Transcript Core Concepts of Development

Impact of Abuse and Neglect on
Early Development
March 30, 2006
The Honorable Lester Langer
Victoria Youcha, Ed.D.
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
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
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
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
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
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
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
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
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
What We Know
•High risk for poor
developmental
outcomes
•Developing brain can
compensate
•Early intervention
increases odds for
favorable outcomes
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
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
BOTH NATURE AND NURTURE
National Center for Infants, Toddlers and
Families
NATURE
Biology wires the
brain for
learning.
Nurture
Nurturing
relationships are
what the brain
thrives on to
develop.
EXPERIENCES
Early experiences, both
positive and negative, have a
decisive impact on how the
brain is wired.
Brain Growth
Image: www.brainconnection.com
© 1999 Scientific Learning Corporation
Plasticity
The brain's ability to change as a
result of experience.
Pruning
Newborn
Early
Childhood
Later
Childhood
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
Video
• Still face
Signs in the
baby that
emotional
needs are not
•Sad affect
met
•Lack of eye contact
•Weight loss
•Lack of responsiveness
•Sensory processing problems
•Rejects being held or touched
Signs of emotional problems
In toddlers/ preschoolers
• Very aggressive behavior
• Attentional problems and deficits
• Lack of attachment
• Sleep problems or disorders
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.
Violence Begets Violence
Childhood abuse increases the odds
of future delinquency and adult
criminality by 40%
The Cycle of Violence (Cathy Spatz Widom)
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%
At what age do you think a
child can experience real
depression?
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 parent’s
mood?
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
Children’s capacity for learning is pretty
much set from birth and cannot be
greatly increased or decreased by how
their parents deal with them.
Studies have found an
association between prenatal
and perinatal complications,
early developmental risk and
later delinquent or criminal
behavior.
At what age do most children develop
their sense of self-esteem?
To develop a
child’s mind,
we must first
nurture a
child’s heart.
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
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
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
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
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
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, Children’s Bureau, April 2005.
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
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
Goals: Reduce recurrence of
maltreatment and improve outcomes
• Increase referrals to early intervention
services (Part C)
• Improve developmental outcomes
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–
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Comprehensive health care
Frequent visitation
Stable placements
Monthly reviews
• Develop new materials for legal and judicial
personnel
Community Partners in Texas
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CASA
Health
Mental Health
Substance abuse
County attorney
District Clerk
Child Protective
Services
• Private attorneys
•
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•
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Early intervention
Foster parents
Faith community
Community foundation
Early childhood
community
• Parenting education
• Private foster care
agency
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
Recommendation #1
Use Evidence Based Models to Prevent
Child Abuse and Neglect
Well-designed services with explicitly defined goals
• Change parenting practices and influence parentchild interactions.
• Ultimately result in less maltreatment.
Recommendation #2
Prevent Multiple Placements for
Infants and Toddlers in Foster Care
• Support & training for foster parents and newly
reunified biological parents
• Placement in a foster-to-adopt home in case
reunification efforts not successful
Recommendation #3
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 #4
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 #5
Assure Comprehensive Health Care
• Comprehensive developmentally appropriate
health care.
• Consistent provider.
• Immunizations.
• Regular developmental screenings.
Recommendation #6
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 #7
Assure Early Childhood Mental Health
Assessment and Services
• Untreated mental health disorders
can have disastrous effects on
children’s functioning now and in
the future.
• Research-based interventions can
help to prevent and treat these
serious disorders.
Recommendation #8
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, researchbased, early childhood programs such as
EHS.
Recommendation #9
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.
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
National Center for Infants, Toddlers and
Families
The end!
National Center for Infants, Toddlers and
Families
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
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Internet Address: http://www.zerotothree.org