrictive and more punitive.
"I had a hard time with aggression, both verbally and physically," he said. "I wasn't just being bad. I was hurt. I was angry. And I didn't know how to properly express myself after the many years of just not being heard. I just wanted someone to understand me and not judge me for my behaviors and actions that I've always had my whole life."
One person who understands is Marissa Pike, of Massachusetts.
"When I was frustrated, I would scream and yell and that was my way to express that I was angry and I was mad," she said. "And so I just was kind of labeled as problematic. I was labeled as confrontational. I was labeled as aggressive and defiant."
Pike was 12 when she went into foster care. Because of her behavior, she says she got moved to 30 placements in less than 10 years.
Some were psychiatric centers and hospitals. She was medicated with anti-psychotic drugs.
But Pike was misdiagnosed.
It would take a few years before she was diagnosed with autism. It was at the core of all the behaviors that kept getting her in trouble.
"I would be overwhelmed doing something and I would refuse to go where the staff would want me to go," she says.
Simple activities or routines at a treatment center could overstimulate Pike and set off a cycle of meltdowns and punishments.
"As a kid, it would be like, 'Oh, we're going to go outside and play dodgeball. And then we're going to go in and we're going to go right to dinner and wash your hands' and stuff like that," she recalls of the regimented life at treatment facilities. "And for me it was like, 'OK, I just did dodgeball. And now I'm like, I need time to decompress' because dodgeball is vicious with kids."
But she says she "didn't have the skills" at the time to say she needed a few moments to relax. Now, as an adult — she's 28 — she can look back and understand she was "just overstimulated and probably needed some noise-canceling headphones and 15 minutes, then I would have been fine.
"But I didn't know that then," she says.
Nor did staff at the institution.
When she refused to come inside, staffers grabbed her, which only made her more upset. When she got angry, staff restrained her, with one, two or three staffers holding her down. That only upset her more.
There were times when she was held down for long periods of time — an hour or more, she says — which triggered rules that she needed to go to the hospital, because prolonged restraint can cause injuries and be dangerous.
Eventually, episodes like this got her sent to the next institution.
Restraint and other punishments are used to control children when they have explosive outbursts, but recent brain science shows those techniques can harm children. They create stress that put a child's body on alert and trigger additional explosive outbursts that the child can't control.
The foster care community, with long ties to institutional care, has been slow to change.
At school, JoJo Kimble got accommodations for her autism.
But in foster care in South Carolina, that autism diagnosis got erased.
She was 15. Suddenly, she got labeled as having bipolar disorder instead.
"It's easier to treat," she says. "You can't treat autism with medication. You can treat depression, the symptoms of depression … with medication and all types of therapy."
Kimble said with the new label she was sent to a series of institutions, including therapeutic group homes and psychiatric hospitals.
Now, at 23, she's out of foster care and back into the separately funded and operated system of public services that treat people with developmental disabilities like autism.
As a result: She lives on her own now. She's in college and studying to become a nurse. She's helping a professor research the impact of childhood cancer on families.
Rasheeda McCrae, who is legally blind, says when she went into foster care at 14, her case manager put a priority on getting a roof over her head but didn't pay much attention to her disabilities.
McCrae has low vision, the result of being physically abused when she was a baby, and behavioral health issues.
She moved in with a Baltimore foster mother in a dark house with several flights of steps that were difficult to maneuver.
Her caseworker, says McCrae, now 35, took her to the home with McCrae's two trash bags of her clothes.
"She didn't even go upstairs," McCrae recalls. "She just came in, dropped my bags, dropped me, did the paperwork and left."
The foster mother was kind but didn't know how to include her blind foster daughter. The other children in the house watched TV together and rode bikes.
"But for me," McCrae says, "I just stayed in my room because I felt uncomfortable and different from everybody else."
After two years with the foster family, she moved to live with an aunt.
Adriene Caldwell, who was 12 when she went into foster care in Texas, says her foster mother was cruel. The woman and her children lived in the nice part of the house and the foster girls — three to five at a time — ate dinner separately in the basement.
"We were second class," says Caldwell, who writes about her experience in a memoir published this year, Unbroken: Life Outside the Lines. "We had to sit on the floor. We were considered dirty. We were not allowed on the furniture."
Caldwell says she went into foster care diagnosed with mild depression and obsessive compulsive disorder. But the foster mother's treatment and cutting remarks increased her depression, and, at one point, Caldwell tried to end her life.
Caldwell, now 46, says the process for reimbursing foster parents gave them little incentive to help children succeed.
"The higher the emotional needs, the higher the payment," she says of what her foster mother was paid.
Other former foster youth with disabilities spoke of positive experiences — especially those who lived in family foster homes.
In Iowa, Samanthya Marlatt was placed with foster parents who were both blind.
"Having a foster parent with a disability was, like, really cool for me to see," she says.
Marlatt has a different disability: cerebral palsy, for which she wore leg braces. It's hard for her to walk long distances.
She watched how her foster parents advocated for themselves to get accommodations that helped them work and live. They got the city to install beeping signals at the crosswalks near their home. They used guide dogs.
From that blind couple, Marlatt says she learned how to advocate for herself.
She and her husband have tickets to a play coming to Ames and she knew to ask for seats where there was a handrail to make it easier to reach.
"It was cool because I saw that, in real time, all of the things they were able to do," says Marlatt. "And then I was able to remember I could do those things, too."
Learning to advocate for herself was contrary, she says, to the lesson she and most kids in foster care learn.
"And this is a big thing in foster care," she says. "I didn't want to ruffle any feathers because I was always afraid of being moved out of where I was and being put in group care. And I really didn't want to be in group care. So if I didn't make a fuss, then I would be fine."
Later, Marlatt became a foster parent herself.
Now she's raising her own daughters. She's in school, completing a master's degree to become a clinical mental health counselor.
Other former foster youth spoke of adults who made a difference: The staffer at the residential center who listened, or a doctor who made the right diagnosis, or a caseworker who kept someone in a family home.
But often, that key adult was someone totally outside the foster care system.
Like for Marissa Pike, the woman with autism from Massachusetts.
"I was 14 or 15," she remembers. "I was walking back from something one day and I met this random lady and I started talking to her."
That "random lady" and Pike became friends. She was the one who spotted Pike's Autism Spectrum Disorder.
The woman called Pike's caseworker and said, "My boss has a son with Asperger's," a term used then for a form of autism. "Marissa presents a lot like him."
Pike says getting the proper diagnosis changed her life.
Now Pike's a foster parent. She was named Foster Parent of the Year in Lynn, Massachusetts, last year. She's adopted two of those kids she once fostered.
At night, she rides ambulances as an emergency medical technician. She's in school, too, getting her master's degree in social work.
Tyrome Laundersville – who missed his parents in Iowa – is another example of someone who got key help from an adult outside the foster care system.
He became homeless when, at 18, he left foster care.
The mother of two friends at his high school invited him to live with them.
"She treated me like a human being. She had a big heart," he says.
That woman was very poor then, he says. She had trouble heating her run-down farmhouse in the winter.
"She made me the person I am today," he says. "She taught me how to cook, how to ride the bus, how to use a checkbook, how to apply for a job — things that he says he wasn't taught when he was in foster care, living in residential treatment centers.
She helped him finally figure out how to regulate his behaviors, which were still a problem when he aged out of foster care.
"I had behaviors. I had everything that I had in placement — the aggression, the property destruction," he explains.
"But she lived on a farm. And she told me: 'If you're going to break my s***, go out to the barn. So I would go out to the barn and punch hay bales and do all of that. And, honestly, she gave me a space to where I could let out my anger and figure out myself and how to control myself while also still supporting me and being that loving person."
Today, Laundersville lives on his own. He's in college, too.
He wants a job where he can change policy for helping foster youth.
That's something these disabled former foster youth share in common: They want to use their lived experience to make foster care a better experience for the children and youth who go there now.
Copyright 2026 NPR
