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Child Evaluations in Abuse, Neglect, and Dependency Cases

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Child Evaluations in Abuse, Neglect, and Dependency Cases Mark D. Everson, PhD Who is the Client? For parental competencies, the client may be the Court or Department ... – PowerPoint PPT presentation

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Title: Child Evaluations in Abuse, Neglect, and Dependency Cases


1
Child Evaluations in Abuse, Neglect, and
Dependency Cases
  • Mark D. Everson, PhD

2
Who 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.

3
What 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.

4
What 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.

5
Pitfalls 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

6
Common 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)

7
Child 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

8
Developmental 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

9
DEVELOPMENTAL 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.

10
DEVELOPMENTAL 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.

11
Parent-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)

12
ATTACHMENT 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.

13
WHAT FOSTERS AND MAINTAINS A SECURE ATTACHMENT?
  • Cumulative experience of responsive care in a
    variety of contexts.
  • Time, well spent, together.

14
INFANTS
  • 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.

15
ATTACHMENT 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

16
Answerable 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?

17
Unanswerable Questions in Child Diagnostic
Evaluations
  • Has the child been abused or neglected?
  • What is the cause of the childs
    diagnosis/impairment?

18
Child 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

19
Child/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

20
Child/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.

21
Premises 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

22
Typical 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?

23
CFEP Program Exclusions
  • Child Mental Health Evaluations
  • Custody Evaluations
  • Psychological Treatment
  • Court Testimony

24
CFEP Standards of Practice
  • Forensic Standards- Methods and procedures-
    Hypothesis testing- Documentation-
    Verification/corroboration- Avoidance of
    conflicting roles

25
CFEP 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

26
Current 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

27
Contrast Between Child Forensic Abuse Evaluations
and CFEP Evaluations
  • Identifying abuse for legal purposes
  • vs.
  • Identifying abuse for more effective treatment/
    intervention planning

28
COMMON 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

29
CASE 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?

32
COMMON 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
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