A Presentation to the Child Welfare Council

Rochelle Trochtenberg Youth Organizer, Humboldt County Transition Age Youth Collaboration Child Welfare Council Member

Cheryl TreadwellCalifornia Dept of Social Services

Penny Knapp, MDProfessor Emeritus, University of California, Davis

September 4, 2013Sacramento, California

Objectives of the Today’s Presentation

Identify the Developmental Concerns for Young Children in Foster Care as discussed in the report.

Share information from the report about California’s youngest foster care population and highlight the opportunities for the Council.

Share the recommendations from the committee.

*The Research tells us…

Infants and toddlers placed in foster care have: Longer placements Higher rates of re-entry into foster care, recurrent

maltreatment, and disruptions of family bonds than children and youth of other ages.

Increased risk for mental health problems for young children and more frequent prevalence of health problems and developmental delays.

Compromised ability to maintain and rebuild relationships.

*Janice L. Cooper, Patti Banghart, Yumiko Aratani. “Addressing the Mental Health Needs of Young Children in the Child Welfare System: What Every Policymaker Should Know.” National Center for Children in Poverty. September 2010.

What are infant/early child mental health implications?

Thirty-eight percent of children in California’s foster care systems are under five.

Seventy-seven percent of children are removed for neglect-related reasons.

Multiple placements: The younger the child is when removed, the more placements he/she will likely have.

Thus, blighted attachment begets fractured attachment.

Why is earlier placement associated with greater problems?

If infant mental health is jeopardized or interfered with, as by early childhood neglect, abuse, malnutrition or trauma, clinical research has shown these consequences:

Biological and developmental:The brain fails to develop fully. Developmental failure of emotional and cognitive functions results from interpersonal understimulation.

Social-emotional and relational:Infants who are traumatized or neglected, are likelier to have lifelong psychiatric symptoms, and lifelong difficulties with personal relationships: e.g. psychiatric symptoms, personality disorders, or difficulties controlling violent impulses.

Thompson, R. A., & Nelson, C. A. (2001). Developmental science and the media: Early brain development. American Psychologist, 56(1), 5-15.

Trauma

Child is overwhelmed and may:

• Dissociate• Be hypervigilant

(+/or “hyperactive”• Have disturbed

sleep, appetite, concentration

DC 0-3 diagnostic criteria

To the earliest interactive experiences, the brain responds by organizing it’s own and developing self

regulation of Attention, Cognition, Mood, Anxiety and Impulse.

Failed self regulation can lead to clinical syndromes:

Failure to regulate........................can lead to................Syndrome/Symptoms 1 Attention ADHD 2 Cognition Learning disabilities

3 Impulse Disruptive behavior disorders

4 Mood/Anxiety Depressive disorders: MDD/BAD Anxiety disorders

5 Relationships Attachment disorders, later relationship difficulties

Sequelae of Early Stress

If the infant's development is jeopardized in the firstyears of life, what happens?

Babies who are poorly nourished or premature haveconstrained brain development.

Babies who begin with normal brains, but who are thenneglected also have problems with brain development.

Babies who begin with normal brains, but who are thenabused also have brain development that deviates fromnormal

Importance of Mental Health Prevention

Developmental and biological reasons Attachment sculpts brain development: Neurogenesis

By age 7, the child's brain is 90% of adult brain weight. Yet, throughout life, new synapses are formed, and reorganization of existing neuron connections continues

Foster placement results from/may create attachment problems

Cost effectivenessDollars saved exceed dollars spent

http://www./rand/org/publications/MR/MR898/

The Plasticity of Brain Architecture Decreases Over Time

• Brain circuits consolidate with increasing age, making them more difficult to rewire

• The timetable of brain plasticity varies: it is narrow for basic sensory abilities, wider for language, and broadest for cognitive and social-emotional skills

• Early plasticity makes the young brain both more vulnerable to harm and more capable of recovery

• At all ages it is more efficient – biologically and economically – to prevent later difficulty than to try to remedy problems that emerge.

• THE EARLIER THE BETTER….

Information about California’sYoungest Population

Infants and toddlers are the largest single group of children entering foster care.

DID YOU

KNOWIn California as of July* 2012 the

total number of children

between the ages of zero

to five totaled 19,349 ?

Proportion of young children compared to the total foster care population

What are the opportunities? Enhance curricula & other training

resources for social workers, court staff, caregivers and other community partners to recognize and respond to the impacts of traumatic stress

Incorporate scientific research into state and local politics and practices in order to promote positive development and prevent future maltreatment

Eliminate fragmentation and duplication of services for young children and their families

Encourage cross systems collaboration between local and state departments and

Formalize agreements between child welfare and other public agencies, community partners in order

To cultivate a system that provides timely, appropriate and quality services that can reduce the impact of trauma on young children in foster care.

What are the opportunities? cont’d

Other Contextual opportunities..

“The need to know more about children outside of specific depts. becomes significant as the CWS becomes more outcomes-focused”… i.e improve the ability to share meaningful data

Program Instructions from various Federal Partners ( i.e ACF, CMS, SAMSHA regarding foster children

specific focus on trauma and well-being) American Academy of Pediatricians

recommendations to primary care physicians to use validated screening tools.

Katie A. Implementation promotes screening, assessment, treatment and improved coordination between mh and cws systems using child and family teams

Affordable Health Act… primary prevention, home visitation programs. etc

Recommendation

Raise the level of awareness regarding the needs of children ages zero to five in foster care and that all state and local agencies develop specialized supports and services for this vulnerable population Identify benchmarks/indicators at the state and local levels to track the system’s success

.

Provide the leadership and forums to increase statewide awareness in order to develop a plan for action.

AND TO….

WHAT IS OUR GOAL?

Thank you… Thank you… Thank you