Susan Stevens' four children live apart from one another, and from her. Amber, 12, and Heidi, 13, live with foster mother Jen Bronsdon, 45 minutes away from their birth mother, who lives in Madison, Wisconsin. Sixteen-year-old Dustin lives in Illinois, and 18-year-old Chris has recently returned to Stevens' home.

Like three-quarters of the children in foster care in the United States, these brothers and sisters don't wake up together or see each other getting ready for school in the morning. They don't engage in the normal day-to-day fray of sibling rivalry, and they don't see their mother's face before they go to bed at night.

All week long, Amber and Heidi save up their stories and thoughts for Sunday phone calls with their birth mom. This is their only time to fill her in on school, friends and activities. They have to do it this way not only because of the miles between them, but because they are seldom permitted to see their mother in person. Dustin, hundreds of miles away, is in a similar situation.

For various reasons, including Stevens' on-again, off-again use of drugs, contact visits between mother and children have been forbidden. Case workers monitor the family's progress and make decisions about when—and if—they are to meet. The separation wears on the family's fragile fabric.

Amber says that the occasional face-to-face visits have brought her a variety of feelings—not just happiness. The visits often left her sad and remorseful. "When I would see her I couldn't leave without crying for like an hour or two," Amber says.

The fact that Stevens sometimes disappointed her children by not showing up didn't help. "There was a point in time where I didn't know if I should see her because she might have an excuse and not come, and that would hurt me and made me mad at her," Amber says. "And I didn't want to be mad at her."

Now that she has been sober for more than seven months, Stevens has gone back to school and is working as a co-manager of an apartment building. She admits that she has disappointed her children in the past, but believes that more contact would have helped her get back on her feet more quickly. "I haven't always shown responsibility in being able to handle it," Stevens says, "yet I know that had I been allowed more physical contact with my kids, that would have left me in a better place emotionally."

Keeping Connections
Veteran foster parent Diana Pankonin of Grant, Nebraska, is a firm believer in the importance of keeping up the connection between children and their birth parents. She remembers a 3-month-old child she once took in. The baby had been labeled with "failure to thrive," a serious medical condition linked with child neglect. When the child's mother began coming to Pankonin's home for face-to-face visits, Pankonin made an important observation.

The young mother—severely disfigured by burns from a car accident—made no attempt to touch the child. She stared intently at her baby from across the room. Her eyes followed the baby from place to place. She would hold him in his infant seat, or arrange a blanket so that her own disfigured skin did not touch his.

Pankonin believes that the child's mother had been so badly scarred—emotionally and physically—she did not want to touch her child and "rub off" on him.

"She felt ugly," Pankonin says, "but she loved that little boy, you could tell."

Pankonin worked with the mother to begin to show physical affection for her child. She taught her to feed him, change his diapers and care for him. "It took a lot of work," Pankonin says, "but we eventually convinced her that her baby needed her and didn't care what she looked like."

She went to court with the mother and helped her regain full custody of her child. When she saw the mother three years later, pregnant with her second child, the mother told Pankonin, "I can take care of this one all by myself."

Marty Beyer, a clinical psychologist and independent consultant who has worked on foster care reform efforts in Alabama and Oregon, says parental visits are the single most important predictor of safe reunification with families. They can motivate parents to make changes in the behavior that caused children to be removed. These visits are also opportunities for birth parents to learn how to meet the needs of their children.

"We don't want them to lose attachment to their parents," Beyer says.

Pam Day, director of foster care for the Child Welfare League of America (CWLA), says that visitation is vital for repairing and strengthening the bond between parents and children. "While visitation can be painful because it reminds parents and children that they are living apart," Day says, "it offers an opportunity to arrive at the best possible permanency for every child."

But foster parents may not be prepared for the emotional storm stirred up by such visits. Wrestling with powerful feelings, many children act out in disruptive ways both before and after spending time with their parents. In many cases, foster parents have not been trained to expect or cope with such behavior. Many foster parents are convinced that such visits are harmful to the children, and believe that the system is being overly sympathetic towards the birth parents.

A Worst-Case Scenario?
Sandy Bartlett of Lewistown, Pennsylvania, is such a foster parent. Every other week, Bartlett would take 5-year-old "M" to visit his birth parents at the children and youth services office in the local courthouse. She was complying with the rules of the department, which stated that the 5-year-old boy would spend one hour every two weeks with his mother and father. But every other week, it became harder and harder, because M was becoming unruly and abusive before and after visits.

"He would hit me, bite me, choke me, he took a baseball bat to me," Bartlett says. "He was a wild child."

M was also self-destructive: "He would scratch, bang his head against the wall, hit himself," Bartlett says. On two occasions, he landed in the hospital due to self-inflicted wounds.

M had been diagnosed with attention deficit-hyperactivity disorder, post-traumatic stress disorder and depression—all common problems for kids who have been abused. "He abused me," Bartlett says, "because that was what he knew."

According to Bartlett, she asked for the visits to stop, but the department would not comply. Exasperated, Bartlett called a technical support staff for help. They came and took M to a respite for two days at a time. Ultimately, M was moved to a psychiatric hospital.

"Face Time" for Kids and Parents
When a child is removed from the home—the fate of half a million U.S. children today—professionals must decide how much and what type of contact between birth parents is appropriate. In cases where children have been abused and are seriously at risk, visitation may be forbidden altogether. Experts agree, however, that face-to-face visits are appropriate, and beneficial, in the great majority of cases.

According to the National Children's Bureau, among children exiting foster care to permanent placements, 66 percent were reunified with their families or other relatives. The numbers suggest it makes sense to nurture family relationships, not cut them off.

Dr. Lois Wright, author of a book on visitation for the Child Welfare League of America, says that when a child is removed from the home, the assumption is that visits will always be allowed, unless there is a compelling reason not to allow them. "The primary reason would be safety issues," Wright says. "Even then, though, the agency can be creative in finding ways to allow visitation, adding supervision and other controls."

Children may regress around the time of visits with birth parents because of the tremendous emotional strain of separation. But experts say that disruptive behavior is not a compelling reason to discontinue visits. "It doesn't mean that the visit has been harmful to the child," Marty Beyer says.

Karen Jorgenson, president of the National Foster Parent Association, encourages foster parents to cooperate with family visits, modeling strong parenting skills and supporting birth parents. "We try to do training on how important it is that foster families develop relationships with birth families," Jorgenson says.

Kids in Foster Care Speak Out
Nancy Carter, a 23-year-old social worker in Holly Springs, North Carolina, lived in out-of-home care between the ages of 14 and 18. She credits her foster mother with helping her maintain a relationship with her birth parents. "She fought for me to be able to see my parents," Carter says. "She took me to my parents home and talked to them like they were important people, which no one else did."

Jen Painter was removed from her father and stepmother's home at 16 due to abuse. Today, she too is grateful to her foster parents for helping her stay connected with her birth parents. "My foster parents were very understanding," Painter says. "They knew the whole point was for me to go back to my family."

Painter, now a 19-year-old sophomore at the University of North Carolina at Chapel Hill, says that cooperation between foster parents and birth parents makes all the difference for kids in care. "It's a whole new world ? and a lot of times you have really good foster parents you can talk to, but it's never the same as having your birth parents," Painter says.

Jen Bronsdon, Amber and Heidi's foster mom, says that it's really about keeping up the bonds between parents and children in any way possible. "Even though the girls don't have a lot of face-to-face contact with their mom, I do try to encourage visits in other ways—sending pictures, letters and stories, photocopying report cards for her, taping songs ? asking for her advice," Bronsdon says.

It hasn't always been easy for Bronsdon, yet she has persisted—for Amber and Heidi's sake. "There were also times when I was more frustrated and would question why we should go through all this work," Bronsdon says, "but I realized it wasn't so much for Sue's sake as it was for the girls."

• The Child Welfare League [1] offers standards on visitation between birth parents and children in foster care.
• Learn more about successful foster parenting from the National Foster Parent Association [2].