DEE WILSON CONSULTING

(Originally published September 2020)

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This is the fourth commentary in a series on “Social Justice in Child Welfare.” The initial commentary discussed the association between poverty and child maltreatment and the effects of poverty, race and caste on child welfare policy and practice. The previous two commentaries addressed the preference in the Adoption and Safe Families Act (ASFA) for adoption over reunification and proposed revisions to ASFA that would reverse this policy preference, increase the use of voluntary agreements (rather than legal structure) for school age foster children and youth, extend ASFA timelines for school age youth and greatly increase federal and state investment in reunification and post-reunification services. 

 

A story about child welfare

 

The following ideas and recommendations have gained wide traction among social justice advocates and child welfare scholars; not every advocate or scholar agrees with every part of this story, but every idea or recommendation has influential supporters:

 

The harms to children resulting from child maltreatment are widely misunderstood.  In the U.S., children in foster care are far more likely to  have been neglected than physically abused or sexually abused. Most children in foster care are placed for neglect only.  Child neglect is thoroughly enmeshed with poverty. Most neglect related placements could be prevented with poverty related services. Involuntary  foster care placement is always traumatic for children and is a childhood adversity  (potentially) with long term consequences on physical health and mental health of foster children.  Studies have shown that foster placement is more developmentally damaging to children than growing up with child maltreatment. Many children in foster care experience multiple placements, run away from foster care or age out of foster care, and a disproportionate number of foster children with poor outcomes are black.  If children must be placed in foster care,  they should only be placed with kinship caregivers. Congregate care should be eliminated. Non-kin foster parents should be required to actively support children’s parents in reunification or face the loss of their foster care license. 

 

Three National Incidence Studies (NIS) found similar rates of child maltreatment among all racial/ethnic groups; therefore, racial disproportionality in foster care is primarily due to racially biased decision making in child welfare agencies. The goal of child welfare agencies should be to eliminate racial disproportionality at all decision- making points, i.e., intake, investigation, out-of-home care  and permanency outcomes. Far too many children are in foster care unnecessarily, especially black and Native American children. Rates of entry into care and the number of children in foster care should be greatly reduced through use of evidence-based practices or, if necessary, by prohibiting involuntary placement of children. The fewer children in foster care, the better. 

 

ASFA should be repealed in its entirety or (at the least) ASFA timelines for completing permanent plans should be eliminated. There should be no termination of parental rights and (therefore) no adoptions unless children’s parents authorize adoption of their child.

 

Most (but not all) of the elements of this narrative are false, misleading, or dangerous.  Consider the following:

 

• It’s true that poverty and neglect are thoroughly enmeshed and that an increase in poverty related early intervention services could prevent many foster placements. However, when     chronically neglected children are endangered due to parental substance abuse and/or mental health conditions (often co-occurring) and sometimes domestic violence as well, poverty related services alone are not enough to protect children from serious harm. Chronic neglect and chronic maltreatment, i.e., combinations of neglect and physical or sexual abuse, are associated with chronically relapsing conditions such as substance abuse and mood disorders which must be addressed in case plans.     

 

• Chronic neglect is at least as dangerous and harmful to children as physical abuse or sexual abuse. More young children die in neglect related incidents than from physical abuse. Chronic neglect has devastating effects on children’s development (The Science of Neglect, 2012), and severely neglected young children are just as likely to show signs of trauma as physically abused or sexually abused children. Child neglect is more likely than physical abuse to be intergenerationally transmitted. 

 

• Children in foster care have usually experienced more than one type of maltreatment. Lack of nurturance, i.e., emotional neglect, is a part of chronic neglect and chronic maltreatment.  Many children in foster care have experienced three or more types of child maltreatment. Minimizing the maltreatment histories of foster children does not serve the cause of social justice.

 

• Placement of a child in foster care is not invariably traumatic, though this view has been expressed so frequently without contradiction, it has come to seem axiomatic. In A Child’s Journey Through Placement, one of the greatest books in child welfare, Vera Fahlberg maintains that the effects of removal on a child is determined by (a) the quality of the child’s relationship with caregivers and (b) how the placement is done. Abrupt unplanned placements are more likely to be traumatic than planned gradual placements of children.  

 

• Nevertheless, many involuntary placements of children are traumatic, with potential long-term effects on physical and mental health.  Loss of a parent in childhood for any reason is one of the adverse childhood experiences (ACEs) in Kaiser Permanente’s research studies. Other ACEs include physical and emotional abuse, growing up with a substance abusing parent or a chronically mentally ill parent, or living in a family with recurrent domestic violence. Most children in foster care have high ACEs scores resulting from family breakdown; and are vulnerable to early onset mental health conditions whether they remain in the home or are placed in foster care. Safe and nurturing foster placements reduce exposure to ACEs rather than increasing them.

 

•  Any claim that a single study or two has shown conclusively that foster care harms children’s development is false, a misunderstanding of what a single study can prove when there are large numbers of studies with conflicting findings.  A few studies have found that maltreated children who remain in the home do better on standard developmental measures than maltreated children placed in foster care. One well designed study (Bada, et al, 2008) found that infants exposed to prenatal opiate abuse and who remained in the mother’s care did as well developmentally as infants in foster care. Several comparison-group studies have found distinct advantages in social development for children in foster care over reunified children. In other words, research regarding the developmental effects of foster care is mixed;  scholars arrive at different interpretations of this research depending on the weight they give to the various studies (a large number).  

 

• The weight of the evidence from multiple studies underlines an  important finding from the National Study of Child and Adolescent Well Being (NSCAW): children with behavioral problems are often poorly served in foster care, moved from home to home and placed on multiple psychotropic medications.  The behavior problems of these children often become worse due to their experience in foster homes or residential care facilities.  Children who enter foster care with few behavioral problems (about half of foster children) and who are quickly stabilized in care benefit from foster care; and do better on standardized developmental measures than reunified children. (Rubin, et al, 2007)  

 

• The most damning well-founded criticism of the U.S. foster care system is that, in the aggregate, it is not therapeutic (and, occasionally, not even safe or humane) for behaviorally troubled school age youth. This intolerable state-of-affairs must be changed, either through major foster care reforms or by finding safe alternatives to foster care, or both.

 

• Currently, there is no way to know whether too many or too few  abused and children are being placed in foster care up against a well-defined standard of child safety.  The idea of a correct (or optimal) entry-into-care rate for CPS programs, absent detailed information regarding case characteristics and availability of community resources to control safety threats, is meaningless.          

 

 Poverty and Racial Disproportionality in Child Welfare

 

The fourth National Incidence Study (NIS-4) “found strong and pervasive race differences in the incidence of maltreatment,” a finding that seemed to reverse the conclusion of the first three National Incidence Studies that there were no significant differences in rates of maltreatment between black and white children. However, a careful analysis of the first three National Incidence Studies discovered large (but not statistically significant) differences in the incidence of maltreatment between black and white families that were contained in the Appendices, differences of approximately the same magnitude as found in NIS-4. The main difference between methodology in NIS-4 compared to NIS-1, 2 and 3 is that the sample size of “sentinel” informants was almost doubled.  This analysis of NIS-4 dramatically changed the scholarly discussion of racial disproportionality in child welfare, a change that many child advocates are uninformed about to this day, even though the reanalysis of the NIS studies was published almost a decade ago and has not been refuted by subsequent studies.

 

Scholars and advocates often point out that differences in poverty do not totally explain racial disproportionality in child welfare (poverty accounts for about 75% of disproportionality in rates of foster placement for black children).  Longer lengths of stay in foster care for black and Native American children also contribute to racial disproportionality. Longer lengths of stay may reflect  indifference to bad outcomes, a feature of structural racism, and/or higher rates of kinship care and higher rates of re-entry into care from reunification and guardianship for black children.

 

A 2017 study of racial disproportionality in California found that after controlling for poverty, non-white Hispanic children in a birth cohort were half as likely to be placed in foster care as white children. Asian American children have by far the lowest rate of foster care placement in the U.S., about half the rate of white children. There are large differences in entry-into-care rates among racial/ethnic minorities in the U.S., differences that reflect rates of poverty (especially severe poverty), historical trauma resulting from centuries of  oppression, and cultural factors as well.  

 

Most racial disproportionality is present at intake before child welfare decision making occurs. Racial disproportionality from intake through permanent planning is a direct result of social injustice, but not necessarily of racial bias in child welfare decision making to the extent claimed by social justice advocates. NIS-4 found the incidence of child neglect was 7 times higher and the incidence of physical abuse 3 times higher in families with annual incomes under $15,000 vs. incomes greater than $15,000. Given the strong relationship between poverty and child maltreatment and rates of extreme poverty among black and Native American families, a lack of racial disproportionality would raise serious questions about racial bias in child welfare.  

 

Poverty rates of black and Native American families are a manifestation of structural racism (see the first commentary in this series), not a competing explanation for racial disproportionality. Nevertheless, during recent years it has been common for U.S. child welfare systems to ignore or give token acknowledgement to the relationship between poverty and child maltreatment, while implementing antiracist training programs that focus on combating racial bias among child welfare staff. Child welfare agencies could, in theory, both increase poverty related services and invest in training programs that address racial bias; but, for the most part, they haven’t.  Many policymakers and managers remain deeply resistant to combatting structural racism through economic interventions, including a large increase in poverty related services. 

 

Reforming foster care systems vs. preventing foster care

 

Social justice/racial justice initiatives have become virtually identified with the goal of reducing foster care by a large percentage, and by persistent efforts to undermine residential care programs through onerous regulations (e.g., Family First), or through budget cuts that force private agencies out of business.  Nevertheless, more than 420,000 children are currently placed in foster homes, unlicensed kinship homes or congregate care facilities on any given day in the U.S.  In any plausible scenario, many hundreds of thousands of American children will continue to be placed in foster care for the foreseeable future.

 

Child advocates have good reason to be upset about the quality of care provided to behaviorally troubled children in foster care and residential care, including a disproportionate number of black and Native American children whose behavior problems often become worse due to their foster care experiences.  Foster care systems cannot be allowed to continue with a failed model of poorly supported volunteer foster parents unprepared by education or experience to care for behaviorally troubled youth with histories of early trauma, and by underfunded residential care systems that are  frequently not therapeutic, and sometimes not even safe.      

 

Foster care systems in the U.S. are performing poorly, and some are gradually falling apart.  In Washington State, foster children and youth who should be in Behavior Rehabilitation Services (BRS) or placed with professional foster parents are sometimes:

• placed in hotels with 2-3 caseworkers and a security guard.

• allowed to sleep in DCYF offices.

• moved from home to home every 24 hours; or

• placed out-of-state in costly residential programs.  

 

Children cared for in these arrangements are disproportionally black. These practices have gone on for years with little public outcry from child advocates, some of whom oppose new investments in residential care, but have no other solutions for the state’s foster care crisis. This is not social justice (or racial justice) regardless of the rationale for refusing to support or invest in foster care improvements. The willingness to allow foster care systems to flounder due to underfunding, and stubborn adherence to a failed foster care business model; and to undermine the few remaining residential care programs is unconscionable. However, the desire to shrink foster care systems –  but not improve them -  has become virtually a litmus test for commitment to social justice among many child advocates. 

 

The upEND movement

 

Developers of the upEND movement recently published an article in the Journal of Public Child Welfare, “It is not a broken system, it is a system that needs to be broken: the upEND movement to abolish the child welfare system.”  To combat racial

 disproportionality and the harms inflicted on black parents and children by foster care, the authors (Dettlaff, et al) advocate prohibiting involuntary placements of children, eliminating congregate care, doing away with ASFA timelines and termination of parental rights. The authors do not make a single comment regarding the harms of child maltreatment about which they are clearly less concerned than the harms inflicted on black parents and children by coercive child welfare interventions, especially foster care.  To their credit, the authors call for investments in a wide range of poverty related services, but have no specific recommendations for how children should be protected when they are in immediate danger from child maltreatment and parents are unwilling to engage in services or agree to temporary out-of-home placement. The authors offer no specific ideas regarding alternatives to congregate care, referring only to “alternative solutions and community supports.” They express no concern regarding the potential consequences of eliminating all ASFA timelines for permanent planning, or doing away with termination of parental rights when parents of children are unable to provide safe and nurturing care due to substance abuse or mental health conditions, or for other reasons.  

 

These recommended policies would indeed “break” the country’s child welfare system, endanger the lives of many thousands of abused and neglected young children, leave child welfare agencies without placement resources for behaviorally troubled youth and resurrect foster care “limbo” on a massive scale.  The reality that upEND’s dangerous recommendations are receiving serious consideration from many child advocates suggests that child welfare reform has reached a crossroads: destroy the child welfare system in order to create a new system regardless of the consequences to maltreated children; or, engage in incremental efforts to create policies and practices that serve impoverished families and all racial/ethnic minorities in a more humane, less coercive and more effective way.  It is a sign of the times that ‘incrementalism’ has taken on a pejorative meaning among many social justice advocates.   

 

References  

 

Bada, H., Langer, J. , Twomey, J., Bursi, C., Lagasse, L. Bauer, C., Shankaran, S., Lester, B., Higgins, R. & Maza, P., “Stability of early living arrangements on behavioral outcomes of children with and without prenatal  drug exposure,” Journal of Developmental and Behavioral Pediatrics, 29(3), June 2008.    

 

Dettlaff, A., Weber, K., Pendleton, M., Boyd, R., Bettencourt, B. & Burton, L., “It is not a broken system, it is a system that needs to be broken; the upEND movement to abolish the child welfare system,” Journal of Public Child Welfare, published on-line September 6, 2020.

 

Drake, B. & Jonson-Reid, M., “NIS interpretations: Race and the National Incidence Studies of Child Abuse and Neglect, Children and Youth Services Review, vol. 33 (1), Jan. 2011.   

 

Fahlberg, V., A Child’s Journey Through Placement, Perspectives Press, 1991; 2012 edition from Jessica Kingsley Publishers, London and Philadelphia.      

 

Fourth National Incidence Study: Report to Congress, Office of Research and Evaluation, Administration for Children, Youth and Families, Washington, D.C., January 2010. 

 

Maclean, M., Sims, S., O’Donnell, M. & Gilbert, R., “Out of Home Care vs. In Home Care for Children Who Have Been Maltreated: A Systematic Review of Health and Wellbeing Outcomes,” Child Abuse Review, vol. 25,4, July-August 2016.      

 

Rubin, D., O’Reilly, A., Hafner, L., Luan, X. & Localio, A., “Placement Stability and Early Behavioral Outcomes Among Children in Out of Home Care,”  Chapter 10 in Child Protection: Using Outcomes to Improve Policy and Practice, ed. by Haskins, Wulczyn & Webb, Brookings Institution Press, 2007.

 

The Science of Neglect: The Persistent Absence of Responsive Care Disrupts the Developing Brain; Working Paper No. 12, Center on the Developing Child, Harvard University, Cambridge, Mass., 2012. 

 

Wiegmann, W., “Equity from the Start. Disproportionality and Disparity Among Young Children in the CW System: What the Data Tell Us,” California Child Welfare Indicators Project,  Berkeley, Ca., 2017.

 

For previous Sounding Boards visit the index page   

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©Dee Wilson     

  

deewilson13@aol.com

    

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