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SECTION
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Report Form
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When reviewing a child custody evaluation, it is useful to consider how the
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information was presented to the court. The enclosed Report Form indicates what
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information should be included, and provides a clear format for presentation. The
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Report Form also provides for increasing levels of interpretation and generalization, as
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discussed in Chapter 11 on the “Ultimate Issue.”
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Custody evaluators can use this Report Form by inserting the appropriate contact
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information in the spaces provided. Instructions for the various sections are enclosed in
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brackets.
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The purpose and recommended content of the various sections of the report are
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discussed in Chapter 14. Each evaluation involves a unique mixture of issues,
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so you will need to adapt the report form for each case. By starting with a
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standard form, however, you will be able to maintain a consistent writing style
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and approach to making inferences.
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As you write each report, remember that only custody-relevant information
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should be included. It may seem fascinating that the couple met on an ocean
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cruise, or that last year when the child was only 12 he pitched in the area-wide
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Little League championship game. The court does not need to know this level of
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detail, however. It is usually sufficient to refer to the date the couple met, or to
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the parent’s pride that the child is an outstanding athlete. Only mention details
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when they have some bearing on the custody dispute, family dynamics,
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parenting abilities, or psychological functioning of a family member.
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The instructions for the various sections of the report often refer to boxed
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information from the text. Be sure to consult these boxed summaries as you
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write.
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To adapt the Report Form for your practice, simply remove the Header identifying
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the section of the CD. You may want to substitute a Header identifying the case
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name, evaluator name, date, and page of the report. Then insert your practice
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information at the end of the Report.
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REPORT OF CHILD CUSTODY EVALUATION
[Name of case]
[Name of Court]
Docket # 00 0000 0000
[Date Report Filed]
CONTENTS OF REPORT
I.
II.
III.
IV.
V.
VI.
VII.
VIII.
IX.
X.
XI.
XII.
XIII.
XIV.
Page
IDENTIFYING INFORMATION…………………………………………………………………………
REASONS FOR REFERRAL
A. Court Order……………………………………………………………………………………..
B. Questions to be Addressed in Evaluation………………………………………………..
INFORMED CONSENT/WAIVER OF CONFIDENTIALITY………………………………………....
DATA-GATHERING PROCEDURES
EXPLANATON OF METHODOLOGY USED IN EVALUATION…………………………………..
BACKGROUND TO THE EVALAUTION……………………………………………………………..
PARENT #1: [Name of parent #1]…………………….….……………………………………………
PARENT #2: [Name of parent #2]…………………….….……………………………………………
CHILD #1: [Name of child #1]………………………………………………………………………….
CHILD #2: [Name of child #2]…………………..…………………………………………………….
FAMILY DYNAMICS……………………………………………………………………………………..
ISSUE OF DOMESTIC VIOLENCE [or other special issue]………………………………………
SUMMARY AND GENERAL CONCLUSIONS ……………………………………………………….
RECOMMENDATIONS……………………………………………….………………………………….
I. IDENTIFYING INFORMATION:
Parent #1: [Name]
[Street address]
Tel: 000-000-0000
DOB: 00/00/0000
AGE: 00
Parent #2: [Name]
[Street Address]
Tel: 000-000-0000
DOB: 00/00/0000
AGE: 00
Child #1:
[Name]
DOB: 00/00/0000
AGE: 0 yrs, 0 months
Child #2:
[Name]
DOB: 00/00/0000
AGE: 0 yrs, 0 months
Parents never married. Relationship began fall 00/00/0000, ended 00/00/0000.
Evaluator: [Evaluator Name]
[Evaluator contact information]
Attorneys: Parent #1
[Attorney name]
[Attorney contact information]
Parent #2
[Attorney name]
[Attorney contact information]
II. REASONS FOR REFERRAL:
A. Court Order
This evaluation was conducted pursuant to a [date] court order appointing a child
custody evaluator signed by the Hon. [judge’s name] of the [Court] Probate and Family Court.
The evaluation was ordered regarding the fitness of mother and father as well as what custodial
arrangements are in the best interests of the children.
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B. Questions to be addressed by evaluation
In order to assess parental fitness and the best interests of the children, this evaluation
addresses the following questions:
1. What is the ability of each parent to parent the children effectively?
2. What parenting tasks has each parent carried out in the past?
3. What kind of relationship does each parent have with the children?
4. How effectively can the parents cooperate with each other?
5. Does either parent have physical or mental health problems that interfere with
their parenting abilities?
6. What is each child’s adjustment and personality style?
7. Are there any patterns of domestic violence or child abuse in the family?
8. What are the custody wishes of each parent and each child?
III. INFORMED CONSENT and PARENT CONTRACT
All of the people interviewed (in person or by telephone) as part of this evaluation were informed
that the information they offered in the context of this evaluation would be used in the
preparation of a report that would go to the court. The parties interviewed indicated that they
understood the conditions under which they were participating in this evaluation and gave their
informed consent to that effect.
The parents in this case signed a Contract and Fee Agreement that explained the
purpose, methods, cost, and lack of confidentiality in this child custody evaluation.
IV. DATA-GATHERING PROCEDURES
A. Interviews with Family Members
00/00/00: Office Interview with father, [name] (X hrs.)
00/00/00: Office Interview with mother, [name] (X¼ hrs.)
00/00/00: Office Interview with father (X½ hrs.)
00/00/00: Office Interview with mother (X¼ hrs)
00/00/00: Office Interview with child #1, [name] (XX min.)
00/00/00: Office Interview with child #2, [name] (XX min.)
B. Observation of Parent/Child Interactions
00/00/00: Observe father with children during home visit (X hrs)
00/00/00: Observe mother with children during home visit (X hrs)
C. Home Visits
00/00/00: Home visit at father’s residence (X hrs.)
00/00/00: Home Visit at mother’s residence (X hrs.)
D. Interviews with Third-Party Collaterals
1. Professionals
00/00/00: [name, position, relationship to case], (telephone or office
interview, XX min.)
2. Friends, neighbors, and family members
00/00/00: [name, relationship to case], (telephone or office interview,
XX min.]
E. Records Reviewed
1. Mother:
● Parent Questionnaire completed and signed by mother on 00/00/0000.
2. Father:
● Parent Questionnaire completed and signed by mother on 00/00/0000.
3. Child #1:
● [Name, relationship to case, address]: type of report, date and how
obtained]
4. Child #2:
● [Name, relationship to case, address]: type of report, date and how
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obtained]
F. Psychological Testing
1. Parents:
[List each test used]
2. Children:
[List each test used]
V. EXPLANATION OF METHODOLOGY USED IN EVALUATION
[Use sections A and B in all reports. Then add either C1: the explanation for not using psychological
tests; or C2: the explanation for using psychological tests, which should include information about (a) the
relevance of each test used, (b) the psychometric properties of each test used, and (c) identification of the
psychological testing expert. The example here uses the MMPI.]
A. Custody Standards and Social Science Research [For all reports]
This evaluator sought to obtain all of the information required for child custody
decisions based on the Best Interests Standard. This information was then assessed
in the context of the most recent social science research on issues related to child custody.
B. Explanation of reliability and validity [For all reports]
In child custody evaluations, it is essential that the assessment devices used are both
reliable and valid. Reliability is the degree to which results are consistent when a test or other
assessment procedure is repeated. Validity is a test or assessment procedure’s ability to
predict behavior in real-life situations.
In child-custody evaluations, convergent validity is also provided by using multiple
independent sources of information (e.g. interviews, observations, home visits, record review,
and test data) about the same variables. The greater number of information sources that lead
to (or converge on) the same conclusion, the more powerful the conclusion, i.e. the more
confidence one can have that the conclusion is within a reasonable degree of psychological
certainty. Some data are also given more weight than others, depending on the neutrality of the
source and the extent to which the information does not involve a subjective judgment on the
part of the informant.
C1. Explanation for not using psychological tests
Psychological tests were not used in the present evaluation because the methods
employed here (interviews, observations, home visits, record review, and information from
collateral sources) are more reliable and valid for child custody evaluations than are the tests
currently available (Rohrbaugh, 2007).1
[If evaluation used psychological tests, then use section C2.]
C2. Explanation for using psychological tests
1. Explanation of relevance for each psychological test used
1 Some standard psychological tests (e.g., MMPI-2, MCMI-III, and WAIS) have been the subject of extensive research
and have well-established reliability and validity (Bow et al., 2005). These tests are appropriate when there are parental fitness
issues such as an inability to be consistent, to modulate emotions, to be emotionally sensitive and available to the child, and to
provide the child with appropriate levels of cognitive stimulation, advocacy, and care and protection (Medoff, 2003). These parental
fitness issues are not present in the current case.
Most of the tests that have been developed specifically for use in custody evaluations measure various aspects of
parenting (e.g., ASPECT, Bricklin Scales, Parent-Child Relationship Inventory, Custody Quotient, and Parenting Scale). Although
their intended results are very relevant, their psychometric properties are poor because there is little normative data and adequate
reliability and validity cannot be established. The Child Abuse Potential Inventory (CAP) is well-conceived and validated, but it is
only relevant to cases involving child abuse. Child abuse is not an issue in the present case.
For the reasons outlined above, neither the standard psychological tests nor the custody-specific tests would have been
appropriate or useful in the present case.
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[Example for MMPI]
In the present custody evaluation, the mother maintained that the father is impulsive and
emotionally explosive. She feels that these characteristics interfere with his ability to parent the
couple’s two children, and also cause the father to interact with the mother in a hostile, verbally
abusive manner. In response to these allegations, this evaluator requested that both parents
participate in a psychological evaluation conducted by [tester name]. The purpose of the
psychological evaluation was to assess these and other personality traits that enhance or
interfere with the stability, firm limit-setting, and emotional sensitivity required for effective
parenting.
Dr. [name’s] psychological evaluation included the MMPI-2, a 567-item parental selfreport questionnaire with a true/false format. Although the MMPI was developed to screen for
severe psychopathology such as depression, paranoia, and schizophrenia, the scores can also
be used to assess the following parenting-relevant variables: capacity for emotional attachment,
potential for antisocial behavior, anger management problems, tendency to alienate the child
from the other parent’s affection, and long-term disposition towards substance abuse (Caldwell,
2005).
2. Explanation of psychometric properties of each psychological test used
[Example for MMPI]
There have been over 10,000 published studies about the MMPI, and its reliability and
validity are well-established (Bow et al, 2005). In order to interpret the results of the MMPI-2,
scores are compared with a normative sample of custody litigants. The present evaluator used
the litigant’s MMPI-2 results to develop hypotheses about how the litigant’s psychological
functioning affected their parenting. These hypotheses were then compared with information
obtained from the independent sources listed in section IV above.
3. Identification of psychological testing expert
In the present evaluation, the psychological testing was done by [name and degree of
testing expert]. Dr [name] is a clinical psychologist with expertise in adapting standard
psychological tests for use in custody evaluations. Dr. [name] based her report on the results of
a computerized scoring system. The inferences about psychological functioning contained in
the present custody evaluation report are derived from Dr. [name’s] psychological testing report.
Dr.[name] can be reached at: [street address, city/town, zip code, phone, fax, email].
D. Order of interviews and observations
In the present evaluation, the mother [father] was interviewed first because s/he had
expressed more complaints and allegations about the other parent than had the father [mother].
This order of interviewing and reporting permitted Parent #2 to respond to the allegations and
complaints during the interviews and by offering additional sources of collateral information.
The use of the labels “Parent #1” and “Parent #2” reflects this order of interviewing and
reporting, and also makes the report language appropriate for all families regardless of the
gender of the parents. These labels are not intended to imply that one parent is more central or
primary than the other parent.
VI. BACKGROUND TO THE EVALUATION:
[Write a very brief paragraph saying when the couple relationship began, when they married, and the
number and current ages of the children. Describe when and why the dispute arose, and the date of
separation. Include the current arrangements for parenting time.]
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VII. PARENT #1: [Name]
The information contained in this section is based on [name’s] report and constitutes [his/her] recollections,
perceptions, claims, and opinions of personal and family events. Information from other sources is identified as such.
A. Data-gathering Procedures and Parent’s General Demeanor:
[Indicate when you interviewed or observed the parent, what measures were administered to
them, and any special materials the parent gave you. Briefly describe the parent’s general
appearance, demeanor, and degree of cooperation during the evaluation.]
B. Concerns and Desires re. Custody:
[In one or two sentences, describe what the parent’s concerns are (e.g., that the other parent has
a substance abuse problem, is negligent, is a caring parent but preoccupied with work, etc).
Then indicate whether the parent wants sole or joint legal custody, and where they want the
children to live.]
C. Personal History:
1. Family background:
[Where born and grew up, parent and sibling names, major problems in family,
current involvement and support of extended family.]
2. Education and Career:
[High school, college, advanced degree, type of occupation, current employment
and schedule.]
3. Health:
[Presence or absence of any major health problems that affect parenting.
Corroboration by physician and medical records if needed.]
4. Religion
[Religious practice as child, adult, during marriage/relationship, as parent, and
currently. Specify whether religion is an area of dispute in separation/divorce.]
D. Living Situation:
[In a few sentences, summarize the information obtained during the home visit regarding:
physical condition of the home (cleanliness and order, safety, food/kitchen, sleeping
arrangements, and play area), child activities, toys, family pets, and family’s involvement in the
neighborhood. Specify who lives in the home or visits regularly.]
E. Relationship History:
[List any previous long-term relationships and marriages, with the current ages of any resulting
children and their current custody arrangements. Report any domestic violence, substance
abuse, or other major difficulties in these relationships.]
F. Parenting Style and History:
[Describe specific parenting activities before separation; refer to text Box 12 for primary caretaker
functions and Box 13 for criteria for identifying attachment figures. Then discuss the relevant
parenting strengths and weaknesses from the list in Box 56. Include information from (1)
evaluator records from parent/child observations, (2) self-report by family members, and (3) thirdparty reports. Then discuss the relevant parenting strengths and weaknesses from the list in Box
56.]
G. Relationship with Children:
[Use the same sources of information as section F, but focus on the emotional tone of the
parent/child relationship rather than on parenting activities. Also consider the parent’s ability to
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empathize with the child, and help them learn to control and direct their feeling appropriately.
First consider the parent’s general relationship capacities, then address their relationship with
each child.]]
H Social and Psychological Functioning:
[Describe the parent’s personality style, based on your behavioral observations, interviews with
the parent, observation of the parent/child interaction, and reports by other family members and
third-party collaterals. If there is an individual or couples therapist, quote their description of the
parent. Report any hospitalizations and medication taken. Do not use technical jargon or
diagnoses. Report on any psychological testing here.]
I. Summary re. Parent #1:
[Describe your conclusions about the parent’s patterns of behavior, emotional issues,
psychological functioning, parent/child relationships, and parenting style. Discuss their role in the
family, especially regarding potential for conflict and cooperation. For each issue, list the specific
types of data that converge on that conclusion.
VIII. PARENT #2: [Name]
The information contained in this section is based on [name’s] report and constitutes [his/her] recollections,
perceptions, claims, and opinions of personal and family events. Information from other sources is identified as such.
A. Data-gathering Procedures and Parent’s General Demeanor:
[Indicate when you interviewed or observed the parent, what measures were administered to
them, and any special materials the parent gave you. Briefly describe the parent’s general
appearance, demeanor, and degree of cooperation during the evaluation.]
B. Concerns and Desires re. Custody:
[In one or two sentences, describe what the parent’s concerns are (e.g., that the other parent has
a substance abuse problem, is negligent, is a caring parent but preoccupied with work, etc).
Then indicate whether the parent wants sole or joint legal custody, and where they want the
children to live.]
C. Personal History:
1. Family background:
[Where born and grew up, parent and sibling names, major problems in family,
current involvement and support of extended family.]
2. Education and Career:
[High school, college, advanced degree, type of occupation, current employment
and schedule.]
3. Health:
[Presence or absence of any major health problems that affect parenting.
Corroboration by physician and medical records if needed.]
4. Religion
[Religious practice as child, adult, during marriage/relationship, as parent, and
currently. Specify whether religion is an area of dispute in separation/divorce.]
D. Living Situation:
[In a few sentences, summarize the information obtained during the home visit regarding:
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physical condition of the home (cleanliness and order, safety, food/kitchen, sleeping
arrangements, and play area), child activities, toys, family pets, and family’s involvement in the
neighborhood. Specify who lives in the home or visits regularly.]
E. Relationship History:
[List any previous long-term relationships and marriages, with the current ages of any resulting
children and their current custody arrangements. Report any domestic violence, substance
abuse, or other major difficulties in these relationships.]
F. Parenting Style and History:
[Describe specific parenting activities before separation; refer to text Box 12 for primary caretaker
functions and Box 13 for criteria for identifying attachment figures. Then discuss the relevant
parenting strengths and weaknesses from the list in Box 56. Include information from (1)
evaluator records from parent/child observations, (2) self-report by family members, and (3) thirdparty reports. Then discuss the relevant parenting strengths and weaknesses from the list in Box
56.]
G. Relationship with Children:
[Use the same sources of information as section E, but focus on the emotional tone of the
parent/child relationship rather than on parenting activities. Also consider the parent’s ability to
empathize with the child, and help the child learn to control and direct their feeling appropriately.
First consider the parent’s general relationship capacities, then address their relationship with
each child.]]
H Social and Psychological Functioning:
[Describe the parent’s personality style, based on your behavioral observations, interviews with
the parent, observation of the parent/child interaction, and reports by other family members and
third-party collaterals. If there is an individual or couples therapist, quote their description of the
parent. Report any hospitalizations and medication taken. Do not use technical jargon or
diagnoses. Report on any psychological testing here.]
I. Summary re. Parent #2:
[Describe your conclusions about the parent’s patterns of behavior, emotional issues,
psychological functioning, parent/child relationships, and parenting style. Discuss their role in the
family, especially regarding potential for conflict and cooperation. For each issue, list the specific
types of data that converge on that conclusion.
IX. CHILD #1: [name, age]
A. Data-Gathering Procedures and Child’s Demeanor
B Relationship with family
C Health
D School
E Social and Psychological Functioning:
F. Summary re. [child’s name]:
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X. CHILD #2: [name, age]
A. Data-Gathering Procedures and Child’s Demeanor
B Relationship with family
C Health
D School
E Social and Psychological Functioning:
F. Summary re. [child’s name]:
XI. FAMILY DYNAMICS
XII. ISSUE OF DOMESTIC VIOLENCE
XIII. SUMMARY AND GENERAL CONCLUSIONS:
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XIV. RECOMMENDATIONS:
A. Legal custody
B. Physical custody
C. Visitation
1. Supervision of Visitation
2. Location of Visitation
3. Pick-up and Drop-off
4. Visitation Schedule
5. Holidays
Respectfully submitted,
[Evaluator Name and Credential]
[Title and Facility]
[State License No.]
[National Certification]
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