Healing the Child in Juvenile Court: Applying an Infant Mental Health Approach. Joy D. Osofsky, Ph.D. LSU Health Sciences Center, New Orleans In collaboration with Judge Cindy Lederman 11 th Circuit Juvenile Court, Miami University of Oregon Law School, March, 2006.
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Joy D. Osofsky, Ph.D.
LSU Health Sciences Center, New Orleans
In collaboration with Judge Cindy Lederman
11th Circuit Juvenile Court, Miami
University of Oregon Law School, March, 2006
FOSTER CARE Mental Health Approach
Overall Delay: 60%
Language – 57%
Cognitive – 33%
Gross motor – 31%
Growth problems – 10%
4% to 10%
Leslie, L.K. et al (2004) Journal of Developmental and Behavioral PediatricsPrevalence Rates of Developmental Delay
FOSTER CARE Mental Health Approach
-25% to 40% under age 6 have significant behavioral problems, most displaying externalizing behaviors (aggression, anger)
3% to 6%
Leslie, L.K. et al. (2004). Journal of Developmental and Behavioral PediatricsPrevalence of Psychiatric Problems
OUR TOOLS: Mental Health ApproachThe lawand science
Consequences of Child Maltreatment symptomatology
Committee on Integrating
the Science of Early Childhood Development
Board on Children, Youth, and Families
Institute of Medicine
National Research Council
From Neurons to Neighborhoods,2000
How children Childhood Development feel is as important as how they think, and how they are treated is as important as what they are taught, particularly with respect to their readiness to succeed in school.
Signs in the baby that emotional needs are not met Childhood Development
Signs of emotional problems Childhood Development
In toddlers/ preschoolers
Conditions of the caregivers Childhood Development
that contribute to baby’s
The Infant Health and Childhood Development Development ProgramAn 8 site clinical trial designed to evaluate the efficacy of comprehensive early intervention in reducing developmental and health problems in low birth weight, premature infants
Random Assignment Childhood Development
Results Childhood Development
15 year longitudinal study of the effects of early childhood interventions on educational achievement and juvenile arrest
Reynolds, Temple Robertson and Mann,
JAMA, May 9, 2001
(10.6 vs. 10.2)
(16.9% vs. 25.1%)
Prenatal and Infancy Home Visitation Childhood Development
Olds, et al. 1997, 1998, 2002, 2004
Elmira Home Visitation Program: Childhood Developmentthe mother
HOME VISITATION: Childhood Developmentthe child (at 15 years)
“ Childhood DevelopmentThe children of this family have been exposed to chronic emotional neglect and are experiencing symptoms of depression, emotional impoverishment and low self-esteem, low academic achievement and aggression. There are strong indications that they have been exposed to long term family and community violence.”
home unfit for human habitation Childhood Development
7 year old retarded sibling left alone
Mother gave food stamps to her boyfriend
home site of drug related activities
children begging for food
allegations of physical abuse by boyfriendReasons for removal
Pre and post-test measures indicate that therapy and other support services provided through the infant mental health interventions had a positive impact on both the infant and the caregiver.
Pre and post observational measures of the infant-caregiver relationship indicated important improvements in both parental sensitivity to the children and in the children’s emotional responsiveness and behaviors.Parent Effectiveness
More positive emotions support services provided through the infant mental health interventions had a
Increased emotional and behavioral responsivenessChanges in the child
95% improved relationship with baby
83% positive changes in child
77% improved parenting
73% improved family life
Of the first 59 children involved in this project, it is important to note that the mothers had a total of156children and the fathers had a total of 138children.
No further abuse or neglect reports in 100% of the cases.
100% rate of reunification
It includes our attachment and bonding experience in the first 18 months of life, as well as how exploration and aggressiveness were handles during toddler hood (terrible two’s) and how we learned self-control or self-regulation of impulses by the time we turned five and went to kindergarten.
Because it is not until school that most of the problems show up on the radar screen. For a few of the most severe, we can spot them by age three or four. They are the ones being kicked out of daycare and preschool for uncontrollable behaviors.
But for the majority, we don’t identify them up until they start failing in school, or get involved in the juvenile justice system, or become a teen parent.
However, we are NOT saying that all mental disorders are a result of what happens in the first few year of life. Some mental illnesses are rooted in genetics and/or biochemistry, such as schizophrenia, bipolar disease, and other neurophysiological disorders such as autism.
NOR are we saying that all children who have bad experiences during the 0-3 years “turn into toast” or become criminals. We cannot oversimplify human development. It is complex, transactional, and unique.
What we ARE saying is that the experience and quality of caregiving received by infants and young children during those critical first few years of life when the brain is being wired, so to speak, has long lasting impact on the future of that child.
Part C Part C screening pursuant to the Individuals with Disabilities Act (IDEA)Individuals with Disabilities Education Act
Make Appropriate Child Care Referrals: home visitation program in your communityEARLY HEAD STARTHEAD START
In Miami there are 1300 day care centers and only 120 are accredited. This is a consistent problem across the country.
DHHS, June 2002