Welcome to my blog, which speaks to parents, professionals who work with children, and policy makers. Through stories from my behavioral pediatrics practice (with details changed to protect privacy) I will show how contemporary developmental science can be applied to support parents in their efforts to facilitate their children’s healthy emotional development. I will address factors that converge to obstruct such support. These include limited access to quality mental health care, influences of a powerful health insurance industry and intensive marketing efforts by the pharmaceutical industry.

Saturday, February 6, 2016

Child Death and Child Protection: Rethinking the 'Intact Families vs. Safe Children' Split

A spate of tragic cases involving the Department of Children and Families (DCF) in Massachusetts recently led Governor Baker to call for “tilting the balance” from keeping families intact to keeping children safe. But as Elizabeth Young-Breuhl argues in her brilliant book Childism:Confronting Prejudice Against Children, published shortly after her untimely death in 2011, a child protection model supporting this dichotomy was misguided from the start.

Young-Bruehl writes: “Since CPS (child protective services) was created as a rescue service—a child saving service—not a family service supporting child development generally and helping parents, greater efficiency in prosecuting parents was achieved but not greater understanding of them, educating of them, or working with them therapeutically to prevent child abuse.”

Young-Bruehl describes the “discovery” of child abuse by pediatrician Henry Kempe in the 1960s. Kempe coined the term “battered child syndrome” based on his observation of children coming to the emergency room with unexplained injuries. Young-Bruehl observes that it was, from the start, not a disease of the abuser but of the child. She writes, “the name thus from the start took attention away from abusers and their motivations; and it implied that children could be helped without their abusers being helped.”
The field of child protection grew out of this “discovery.” Young-Breuhl describes in her book “Kempe had launched one of the swiftest transitions from identification of a social problem to legislation in America’s history . . .. The states all increased their vigilance by establishing or strengthening Child Protective Services (CPS) departments.”
But from the start, the system was not founded in an understanding of child development. 
A number of years ago I had the opportunity to speak to a group of lawyers at a symposium entitled “Child Protection in the 21st century.” The West Virginia Law School student who invited me wisely observed that those in the legal profession are often in a position to decide what is "in the best interest of the child" with little substantive understanding of what exactly is in the best interest of the child.  He invited me to share my knowledge as an expert in early childhood mental health.

 One of my co-presenters was a delightful judge from central West Virginia who has been doing child protection work for over 20 years. He openly admitted to his lack of knowledge on the subject of contemporary child development research.

Young-Breuhl, in her use of the word “motivations” ties her ideas in directly with explosion of research in the field of early childhood mental health offering evidence that children develop in a healthy way when people who care for them listen with curiosity for the motivations and intentions of behavior. When we offer non-judgmental listening to parents, when we are interested not in what they did wrong but in understanding their motivations, we support their efforts to listen to children, in turn supporting healthy development of families.

One solution lies in an innovative program developed by the non-profit Zero to Three: Safe Babies Court Teams Project. Judges, child welfare staff, attorneys, service providers, and other community leaders work together, enhancing their knowledge of child development while aiming to transform the experiences of children in the child welfare system.

Identifying the central role of listening to parents, they articulate an aim to “recognize the overwhelming odds confronting parents, [and] honor the parents’ personal journey.”

Every year I have the privilege of teaching the first class of Springfield College of Social Work Child and Adolescent Program. The majority of students are social workers on the front lines of the child protection system. I am struck by both the curiosity and openness of the students, and the number of extraordinarily difficult circumstances they find themselves in. They feel empowered and encouraged by the idea that listening, being fully present with parents who themselves have experienced significant trauma, can be a critical initial step in setting families on a different path.

But it is impossible to expect these overworked and underpaid DCF workers to listen in this way if they themselves are not heard and supported. The image comes to mind of a set of Russian dolls. When the legal system listens to the front-line professionals, they in turn listen to the parents, who in turn listen to the children.


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