306: Enhancing Assessments: Getting to Underlying Issues

1. 306: Enhancing Assessments: Getting to Underlying Issues Shauna Reinhart, MPA; PA Child Welfare Training Program & Jeannette Rice; Children’s Advocacy Center of Lawrence County

2. Agenda • Welcome and Introductions • Making Connections • Underlying Issues • Tools • Domestic Violence • Closing

3. Overview I was hired to do infant/child development – What’s that got to do with underlying issues? • Why is underlying issues a concern? • Child Welfare • Family Centers • What is your role? • Prevention • Unique Role

4. Learning Objectives • Identifying underlying issues & their influence on families, children and youth; • Describing methods, situations and processes that help facilitate the use of screenings by Family Center staff; and • Delineating key elements of the domestic violence cycle, domestic violence screening tools and the impact of domestic violence on infants and toddlers.

5. Underlying Issues: What Are They and Why? • What is an underlying issue? • What is the root cause of the concern? • It is not just about children. It also includes: • Adolescents; • Parents; and • Family. • Why? • Safety, Permanency and Well-Being. • Why me? • You have a unique role as a home visitor.

6. Tools for Identifying Underlying Issues • Critical Thinking • Strength-Based, Solution-Focused Questioning • Enhancing Assessments Toolkit • Screening and Assessing • Looking and Listening • Relationship with Families

7. Critical Thinking • Tune into self; • Challenge assumptions; • Consider: the arguments, alternatives and context; • Know the source of the information; and • Assume a posture of relative skepticism.

8. Strength-Based, Solution-Focused Questions • Exception Questions • Coping Questions • Scaling Questions • Miracle Questions • Indirect Questions

9. Enhancing Assessments Toolkit • The Matrix • The Tools • The Resources • Facilitated Discussion Guide

10. Parents As Teachers Model • DoVES: Domestic Violence Evaluation Scale • Edinburgh Post-Natal Depression • Life Skills Progression http://www.lifeskillsprogression.com/home/index • Toolkit http://www.pacwcbt.pitt.edu/Resources/PA%20Enhancing%20Assessments%20Toolkit.pdf

11. Why Focus on Domestic Violence? • 25% of participants in the Evaluation of Pennsylvania’s Developmental Screening Project endorsed incidents of IPV within the past year. • 38.9% of participants have taken our survey or thought that they needed a PFA at some point in their lives. • These families, who are currently receiving services from Children and Youth, have children under 5 years in their home. Source: Child Welfare Education and Research Programs (2011). Caregiver Interviews: A Portrait of Pennsylvania's CYS-Involved Families (Report No. 6). Pittsburgh, PA: University of Pittsburgh, School of Social Work.

12. Brain Development • Brain development happens rapidly from birth to age 5. • Brain development is encoded in a person’s genes, but it is strongly influenced by the environment. • The brain develops new “circuitry” based on what has already been established. • New pathways lead to new skills. • Children rely on their parents to have their basic needs met to help their bodies and brains grow and develop.

13. Stress • Learning to cope with stress is an important part of a child’s development. • A child between the ages of birth and five is especially vulnerable to the effects of stress. • A young child cannot cope with the negative effects of stress without relying on a supportive relationship with a parent or caregiver. • Not all stress is bad. Some stress is a normal part of life. • “Toxic stress” occurs when a child is subjected to high levels of stress for extended periods of time. This type of stress is extremely detrimental to development.

14. Stress (continue) • Infants cannot regulate their own stress response. They rely on parents and caregivers to help and calm and self-soothe, especially during the first year. • A child’s ability to cope with stress in the early years has consequences for physical and mental health throughout life. • The relationships children have with their caregivers play a critical role in the development of the stress response system during the early years of life. • The presence of a sensitive and responsive caregiver can protect infants and toddlers from experiencing excessive stress – even children who tend to be temperamentally fearful or anxious – and help them cope better.

15. Self-Regulation • Self-regulation develops slowly over the first few years of life. • From birth, children are learning about regulating their emotions as well as their actions by watching their parents.

16. Adverse Childhood Experiences (ACE) Study • Dr. Vincent Felitti • www.cdc.gov/ace • One of the largest investigations ever conducted looking at relationships between childhood maltreatment and later life health and well-being. • Collaboration between CDC and Kaiser Permanente’s Health Appraisal Clinic in San Diego.

17. Cycle of Abuse DENIAL

18. Types of Domestic Violence • Physical • Sexual • Using Intimidation • Using Emotional Abuse • Using Isolation • Minimizing Denying and Blaming • Using Children • Using Male Privilege • Using Economic Abuse • Using Coercion and Threats

19. Closing and Contact Information • Questions • Transfer of Learning • Workshop evaluations Shauna Reinhart, Child Welfare Training Program, shr30@pitt.edu Jeannette Rice, Children’s Advocacy Center- Lawrence County, jrice@jamesonhealth.org