Title: Child Evaluations in Abuse, Neglect, and Dependency Cases
1Child Evaluations in Abuse, Neglect, and
Dependency Cases
2Who is the Client?
- For parental competencies, the client may be the
Court or Department of Social Service. - For child evaluations, the client is most
frequently the Department of Social Services.
3What Are DSS Needs?
- Objective expert opinion to aid their decision
about the A/N/D issue in question. - - Testimony and/or report that is
admissible and legally defensible. - Expert input on treatment and intervention needs
to aid case planning.
4What Are DSS Needs?
- Forensic role
- Objective expert opinion to aid their decision
about the A/N/D issue in question. - - Testimony and/or report that is
admissible and legally defensible. - Diagnostic role
- Expert input on treatment and intervention needs
to aid case planning.
5Pitfalls in Meeting DSS Needs
- Providing expert opinion w/o usurping DSS role
and responsibility - Ensuring that evaluation supplements rather than
supplants the DSS investigative process - Role of Crawford ruling in limiting admissibility
of forensic evidence - Limitations of diagnostic process in identifying
etiology and resulting limitations in treatment
planning
6Common Types of Child Evaluations in Abuse and
Neglect Cases
- Diagnostic
- Child mental health evaluations
- Developmental evaluations
- Parent-child attachment evaluations
- Forensic
- Child forensic abuse evaluations
- Hybrid
- Child-Family Evaluation Program (CFEP)
7Child Mental Health Evaluations
- Purpose identification of significant
psychological or cognitive impairments - Components psychological testing
- clinical interviews
- Providers MA level psychologist or higher
- Limitations diagnosis-driven
reliance on
client self report
8Developmental Evaluations
- Purpose identification of developmental
delays or irregularities in children yrs. 0-4 - Components parent interviews
- developmental testing
observations - Providers MA level professional with
specialized training - Limitations reliance on parent report
- etiology not well addressed
9DEVELOPMENTAL ASSESSMENT
- BASC 2 Behavior Assessment System for
Children, Second Edition. For children 2 and up
comprehensive system that includes scales for
parent, child and teacher, plus a student
observation scale. - CBCL Child Behavior Checklist. For children
age 2 ½ 18 years. Assesses behavior problems
and adaptive behaviors. Rating scales for
parent, adolescent and teacher.
10DEVELOPMENTAL ASSESSMENT CONTINUED
- ITSEA and BITSEA Infant Toddler Social
Emotional Assessment for children 1 3 years.
Completed by daycare provider and a parent. - TSCYC Trauma Symptom Checklist for Young
Children for children ages 3 12 years to
assess trauma specific symptoms. Completed by
parent or caregiver. Separate scale for self
report for 8 12 year olds.
11Parent-Child Attachment Evaluations
- Purpose assessment of quality and security of
attachment relationship - Components observations of parent/child
interaction - parent interview
- Providers PhD or MA level with specialized
training - Limitations limited number of trained
evaluators (Demand ? Supply)
12ATTACHMENT IS
- A biologically based need, separate from other
needs, that cannot be delayed or deterred. - The process of creating a mental representation
of the caregiver. - Template for future relationships including
friendships, intimate relationships and parenting
relationships.
13WHAT FOSTERS AND MAINTAINS A SECURE ATTACHMENT?
- Cumulative experience of responsive care in a
variety of contexts. - Time, well spent, together.
14INFANTS
- Typically form attachments to both parents by 6-9
months. - May form different types of attachments to each
of their parents. - Cannot form an unlimited number of attachments
less than a handful.
15ATTACHMENT ASSESSMENT
- Strange Situation primarily infants (12-18
months but can be used with preschoolers with
modifications) - Attachment Q sort ages 1- 5 years
- Narrative Story Stem Technique preschool to
elementary age - CAI Child Attachment Interview middle
childhood - AAI Adult Attachment Interview adolescents
and adults
16Answerable Questions in Child Diagnostic
Evaluations
- Does the child have a mental health diagnosis or
definable psychological impairment? - What are the strengths and weaknesses of the
child? - What therapeutic or other intervention might be
useful? - Does the child have a diagnosis/ impairment/
symptom pattern consistent with abuse or neglect?
17Unanswerable Questions in Child Diagnostic
Evaluations
- Has the child been abused or neglected?
- What is the cause of the childs
diagnosis/impairment?
18Child Forensic Abuse Evaluations
- Purpose assessment of maltx allegations
- Components record review
- forensic interviews of child and caregivers
- collateral contacts
- Providers PhD or MA level with specialized
training/supervision - Limitations cooperation of various parties
skill level of evaluator
19Child/Family Evaluation Program (CFEP)
- Replaces Child Mental Health Evaluation Program
(CMHEP) (1986-2006) - Established in 2001
- Formerly called Child Forensic Evaluation Program
(CFEP) - 100 rostered providers throughout the state
20Child/Family Evaluation Program (CFEP)
- Designed to assist CPS in decision making and
case disposition - Conducted using forensic standards in order to
enhance potential utility as needed in civil
A/N/D proceedings - Limited to cases that have not been, or are
unlikely to be, determined through standard CPS
investigative process or through medical
evaluation.
21Premises Underlying CFEP
- Knowledge of etiology is generally necessary for
effective treatment planning. - DSS cannot make effective treatment or
intervention plans without first addressing the
likelihood of abuse or neglect - A hybrid evaluation that addresses both the
likelihood of abuse/neglect and treatment needs
is necessary
22Typical CFEP Referral Questions
- 1a. Is it likely that this child has experienced
abuse and neglect? - If so, what is the likely nature and extent? Who
is the likely perpetrator? - OR
- 1b. Is this child at risk for abuse or neglect
with current caregivers? -
- 2. Given concerns about abuse What are
recommendations for intervention or treatment? -
23CFEP Program Exclusions
- Child Mental Health Evaluations
- Custody Evaluations
- Psychological Treatment
- Court Testimony
24CFEP Standards of Practice
- Forensic Standards- Methods and procedures-
Hypothesis testing- Documentation-
Verification/corroboration- Avoidance of
conflicting roles
25CFEP Standards of Practice (cont.)
- Expected Evaluation Components - Record
review- Two or more child interviews and
documentation- Interviews with primary
caretaker(s) and collaterals- Interview with
alleged perpetrator
26Current Reappraisal of Appropriate Conclusions
for CFEP Evaluations
- General acceptance
- - Childs statements and behaviors are
consistent with . - - Listing of relevant hypotheses with none
chosen as most likely - Debatable
- - Opinion about probability of abuse
- - Listing of relevant hypotheses with one
chosen as most likely
27Contrast Between Child Forensic Abuse Evaluations
and CFEP Evaluations
- Identifying abuse for legal purposes
- vs.
- Identifying abuse for more effective treatment/
intervention planning
28COMMON EVALUATION ERRORS
- One-shot interview of child
- If I didnt see it or hear it, it aint
sosyndrome - Failure to consider impact of unsupervised
contact with alleged perpetrator on disclosure
process - Faulty analysis of childs statements about abuse
29CASE OUTLINE
- Family structure 4 year old girl
- Mother
- Live-in boyfriend
- Allegation Fondling by mothers boyfriend
during - bath time, based on childs spontaneous
- statement to preschool teacher
- Thomas washes me too hard and it hurts
- my peepee.
-
30- Mothers interview
- Thomas occasionally bathes child in tub
- Doubts allegations
- Thomas interview
- Bathed child in tub on only 1 occasion
- Has never touched childs genital area
31- Childs interview
- Thomas has never given her a bath
- No one, including Thomas, has ever touched her
genitals - Evaluation Findings
- No sexual abuse, based on childs denial
- Any problems with this analysis?
32COMMON EVALUATION ERRORS(continued)
- Failure to consider alternative explanations
for recantation - Interviewing parent figure regarding
allegations in presence of child - Failure to interview alleged perpetrator
- He said/she said surrender