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Thursday, March 31, 2011

Aboriginal Child Protection Case fails at the Canadian Human Rights Tribunal

The Canadian Association of Social Workers is reporting that "On March 14, 2011, the Canadian Human Rights (CHR) Tribunal dismissed on a legal technicality the complaint filed in 2007 by the First Nations Child and Family Caring Society of Canada (FNCFCS) and the Assembly of First Nations, which alleged that the Federal Government is racially discriminating against First Nations children by providing less child welfare benefit on reserves."

I have written before about the high impact on Aboriginal communities of public policies in the past. These policies certainly include the decision to take thousands of children away from families and place them in residential schools. About half of those children would not survive having been subject to abuse of various kinds, malnutrition and maltreatment in the form of loss of love, caring and nurturing. The legacy was inevitable. The Aboriginal communities of Canada lost generations of family and parenting modeling. Now we have children being raised by adults who lacked the teaching needed to build healthy inter generational parenting.

Several studies have shown that the impact has been dramatic problems with children that have resulted in very high rates of Aboriginal children within the child protection systems.

The First Nations Child and Family Caring Society of Canada notes on their website, "The inequalities in First Nations child welfare funding are longstanding and well documented (Royal Commission on Aboriginal Peoples [RCAP], 1996; McDonald & Ladd, 2000; Loxley et. al., 2005; Amnesty International, 2006; Assembly of First Nations, 2007; Auditor General of Canada, 2008; Standing Committee on Public Accounts, 2009) as are the tragic consequences of First Nations children going into child welfare care due, in part, to the unavailability of equitable family support services (McDonald & Ladd, 2000; Blackstock and Trocme, 2005; Amnesty International, 2006; Clarke, 2007; Auditor General of Canada, 2008; National Council on Welfare, 2008). This inequity is further amplified for First Nations children by shortfalls in education funding, housing and publically funded voluntary sector supports (Blackstock, 2008)."

It is our nation that created the legacy and our nation should be willing to find solutions - but solutions need to be properly funded. We underfunded care of Aboriginal children in the residential schools which led to some of the problems (although the program should never have been established) and now we underfund the solution.

This is a political issue and should be raised during our present Federal election.

Sunday, March 27, 2011

More research on foster care impacts

J.J. Doyle of MIT has again done an extensive review of whether foster care is good for children. He concludes not using a large data base and builds on earlier work that he has done. Critics of foster care may well start to salivate at these results but, before they do, it is vital to see that the results again focus on a particular part of the foster care population.

His results show:

"The results suggest that placing children in foster care increases their likelihood of becoming delinquent during adolescence and requiring emergency health care in the short term. Along this one dimension of child safety, it does not appear that foster care is serving a protective role."

This is an important caution that replicates earlier work by not only Doyle but other researchers through the Chapin Hall Center for Children at the University of Chicago. But Doyle also notes that his work applies to a particular subset of children in the child protection system:

"The results do apply to a particularly policy-relevant group: those children where the investigator does matter. These are marginal cases where investigators could disagree about how to proceed. This variation is at the heart of the policy question of whether the child-protection system is too aggressive or not aggressive enough."

From a policy perspective this is quite crucial. How to proceed with cases for which the answer may not be clearly place or clearly keep in the family. In general, his work suggests that keeping those children in the family may be better. Bear in mind that other research tells us that effective supports are a crucial element to making that work.

Doyle places one other caveat: "Further, the results apply to somewhat older children, between the ages of 5 and 15, who were investigated for abuse or neglect in Illinois during the 1990s. To the extent that other foster care systems perform better than this one, the answer could change. Future research that considers younger children, other states, and other time periods would allow an examination of whether the results apply more generally to child protection policies in the U.S."

Thus, important questions related to younger children in particular remain unanswered. It is crucial that we continue to see the degree to which these impacts are true for younger children. Research in the UK suggests that getting a stable answer for children by age 7 is vital. As children age and family patterns (along with other related environmental problems) become more entrenched, negative outcomes become more likely.

As Doyle says in the introduction to his article: There is no dispute that severely abused or neglected children should be protected, and a foster family home has been judged the best alternative whenever possible. A key policy question is one of degree: how aggressive should child protective services be? Child protection agencies trade off two competing goods: family preservation and child protection ... More aggressive child protection may reduce child abuse or neglect, but removal from parents may be traumatic to children as well. For example, much has been written about the potential for such instability to hinder child development, and multiple placements once a child has been placed in foster care has been associated with greater emotional and behavioral problems among foster children."

Doyle's article is currently in press with the Children and Youth Services Review.

Thursday, March 24, 2011

The sad case of Nubia Barahona

This is a child who died in Florida despite possible ways in which the child protection system may have saved her. Like so many cases before her, this is not a case where her death should lead to over reaction by CPS resulting in over apprehension of children - it should act as a way to reconsider how well we are doing with cases that do need protection. Like so many cases before, there were many opportunities to intervene if the voices being raised had been heard:

"The red flag of caution and warning was raised many times: By teachers and principals,by a Guardian Ad Litem (GAL) and her attorney, by a nurse, by a psychologist, byNubia's "family" stonewalling the search for fundamental information.But nobody seemingly put it all together" (p.2).

The case raises a number of flags that we have seen before:

* parents who stonewalled
* parents who withdrew from systems (e.g. school in this case) where behaviors were getting noticed -- "After the end ofthe 2009-2010 school year, the Barahonas chose to home school the children,taking away most of their visibility to outside eyes and increasing the dangerthat abuse and neglect would go unrecognized. This was further compoundedby the lack of formal requirements relating to the monitoring of students being home schooled" (p.7)
* professionals who failed to bring together data that would create a more global than partial picture of what was happening. As the report states at p. 5: " failed to consider critical information presented by thechildren’s principal and school professionals about potential signs of abuseand neglect by the Barahonas."
* parents refusing services

This death review offered something different than has been seen in many prior reviews which is a comment on the parenting assessment that had been done. There was a failure to properly gain data from multiple reliable sources that would have shown the assessor a broader picture. It also would have shown contradictory information such as school progress. A poor parenting capacity assessment creates the opportunity for child protection authorities to make bad clinical risk judgments that leave children vulnerable. As they state on p. 11, "What’s needed are clearly articulated expectations for any psychologicalevaluation as well as clear criteria for reviewing the performance of anycontracted psychologist or other expert called on to evaluate children on behalfof the court." Such guidelines do exist in the professional literature as well as a variety of publications.

The authors also note that delays in assessments leave cases without appropriate consideration. Such delays may not be the fault of anyone person but rather of processes that just move slowly. If assessment is going to be effective, then it must have access to a wide range of data. This point has been made by many authors and is repeated by this review. In addition, this assessor appears to have wrongly considered that attachment in a care home should have priority over the safety of the child. This is a growing area of concern given that legal processes leave young children in alternate care for long periods creating attachment between the child and the alternate caregivers that will need to be broken if a child is to come back to family.

A further area of concern that we have again seen too often in death reviews is the failure of CPS staff to properly assess and coordinate information coming in. Fragmented data has been behind many CPS failures. As the authors state on p. 10, "A serious deficiency, however, was the failure of individuals involvedin the case to talk with each other rather than relying on inadequateinformation technology. Many of the communications problems that can beidentified in this and other cases can be overcome by prompt and coordinatedinterpersonal interaction among those involved in the care of the child."

As one says with so many of these cases, let us hope that Nubia did not die in vain.

Saturday, March 12, 2011

Willful Blindness in Child Protection

I have spoken about Heffernan's recent book on willful blindness in a prior post. Its a rather amazing read and I again recommend it. The book raises a number of issues that are quite relevant to child protection work. Here are a few of the themes:

1. Belonging in the group - It is hard to dissent in a group. Her report of a broad range of research in a number of fields of endeavor shows that, even when an individual knew that the decision was likely wrong. The notion that a professional group might be stronger as a result of collective wisdom may well not be true. It appears that, within a corporate team, dissent is difficult to do and often not welcome. There is a strong need for affiliation in human beings. To dissent is to step outside that and create the risk of being ostracized. We do not do well in such a position.

2. Using case plans that don't work - Case planning in many child protection agencies is done under the heavy burden of high caseloads, high turnovers and a favored way of doing things. There is a "corporate" culture about "how" things are done. Unfortunately, this can also lead to interventions that are familiar but for which there is little evidence of effectiveness. For example, there is a great deal of in-home parenting programming for which there is scant data that suggests that any long term changes occur.

3. Failing to look at the research that tells us what does work. In the United States Senate Committee on Finance Hearings on March 10, 2011 a former Oregon foster child, Isha "Charlie" McNeely pointed out a fact that systems often ignore. Foster children, in very large numbers, will experience multiple placements meaning that home may be far less stable and nurturing than before coming into care. Thus, we may be blind to the impact of child protection decisions in which we may be doing harm in the name of protection. The practice question, of course, is whether or not we are considering that in our case planning. Does this child need to come into care, and if so, what is going to make that safe and productive.

4. Family connections matter but in child protection that can be messy so, once parental rights are terminated, it is easier to ignore them. McNeely notes that most foster children will make steps to find the biological roots either during or after aging out of foster care. So instead of being blind to that, how do we manage that? Finding ways to sustain relationships may serve many foster youth better. Child protection workers are reluctant because that can interfere with adoption planning. Even in cases where adoption will not occur, case managing difficult biological relationships is quite challenging within an overworked environment. Biological links may not mean, however, the parents who were incapable. There may be healthier people in the family system who can provide support.

5. Budget cuts mean reduced services. To be blind to that must be willful. In the media we have seen more and more reporting that as the economy has worsened, pressures on family have increased, there is growing poverty and children are in increased need of protective supports. With the right services, we can help families under these economic strains stay safe. The demand for the services is increasing while budgets in Canada, the United States and the United Kingdom are getting squeezed. A current example is a story out of Pittsburg in the United States ( http://www.pittsburghlive.com/x/pittsburghtrib/news/regional/s_726933.html

Good child protection has eyes wide open. These are but a few examples. Of course, a major challenge is to get the eyes of politicians open to the reality of their decisions.