Please use the chart paper
to share your thoughts on
the following question:
Consider your work with
families experiencing abuse
and neglect--what challenges do you
encounter?
Meeting the Requirements
of CAPTA and IDEA
Implications for Part C
Early Intervention
Marian Jarrett, Ed.D.
Karin Spencer, MA
George Washington University
Session Agenda






Requirements of CAPTA and IDEA
Challenges for Early Intervention
Abuse and Neglect of Infants and Toddlers
Red Flags
Assessment
Intervention Strategies
CHILD ABUSE AND NEGLECT:
DEVELOPMENTAL CONSEQUENCES





Difficulty forming relationships in preschool and
early adolescence
Lower levels of school achievement, especially
in adolescence
More likely to require special education—72%
by 3rd grade
More behavior problems
More likely to use drugs and alcohol
CAPTA


The Keeping Children Safe Act of 2003
amended the Child Abuse Prevention and
Treatment Act (CAPTA)
As of July 1, 2004, referral required “of a child
under the age of 3 who is involved in a
substantiated case of child abuse or neglect
to early intervention services funded under
Part C of the Individuals with Disabilities
Education Act (Sec.106(b)(A)(xxi)).
PART C of IDEA 2004
SEC. 637.State Application and Assurances
“. . . require the referral for early intervention services
under this part of a child under the age of 3 who—
(A) Is involved in a substantiated case of child abuse or
neglect; or
(B) Is identified as affected by illegal substance abuse,
or withdrawal symptoms resulting from prenatal
drug exposure;”
IMPORTANCE OF CAPTA

Children reported to CPS and/or in
foster care experience many
developmental delays – including
social-emotional delays.

Infants and toddlers referred to CPS
need access to services provided by
early intervention system
THE INTENTION OF THE LAW

Every child referred under CAPTA
shall be screened by a Part C provider
or designated primary referral source
to determine if a referral for an
evaluation for EI service is warranted.

All children are to be screened, but not
all will be referred.
(IDEA Infant and Toddler Coordinators Association (ITCA), 2004)
CHALLENGES
Predicted Increases in Part C

Before CAPTA, 7% of infants and toddlers
in Part C were also in Child Welfare
System

After CAPTA, predictions:
 70% increase in referrals
 20-30% increase in enrollment
What is actually happening??
THE CULTURE OF THE
CHILD WELFARE SYSTEM







Life and death responsibilities
Staff shortages/high caseloads
Inadequate supervision
Public expectation of a punitive system of
accountability
Risk of violence
Adversarial relationships with families
Voluntary or mandated services
(Cohen, 2005)
THE CULTURE OF THE EARLY
INTERVENTION SYSTEM




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Each state defines eligibility criteria
Comprehensive, multidisciplinary evaluations
and intervention
Meet developmental needs of child and
needs of the family
Family centered services based on the IFSP
Services are voluntary
NEED FOR COLLABORATION
BETWEEN EI & CW





Clear definition of roles and
responsibilities
Development of trust
Explanation of EI and CW to families
Joint visits to families
Procedures to follow when families refuse
services
(Cohen, 2005)
CHALLENGES
TO EARLY INTERVENTION
Increased workload
 Assessments to identify social
emotional needs
 Interventions with children and
parents
 Enhance ability to address parental
issues that affect infant mental health

CAPTA CHALLENGES
TO CHILD WELFARE





Work to educate families to accept referral to
EI
CW does not know the potential of EI
Limited staff available/capacity to address
developmental problems
Supervisors do not want to add another
mandate to workers’ job
Confidentiality issues
CHALLENGES OF WORKING
WITH PARENTS
Majority living in poverty
 Poor housing conditions
 Parental substance abuse and mental
health issues are common
 Mothers in abusive relationships
 Multi-stressed, chaotic and unstable
families

CHALLENGES OF WORKING
WITH PARENTS
Inadequate basic care giving skills
 Lack structure, limits and routines
 Many lack knowledge of typical child
development, behaviors and needs
 Discipline is punitive in nature –
expression of parent’s frustration

CHALLENGES OF WORKING
WITH PARENTS
Lack formal and informal supports
 Difficulty trusting others and forming
healthy relationships
 History of poor relationships and
experiences with other “helping
professionals”
 Generational cycle of abuse
 Overwhelmed by their own needs

EVERYDAY IN AMERICA
4
children are killed by abuse
or neglect
 2,383
children are confirmed
as abused or neglected.
(Children’s Defense Fund, 2007)
Everyday In America
All
White
Asian
Amer
Black
Latino
Babies die before
their first
birthday
77
36
3
22
14
Babies born into
poverty
2,411
749
57
697
874
Babies are born to
mothers who are
not HS grads
2,494 969
62
394
1,251
Babies are born to
unmarried mothers
4,017 1,537 97
1,158
1,201
(Children’s Defense Fund, 2007)
Virginia’s Children
Child Population
1,789,782
Living in Poverty
238,312
Child A&N Victims
6,959
Type of Abuse and Neglect
Neglect and Medical Neglect
Percent
64.2%
Physical Abuse
Sexual Abuse
24.6%
15.8%
Psychological and Other Maltreatment 1.6%
(CLASP, 2006)
ABUSE AND NEGLECT AND
DEVELOPMENTAL DISABILITIES
 Children
who experience abuse
and neglect are at high risk for
developmental delays
 psychological, behavioral and
health problems
 Social emotional development

ABUSE AND NEGLECT AND
DEVELOPMENTAL DISABILITES
53% of all children 3-24 months
whose families were investigated
for maltreatment were classified
as high risk for developmental
delay or neurological impairment.
MALTREATED INFANTS AND
TODDLERS

Infants represent ~5% of the children in
the US and 10% of all child maltreatment
victims. (ACF, 2005).

Infants and toddlers most likely to
experience recurrence of maltreatment

Child victims with a disability-- over 50%
more likely to experience recurrence
maltreatment
INFANTS AND TODDLERS IN
FOSTER CARE
80% with prenatal drug exposure
 40% born low birthweight/premature
 Many with acute and chronic health
problems
 More than 50% have developmental
delays or disabilities; few linked to EI
 One-third of infants discharged will
re-enter the child welfare system

THE BRAIN AND EMOTIONAL
DEVELOPMENT




Infants need sensitive, responsive care for
parts of brain that control emotions to
develop properly
Caregivers effectively manage baby’s
emotional states
Baby develops neurological and emotional
foundations
Enables baby to gradually learn to regulate
emotions on her own
ASSOCIATED FACTORS

Factors associated with abuse and
neglect contribute to developmental
problems
Poverty
 Poor nutrition
 Lack of prenatal and medical care
 Substance abuse

(Shonkoff & Phillips, 2000)
CONSISTENT, RESPONSIVE
CARE NEEDED
But - some parents/caregivers:
Reject bids for emotional/physical
closeness
 Are punitive and abusive
 Suffer from depression
 Abuse drugs
 Are overwhelmed by meeting own
needs and need of their children

MENTAL HEALTH IS…

The successful performance of mental
function, resulting in:
 Productive activities
 Fulfilling relationships
 Ability to adapt to change and to cope
with adversity…

Mental health is the springboard of
thinking and communication skills,
learning, emotional growth, resilience, and
self esteem.
INFANT MENTAL HEALTH IS…




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The developing capacity to experience,
regulate and express emotions
Form close and secure interpersonal
relationships
Explore the environment and learn
In the context of family, community and
cultural expectations for young children
Synonymous with healthy social emotional
development
(Hunter, 2006: Adapted from Zero to Three)
SOCIAL EMOTIONAL
RED FLAGS
Behavioral responses to stress and
trauma of abuse and neglect
• Anger and rage
• Anxiety and hyper vigilance
• Emotional shut down
• Bodily reactions
SOCIAL EMOTIONAL
RED FLAGS

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Chronic sleeping, feeding problems
Excessive fussiness, crying
Unusually difficult to be consoled
Minimal interest in social interaction
Avoids eye contact and physical closeness
Does not turn to familiar adult for comfort
Unable to comfort or console self
SOCIAL-EMOTIONAL
ASSESSMENTS
Hawaii Early Learning Profile (HELP)
 Ages & Stages Questionnaire: SocialEmotional (ASQ:SE)
 Brief Infant-Toddler Social Emotional
Assessment (BITSEA)
 Infant-Toddler Social Emotional
Assessment (ITSEA)
 The Ounce Scale, Social & Emotional
Development

SOCIAL EMOTIONAL
ASSESSMENTS

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Early Coping Inventory
Devereux Early Childhood Assessment
(DECA)
Vineland SEEC: Vineland SocialEmotional Early Childhood Scale
The Functional Emotional Assessment
Scale (Greenspan & DeGangi)
INTERVENTIONS
Things to remember...
Build relationships over time
 Introduce self, program, purpose
 Review confidentiality policy
 Take cues from parents
 Keep visits and be on time
 Basic needs come first

INTERVENTIONS
Fostering resilience
Establish and facilitate caring
relationships
 Communicate high expectations
 Provide opportunities for
participation

INTERVENTIONS
Home Visit Tips

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Relate to the parent first
Avoid bonding directly with the child
Ask open ended questions
Ask about pregnancy, infancy and
parenthood
Avoid making too many suggestions
Listen, listen, listen
INTERVENTIONS
Enhancing parent-child relationships



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Relationships change relationships-use the
parallel process
Parent’s experiences as a child
Notice and comment on parental, child and
relationship strengths
Use natural environment
Incorporate activities that involve interaction
Dispel myths
INTERVENTIONS
Strategies
 Offer
developmental guidance
 Celebrate milestones
 Speak for the baby
 Develop strategies and supports
together
INTERVENTIONS
STRATEGIES
Bringing it back to baby
 Being OK with silence
 When a family “no shows”
 When parents are clearly unable to
engage

PART C PROGRAMS AND
PROVIDERS CAN…
Provide high quality home visits
 Emphasis on Service Coordination
 Focus on social-emotional domain
 Learn about local Child Welfare system
and services
 Take care of ourselves as we do this
important work

TAKING CARE OF
OURSELVES


Be self aware:
 How we are is as important as what we
do
 Beware of burn out
 Know our limits
 Pay attention to our own feelings
Remember that parents are responsible
for the choices they make, not us
INSPIRATION
FROM A PARENT
Courage doesn’t always roar.
Sometimes courage is the quiet voice
at the end of the day saying,
“I will try again tomorrow.”
-Anonymous-
CONTACT INFORMATION

Marian H. Jarrett, EdD
mjarrett@gwu.edu

Karin H. Spencer, MA
kspencer@gwu.edu
REFERENCES & RESOURCES
Barnett, D. (1997). The effects of early intervention on maltreating parents
and their children. In M. J. Guralnick (Ed.), The effectiveness of early
intervention (pp. 147-170). Baltimore: Paul H. Brookes.
Bono, K. E., Bolzani Dinehart, L. H., Claussen, K. G., Mundy, P. C., & Katz,
L. F. (2005). Early intervention with children prenatally exposed to
cocaine: Expansion with multiple cohorts. Journal of Early Intervention,
27(4), 268-284.
Cohen, E. P. (2005). Building bridges between child welfare and early
intervention programs. George Washington University Community
Forum, February 11, 2005, Washington, DC.
REFERENCES & RESOURCES
Department of Health and Human Services (2005). Child maltreatment
2003: Reports from the states to the National Child Abuse and
Neglect Data Systems - national statistics on child abuse and
neglect. Washington, DC: U.S. Government Printing Office.
Dicker, S., Gordon, E., & New York State Permanent Judicial
Commission on Justice for Children (Eds.). (2004). Ensuring the
healthy development of infants in foster care: a guide for judges,
advocates and child welfare professionals. Washington, DC: Zero To
Three.
Early Head Start National Resource Center at Zero to Three. (n.d.). In
Home visitor's hand book for the Head Start home-based program
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REFERENCES & RESOURCES
Early Identification Project & University of Colorado Health
Sciences Center (Eds.). (2003). Interagency collaboration:
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Denver: JFK Partners.
Egeland, B., & Erickson, M. F. (2004). Lessons from STEEP:
Linking theory, research and practice for the well-being of
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problems: strategies for intervention (pp. 213-242). New
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Erickson, M. F., & Kurz-Riemer, K. (1999). Infants, toddlers
and families: A framework for support and intervention.
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REFERENCES & RESOURCES
Hawley, T., & Gunner, M. (2000). Starting smart: How early experiences
affect brain development (2nd ed.). Washington, DC: Ounce of
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referrals of abused or neglected children to EI: The MECLI. George
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Jaudes, P. K., & Shapiro, L. D. (1999). Child abuse and developmental
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Ounce of Prevention & ZERO TO THREE. (1998). Ready to succeed: The
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REFERENCES & RESOURCES
Pawl, J. H. (1995). The therapeutic relationship as human
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1-5.
Rosenberg, S., & Robinson, C. (2003). Is Part C ready for
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Treating parent-infant relationship problems: Strategies for
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Shonkoff, J. P., & Phillips, D. A. (Eds.). (2000). From neurons to
neighborhoods: The science of early childhood development.
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