Meeting the Requirements of CAPTA and IDEA
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Transcript Meeting the Requirements of CAPTA and IDEA
Please use the chart paper
to share your thoughts on
the following question:
Consider your work with
families experiencing abuse
and neglect--what challenges do you
encounter?
Meeting the Requirements
of CAPTA and IDEA
Implications for Part C
Early Intervention
Marian Jarrett, Ed.D.
Karin Spencer, MA
George Washington University
Session Agenda
Requirements of CAPTA and IDEA
Challenges for Early Intervention
Abuse and Neglect of Infants and Toddlers
Red Flags
Assessment
Intervention Strategies
CHILD ABUSE AND NEGLECT:
DEVELOPMENTAL CONSEQUENCES
Difficulty forming relationships in preschool and
early adolescence
Lower levels of school achievement, especially
in adolescence
More likely to require special education—72%
by 3rd grade
More behavior problems
More likely to use drugs and alcohol
CAPTA
The Keeping Children Safe Act of 2003
amended the Child Abuse Prevention and
Treatment Act (CAPTA)
As of July 1, 2004, referral required “of a child
under the age of 3 who is involved in a
substantiated case of child abuse or neglect
to early intervention services funded under
Part C of the Individuals with Disabilities
Education Act (Sec.106(b)(A)(xxi)).
PART C of IDEA 2004
SEC. 637.State Application and Assurances
“. . . require the referral for early intervention services
under this part of a child under the age of 3 who—
(A) Is involved in a substantiated case of child abuse or
neglect; or
(B) Is identified as affected by illegal substance abuse,
or withdrawal symptoms resulting from prenatal
drug exposure;”
IMPORTANCE OF CAPTA
Children reported to CPS and/or in
foster care experience many
developmental delays – including
social-emotional delays.
Infants and toddlers referred to CPS
need access to services provided by
early intervention system
THE INTENTION OF THE LAW
Every child referred under CAPTA
shall be screened by a Part C provider
or designated primary referral source
to determine if a referral for an
evaluation for EI service is warranted.
All children are to be screened, but not
all will be referred.
(IDEA Infant and Toddler Coordinators Association (ITCA), 2004)
CHALLENGES
Predicted Increases in Part C
Before CAPTA, 7% of infants and toddlers
in Part C were also in Child Welfare
System
After CAPTA, predictions:
70% increase in referrals
20-30% increase in enrollment
What is actually happening??
THE CULTURE OF THE
CHILD WELFARE SYSTEM
Life and death responsibilities
Staff shortages/high caseloads
Inadequate supervision
Public expectation of a punitive system of
accountability
Risk of violence
Adversarial relationships with families
Voluntary or mandated services
(Cohen, 2005)
THE CULTURE OF THE EARLY
INTERVENTION SYSTEM
Each state defines eligibility criteria
Comprehensive, multidisciplinary evaluations
and intervention
Meet developmental needs of child and
needs of the family
Family centered services based on the IFSP
Services are voluntary
NEED FOR COLLABORATION
BETWEEN EI & CW
Clear definition of roles and
responsibilities
Development of trust
Explanation of EI and CW to families
Joint visits to families
Procedures to follow when families refuse
services
(Cohen, 2005)
CHALLENGES
TO EARLY INTERVENTION
Increased workload
Assessments to identify social
emotional needs
Interventions with children and
parents
Enhance ability to address parental
issues that affect infant mental health
CAPTA CHALLENGES
TO CHILD WELFARE
Work to educate families to accept referral to
EI
CW does not know the potential of EI
Limited staff available/capacity to address
developmental problems
Supervisors do not want to add another
mandate to workers’ job
Confidentiality issues
CHALLENGES OF WORKING
WITH PARENTS
Majority living in poverty
Poor housing conditions
Parental substance abuse and mental
health issues are common
Mothers in abusive relationships
Multi-stressed, chaotic and unstable
families
CHALLENGES OF WORKING
WITH PARENTS
Inadequate basic care giving skills
Lack structure, limits and routines
Many lack knowledge of typical child
development, behaviors and needs
Discipline is punitive in nature –
expression of parent’s frustration
CHALLENGES OF WORKING
WITH PARENTS
Lack formal and informal supports
Difficulty trusting others and forming
healthy relationships
History of poor relationships and
experiences with other “helping
professionals”
Generational cycle of abuse
Overwhelmed by their own needs
EVERYDAY IN AMERICA
4
children are killed by abuse
or neglect
2,383
children are confirmed
as abused or neglected.
(Children’s Defense Fund, 2007)
Everyday In America
All
White
Asian
Amer
Black
Latino
Babies die before
their first
birthday
77
36
3
22
14
Babies born into
poverty
2,411
749
57
697
874
Babies are born to
mothers who are
not HS grads
2,494 969
62
394
1,251
Babies are born to
unmarried mothers
4,017 1,537 97
1,158
1,201
(Children’s Defense Fund, 2007)
Virginia’s Children
Child Population
1,789,782
Living in Poverty
238,312
Child A&N Victims
6,959
Type of Abuse and Neglect
Neglect and Medical Neglect
Percent
64.2%
Physical Abuse
Sexual Abuse
24.6%
15.8%
Psychological and Other Maltreatment 1.6%
(CLASP, 2006)
ABUSE AND NEGLECT AND
DEVELOPMENTAL DISABILITIES
Children
who experience abuse
and neglect are at high risk for
developmental delays
psychological, behavioral and
health problems
Social emotional development
ABUSE AND NEGLECT AND
DEVELOPMENTAL DISABILITES
53% of all children 3-24 months
whose families were investigated
for maltreatment were classified
as high risk for developmental
delay or neurological impairment.
MALTREATED INFANTS AND
TODDLERS
Infants represent ~5% of the children in
the US and 10% of all child maltreatment
victims. (ACF, 2005).
Infants and toddlers most likely to
experience recurrence of maltreatment
Child victims with a disability-- over 50%
more likely to experience recurrence
maltreatment
INFANTS AND TODDLERS IN
FOSTER CARE
80% with prenatal drug exposure
40% born low birthweight/premature
Many with acute and chronic health
problems
More than 50% have developmental
delays or disabilities; few linked to EI
One-third of infants discharged will
re-enter the child welfare system
THE BRAIN AND EMOTIONAL
DEVELOPMENT
Infants need sensitive, responsive care for
parts of brain that control emotions to
develop properly
Caregivers effectively manage baby’s
emotional states
Baby develops neurological and emotional
foundations
Enables baby to gradually learn to regulate
emotions on her own
ASSOCIATED FACTORS
Factors associated with abuse and
neglect contribute to developmental
problems
Poverty
Poor nutrition
Lack of prenatal and medical care
Substance abuse
(Shonkoff & Phillips, 2000)
CONSISTENT, RESPONSIVE
CARE NEEDED
But - some parents/caregivers:
Reject bids for emotional/physical
closeness
Are punitive and abusive
Suffer from depression
Abuse drugs
Are overwhelmed by meeting own
needs and need of their children
MENTAL HEALTH IS…
The successful performance of mental
function, resulting in:
Productive activities
Fulfilling relationships
Ability to adapt to change and to cope
with adversity…
Mental health is the springboard of
thinking and communication skills,
learning, emotional growth, resilience, and
self esteem.
INFANT MENTAL HEALTH IS…
The developing capacity to experience,
regulate and express emotions
Form close and secure interpersonal
relationships
Explore the environment and learn
In the context of family, community and
cultural expectations for young children
Synonymous with healthy social emotional
development
(Hunter, 2006: Adapted from Zero to Three)
SOCIAL EMOTIONAL
RED FLAGS
Behavioral responses to stress and
trauma of abuse and neglect
• Anger and rage
• Anxiety and hyper vigilance
• Emotional shut down
• Bodily reactions
SOCIAL EMOTIONAL
RED FLAGS
Chronic sleeping, feeding problems
Excessive fussiness, crying
Unusually difficult to be consoled
Minimal interest in social interaction
Avoids eye contact and physical closeness
Does not turn to familiar adult for comfort
Unable to comfort or console self
SOCIAL-EMOTIONAL
ASSESSMENTS
Hawaii Early Learning Profile (HELP)
Ages & Stages Questionnaire: SocialEmotional (ASQ:SE)
Brief Infant-Toddler Social Emotional
Assessment (BITSEA)
Infant-Toddler Social Emotional
Assessment (ITSEA)
The Ounce Scale, Social & Emotional
Development
SOCIAL EMOTIONAL
ASSESSMENTS
Early Coping Inventory
Devereux Early Childhood Assessment
(DECA)
Vineland SEEC: Vineland SocialEmotional Early Childhood Scale
The Functional Emotional Assessment
Scale (Greenspan & DeGangi)
INTERVENTIONS
Things to remember...
Build relationships over time
Introduce self, program, purpose
Review confidentiality policy
Take cues from parents
Keep visits and be on time
Basic needs come first
INTERVENTIONS
Fostering resilience
Establish and facilitate caring
relationships
Communicate high expectations
Provide opportunities for
participation
INTERVENTIONS
Home Visit Tips
Relate to the parent first
Avoid bonding directly with the child
Ask open ended questions
Ask about pregnancy, infancy and
parenthood
Avoid making too many suggestions
Listen, listen, listen
INTERVENTIONS
Enhancing parent-child relationships
Relationships change relationships-use the
parallel process
Parent’s experiences as a child
Notice and comment on parental, child and
relationship strengths
Use natural environment
Incorporate activities that involve interaction
Dispel myths
INTERVENTIONS
Strategies
Offer
developmental guidance
Celebrate milestones
Speak for the baby
Develop strategies and supports
together
INTERVENTIONS
STRATEGIES
Bringing it back to baby
Being OK with silence
When a family “no shows”
When parents are clearly unable to
engage
PART C PROGRAMS AND
PROVIDERS CAN…
Provide high quality home visits
Emphasis on Service Coordination
Focus on social-emotional domain
Learn about local Child Welfare system
and services
Take care of ourselves as we do this
important work
TAKING CARE OF
OURSELVES
Be self aware:
How we are is as important as what we
do
Beware of burn out
Know our limits
Pay attention to our own feelings
Remember that parents are responsible
for the choices they make, not us
INSPIRATION
FROM A PARENT
Courage doesn’t always roar.
Sometimes courage is the quiet voice
at the end of the day saying,
“I will try again tomorrow.”
-Anonymous-
CONTACT INFORMATION
Marian H. Jarrett, EdD
[email protected]
Karin H. Spencer, MA
[email protected]
REFERENCES & RESOURCES
Barnett, D. (1997). The effects of early intervention on maltreating parents
and their children. In M. J. Guralnick (Ed.), The effectiveness of early
intervention (pp. 147-170). Baltimore: Paul H. Brookes.
Bono, K. E., Bolzani Dinehart, L. H., Claussen, K. G., Mundy, P. C., & Katz,
L. F. (2005). Early intervention with children prenatally exposed to
cocaine: Expansion with multiple cohorts. Journal of Early Intervention,
27(4), 268-284.
Cohen, E. P. (2005). Building bridges between child welfare and early
intervention programs. George Washington University Community
Forum, February 11, 2005, Washington, DC.
REFERENCES & RESOURCES
Department of Health and Human Services (2005). Child maltreatment
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Neglect Data Systems - national statistics on child abuse and
neglect. Washington, DC: U.S. Government Printing Office.
Dicker, S., Gordon, E., & New York State Permanent Judicial
Commission on Justice for Children (Eds.). (2004). Ensuring the
healthy development of infants in foster care: a guide for judges,
advocates and child welfare professionals. Washington, DC: Zero To
Three.
Early Head Start National Resource Center at Zero to Three. (n.d.). In
Home visitor's hand book for the Head Start home-based program
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REFERENCES & RESOURCES
Early Identification Project & University of Colorado Health
Sciences Center (Eds.). (2003). Interagency collaboration:
A guidebook for child welfare and Part C agencies (Vol.).
Denver: JFK Partners.
Egeland, B., & Erickson, M. F. (2004). Lessons from STEEP:
Linking theory, research and practice for the well-being of
infants and parents. In A.J. Sameroff, S.C. McDonough &
K.L. Rosenblum (Eds.), Treating parent-infant relationship
problems: strategies for intervention (pp. 213-242). New
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Erickson, M. F., & Kurz-Riemer, K. (1999). Infants, toddlers
and families: A framework for support and intervention.
New York: The Guilford Press.
REFERENCES & RESOURCES
Hawley, T., & Gunner, M. (2000). Starting smart: How early experiences
affect brain development (2nd ed.). Washington, DC: Ounce of
Prevention Fund and Zero to Three. Lippitt, J. A. (2005). Implementing
referrals of abused or neglected children to EI: The MECLI. George
Washington University Community Forum, February 11, 2005,
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Jaudes, P. K., & Shapiro, L. D. (1999). Child abuse and developmental
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children in foster care: A guide for professionals (pp. 213-234).
Baltimore: Paul H. Brookes.
Ounce of Prevention & ZERO TO THREE. (1998). Ready to succeed: The
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REFERENCES & RESOURCES
Pawl, J. H. (1995). The therapeutic relationship as human
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Rosenberg, S., & Robinson, C. (2003). Is Part C ready for
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Sameroff, A. J., McDonough, S. C., & Rosenblum, K. L. (Eds.). (2004).
Treating parent-infant relationship problems: Strategies for
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Shonkoff, J. P., & Phillips, D. A. (Eds.). (2000). From neurons to
neighborhoods: The science of early childhood development.
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