JUDGE PAMELA ABERNETHY

LA PLATA, MARYLANDJUNE 16, 2008

PROTECTING BABIES FROM THE BENCH

We Know the Science: Now What?

What we know is not what we do. LET’S CHANGE THAT

Judicial leadership to close the gapThis isn’t just knowledgeThis is the most important knowledge of our

time

FIRST FRAME THE MESSAGENEXT IMPLEMENT ACROSS ALL COURT

PROGRAMSIT IS NOT ALWAYS ABOUT MONEYIT IS ABOUT LEADERSHIP

FRAMING 2: CRUMBS FROM THE TABLE OF JOY

•Sad affect•Lack of eye contact•Weight loss•Lack of responsiveness•Sensory processing problems•Rejects being held or touched

Signs in the baby that emotional needs are not met

• Very aggressive behavior

• Attention problems and deficits

• Lack of attachment

• Sleep problems or disorders

Signs of emotional problemsIn toddlers/ preschoolers

Exposure to Violence . . .increases cortisol

levels in the brain;increases activity in

the brain involved in vigilance and arousal (the “flight or fight” responses);

the brain interprets others’ actions as threatening and in need of an aggressive response.

Violence Begets Violence

Childhood abuse increases the odds of future delinquency and adult criminality by 40%

The Cycle of Violence (Cathy Spatz Widom)

Framing the Message 2: The brain as hand……….

The brain is the least developed organ at birth.

90% of the brain’s growth occurs from birth to age five.

A baby’s brain doubles in weight from birth to age three.

First caregivers have profound effects on virtually every facet of early brain development.

Healthy childhood experiences plays a critical role in determining future health and productivity.

Marion County's Early Childhood Initiative

Brain Growth

Image: www.brainconnection.com© 1999 Scientific Learning Corporation

FRAMING THE MESSAGE 2

RELATIONSHIPS

RELATIONSHIPS

RELATIONSHIPS

Marion County's Early Childhood Initiative

The quality and reliability of a child’s first relationships form the brain architecture

From Neurons to Neighborhoods: The Science of Early Childhood

Development

Committee on Integratingthe Science of Early Childhood Development

Board on Children, Youth, and Families

Institute of MedicineNational Research Council

Shonkoff, J.P., & Phillips, D. (Eds.) (2000). From Neurons to Neighborhoods: The Science of Early Childhood Development. Committee on Integrating the Science of Early Childhood Development. Washington, DC: National Academy Press.

Zero to Three

Thanks to Victoria Youcha Zero to Three http://www.zerotothree.org/

Framing the Message 3: Return on Investment

High risk children are at high risk for poor developmental outcomes

Early intervention increases the odds for favorable outcomes Early intervention saves us thousands of tax payer costs. Heckman, J. Grunewald, R. & Reynolds, A., (2006). The Dollars

and Cents of Investing Early: Cost-Benefit Analysis in Early Care and Education.

Karoly, L. Kilburn, M.R., &Cannon, J. (2005). Proven Benefits of Early Childhood Intervention. Research Brief. Santa Monica, CA:RAND Corporation.

Karoly, L. (1998). Early Childhood Interventions: Benefits, Costs, and Savings. Research Brief. RAND Corporation.

Brain MalleabilityBrain Malleability

Spending on Health, Education, Spending on Health, Education, Income Support, Social Income Support, Social Services and CrimeServices and Crime

11 3 3 10 10 60 60 80 80

ConceptionConception AgeAge

Intensity Intensity ofofBrain’s Brain’s Devel.Devel.

Public Public ExpendExpend..

BirthBirth

Dr. Bruce Perry M.D. PhD. Dr. Bruce Perry M.D. PhD. OPPORTUNITY AND INVESTMENTOPPORTUNITY AND INVESTMENTBrain’s Wiring and DevelopmentBrain’s Wiring and Development

Missed Opportunity to Invest

Percent of Percent of total brain total brain

growthgrowth

Cumulative percent of Cumulative percent of public spending on public spending on

children 0–18children 0–18

Age in yearsAge in years

00

2020

4040

6060

8080

100100

00 11 22 33 44 55 66 77 88 99 1010 1111 1212 1313 1414 1515 1616 1717 181800

2020

4040

6060

8080

100100

Brain growthBrain growth

Public spendingPublic spending

The mismatch between opportunity and investment:

“These are public health issues. Government has already decided that it is in the public interest to aggressively legislate interventions which decrease destructive and expensive health problems such as infectious diseases. Childhood experiences have no less a critical role in determining the health and productivity of the population – and deserve equal standing in public health policy.”

www.ChildTrauma.org“How Nurture Becomes Nature: The Influence of

Social Structures on Brain Development” B.D. Perry

Return on Investment : Adverse Childhood

Experiences

Recurrent and severe physical abuse Recurrent and severe emotional abuse Sexual abuse

Growing up in household with: Alcohol or drug user Member being imprisoned Mentally ill, chronically depressed, or institutionalized

member Mother being treated violently Both biological parents absent Emotional or physical abuse

(Fellitti,1998)

Return on InvestmentEvidence from ACE Study indicates…

Adverse childhood experiences are the most basic cause of health risk behaviors, morbidity, disability, mortality, and healthcare costs

V. Felitti, 2001

OK NOW WHAT?

OUR SEVEN YEARS OF EFFORT ACROSS ALL COURT PROGRAMS

SCIENCE IN ACTION: Our Court Programs for Infants and Toddlers

• Criminal Court: “Project B.O.N.D”• Dependency Court:

• “Fostering Attachment Treatment Court” • Changes to dependency court orders • “T.O.T” drug court for pregnant moms

• Domestic Relations Cases: Zero to Three Protocol

• Court /Community Collaboration: “Great Beginnings: Building the Foundation for Learning”

MARION COUNTY COURT

Project Bond

Fostering Attachment

Ten on Tuesdays

Dom Rel Protocol

Great Beginnings

Building Our Capacity for Nurturing and Development

The criminal court is an opportune contact point at which to identify at-risk parents since many defendants show up in court with the very behaviors that also cause risk to their children

• All criminal defendants in Marion County Circuit Court are asked to identify themselves as pregnant or the parent of a child age 0-5. 

• If the case proceeds to a probationary sentencing, the defendant has the option of agreeing to Project BOND probation conditions in exchange for a reduction of another sanction (i.e. a reduction of a fine or number of days of community service)

•  

“Project BOND” probation conditions are:

• · Attend parenting classes as referred by Project BOND coordinator.

• · Apply for assistance through AFS and OHP if eligible.

• · Go to an interview with the court’s Project BOND coordinator to get information about community support available to parents.

• · Provide proof of completion.

Project B.O.N.D.The defendant

appears before the court's Project Bond coordinator completes an intake form.

The defendant watches a video entitled "The First Years Last Forever”

The defendant is interviewed to make sure they know how to contact OHP to determine eligibility.

Project Bond contact information

For more information contact Project BOND Coordinator:503-589-3234

Marion Count Circuit Court100 High Street NESalem, OR 97310www.ojd.state.or.us/mar

A RELATIONAL APPROACH TO CHILD WELFARE FOR INFANTS AND TODDLERS

Fostering Attachment Treatment Court

Fostering Attachment Treatment Court Combines:

A drug courtA family dependency

courtA relief nurseryNeurobiology of

brain developmentRelationship FocusedChild Centered

Effective Family Dependency Treatment Courts Can…

Provide wrap-around, cross-disciplinary services to families, up-front

Bring services with multiple funding streams to the drug court team efforts

Select evidence-based interventions and measure outcomes

Generate local support for therapeutic jurisprudence

What Is a Relief Nursery?

An Oregon model for child abuse intervention that provides comprehensive family services for children under six.

Family Building Blocks, Salem’s Relief Nursery, offers high risk families intensive multiple services in this comprehensive approach

Relief Nursery Services Include:

Therapeutic classroomsHome visitsParent skills lab and parent supportClothing closet and toy lending libraryEmergency childcareMental health consultation and treatment

How It Works

Criteria for Admission to Fostering Attachment Court

Evidence of parental methamphetamine involvement

Infant/toddler between 6 weeks and 3 years old at enrollment

Children at risk for or victims of trauma or neglect, thus at risk for insecure/disorganized attachment to primary caregiver

Readiness to change (Motivation Stage of Change)

• 782 or 70% of Marion County foster care placements are due to parental meth addiction

• In 2006, 276 children were waiting for Family Building Block therapeutic classroom services

• Lack of resources for mothers recovering from meth addiction especially those with children– Housing– Mental health and substance abuse treatment– Employment– Transportation– Parenting skills

A Blueprint for ChangeCommunity Needs Assessment

FAMILY CHALLENGES

Methamphetamine addictionMultiple risk factors and limited protective factorsPoor parenting and self-sufficiency skillsMental health concernsLack resources to manage their child’s needsSystem avoidantInability to effectively SELF ADVOCATE

SYSTEM CHALLENGES

Language and philosophical differencesInflexible service deliveryCase loads too highLack of appropriate resourcesFamily distrustInability to respond to parent/child needs in a timely

mannerLack of political will and mechanisms to channel

public support

Fragmented Services!

INFAN

T

MEN

TAL

HEALTH

FOSTERPARENTS

RELIEF NURSERY

COURT PARENTDHS

CHILD

WELFARE

DRUG TX

HOW DO YOU ACHIEVE THIS?

FOSTERING ATTACHMENT COURT

FOSTERPARENTS

RELIEFNURSERY

DRUGTX

DHSCHILD

WELFARE

PARENT INFANTMENTALHEALTH

VALUES

Quality early childhood services that promote children’s social and emotional development is one of the most productive investments in the future of our children, families, and communities

Services should be child and family centered

VALUES . . .

Services should be integrated in a way that makes sense for the child and family – not the convenience of the system

Effective child, family, school and community interventions require interagency collaboration.

Parents are partners with service providers and should be included in decision-making.

COLLABORATION

COLLABORATIONSYSTEMS CHANGEEVIDENCE-BASED AND BEST PRACTICESSUFFICIENT RESOURCESEVALUATION

What’s NeededHigh trust levelsWell-developed communication systems

Designated coordinator Efficient meetings Shared data

Open decision-making with equal input from partners Administrative Direct service level Stakeholders – including families Project data

Evidence-Based PracticeDHS

CHILD WELFARE

MARION CO. CIRCUIT COURT

FAMILY BUILDING BLOCKS

VALLEY MENTAL HEALTH

FOSTERING ATTACHMENTChild and Family Team

Early Childhood Services

• N-CAST• Parents as Teachers• Therapeutic Classes• Family Support• Wraparound services

Drug Court

• 10 Key Principals

• Integrated case mgt

CASCADIA DRUG/ALCOHOL TREATMENT

Drug Treatment•Matrix•ASAM•Seeking Safety•Motivational Enhancement

Mental Health•Parent/Child Dyads•Circles of Security•Promoting First Relationships

2008 Evaluation

To date, 56 children, 39 mothers and 6 fathers served

22 parents, 26 children currently engaged in all services

Among 14 graduates, 1 new arrest with children re-removed, 1 new

founded claim resulting in the state taking jurisdiction over another

graduate’s new baby, in both cases precipitated by return to active

methamphetamine use

38 children reunified and remain with parents, 7 reunified and

returned to care

Average length of stay is 12.1months to graduate

19 participants completed addiction treatment, and 19 currently

active in treatment as part of overall service plan

Just Do It:Changes to the court ordersDevelopmentally appropriate Child-Centered Case Plans

Creation of the Developmental Guide for the Child Well Being

Sample from 0 to 6 months

Child Centered Case Plan Checklist:  Full physical check up at 2, 4 and 6 months Immunizations as scheduled Developmental screening (ASQ/ASQ SE) or

Assessment through Early Intervention Enrollment in WIC A plan to create an attachment-supportive

environment  

T.O.T: “Ten on Tuesdays” drug court for pregnant moms

T.O.T Moms with Partners from Oregon Health Sciences University Medical Auxiliary

They provide layette sets with book, hat, booties, and blanket when mom gives birth to a drug-free baby.

Infant Toddler Domestic Relations Protocol

Under the leadership of Judge Jamese Rhoades, our Local Family Law Advisory Committee developed 0 to 3 protocol for domestic relations custody cases

“Dear Parent:

Your case has been flagged because it involves a young child. Our court is paying special attention to cases involving young children because of research that indicates attachment and brain development at this stage is critical. A child’s brain is undeveloped at birth, and organizes 85% of its core brain structures during the first three years in accordance with the child’s experiences. Young children who fail to develop healthy attachments due to sudden separation, poor parenting skills, inconsistent or inadequate day care, chronic maternal depression, neglect or abandonment, frequent moves, abuse, or other trauma are at risk for problems later in life.

As a parent, there are things you can do. Be the best parent you can be when you are with your child. If you feel stressed, depressed or otherwise need assistance with parenting issues, get help from a trusted friend, counselor, support group or parenting class. Do it now, while you have the most influence over your child’s brain development. Also, help your child maintain a healthy relationship with the other parent. Try to maintain a normal schedule and routine during the separation process as much as possible. Unless there has been abuse, it’s important to recognize that your child needs both parents. The more you cooperate with and support the other parent, the better life will be for your child as he or she grows up. In fact, the single most destructive part of divorce on a child is parental conflict - a variable which you have some control over. Parental conflict puts children at risk for suffering and maladjustment later in life.

A number of resources are available through the court and community to help parents with conflict and parenting issues. Sample parenting schedules that take into consideration a child’s need for attachment are available for your consideration as you develop a parenting plan in mediation. In addition, parenting classes and parental supports can help parents improve skills that will help children’s brain development. Please take advantage of the resources listed in the “Parent Resources” sheet enclosed with this letter and on the court’s website at: http://www.ojd.state.or.us/mar/familylaw/ParentResources.htm

I expect both parents to focus on solutions that will serve the best interests of your child. If there are safety concerns, these issues should be brought to the court’s attention. I appreciate your attention to these important issues.”

Domestic Relations Cases Involving ChildrenTalking Points for Orientation

The court is paying closer attention to cases involving young children because researchshows that attachment to a parent or parents can impact a child’s brain development. Eighty five percent of a child’s core brain structures are organized during the first threeyears of life.

Attachment is the emotional connection that develops between an infant and his or herprimary caregivers. A child with a healthy attachment has the basis to develop healthyrelationships throughout life and is better able to learn. S/he is more likely to becomeindependent, to develop a conscience and is better able to deal with stress and anxiety.

As parents who are going through a period of family transition, you can help your childmaintain secure attachments by making sure s/he has regular and frequent contact withboth parents. The Family Law Department has additional information about how you canmaintain a healthy attachment to your child, along with other parenting resourcesavailable in the community. Information is also available on our website(www.ojd.state.or.us/mar) (coming soon). Please take advantage of this information.

It is not just the quantity of parenting time you have with your child. The quality matterstoo. Parental stress, depression, substance abuse and poor parenting skills can have animpact on your child’s development. You can make a big difference in your child’s braindevelopment by addressing these issues while your child is young. Staff in the FamilyLaw Department can help you get connected with community resources.

If you don’t have a young child, you still should be concerned about your child’s

Judges Talking Points: Dom Rel

If you don’t have a young child, you still should be concerned about your child’sadjustment during separation and divorce. Extended parental conflict can have negativeconsequences for children, no matter what age they are. A mediator can help you workout your differences without a court battle and may have suggestions if you continue tohave problems. It makes much more sense for parents to decide what the plan will be forthe child with a mediator, than to have a judge who knows very little about yourrespective needs to do it for you.

Sample parenting plan schedules are available that consider a child’s age and need forcontact with both parents. These may help you determine what an appropriate schedulewill look like when you meet with the mediator and after you have considered what yourchild’s needs are. Information about accessing this resource is available on the “ParentResource List”.

If you have serious safety concerns, raise them with the court rather than taking thingsinto your own hands and restricting access of the other parent.

For parents who are concerned that there may be a disagreement as to which parentshould have legal custody of the child, please keep in mind that one of the factors thecourt will consider in awarding custody is each parent’s willingness and ability toencourage a close and continuing relationship with the other parent. ORS 107.137(1)(f). So, on several levels, one can say that it “pays” to encourage the participation of the otherparent in the child’s life.

Third Judicial District September 22, 2006Third Judicial District September 22, 2006

Judge’s Talking Points ctd.

Documents in Website Library

Handouts for Parents:   Parent Resource List (Court Generated):     Parent Resource List (Early Childhood Consortium):     Circle of Security Documents:     Nutrition Handout      

www.ojd.state.or.us/mar

BUILDING THE FOUNDATION FOR LEARNING

Marion County's Early Childhood Initiative

GREAT BEGINNINGS

2008 Action Plans

Marion County's Early Childhood Initiative

Proposed Developmental Screening at well-child visits;

Quality Child Care project for Family, Friends and Neighbors child care providers: college courses for child care providers

Increasing training, developmental support and information in Home Visiting programs

Community awareness campaign working with United Way “Born Learning”

Community –wide “Reach Out and Read” using ZTT “Cradling Literacy” curriculum; providing lending libraries to child care providers

THE END!!!!!!!!!!!!!!!!!!!