Child Welfare Myths: Foster Care Is Worse than Remaining Home

As a field, child welfare seems to be particularly vulnerable to myths and misconceptions, which are often backed up by inaccurate interpretations of research. Unfortunately, these myths and misconceptions, when promoted by powerful and wealthy advocates, can be perpetuated and enshrined into policy. This is the beginning of an occasional series in which I attempt to deconstruct some of the most common myths. We start with one of the most common and potentially destructive–the myth that children left with their families always do better than they would if placed in foster care.

This myth was recently exhibited in all its glory by the Arizona Star as part of a major series on child welfare in that state. Here is how reporter Emily Bregel describes a frequently quoted study.

Research indicates that children left with their own troubled families fare better than those brought into the foster care system. A 2007 study found children whose families were investigated for abuse and neglect but remained home were less likely to become teenage parents or juvenile delinquents than similarly abused children who were removed from home. Those left at home were also more likely to have jobs as young adults, compared with children of similar backgrounds who were put in foster care.

This oft-misquoted study was published by Massachusetts Institute of Technology’s Joseph Doyle in 2007. Doyle’s study has been used relentlessly–and often inappropriately–by advocates of reducing foster care placements. Doyle used a creative method to estimate the effects of foster care on Illinois children ages 5 to 15 who were receiving welfare and who were investigated for maltreatment for the first time between July 1, 1990 and June 31, 1991. He compared long-term outcomes (delinquency, teen motherhood, and employment) for the children assigned to investigators with higher removal rates to outcomes for those assigned to investigators with lower removal rates.

By comparing the outcomes for the two groups, Doyle could estimate the effects of being placed in foster care for children who were on the margin of placement–those who might have been placed by one investigator and not by another. For those children, Doyle found large differences favoring those children who were not removed from their homes. Doyle’s results say nothing about the children whose cases were unambiguous and who would have been placed (or not placed) regardless of the investigator.¹

Obviously, we cannot do a controlled experiment in which the same child is both placed and not placed in foster care to get at the true difference that it makes in children’s lives. Perhaps the best we can do is ask the children themselves. Researchers at the University of Chicago’s ChapinHall research center surveyed 727 sixteen and seventeen year olds who had in foster care in California for at least six months. When asked about their treatment by their parents or other caregivers before entering foster care, 36% reported that they were hit hard with a fist, kicked or slapped; 32.4% reported that a caregiver threw or pushed them; 28.4% reported missing school to do chores or care for a family member; 28.3% reported having to go without things they needed because the parent’s paycheck was spent on “adult interests,” 26.4% reported that their caregiver beat them up; and 24.9% reported that their caregiver failed to protect them from harm by someone else. A shocking 29.7% reported sexual molestation and 20.7% reported rape. Horribly, 18.6% reported that their caregiver tried to choke, smother or strangle them and 16.9% reported being locked in a closet or room for several hours or longer.

When asked about characteristics of the parent or caregiver they lived with before entering foster care, 48.8% reported inadequate parenting skills, 49.7% a criminal record, 48.3% drug abuse, 48.8 alcohol abuse, 33% reported that a caregiver was abused by or abused a spouse or partner and 25.6% said a caregiver had mental illness. In addition, a total of 56.9% reported that they either agreed, strongly agreed or very strongly agreed with the statement, “All in all I was lucky to be placed in the foster care system,” while only 17.6% disagreed.

The California survey suggests that more often than not, foster care is an improvement over families where children are unsafe, fearful, hungry, unsupervised, or unloved. However, I have learned from my own experience as a social worker that, while some children make the miraculous journey from hell to heaven when they are placed in the best foster homes, many foster homes are only slightly less chaotic and more nurturing than the homes from which the children have been plucked. The beatings, rapes, and hunger may be over but many children and youth continue to be neglected emotionally, educationally, and in other ways in foster care. When combined with the trauma caused by separation from family, it is not surprising that young people whose home lives were on the border between acceptable and unacceptable to an investigator may do worse in foster care than they would have done at home.

Neglect of children in foster care is inexcusable: these children need more than the usual nurturing in order to make up for the trauma and deprivation they may have already suffered in their birth homes. That’s why we need to increase the number of children placed with kin as well as other alternatives to traditional foster care, such as residential schools and hybrid arrangements that combine features of foster and group homes. But what we don’t need to do is abandon children in homes where they are not safe.

The misuse of Doyle’s article has supported the ideas that it is always better to reduce the number of children in foster care and that reduced care numbers are a prima facie indicator of improvement. It has led to many systems, like that of my home town of Washington DC, using reduction of foster care numbers as an outcome in itself–independent of trends in actual maltreatment. Using foster care reduction as an indicator of success fails to recognize that some placements are needed to keep children safe. It also means that jurisdiction, like New York City for example, may be claiming partial credit for the results of gentrification.

The misuse of research and data, especially when translated into policy, should disturb everyone regardless of their feelings about the particular issue. Doyle’s research suggests that when the case for removal is marginal, the default option might be to keep the child at home–with supervision and services by the state. It does not suggest that removal of a child from home is always the wrong decision or that programs should be rated solely on the ability to cut foster care rolls.

Another problem with making inferences from Doyle’s study about foster care today is the age of his data, which are from 1990 and 1991. Child welfare culture and practices have changed greatly since that time and the relevance of research from 25 years ago is questionable. ↩

Domestic violence and child abuse: a lethal combination

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It did not take long for the press to discover that Devin Kelley, the the perpetrator of the recent mass shooting in Texas, had repeatedly assaulted his first wife and fractured the skull of his infant stepson in 2012. He was court-martialed for those offenses, pled guilty, and was imprisoned for a year.

I could not help noting the parallel to the case that I wrote about in my last post–that of Antoine Flemons, who at two months old was beaten to death by his father, Antoine Petty. The post focused on one aspect of this case–the fact the father was known to have abused many other children. I argued that baby Antoine might have been protected by a broader policy to identify at birth babies born to parents with such a record.

But the revelations about the Texas shooter reminded me of another important aspect of Antoine’s family that put the baby in grave danger. In an interview with the Washington Post, Antoine’s grandmother stated that her daughter Geneice Petty loved her son but suffered from “battered women’s syndrome.” In other words, she was a victim of domestic violence.

The connection between domestic violence and child abuse is well-documented. Research suggests that “in an estimated 30 to 60 percent of the families where either domestic violence or child maltreatment is identified, it is likely that both forms of abuse exist.”

In the 40 states providing domestic violence data to the Administration Children and Families for its Child Maltreatment 2015 report, 25% of child maltreatment victims were found to have a caregiver who was either a victim, perpetrator or witness of domestic violence.

Co-occurring domestic violence and child abuse can take several forms. In many cases, one parent (usually the father) abuses both the other parent and the child or children. There are other configurations, such as families in which the abused parent in turn abuses the children.

In baby Antoine’s case, no information has been released to the public. One can speculate in view of the father’s extreme violence that Geneice Petty was afraid to protect her children and that her husband bullied her into covering up his killing of their son.

The key question is what could have been done to prevent the death of Antoine. Historically, child welfare systems have had not responded effectively to domestic violence. Common and problematic patterns have included ignoring or minimizing the domestic violence and, conversely, giving women an ultimatum to leave the abuser or leave their children–a response which often leads women to fear and avoid child protection authorities rather than seek their help.

One study found that “[Domestic violence]appears to have only a minor role in influencing the decisions of child welfare workers; yet, children exposed to [domestic violence] often have multiple contacts with [child welfare services] due to the higher number of repeat allegations of maltreatment.”

The Children’s Bureau has has published a useful manual about how to handle child maltreatment cases in which domestic violence is present or suspected. The manual’s many recommendations provide alternatives to the problematic practices mentioned above.

Unfortunately, we don’t know if Maryland child welfare workers even identified domestic violence in earlier cases involving Antoine’s parents, let alone how they responded. That’s why, as I have said over and over again about all child maltreatment deaths and serious injuries, there needs to be a thorough investigation, a public report, and a proposal for changes in policy and practice to protect future baby Antoines.

Would a broader birth match have saved Antoine Flemons?

Antoine Flemons 3 — Photo from GoFundMe fundraiser by Geneva Flemons

Little Antoine Flemons never had a chance. Prince George’s County Maryland Prosecutors described how his father, Antoine Petty, “dangled the infant by the arm and repeatedly struck him before handing the baby to his mother to feed. When the baby continued to cry, Petty dealt another round of blows, quieting the child forever.”

Antoine’s parents left his body in the car for over 24 hours before burying him, according to police. The Judge sentenced Petty to 40 years in prison for his son’s murder. Antoine’s mother pleaded guilty to involuntary manslaughter and will be sentenced in December.

Information shared by the prosecutors revealed that Petty, the father of nine, had a long history with Child Protective Services dating back until at least 2007. He was reported for carving a three-inch cross into a five-year-old daughter’s arm, pushing a five-year-old down stairs, giving a ten-year-old a black eye, forcing a daughter to watch him having sex with a girlfriend, and failing to adequately nourish an eleven-month-old. One of his children was found at age 11 months to have rib fractures which were found by a doctor to be ‘not accidental.”

How could this father be allowed to mistreat child after child and this mother to fail to protect them for close to ten years when so many acts of maltreatment were reported to CPS? It would be more appropriate to ask how such a parent can be stopped. When an abusive parent has a new child, there is no mechanism in most states to trigger protection for that child.

Interestingly, Maryland is one of the few states that does have such a mechanism– a “birth match” program. Under birth match, birth records are matched against a list of parents who had their parental rights terminated within the last five years due to abuse or neglect. Parents thus identified receive a visit from a social worker to assess the child’s safety. If the parents refuse the visit, a case can be opened if there is reason to expect abuse or neglect.

But Maryland’s birth match law did not protect little Antoine. It is unlikely that his parents had their rights terminated in the past. Perhaps Antoine would have been protected by a broader law, such as Minnesota’s, which triggers an investigation or family assessment under a broader set of circumstances. These include when a parent has subjected a child to “egregious harm,” has failed to protect a child from such harm, has committed child neglect endangering physical or mental health, and has committed first second or third degree assault among others.

We don’t know if a broader birth match law would have protected little Antoine because no information has been released about the results of the prior investigations against Antoine’s parents.

As I discussed in an earlier post, all deaths of children in families known to CPS should be investigated immediately and the results made available to the public. Only with such an investigation can we know how and why the system failed little Antoine.

There has been a shocking lack of calls for such an investigation from Maryland legislators and child advocates. Only the Washington Post broke the silence, asking, Could this 2-months old’s death have been prevented? Nobody who cares about children in Maryland should rest until they know the answer, and until measures have been put in place to prevent similar tragedies in the future.

To Prevent Further Tragedies, Require Immediate Fatality Reviews

On November 6, 2016, Trinity Jabore was born in the District of Columbia with marijuana in her system and weighing less than five pounds. On December 25 of the same year, Trinity’s lifeless body was taken to the morgue. A pathologist determined that Trinity’s brief life had been one of suffering. She weighed less than her birthweight, she had multiple fractured ribs, and she died from consuming water that had been mixed with condensed milk.

Soon the Washington Post learned that the District’s Child and Family Services Agency (CFSA) had received multiple calls reporting neglect of other children born to Trinity’s parents. The final call occurred early in the month of her death. A teacher reported that her brother had showed up in school with a bruise under his left eye and stated that his mother had punched him because he “wasn’t listening.” Three weeks later, the investigators had talked to the brother but had not managed to contact his parents. They were still “trying to make contact” when Trinity died.

Trinity’s story is unfortunately very familiar. I have written about the deaths of Zymere Perkins in New York and Yonatan Aguilar in Los Angeles. A recent series published in the Fayetteville Observer revealed that more than 120 North Carolina children have died within a year of a child maltreatment report. Each of these deaths is the tip of the iceberg of system failure. We have no idea how many children are suffering in toxic homes as you read this column. Tonisha Hora was left in an abusive home for ten years despite repeated calls to CPS about her plight and that of her sister.

The first response to Trinity Jabore’s death should have been for an independent panel to conduct a comprehensive review of her parents’ prior contacts with the child welfare system to determine how she was left unprotected . This review should have been conducted immediately and included recommendations to prevent such tragedies in the future.

Unfortunately, Trinity has been dead for 9 months and no such review has been released. Like other jurisdictions, the District of Columbia has a Child Fatality Review Committee, upon which I serve. But I have been disappointed by the long lag times and lack of thoroughness of these reviews.

The Committee is about to issue its annual report, which will contain reviews of deaths that occurred between 2012 and 2015. It takes some months for the panel to receive notice of child deaths and all the relevant information including pathology reports. Because the panel is understaffed, there is a further delay after cases are received. The District of Columbia Auditor recently found that the percentage of child deaths reviewed by the CFRC has been declining as the panel’s budget has been cut drastically. Similar issues plague other child fatality review teams, such as the one in North Carolina.

There is another problem with child fatality review panels as a mechanism for reviewing systems’ failure to identify children at risk. In about half the states, these teams review all child fatalities, not just those that are due to child maltreatment, or those of children known to child welfare agencies. The District’s panel reviews all fatalities of young people aged 18 and younger, including all premature infants, gun violence victims, children with terminal illnesses, and accident victims. It does not review the actual files but brief summaries provided by overworked CFRC staff. And Trinity’s death will be mentioned only briefly in an annual report devoted to all of the child deaths that were reviewed in the same year.

An internal CFSA review has probably already occurred, but the public will not know about it for some time. It was in April 2017 that the agency released its review of child deaths occurring in 2014 and 2015. Moreover, Trinity’s death will be folded into a report on all deaths of children known to CFSA within four years of their death–a total of 30 deaths in 2015.

The death of a child known to the system should be treated like a plane crash or the loss of the space shuttle Challenger. It should be reviewed immediately and exhaustively by experts of the highest caliber. The point is not to allocate guilt or punishment but to change policies or practices to save children in the future.

In the State of Washington, the Children’s Administration (CA) conducts a review when the death or near-fatality of a child was suspected to be caused by child abuse or neglect, and the child had any history with CA (including a hotline report that was not investigated) at the time of death, or in the year prior. The review committee is made up of individuals with no prior involvement with the case, and typically includes CA staff, ombudsman staff, and community professionals selected from diverse disciplines with expertise relevant to the case. The review committee has full access to all records and files relevant to the review. The agency must release review results within 180 days following the fatality, unless granted an extension by the Governor.

These reports are subject to public disclosure and must be posted on the Department’s website. The Department is authorized to redact confidential information contained in these reports. In order to promote accountability and the consistent implementation of recommendations, the state’s family and children’s ombudsman is required to issue an annual report to the Legislature that includes an update on the implementation of recommendations issued by fatality review committees.

Every state or other relevant jurisdiction should follow Washington’s example and require a thorough, immediate independent review of all all cases of children children who die, are seriously injured or disappear (as in the case of Relisha Rudd in the district of Columbia) when there is a family history with CPS. This should be a requirement for federal funding.

No more children should suffer because of agency incompetence, extreme family preservation ideology or underfunding. Let us take the first step and ensure all of these terrible cases are investigated immediately and acted upon fast.