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Impact of Abuse and Neglect on Early Development March 30, 2006 The Honorable Lester Langer Victoria Youcha, Ed.D. Slide 2 Portrait of Young Children in Foster Care in U.S. Largest cohort of children in care account for 1 in 3 admissions More likely to be abused and neglected Remain in placement longer 33% return to placement 79% of child fatalities occur under age 4 Lower rate of reunification Developmental delay is 4 to 5 times greater than children in general population Almost 80% have prenatal exposure to maternal drugs More than half suffer from serious physical health problems Slide 3 Trauma for infants and toddlers in foster care Separation from parents, usually sudden and traumatic Difficult experiences precipitating placement Frequently leads to temporary or permanent impairment in all areas of development Slide 4 Physical Development Involvement with CWS correlated with negative impact on physical development Shorter Smaller head circumference 59% either over/underweight 3X normal population *National Survey of Child and Adolescent Well-Being (NSCAW), CPS Sample Component, Wave 1 Data Analysis Report, April 2005 Slide 5 High Risk for Developmental Delay High Risk of Developmental Delay More than half of the infants and toddlers involved with CWS were at high risk for developmental delay or neurological impairment National Survey of Child and Adolescent Well-Being (NSCAW), CPS Sample Component, Wave 1 Data Analysis Report, April 2005 Slide 6 Black infants under age 2 involved with CWS at particularly high risk for developmental delay National Survey of Child and Adolescent Well-Being (NSCAW), CPS Sample Component, Wave 1 Data Analysis Report, April 2005 Slide 7 Cognitive Delays Children age 3 and younger were at very high risk of having below average cognitive development National Survey of Child and Adolescent Well-Being (NSCAW), CPS Sample Component, Wave 1 Data Analysis Report, April 2005 Slide 8 Language Delays 14% of children age 5 and younger score lower than 2 SD below mean Older preschoolers have lower language scores than infants Overall children involved with CWS score somewhat below average National Survey of Child and Adolescent Well-Being (NSCAW), CPS Sample Component, Wave 1 Data Analysis Report, April 2005 Slide 9 Temperament/Emotional Regulation For children up to age 3 Higher rates of insecure attachment Lower rates of compliance National Survey of Child and Adolescent Well-Being (NSCAW), CPS Sample Component, Wave 1 Data Analysis Report, April 2005 Slide 10 Behavior Problems Two and three year olds were five times more likely to have behavior problems than the norm National Survey of Child and Adolescent Well-Being (NSCAW), CPS Sample Component, Wave 1 Data Analysis Report, April 2005 Slide 11 What We Know High risk for poor developmental outcomes Developing brain can compensate Early intervention increases odds for favorable outcomes Slide 12 From Neurons to Neighborhoods: The Science of Early Childhood Development Committee on Integrating the Science of Early Childhood Development Board on Children, Youth, and Families Institute of Medicine National Research Council Slide 13 Core Concepts of Development Early environments matter Human relationships are the building blocks of development The course of development can be altered in early childhood by effective interventions that change the balance between risk and protection From Neurons to Neighborhoods,2000 Slide 14 NATURE Biology wires the brain for learning. Nurture Nurturing relationships are what the brain thrives on to develop. National Center for Infants, Toddlers and Families BOTH NATURE AND NURTURE Slide 15 Early experiences, both positive and negative, have a decisive impact on how the brain is wired. EXPERIENCES Slide 16 Brain Growth Image: www.brainconnection.com. 1999 Scientific Learning Corporation Slide 17 Plasticity The brain's ability to change as a result of experience. Slide 18 Pruning Newborn Early Childhood Later Childhood Slide 19 It is rarely the case that a maltreated infant has no symptomatology. Larrieu, 2002, Institute of Infant and Early Childhood Development, Tulane University Medical Center Slide 20 Video Still face Slide 21 Sad affect Lack of eye contact Weight loss Lack of responsiveness Sensory processing problems Rejects being held or touched Signs in the baby that emotional needs are not met Slide 22 Very aggressive behavior Attentional problems and deficits Lack of attachment Sleep problems or disorders Signs of emotional problems In toddlers/ preschoolers Slide 23 Exposure to Violence... increases cortisol levels in the brain; increases activity in the brain involved in vigilance and arousal (the flight or fight responses); the brain interprets others actions as threatening and in need of an aggressive response. Slide 24 Violence Begets Violence Childhood abuse increases the odds of future delinquency and adult criminality by 40% The Cycle of Violence (Cathy Spatz Widom) Slide 25 The Link Between Dependency & Delinquency Being abused or neglected as a child increases the likelihood of arrest as a juvenile by 59% arrest as an adult by 28% arrest for a violent crime by 30% Slide 26 Slide 27 At what age do you think a child can experience real depression? Slide 28 At what age do you think a baby can begin to sense whether his parent is depressed or angry and can be affected by his parents mood? Slide 29 A 6 month old or younger child who witnesses violence, such as seeing her father often hit her mother, can suffer long term effects from the experience, because children that young have a long term memory Slide 30 Childrens capacity for learning is pretty much set from birth and cannot be greatly increased or decreased by how their parents deal with them. Slide 31 Studies have found an association between prenatal and perinatal complications, early developmental risk and later delinquent or criminal behavior. Slide 32 At what age do most children develop their sense of self-esteem? Slide 33 To develop a childs mind, we must first nurture a childs heart. Slide 34 Access to Services Fewer than half the toddlers and preschoolers who needed services were receiving them National Survey of Child and Adolescent Well-Being (NSCAW), CPS Sample Component, Wave 1 Data Analysis Report, April 2005 Slide 35 Likelihood of Receiving Services Most Likely: Children in foster care and those with active protective services cases Least Likely: Children where there was no active CWS involvement National Survey of Child and Adolescent Well-Being (NSCAW), CPS Sample Component, Wave 1 Data Analysis Report, April 2005 Slide 36 Children remaining in the home were far less likely to receive services than those in foster care. National Survey of Child and Adolescent Well-Being (NSCAW), CPS Sample Component, Wave 1 Data Analysis Report, April 2005 Slide 37 Age Disparities Infants and toddlers were much less likely to receive services than preschoolers. Only 1 of every 10 babies needing services was receiving them compared to one of every three preschoolers. National Survey of Child and Adolescent Well-Being (NSCAW), CPS Sample Component, Wave 1 Data Analysis Report, April 2005 Slide 38 Racial Disparities Black children were more likely than white children to be placed in foster care. Black children were only about half as likely to receive services as white children. National Survey of Child and Adolescent Well-Being (NSCAW), CPS Sample Component, Wave 1 Data Analysis Report, April 2005 Slide 39 Factors Predicting Times Permanency Caseworker consistency a single change of caseworker reduced likelihood of permanency by 52% Fewer placements each additional placement reduced odds of permanency within 12 months by 32% Concurrent Planning: What the Evidence Shows. Research to Practice in Child Welfare. US Department of Health and Human Services, Administration for Children and Families, Administration on Children, Youth and Families, Childrens Bureau, April 2005. Slide 40 Permanency Factors Continued Poverty extremely poor children were 90% less likely to achieve permanence in 1 year Substance abuse presence increased likelihood of permanency by 23% Weekly visitation each additional day of visitation per week tripled the odds of permanent placement within 1 year Slide 41 COURT TEAMS FOR MALTREATED INFANTS AND TODDLERS Based on Miami-Dade Model begun in 1997 Federally-funded pilot program in Polk County, IA Fort Bend County, TX Forrest County, MS Judicial leadership plus community partners =enhanced and more coordinated services Mental health intervention for parent/baby together Slide 42 Goals: Reduce recurrence of maltreatment and improve outcomes Increase referrals to early intervention services (Part C) Improve developmental outcomes Comprehensive health care Frequent visitation Stable placements Monthly reviews Develop new materials for legal and judicial personnel Slide 43 Community Partners in Texas CASA Health Mental Health Substance abuse County attorney District Clerk Child Protective Services Private attorneys Early intervention Foster parents Faith community Community foundation Early childhood community Parenting education Private foster care agency Slide 44 Court Team Model Key Components Judicial leadership Partnership with child development/mental health Community team Training/technical assistance Services for children - addendum to court order Monthly case reviews Mental health intervention Slide 45 Use Evidence Based Models to Prevent Child Abuse and Neglect Well-designed services with explicitly defined goals Change parenting practices and influence parent- child interactions. Ultimately result in less maltreatment. Recommendation #1 Slide 46 Support & training for foster parents and newly reunified biological parents Placement in a foster-to-adopt home in case reunification efforts not successful Recommendation #2 Prevent Multiple Placements for Infants and Toddlers in Foster Care Slide 47 Implement Developmentally Appropriate Visitation Practices Predictor of reunification is frequency of visits. Visits should occur: frequently. for a long enough period of time. in a comfortable and safe setting. Recommendation #3 Slide 48 Ensure Ongoing Post Permanency Services and Supports Challenging behaviors and emotional issues create stress for adoptive and biological families. Increased risk of adoption and reunification failure. Services and supports for families can help stabilize and preserve placements Recommendation #4 Slide 49 Assure Comprehensive Health Care Comprehensive developmentally appropriate health care. Consistent provider. Immunizations. Regular developmental screenings. Recommendation #5 Slide 50 Ensure Access to Part C Services Efforts underway at federal and state level to build stronger connections between the child welfare system and the Part C system: CAPTA reauthorization IDEA reauthorization Challenge to help states build the capacity of their Part C systems. Recommendation #6 Slide 51 Assure Early Childhood Mental Health Assessment and Services Untreated mental health disorders can have disastrous effects on childrens functioning now and in the future. Research-based interventions can help to prevent and treat these serious disorders. Recommendation #7 Slide 52 Provide Quality Early Learning Opportunities All babies and toddlers need positive early learning experiences. Maltreated infants and toddlers need additional supports that can be addressed by comprehensive, research- based, early childhood programs such as EHS. Recommendation #8 Slide 53 Use Court Oversight To Ensure Safety and Permanence Judges responsible for well-being of children in their courts. Judges can be powerful agents of change. Court/ Community Teams can be effective strategy. Recommendation #9 Slide 54 Questions Every Judge Should Ask Has the child received: a comprehensive health assessment referral to Part C for a developmental evaluation mental health screening and services referral to high-quality early childhood program Slide 55 The end! National Center for Infants, Toddlers and Families Slide 56 ZERO TO THREE: National Center for Infants, Toddlers and Families 2000 M Street, N.W., Suite 200 Washington, D.C. 20036 Phone: 202-638-1144 Fax: 202-638-0851 For publications only: 800-899-4301 E-Mail Address: 0to3@zerotothree.org Internet Address: http://www.zerotothree.org National Center for Infants, Toddlers and Families