Racial Bias in Child Protection

The question of racial bias in child protection is a crucial one that is not often subject to systemic research. There is an apparent case that it does exist as non-Caucasian children are over represented in child welfare systems in both Canada, Australia and the United States, for example. A question that is in need of review is whether this is due to racial bias or other factors.

In Canada, there has been a series of public policies that have targeted Aboriginal populations. The Residential Schools that ran for over 50 years (with the last one being closed in 1996) meant that several generations of children were removed from parental care. They did not get healthy, culturally significant parenting modeled to them. To the contrary, they received harsh, emotionally and physically abusive (and at times sexually abusive) caregiving. They did not receive the nurturing parenting that created a basis upon which they would know how to care for their own children.

Canada also saw the implementation of policies designed to remove large numbers of children from Aboriginal parental care and placing children in non-Aboriginal homes. This came to be known as the “60s scoop”. Australia saw some similar policies.

Research in the United Sates has shown that black populations are over represented in the child protection system there. Research by Berger et a., (n.d.) raised the question of whether this racial bias might be systemic. They concluded that racial bias is more evident when subjective decisions must be made.

However, their research also indicates that many of the expected bias results were better accounted for socio-demographic issues. Clearly, poverty is one of the most powerful. It can be strenuously argued that, if we really seek to address a lot of child protection concerns, we need to address the question of poverty. A significant portion of child protection caseloads involve economically distressed families. This is particularly so for questions of maltreatment. Thus, we may be bringing into care children because we are not prepared, as a society, to address these fundamental economic questions.

Research that I have reviewed in earlier blogs shows that children growing up in the care of child protection authorities tend to have much poorer long term outcomes as opposed to growing up in their own families. This is true even if those families are just good enough. Thus, the long term societal problems grow because we do not address the question of poverty. This can be construed in the classic economic argument of the rich v. poor and the need for the redistribution of wealth. Given the increasing gaps between the rich and the rest of society, that is a tempting argument.

But it is not one that is likely to influence present political structures where taxpayers are pressing government to be more frugal. We see economic collapses in major economies in several countries. Curiously, of course, such forces will increase poverty and raise the number of maltreatment cases that child protection must address. That in turn, will increase the cost to society.

In the alternative, child protection budgets may not increase resulting in changes to the kinds of cases the get opened. When resources are tight, the threshold for opening a case rises.

Rather than looking at the redistribution of wealth, one might also recognize that costs in the long term for taxpayers go down as we solve these poverty issues. Children who grow up in care cost us dearly – not just in the day to day costs of the state being their caregivers. They tend to have much higher rates of mental illness, crime, substance abuse, incarceration and unemployment. Their children are more likely to also be brought into care. This is very expensive.

Of course, this is not a new argument but it is one that has, thus far, fallen on fallow ground. As citizens, we have trained our politicians to look at shorter term outcomes because we want immediate results. Societies today have little interest in long term thinking. We want solutions now! These are problems that cannot be solved in the now.

Reference:

Berger,L., McDaniel, M., & Paxson, C. (n.d.). Assessing Parenting Behaviors across Racial Groups: Implications for the Child Welfare System. Unpublished manuscript. Downloaded 2012/05/26 at http://socwork.wisc.edu/files/race_parenting_SSR_final.pdf

Texas child death story highlights prevention need

A story appearing this week in San Antoni, Texas talks about continuing concern with the effectiveness of child protection to prevent the deaths of children from abuse by caregivers, mainly parents. The importance of the story is really the piece that does not get highlighted in the headlines. It is twofold - the impact of the economic failures in the past several years and the failures to properly fund prevention services.

When we look at the economic crisis that has been prevalent in the world economies, the abuse, neglect and maltreatment of children appears to be one of the consequences. Families most directly hit by the downturn find themselves struggling to put food on the table and provide shelter. These pressures create poverty induced effects on families that can bring child protection into the household. As a society, we need to face the crisis not as a family failure but rather as a failure of society. Too often, the marginalized populations find themselves involved with CPS. Social workers must respond to what goes on in the family, but when will we as a society be willing to address the root causes?

This leads to the second issue which is the underfunding of prevention services. When social policy is driven by the most recent child protection fatality, it is response services that get the funding. Certainly good funding is needed here so that caseloads are not out of control and CPS response times are reasonable. But good social policy is also about preventing problems through things like home care nursing, teen pregnancy supports, domestic violence interventions and so on. These programs help to reduce the need for child protection and will also aid in preserving family units which is the goal of most child protection legislation.

Too often, children are involved in child protection programs because of the pressures in families that arise from larger social issues that society is not addressing.

Judge John Riley and his controversial views on aboriginal justice

I have just read a fascinating article from Australia from Carole Zufferey on the nature of privilege that inherently exists for social workers who are white. She reflects on her own career and concludes:

This is a beginning attempt to reflect on my own white power and privilege in my role as a professional social worker in a statutory context that intervenes in the protection of children, which included removing children from their families as a result of abuse or neglect.

In Australia, the child protection system engaged in gathering up aboriginal children in large numbers. She describes:

Furthermore, Aboriginal protectionist and assimilation legislation and policies were enacted in state jurisdictions, commencing with the Victorian Aboriginal Protection Act 1869. These policies resulted in the systematic removal of up to 100,000 Aboriginal children from their families into public institutions and missions across Australia, up until the 1970s, creating what is now referred to as the Stolen Generations.

In Canada, we had a similar program which came to be known as the Sixties Scoop. This resulted in large numbers of children being removed from aboriginal homes and then placed into the homes of white families. Even today, aboriginal children are dramatically over represented in child welfare systems in Canada.

In a recent talk, former Judge John Reilly raises the notion that we may simply have it wrong when we think about social justice and crime. Speaking in Calgary, he puts forward his ideas which can be seen via YouTube from his TedxCalgary presentation. You can see it at

Judge John Reilly speaking at TedxCalgary


Reference:

Zufferey, C. (2012). 'Not knowing that I do not know and not wanting to know: Reflections of a white Australian social worker. International Social Work, In Press.

Aging out of foster care

One of the most perplexing challenges for child protection systems, is what happens to children who age out of the system. This is the point when the child becomes legally an adult and then moves beyond the mandate of the child protection authority. There are many jurisdictions that make some level of support available for some children as they make their way through this transition. Not all children will receive this support.

As I have noted in other posts, the outlook for these individuals is often poor. Research has noted that they tend to not finish high school, have poor employment prospects and records, have higher rates of mental health and substance abuse concerns, greater involvement in the criminal justice systems, early parenthood and more relational problems. Not a rosy picture!

Some soon to be published research by Cunningham and Diversi takes a qualitative look at the aging out experience. It is a valuable addition to the literature. It includes the voices of young people in the transition. Their conclusions also help to inform the debate around what should happen - because clearly we are, as yet, not successful frequently enough with youth who are aging out.

Yes, there are exceptions. Recently, at the very excellent Canadian Society for the Investigation of Child Abuse Conference, I listened to twins, now adults and in university, speak about their journey with the incredible support of a dedicated foster parent. Even so, they spoke of a sibling whose life trajectory has not been so successful. I fear that their story of success is more the exception than the norm.

As an aside, if you have the chance to attend their future conferences, it is an excellent conference - has been for several years.

Returning to the Cunningham and Diversi research, they note in their conclusions:

The youth we spoke with described a transition to adulthood that was immediate and complete, lacking the series of small steps toward autonomy that is common among emerging adults in contemporary societies (Arnett, 2004). Furthermore, the independence experienced by foster youth clashes with research highlighting the brain development which continues into adulthood, and the impact of trauma on emotional regulation and decision-making (Avery and Freundlich, 2009). Youth struggled to meet their basic needs, describing unemployment, hunger, and home- lessness. For the youth interviewed, securing employment held a special signifi- cance as the difference between housing and homelessness. Youths’ experiences of aging out often centered on their preparedness for, or lack of preparation, to secure living wage jobs. The emphasis on employment among the youth we spoke with runs counter to the trend of delayed workforce entry among young adults (Furstenberg et al., 2005).

In other words, our system to move youth to adulthood does not recognize that they may not have achieved the maturational level to handle this without support - something that we see in many families throughout western culture. The age of leaving home appears to be going up as the challenges of moving to adulthood is increasingly complex. Yet, if you are aging out of the foster care system, you are most often expected to handle that transition sooner, with fewer supports and often with significant emotional challenges. Why we would expect these youth to do it differently than most youth is a mystery.

This might be explained by the artificial legal definition of when you become an adult. This can vary from 18 - 21 years of age. But this definition has little to do with real world challenges - it is only a legal definition.

One of the things that we might consider in helping these youth is supporting familial relationships over time. I was struck by this conclusion:

Youth spoke of relationships with siblings, foster family members, and the affirmation that came in some cases from reunification from birth parents. However, most youth experienced high levels of social network disruption, citing frequent moves and the loss of family and home. The loss that youths spoke about most frequently was separation from siblings. Older siblings expressed fear and a sense of responsibility for their younger siblings, even in the face of having to meet basic needs on their own. The lack of contact with siblings is particularly painful considering that most foster youth report closer relationships with their siblings than with parents (Courtney et al., 2007; Reilly, 2003) and sibling relationships are typically the most enduring across the lifespan

How important sustaining these relationships are! This may well make the transitions healthier.

I was also struck by the resistance to help that had been seen in the research sample. It made me wonder how we their personal stories made seeking and accepting support such a challenge:

The self-reliance youth expressed was extreme, with their anxiety about dependence on others evident in statements such as the fear of being ‘shot down’ when asking others for help, or the need to avoid permanent connections to others through adoption or legal guardianship, in order to protect themselves from further loss. The possible reality of being homeless and living on the streets illustrates the extreme anxiety that youth may feel over the transition to independence, and the need for developing autonomy beyond that expected of most youth and young adults in our society. The level of self-reliance expressed by youth interviewed mirrors the ‘survivalist self-reliance’ described by Samuels and Pryce (2008) which illustrates the resilience of youth but also presents a risk, as youth resist relationships with others who might provide support. In particular, the authors noted that youth were especially resistant to seeking emotional support from others.

This work is worth a read as it certainly adds to our understanding of both how challenging this transition is but also how poorly we prepare and support that transition with a population who find the support difficult to get and accept.

Reference:

Cunningham, M.J. & Diversi, M. (2012). Aging out: Youths' perspectives on foster care and the transition to independence. Qualitative Social Work, on line first. downloaded 2012/05/15 from http://qsw.sagepub.com/content/early/2012/05/03/1473325012445833.   doi: 10.1177/1473325012445833

Child protection expert witness reports

A study done through the University of Central Lancashire in the UK, published in February 2012, should serve as a valuable guide on some important ways to think about the quality of expert reports for the courts. While this is focused on experiences in the British courts, there is much guidance relevant to multiple jurisdictions on major problems with reports tendered as evidence to guide judges.  These reports can have a powerful effect on proceedings.

This research looked at 126 reports in the family courts. They looked at the crucial issues of the qualifications of the assessors, the extent to which the conclusions could be linked to the data in the report,  the types of methods used for the assessment and their relevance to the questions to be assessed, the type of language used - amongst other issues.

One interesting area that arose is the notion of experts who do not maintain a clinical practice but are essentially running a business as only supplying expert witness reports. The thought here is that the expert has become an expert on being an expert and may, therefore, become less connected to current treatments and interventions.

The report also notes three very concerning trends that can be seen in most jurisdictions:

1. an over reliance on psychometrics;
2. the use of outdated assessment measures; and
3. the use of measures that are not relevant to the questions to be considered by the assessor.

Courts and other consumers of assessment reports should be very concerned about this. In particular, there should be concern with the use of tests that are not relevant. One area that the study did not raise, but which merits consideration, is the use of measures that have not been normed on the population being assessed.

Another disturbing area that the study identifies is experts rendering opinions in areas for which they are not properly qualified.

One further area of comment is for the assessor to provide opinions but also to consider alternatives. Opinions should also be connected to generally accepted theory and other evidence based practice. This should be shown in the report.

This study is worth a review by both those providing expert opinions but also by those who use them. Experts should be aware of this study as it may well serve as an interesting basis for cross examination by a party not served favourably by an expert report.

Reference:

Ireland, J.l. (2012). Evaluating expert witness psychological reports: Exploring quality. University of Central Lancashire. Downloaded 2012/03/19 from http://www.uclan.ac.uk/news/files/FINALVERSIONFEB2012.pdf

Foster Caregivers

Foster parents have often been accused of simply seeing the care of children as a money making scheme - their business so to speak. This has rarely been my experience in decades of working in the field. While there have been a few occasions where I wondered about the motivation of the foster parent, they have been rare indeed.


New research published this week in the British Journal of Social Work offers insight into the views of foster parents and their perceptions. The work was done in Australia but resonates for me.


The goal of a foster parent is to find ways to offer a family environment for children who are, in most cases, temporarily in their care. For many children, the stability of the foster home can represent an almost foreign experience. This can lead some children to quickly adapt and even start to call the foster parents mom and dad. For other children, it is a difficult to adapt fearing to do so would be disloyal to their biological family. Some children arrive with few behavioural or medical problems - many arrive with complex issues.


It is with this in mind that I found the research of Blythe et al of note. The authors, who did a qualitative study, show the real dilemma that can exist between children in short versus long term care.

Participants identified the responsibility of a short-term foster-carer to include preparing the children for either reunification with their birth fam- ilies or transition to a long-term placement. Given the notion of future re- unification or transition, participants described that to assume a mothering role was inappropriate. Conversely, participants specified their responsibil- ity as a long-term foster-carer to involve embracing the children into their own families. Felicia explained: ‘In short-term you’re preparing the child for their long term placement. Where long-term—you’re it. So you’re mum. . . . Your family becomes their family.’

With this, you can see the competing roles that many foster parents must manage. However, this research also helps us to see the level of commitment that foster carers bring to the task:

Foremost in participants’ stories was their commitment to the children. Most participants described a willingness to accept the good with the bad, celebrating and lamenting with and for the children. Although some parti- cipants revealed caring for the children was often arduous due to the chil- dren’s complex behavioural, developmental and psychological needs, their commitment to the children was unwavering. When reflecting on her own commitment, Gloria commented:

...it’s been bloody hard work but I guess we went into these two boys [thinking] okay, we’re going to see them through and no matter what is required, we’re going to do the best we can to make sure that happens.

The degree of emotional commitment also needs to vary depending upon the length of anticipated stay. The longer the stay, the greater the commitment to being "mother". Some of the research participants also spoke about trying to make up for deficits that the children had experienced.


The complex needs of the children and the competing need to provide a secure, safe and nurturing environment was something that showed in this research. Also evident is the ambiguous role of the foster parent who is the carer but not the legal parent.

It is clear that the participants perceived themselves as mothers to the long-term foster children in their care. However, questions remain regard- ing how these women maintain their maternal self-perception within a gov- erning system that retains legal authority over the children, thus limiting their maternal autonomy.

This research showed the deep commitment to the role and belies the critics who seek to demean the contribution that foster parents make to the care of children who come into the system. This research shows what I have come to understand is the norm. Yes, there are sad cases where foster carers have not been safe - those cases are important ones for us to also research and understand but they should not be the story of what is typical.


Reference:


Blythe, S.L., Halcomb, E.L., Wilkes, L. & Jackson, D. (2012). Perceptions of Long-Term Female Foster-Carers: I’m Not a Carer, I’m a Mother. British Journal of Social Work, online first. doi:10.1093/bjsw/bcs047

Neonatal Abstinence Syndrome

Research published today in the medical journal JAMA is frankly alarming.

The rate of newborns diagnosed with neonatal abstinence syndrome (NAS) in the U.S. nearly tripled over the last decade, according to a JAMA study.

Using national databases, researchers examined trends in maternal opiate use and NAS diagnoses from 2000 to 2009. Among the findings:

• NAS diagnoses rose from 1.20 per 1000 hospital births in 2000 to 3.39 per 1000 in 2009.
• At the same time, maternal opiate use increased almost fivefold, from 1.19 to 5.63.
• Hospital length of stay for NAS remained relatively steady, averaging 16 days.
• Total hospital charges for NAS rose nearly fourfold, from $190 million to $720 million.

The researchers estimated that in 2009, roughly one infant was born every hour with symptoms of drug withdrawal.

This research along with others that have been appearing on the dramatic rise of opiates, particularly those such as Oxycodone, Oxycontin and others should be causing society to be up in arms against big pharama. But it is also a wake up call that we must be looking at why addiction continues to be such a major force in our society. Prevention is going to come when we truly seek to consider:

* why families are so emotionally fractured;
* children are born into families that are so busy that true emotional presence is missing;
* sexual and physical abuse and maltreatment remain all to frequent occurrences; and
* we are societies where dominance, control and greed have taken such power over love, care, acceptance and nurturance.

Sure, there are genetic predispositions for addiction, but it is environment (e.g. family, community and society) where things like addiction emerge or not.

The cost to society of children born with NAS and FASD is enormous.