Early Intervention in Child Welfare Can Make a Difference

Early Intervention in Child Welfare Can Make a Difference

December 23, 2013 | Erin J. Maher, Director of Program Evaluation, Casey Family Programs

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When Marjorie was removed from her home, she was less than 18 months old and living with her mother and maternal grandfather. The grandfather had a history of sexually abusing Marjorie’s mother when she was a child. Child Protective Services suspected ongoing physical abuse to be present in the household. A comprehensive local screening program for all children in foster care showed clinical concerns regarding Marjorie’s social and emotional development, behavior, and gross motor and speech-language delays.

When Marjorie was removed from her home, she was less than 18 months old and living with her mother and maternal grandfather. The grandfather had a history of sexually abusing Marjorie’s mother when she was a child. Child Protective Services suspected ongoing physical abuse to be present in the household. A comprehensive local screening program for all children in foster care showed clinical concerns regarding Marjorie’s social and emotional development, behavior, and gross motor and speech-language delays. Marjorie was referred to an assessment and treatment program for young children and their families that included the use of several evidence-based practices, such as Parent Child Interaction Therapy and Child Parent Psychotherapy, a care coordinator, and a multi-disciplinary clinical team. During her time in the treatment program, Marjorie was showing signs of anxiety and trauma including sleep disturbance; refusal to engage socially with other children or caregivers; picking at her skin, hair, and belly button to the point of scabbing and irritation; refusal to bathe; standing alone in a corner for up to 30 minutes; and screaming when caregivers attempted to soothe her.

In the treatment program, Marjorie received speech and language therapy, as well as Child Parent Psychotherapy with her foster mother. Marjorie’s biological mom, Cindy, was progressing in her service plan, and the bond with her daughter was positive and strong. Because of this, Cindy was engaged in Marjorie’s treatment as well and attended physical therapy and learned to use speech and language strategies with her. Mother and child also participated in weekly Child Parent Psychotherapy. Cindy received therapy to address her own childhood trauma. After a year of services for Cindy and her daughter, Marjorie’s trauma symptoms subsided and reunification seems likely.

-Case study from the Developmental Screening and Enhancement Program and KidSTART program in San Diego, California (http://www.rchsd.org/programsservices/a-z/c-d/developmentalservices/)

Case studies such as this one highlight the complexity of children’s needs that can result from experiencing or being exposed to trauma in the home, sudden separation from a primary caregiver, and the intergenerational cycle of maltreatment. Marjorie’s story also emphasizes the need to focus holistically on the child and the child’s caregivers, including the foster and biological families. The number and complexity of the needs of the family require careful screening, assessments, and high-quality services. However, due to a lack of resources and understanding of the developmental needs of children who have experienced maltreatment, such a service response is not commonplace.

To explain the urgency of working toward such a comprehensive service response, Casey Family Programs recently released Making the Case for Early Intervention in Child Welfare: A Research and Practice Brief. The brief highlights why young children and their families deserve special attention if Casey Family Programs is to reach its goal of safely reducing the number of children in foster care, improving child and family well-being, and preventing long-term involvement in child welfare. It summarizes the state of programming and evaluation for child welfare interventions that specifically target families with young children and outlines policy, practice, and investment recommendations for the field that specifically address some of the issues explored in the case study above.

Erin J. Maher, PhD, is the director of program evaluation for Casey Family Programs in Seattle, Washington. She co-authored the research brief on the importance of early intervention for very young children.