CHILD WELFARE EVALUATIONS

Susan Cohen Esquilin, Ph.D.

TOPICS

• Purposes

• Process

• Testing

• Conclusions and Recommendations

GENERAL PURPOSE

• Child welfare evaluations are triggered by issues related to child protection and permanency

• Was child a victim of maltreatment?

• What are the service needs of the parent to reduce maltreatment risk?

• What should be the permanency plan?

• Has parent changed sufficiently to reduce maltreatment risk?

• What will be the impact of the various possible plans on the child(ren)?

• Often they include parents; in this presentation, focus is on the child evaluation, as these are most relevant to educational issues

TYPES OF CHILD EVALUATIONS

• Investigatory

• Most related to sexual abuse;

• “Front End” Evaluations (Service Planning)

• CHEC evaluations

• Behavioral issues in placement raise risk of placement instability

• Reactions to visits raise concerns about impact of visits

• “Back End” Evaluations (Permanency)

• Needs for Permanency

• Attachment/Bonding

• Relationships with Siblings

• Children’s Wishes

PROCESS: ENGAGEMENT OF EVALUATOR• Investigatory: Regional Diagnostic Center, or private; DCPP requests

• Service planning:

• CHEC: at identified centers for all children

• More specialized; DCPP requested

• Permanency evaluations: all parties may request

• Requesting party contacts evaluator, sends background information and records, identifies questions/issues, establishes time constraints

• Evaluator may request more records but access may not be given

• Evaluators may have contracts but are not employees of any of the parties

PROCESS: PROCEDURES USED

• Child is seen in unfamiliar clinical setting; usually brought by worker or aide.

• Rarely, evaluators see child in home setting. Rarer for child to be seen in school setting.

• Children are typically interviewed. Young children are often observed at play.

• Children may or may not be formally tested.

• Children may be seen in interaction with significant others. In permanency evaluations, children are typically seen with birth parents, and with others who are identified as potential permanency resources (“bonding evaluations”). The interactions are observed. Evaluators may or may not play an active role in these encounters; no standard format

ISSUES EXAMINED

• Emotional/Behavioral Difficulties and Strengths

• Major focus on trauma and its impact

• Source of problematic sexualized and aggressive behavior

• Relationship/Attachment Issues

• Intellectual and Academic Functioning Rarely Addressed

• May be assessed informally and in gross ways

• Behavioral and relationship issues can be very relevant to school setting and academic functioning

TESTING: GENERAL ISSUES

• No standard battery; instruments used are dictated by nature of problem to be addressed

• Many specialized tests have smaller and more narrow normative samples

• It is important that child’s demographics are reflected in the standardization sample

TESTING: EXAMPLES OF TESTS

• General behavioral checklists completed by caregiver, teacher, child (BASC-2, Achenbach, SEARS)

• Objective personality instruments (Millon PACI, MACI, MMPI-A )

• Instruments targeting specific problems (CSBI, TSCC, CDI). New instruments are constantly being developed.

• Projective instruments (drawings, sentence completion, story telling techniques, Rorschach)

INFORMATION FROM TESTING• Validity scales: consistency, overreporting, underreporting

• information about whether child is within or outside the normal range on various domains, as compared with other children of the same gender and age, assuming demographics of sample are adequate

• Often, scores are reported as being “clinically significant” or “at risk” or “high risk”. Tests differ, but such statements often reflect scores at the 94th percentile or higher (1.5 standard deviations from the mean).

• Some projective instruments have normative data available. Much data from projective testing is reported more qualitatively and can reflect interpretations with which other psychologists might disagree.

CONCLUSIONS AND RECOMMENDATIONS: INVESTIGATORY

• Conclusion addresses likelihood that abuse has occurred

• Recommendations are typically related to child protective needs: physical and emotional safety

CONCLUSIONS AND RECOMMENDATIONS: SERVICE PLANNING

• Nature of child’s difficulties

• Identification of problems (sometimes with diagnosis)

• Discussion of likely sources of problem (e.g., reactions to trauma, reactions to uncertainty regarding permanency, likelihood of genetic-familial predispositions)

• Intervention needs

• Appropriateness of evaluation for medication

• Child’s individual therapeutic needs: types of interventions, goals of interventions, treatment approaches

• Services recommended for caregivers: psychoeducation, management (major issue)

• Visitation: increased or decreased frequency; supervision and type; setting

CONCLUSIONS AND RECOMMENDATIONS: PERMANENCY

• Child’s current emotional status and needs

• Needs in permanent home

• On-going treatment needs

• Nature of child’s relationship with and impact of loss of:

• Biological parent

• Other potential permanency resources

• Siblings

• Child’s wishes and assessment of issues of loyalty, influence

APPLICABILITY TO EDUCATIONAL SUCCESS

• Any significant emotional problem has relevance (attention/concentration, affect management, poor self-concept, anxiety, behavioral control). Skilled management of these problems will help a child succeed.

• Significant relationship/attachment issues

• Histories of trauma combined with out-of-home placement contribute to the presence of a high level of reactivity in foster children

• People (adults and peers) are often seen as sources of danger

• Many “behavior problems” reflect responses to danger signals: fight, flight, freeze

• Attuned responding will help children feel safe and succeed.

AREAS TO CONSIDER FOR COORDINATION• Confidentiality may preclude release of full reports with family

information

• If child’s behavior is an issue in school, it would be important for school personnel to have some guidance from the people who know the complete history as to how to manage the problems

• If the school is providing some of its own counselling services, it would be very important that there be communication and consistency of approach with therapists outside the school

• It is important that birth parents be involved in discussions with school personnel, because, in the event of reunification, the child will do best if the birth parent is on board

LIMITATIONS OF CHILD WELFARE EVALUATIONS

• The audience for child welfare evaluations is DCPP, attorneys, and judges—who are making decisions abut removal, services outside of school system, permanency

• Psychologists conducting the evaluations are not thinking about school personnel as they are writing the evaluations

• Much of what is said about the kind of behavioral management the child requires is directly applicable to school personnel

• Evaluating psychologists should be able to make recommendations regarding management in school if asked to do so