I found the recounting of the circumstances under which the children grew up difficult to stomach. This history is not specific to the US, but can be found in other places as well. it reflects a view on children's worth and rights that is very different than what it is today (for the most part). I liked the juxtaposition of the two experiences, then and today, as it brought home that while the circumstances of of abject poverty have hopefully changed, the emotional minefields remain the same for kids in foster care. I found the latter part of the book a bit rushed, which lessened the appreciation for the book as a whole.
I listened to this in audio, which made the harrowing passages easier to get past, but on the other hand I did not like the speaker all that much.