Make the Child the Client
By Richard J. Gelles | The death of seven-year-old Nixzmary Brown in January 2006, tortured, molested, and starved by her stepfather, is an all-too-familiar narrative with all the usual suspects. Nixzmary’s New York City Administration for Children’s Services (ACS) caseworker went weeks before seeing the child and failed to update the file in a timely or appropriate manner. The caseworker’s supervisor failed to follow through and obtain a warrant to help find Nixzmary after the girl was absent from school for weeks and after the school reported that Nixzmary showed up at school with a gash over her eye. Although ACS caseworkers and supervisors had multiple opportunities to protect Nixzmary, they failed.
Nixmary’s case is, unfortunately, not uniquein fact it is tragically common. In Rhode Island, T.J. Wright was beaten to death by his foster parents in October 2004. According to a report issued by the Rhode Island Office of the Child Advocate, the state child-welfare department missed seven opportunities to intervene and protect T.J.. In Philadelphia, a caseworker placed a child in the foster home of a man with a criminal record that included child endangerment, and the child was sexually assaulted for months. The same caseworker failed to follow policy and have the child tested for HIV, and the child, who was HIV-positive as a result of the sexual abuse, went untreated for a year.
When a public tragedy such as the death of Nixzmary occurs, the typical response of administrators of child-welfare systems is that “the child fell between the cracks” of the system. While high-profile tragedies capture media attention and are used to emphasize the failings of the child-protective-service system, fortunately, child homicide, sodomy, and rape are rare. Neglect, starvation, abandonment, berating, and belittling are far more common. On any given day, an estimated 500,000 children reside in some form of out-of-home care, primarily because of abuse or neglect. Children in out-of-home care are wards of the government, their custody residing with the state, county, or local child-welfare agency. Of the children in foster care, more than 120,000 are freed for adoption and are awaiting placement, according to statistics from the U.S. Department of Health and Human Services. The average child available for adoption has waited nearly four years. Since there are only 46,000 completed adoptions each year, many of these children will wait in foster care, and a large portion will never be adopted. Each year, some 20,000 to 25,000 children reach the age of majority and age out of the system. At that point the state relinquishes legal custody, and the foster families or residential facilities no longer receive financial support. Aging out of the system puts the former wards of the state onto the street with some or minimal assistance. In some states, the age of majority can be as young as 17.
The nation’s child-welfare systems cannot assure the safety of children who come to their attention. For those children who are removed from their caregivers because of safety concerns and who are subsequently reunited, slightly less than seven percent were abused or neglected again within six-months of reunification, according to HHS. The re-occurrence of abuse or neglect increases to as high as 30 to 40 percent the longer a child remains with parents who have previously maltreated their children. Between 1,500 and 2,000 children are killed by their caretakers each year, and half of the murdered children are slain after they or their families have come to the attention of child-protective-service agencies.
In response to tragedies, child-welfare agency administrators together with state legislators and public officials, attempt to fill the cracks by “rounding up the usual suspects.” Without fail, the response involves hiring more child-welfare employees, attempting to reduce caseloads, and calling for more training. And, equally without fail, after the usual suspects have been rounded up, the new employees hired, and more intensive training rolled out, another error of omission by the child-protective-service system results in preventable harm to a child.
How can we improve the nation’s child-welfare systems? How can we assure the safety and stability of the nation’s most vulnerable children? My colleagues and I at Penn’s Field Center for Children’s Policy, Practice, and Research have wrestled with the challenge of improving the child-protective-service system without merely “rounding up the usual suspects.” Here are some of our insights:
In the 1960s, when child maltreatment became a social issue, clinical and social-service responses focused on protecting children and assuring their safety. During the 1970s the focus began to shift from child to caregiver. The shift was primarily due to a new paradigm of child maltreatment that proposed that social factors such as stress and poverty were the prime causes of abuse and neglect. Federal policy prescribed family preservation as the core value and prime goal of the child-welfare system. When the parent is the client and family preservation is the goal, administrative and individual efforts are framed by the parent’s needs, deficits, or strengths. However, the emphasis on parents often ignores the needs of the child. Many of the “cracks” in the child-protective-service system occur because children’s needs and safety are obscured by the focus on parents’ needs. The most important first step in child-welfare reform is to position the child as the client, and safety and stability as the goal.
Children need stability.
The pre-eminent goals of child-protection agencies often swing between safety (removing at-risk children from their homes) and preservation (helping families and keeping children from being placed into foster care). The direction of the pendulum swing is typically dictated by the most recent tragedy in the system (e.g. foster-care placements grew in New York City in the aftermath of the Nixzmary Brown case). The moving pendulum obscures the more appropriate goal of the child-protective-service system. As important as safety is, and as important as preservation may be, child-welfare systems must focus on creating a stable environment for children who have been abused or neglected. Short-term safety is an inadequate goal and preservation is extremely difficult to successfully achieve. The true arbitrator and benchmark of whether child-welfare systems are meeting the needs of their core clients, children, is whether children are provided with a secure base to enhance their reaching their developmental potentials.
Systems make decisions.
Any system is only as strong as its weakest link. The weakest link of the child-welfare system is the individual caseworker. I am fond of the hyperbole that characterizes the typical front-line child-welfare worker as a 25-year-old art-history major. However, it is more accurate to say that there are many seasoned and mature front-line child-welfare workers who have a wealth of experience to draw upon in their work.
On the other hand, it is equally true that child-welfare work has been de-professionalized in the past 30 years. Few front-line caseworkers hold professional degrees in social work or human services. For all the increases in the number of workers in child welfare and funding for child-welfare agencies, front-line child- welfare caseworkers still enter homes severely lacking in training, insight, and the proper skills to assess risk and family needs.
Even if workers are adequately prepared to undertake front-line work, when they go about their business, they often open a toolbox that is half empty. At the core of a child-protective worker’s responsibilities is to investigate and assess the suspicion that a child has been abused or neglected and then determine the level of risk to the child and the services the caregivers may require. In the absence of accurate assessment training and tools, many front-line child-welfare workers employ what I call “olfactory” risk assessment. Rather than simply call for “more training,” systems must invest in research and development of tools and technology that will enhance front-line workers’ ability to make timely and accurate decisions.
Know where the children are and whether they are well.
The last and most important weakness of front-line services is the limited ability of caseworkers to provide close monitoring of at-risk children. A report issued by the U.S. Inspector General a month before Nixzmary was killed found that most child-welfare systems fail to see children in foster care at least once per month, as prescribed by state law. On top of that, most states have no data-management system to determine how often children in foster care are seen. According to the Inspector General, only 19 states and the District of Columbia can even report how often visits occur. It may well tax the manpower of state agencies to physically visit at-risk children. As long as caseworkers and supervisors are over-worked and under-trained, cases such as Nixzmary Brown’s will still occur. But, to be unable to actually know whether visits are occurring and to blame the lack of information on “manpower shortages” is malfeasant and unforgivable. The lack of monitoring and contact creates one of the greatest structural chasms in the child-welfare system.
The mantra that children are harmed because they “fell through the cracks of the system,” and the knee-jerk reaction to tragedies of “rounding up the usual suspects” needs to be replaced by a systematic search for the “tipping point” or “center of gravity” of the child-protective-service systems. I believe the four core issues I identified must be addressed before we as a nation can improve our ability to assure the safety and developmental potential of the nation’s maltreated and vulnerable children.
Dr. Richard J. Gelles is Joanne and Raymond Welsh Chair of Child Welfare and Family Violence and dean of the School of Social Policy & Practice. He also serves as director of the Center for Research on Youth and Social Policy, director of the Ortner-Unity Program on Family Violence, and co-director of the Field Center for Children’s Policy, Practice, and Research.
©2006 The Pennsylvania Gazette