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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.

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please use the chart paper to share your thoughts on the following question
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?

marian jarrett ed d karin spencer ma george washington university

Meeting the Requirements

of CAPTA and IDEAImplications for Part C

Early Intervention

Marian Jarrett, Ed.D.

Karin Spencer, MA

George Washington University

session agenda
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
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
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
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
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
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
CHALLENGESPredicted 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
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
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
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
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
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
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 parents16
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 parents17
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
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 america19
Everyday In America

(Children’s Defense Fund, 2007)

virginia s children
Virginia’s Children

Child Population 1,789,782

Living in Poverty 238,312

Child A&N Victims 6,959

(CLASP, 2006)

abuse and neglect and developmental disabilities
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
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
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
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
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
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
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
MENTAL HEALTHIS…
  • 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
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
SOCIAL EMOTIONALRED 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 flags31
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
SOCIAL-EMOTIONAL ASSESSMENTS
  • Hawaii Early Learning Profile (HELP)
  • Ages & Stages Questionnaire: Social-Emotional (ASQ:SE)
  • Brief Infant-Toddler Social Emotional Assessment (BITSEA)
  • Infant-Toddler Social Emotional Assessment (ITSEA)
  • The Ounce Scale, Social & Emotional Development
social emotional assessments33
SOCIAL EMOTIONAL ASSESSMENTS
  • Early Coping Inventory
  • Devereux Early Childhood Assessment (DECA)
  • Vineland SEEC: Vineland Social- Emotional Early Childhood Scale
  • The Functional Emotional Assessment Scale (Greenspan & DeGangi)
interventions things to remember
INTERVENTIONSThings 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
INTERVENTIONSFostering resilience
  • Establish and facilitate caring relationships
  • Communicate high expectations
  • Provide opportunities for participation
interventions home visit tips
INTERVENTIONSHome 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
INTERVENTIONSEnhancing 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
INTERVENTIONSStrategies
  • Offer developmental guidance
  • Celebrate milestones
  • Speak for the baby
  • Develop strategies and supports together
interventions strategies39
INTERVENTIONSSTRATEGIES
  • 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
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
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
INSPIRATIONFROM 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
CONTACT INFORMATION
  • Marian H. Jarrett, EdD

[email protected]

  • Karin H. Spencer, MA

[email protected]

references resources
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 resources45
REFERENCES & RESOURCES

Department of Health and Human Services (2005). Child maltreatment 2003: Reports from the states to the National Child Abuse and 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 option. Retrieved from http://www.headstartinfo.org/pdf/EHS-Home-VisitorHdbk.pdf

references resources46
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 York: The Guilford Press.

Erickson, M. F., & Kurz-Riemer, K. (1999). Infants, toddlers and families: A framework for support and intervention. New York: The Guilford Press.

references resources47
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, Washington, DC.

Jaudes, P. K., & Shapiro, L. D. (1999). Child abuse and developmental disabilities. In J. A. Silver, B. J. Amster & T. Haecker (Eds.), Young 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 lasting effects of early relationships. Authors.

references resources48
REFERENCES & RESOURCES

Pawl, J. H. (1995). The therapeutic relationship as human connectedness: Being held in another\'s mind. Zero To Three, 15(4), 1-5.

Rosenberg, S., & Robinson, C. (2003). Is Part C ready for substantiated abuse and neglect? Zero to Three, 24(2), 45-47.

Sameroff, A. J., McDonough, S. C., & Rosenblum, K. L. (Eds.). (2004). Treating parent-infant relationship problems: Strategies for intervention. New York: The Guilford Press.

Shonkoff, J. P., & Phillips, D. A. (Eds.). (2000). From neurons to neighborhoods: The science of early childhood development. Washington, DC: National Academy Press.

ZERO TO THREE Infant Mental Health Resource Center. (n.d.). About mental health. Retrieved October 4, 2005, from http://www.zerotothree.org/Search/index2.cfm

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