Wandering the streets of Baltimore alone in the spring of 2008, “baby unknown” (we’ll call him “Derek”) was picked up by police, taken to the Department of Social Services (DSS) and then referred to us for treatment foster care. Abandoned without identification and unable to tell us his name or the whereabouts of his family, his initial communication was limisted to the three fingers he held up when asked how old he was. Eating food very quickly– perhaps for fear that it would be taken away– avoiding eye contact with anyone, and afraid of being left alone even in an adjacent room of a house, the signs of abuse and neglect were becoming evident. He was destructive of household furnishings and physically aggressive towards other children. His stares were blank, nightmares were frequent and, when he eventually tried to speak, it was with a stutter. While 3-year-old children are prone to occasional temper tantrums, Derek demanded constant attention and, when he didn’t get it, would resort to agitated fits of screaming and biting. Derek was placed with a committed, loving treatment foster parent and followed closely by a skilled and caring Building Families clinical social worker whose home and school visits created a strong working bond. Much needed internal and external evaluative services were engaged. The result? A difficult, yet rewarding four years for Derek. He articulated traumatic memories of his mother and “the man” that put him out on the street. And though these recollections triggered reactive behavior, our programs offered a way forward. With a new name and birth certificate, much-improved behavior, a developing love for swimming, and a legal adoption by his foster parent, Derek is beginning to experience life’s joys.