These particular youth have been raised within a foster-care system that provides the essentials of life — such as food, shelter, clothing and some medical attention — but all too often with little affection amid a tattered pattern of care. For instance, it is not uncommon for a 19-year-old ward to have experienced multiple foster homes with staff rather than parents; these children have been managed and controlled, but not nurtured. Many of these youth are burdened with the expectation that they are now an adult and should be able to make their way in the world. They tend to lack a positive self-image and any real self-esteem. They have only rudimentary skills and many become homeless.