by Kathryn A. Piper, Esq. THE CHILDREN’S CORNER
Translating the Science of Brain Development into Child Welfare Policy and Practice
In recent years there has been a flood of scientific research in brain development and the impact of traumatic stress upon the developing brains of infants and tod- dlers. The scientific findings have shown that trauma that very young children ex- perience in high-risk environments—due to such things as maternal depression, pa- rental substance abuse, domestic violence, and extreme poverty—leads to levels of stress that can be literally toxic to the de- veloping brain. The results are long-term damage to the brain that can lead to per- sistent emotional and behavioral prob- lems, impulsivity, difficulty with concentra- tion, and lower cognitive functioning. With- out the buffer of strong, nurturing relation- ships, trauma can have a lifelong impact on the way in which the brain is hardwired, thereby affecting the foundation for all fur- ther learning.
Anyone who has worked in the field of child welfare for any length of time will tell you that one of the most frustrating as- pects of this work is to see the develop- mental damage that has been done to these children long before they come to the attention of the child welfare system and the courts. According to Darcy Lowell, M.D., 60% of children in the child welfare system have documented developmental delays.1
As a whole, our system does a reason- ably good job keeping children safe and has done an increasingly better job at pro- viding children in foster care with timely, permanent homes. But the goal of ensur- ing well-being and optimal developmental outcomes for children in at-risk families has proven to be more elusive. Fortunately, there is hope that this will change. In October 2011, interdisciplin- ary teams from all five New England states gathered in Nashua, New Hampshire, at the New England Early Development, Sci- ence and Child Welfare Summit to begin to grapple with the challenge of translating science into practice.2 The purpose of the summit was to provide state leaders and program directors with knowledge about how early childhood trauma and neglect af- fect brain development in infants and pre- schoolers, including the long-term physical and mental health consequences. The sum- mit also provided useful information about innovative, evidence-based intervention,
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prevention and systemic responses to this problem. Each state team collaborated on strategies to integrate science into policy and best practices across systems and to come up with a shared plan to strengthen families and young children.
What do we know about early brain de- velopment? We know that by three years of age 80% of brain development is com- plete.3 The neural networks that are formed during infancy are created based on repetitive experiences with the envi- ronment, most particularly
through par-
ent/child interactions. These early synaptic connections serve as the scaffolding for all further development. Studies have shown that 40% of depressed mothers have ba- bies with decreased brain activity.4 When a baby experiences toxic stress, the physiological response is a release of cortisol, a potent chemical that can cause damage to the developing brain. In fact, cortisol has a more devastating impact on the brain than any other chemical.5 Infants and toddlers are the most vul- nerable to maltreatment and its after- math and have the highest rates of victim- ization. They constitute the largest single age group of children entering foster care.6 Over 30% of the children who are abused and neglected each year are under the age of three.7 In Vermont, children through age three accounted for 43% of all new abuse/ neglect petitions filed between September 2010 and October 2011.8 Based on what we now know, it is clear
that prevention is crucial. It is very hard to “get these children back” once the dam- age is done and very costly to “close the achievement gap” if the foundation for early learning has not been laid. We need to identify high risk families as early as pos- sible. By doing so, we are given a tremen- dous opportunity to change the trajectory of children’s lives.
In listening to the many speakers at the New England Summit, it became clear that Vermont is well ahead of the game on sev- eral counts. Vermont already has an effec- tive interdisciplinary team of top policy makers in place: the Justice for Children Task Force. The Task Force was responsible for reforming legislation governing juvenile proceedings, which became law in 2009. Several of the best practices that were rec- ommended at the New England Summit
THE VERMONT BAR JOURNAL • WINTER 2012
have already been written into Vermont law. Vermont’s Department for Children and Families (DCF) has also set the stage for effective prevention efforts through their family engagement and differential response initiatives. Both of these policies have shifted resources into prevention and early intervention and have successfully tapped into existing family and communi- ty resources. We need to do more. Conference speak- ers emphasized the importance of going beyond child safety, beyond the “present- ing problem” of the reports to DCF and doing a comprehensive assessment of all infants and toddlers that come to the at- tention of the child welfare system. Some of the other suggestions included:
• a pre-removal meeting involving the parent, relatives, case worker, poten- tial service providers, and others to es- tablish a parent-child contact plan and a service plan even before the child is removed from the home;
• establishing a mentoring relationship between foster and birthparents;
• engaging parents and their infants and toddlers in dyadic therapy;
• holding monthly interdisciplinary team meetings for all babies in the child wel- fare system;
• ensuring daily parent/child contact for all infants and toddlers in foster care; and
• training childcare workers, DCF inves- tigators, lawyers, judges, preschool teachers and others working with in- fants and toddlers and their families on the impact of trauma on brain de- velopment.
One of the most hopeful presentations involved a report on the outcomes of a model program called the Safe Babies Court Teams Project, which is a program to help maltreated infants and toddlers reach safe and permanent homes quickly. The program’s core components include cross-disciplinary collaboration, coordina- tion with community partners and child development experts, frequent child par- ent contact, developmental screenings, and monthly case reviews. The outcomes reached so far have been impressive: 97% of identified services needs of babies were
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