Parental Drug Use as the Condition for Removal

 “Thirty-nine per cent of children enter foster care because of parental drug use”  is the most commonly quoted statistic regarding the role of drugs in a child’s removal from home.  However, that  number is an average of US state removal statistics.  While recently updating my book Will I Ever See Your Again? Attachment challenges for Foster Children, I came across the following graph indicating that the proportion of children who enter foster care due to parental drug use varies greatly from state to state from 3.6% to 69%.  (Source: AFCARS 2019, most recent data.)


                                  At a glance:

Individual State statistics

Parental Alcohol or Other Drug Abuse as an Identified Condition or Removal by State, 2019
In descending order




National Average 38.9%



Changes to AZ Law Help Foster Children “Stay Put...”


I have served on the Arizona Foster Review Board for 21 years.  A few years ago we had a case in which a mother and her 3-year old daughter, Kiley, moved to Arizona from Ohio after the mother’s divorce from Kiley’s father.  Although he knew the location of the mother and his daughter, the father made no effort to keep in contact with them.  The mother remarried but when Kiley as 4 1/2, she was removed from the mother and step-father and placed in foster care due to domestic violence and other issues.  The mother’s parental rights were terminated and Kiley was placed with a foster-adopt family to which she quickly became bonded.  Almost three years later, when Kiley was 7, the DCS case worker located Kiley’s father in Ohio in an effort to place Kiley with him.  Kiley did not remember her father; she thought that her step-father was her ‘real’ father.  When asked in an interview about his daughter’s activities and likes and dislikes, Kiley’s biological father knew nothing about her.  He also refused to acknowledge that Kiley had suffered any trauma from the violent environment from which she was removed.  Kiley, on the other hand, named her foster mother, “Mommy Cindy” and her foster father, brothers, and sister when asked who was in her family.  The psychologist who was contacted to perform a bonding assessment described the only in-person visit between Kiley and her biological father as having “gone poorly.” Conversely, when he observed Kiley with her foster mother, he reported that “their interaction was seamless.”  The psychologist concluded that the “prognosis that the father will be able to demonstrate minimally adequate parenting is poor” and that there was a “potential traumatic emotional cost” of moving Kiley to her father in Ohio based on Kiley’s “lack of attachment and relationship with her father.”  An additional concern was that the father also had 6 other children with four women and a drug arrest background.  Despite the psychologist’s recommendations, the case plan of adoption, Kiley’s 3 years with her future adoptive family, and fierce objections from the foster parents as well as sadness and despair from Kiley, herself, she was moved to her father in Ohio.


This story is not uncommon.  Sometimes, years after a child is placed in a foster/adopt home with adoption processes well underway, a relative is found or “pops up”  and the child is moved from what may have been the only loving home the child has ever known, to be placed with “family” who do not know her at all, handing the child another traumatic event on top of the one that brought the child into foster care in the first place.  


Another recent case involved a substance exposed newborn placed in a foster-adopt home shortly after birth.  The foster mother drove from the family’s rural home over 150 miles to Phoenix Children’s Hospital weekly to attend to the child’s drug-exposure-caused withdrawal symptoms, eating difficulties, and developmental disabilities for 15 months (a time span that surely encompasses the period during which the child formed an attachment to the foster mother) until a great aunt and uncle from another state appeared and was awarded custody of the child by the judge.  The great aunt and uncle did not know the baby or the baby’s many problems. I testified as an expert witness in that case that moving the child away would be traumatic for the child on many levels. I was beyond shocked at the court’s decision to move the child.


Fortunately, Arizona lawmakers addressed these problems in August of 2018 through modifications to Arizona Revised Statutes, Title 8 - changes that would have changed the outcome in both of these scenarios.


For Kiley, modifications to ARS 5-514.03(A) addressing kinship care would have given her a better chance of remaining with the family that she loved by replacing “the program shall promote the placement of the child with the child’s relative for kinship foster care” with “the placement of the child who is in the custody of the department shall be determined by the best interests of the child (emphasis added.)  Kiley’s best interest would have been to remain with her potential adoptive home which had been providing a loving home for almost 3 years.  



For the infant in the second scenario, kin who appear 15 months after a foster adopt placement would not be considered for placement because of this added time limit:  “The department shall use due diligence in an initial search to identify and notify adult relatives of the child or person with significant relationship with the child within 30 days after the child is taken into temporary custody.” (Emphasis added.)


An added time limit to find a permanent home for infants in care would also have prevented the child’s move to a great aunt and uncle she did not know:


ARS 8-503(A)(10): (The department) shall “maintain a goal that infants who are taken into custody by the department be placed in a prospective permanent placement within one year after the filing of a dependency petition.  


Also, ARS 8-514(B)3 gives some foster parents equality with kin:  “A foster parent or kinship caregiver with whom a child under three years of age has resided for nine months or more is presumed to be a person who has a significant relationship with the child.”


The infant had been with the potential adoptive home that provided extraordinary care for serious effects of drug exposure for over 15 months giving the foster parents equality with kin.  She was exactly where she should have stayed.

The Role of Culture in Child Dependency Cases

 

Cultural Connections for Foster Children

 

Last year I was asked to develop a training for the Arizona Court Improvement Program to address the role of culture in child dependency cases.  As I prepared the presentation, I wasn't sure where to begin to address the question, "what is role of culture in child dependency cases?   From my FCRB experience, I know that Section III (D) in the DCS Progress Report addresses “efforts to maintain cultural connections, including opportunities for the child to build cultural awareness, identity, and involvement.”

 

From a long list of definitions of “culture,” I selected, “society’s common foundation of beliefs and behaviors and its concepts of how people should conduct themselves” (Hunter School of Social Work web page.) I then began putting together the presentation with the idea of addressing national and ethnic cultural differences and how we assure that the child’s cultural “beliefs, behaviors, and concepts” remain in the child’s life as he moves through the foster care system.  Pretty straight forward.  

 

But it quickly became apparent that not every child is tied to an ethnic or national culture.  My grandmother was born in Prague, Bohemia, and came to the US as a child bringing her Bohemian (note the capital “B”) ways with her.  Her daughter, my mother, cooked Bohemian food, knitted “continental” style, spoke to her mother in Bohemian. She had clearly adopted some of her mother’s culture.  My brothers and I have some curiosity about Bohemia (now Czech Republic) but no real connection to the Bohemian culture.

 

So we make efforts to assure that those children who are tied to an ethnic or national culture keep those connections.  But, I soon realized that cultural influence extends far beyond just ethnic/national culture.  Additional cultural influences include the foster child’s family, neighborhood, church/organizations, and school.  Each of these “cultures” (aka “microsystems”) have common beliefs and behaviors and a child placed in foster care loses connections to all of them in one swift move. As a foster child, I clearly remember the experience of being placed into different foster homes.  It was almost paralyzing.  And it didn’t matter whether it was kinship or non-kinship placement, or if the foster parents and their home were perfect in every way; the rules were different from my home “culture” and I didn’t know what they were.  In one “kinship” placement, my brother and I went to a new school for three weeks.  We were lost in that particular school culture.  Nothing was the same; not the school work, the teaching methods, the rules, and no one answered our main question, “how come no one is wearing their uniforms?” (We were Catholic school kids and that was true “culture shock.”).  We were also far away from our church where we were both involved with Scout troops and, of course, we did not know our new neighbors (church and neighborhood - two more cultures lost.)  But, for us, it was more of a temporary stressor because we knew we would be reunited with our mother and older brothers eventually.*

 

For children who are abused/neglected, the “culture shock” is much worse.  Children who have been physically abused, or who have not had adequate food, managed to adapt to their abusive environments for survival.  Perhaps they learned how to sneak and hide food or steal change to buy food; or they became adept at sensing when it was safe to approach a parent and when it wasn’t.  Most of these children have spent their entire lives in abusive/neglectful homes.  It’s all they know; and their neural pathways for their specific survival behaviors are strong.  When they are removed and placed in foster care, they enter unfamiliar territory with unknown rules and new people who might or might not hurt them. They are unsure of how to get food; nervous about attending a new school, and have no neighborhood friends to play with after school.

 

In their new placement, these children may display behaviors that we would consider “survival” tactics in their abusive homes but “odd” in their foster homes e.g., hoarding food, stealing money, or raising their arms in self-defense when approached by an adult.  That was their home culture.  At school they may be so far behind that they become lost or just give up trying (every move through foster care results in 4-6 months loss of academic progress in school.).  Regardless of the quality of their care, their removal from home and school cultures may be unsettling because the abuse and neglect way of life is all they know.   

 

It becomes apparent that, in addition to assuring connections to ethnic/national cultures, we also need to consider connections to the child’s “microsystems.”  So we ask, always with the safety of the child in mind, “Is it possible for the child to remain in the same school (in accordance with ARS 15-816.01) and/or continue to participate in church/scouting activities?  Can we enlist the assistance of safe family members for transportation to and from these locations to help keep the child’s connection to friends and family strong?  How can we safely help the child preserve some connection to his extended family, neighborhood, school, church, extracurricular activity? Children removed from their homes will always have difficulty adjusting to a new environment, but the more “cultural” connections we can maintain for them, the less “culturally shocking” their move will be. 

 

 

*We were in foster care each time our mother, who was battling cancer, was hospitalized, which was quite often, but we returned home when she did. We returned to foster care after she died and eventually were placed with an aunt and uncle. Our older brothers were self-sufficient

 

Breaking the Foster Cycle

One of the most detrimental experiences for a child’s immediate and future well-being is to be moved from foster home to foster home, or, in the case of failed reunifications, from foster home to biological parents and back to a foster home.  Changes in placement affect the child’s sense of trust, feelings of abandonment, and ability to attach to new caregivers.  But this movement, informally referred to as “foster cycling,” will occur for most children in foster care. 

According to childwelfare.gov, multiple placements are also associated with higher delinquency rates in males; increased (actually, double for most children) visits to emergency rooms because of the lack of continuous medical care; and increased use of mental health services.  Multiple placements lead to multiple schools and every school change results in an estimated loss of 4 to 6 months of school progress per school change.  Over one-third children who age out of foster care will have attended five or more schools while in care. (See:  www.theatlantic.com/archive/2014/02/every-time-fosters-kids-move-they-lose-months-of-academic-progress/284134)

Among the reasons for foster cycling are foster parent turnover, failed reunifications with biological parents, and unusual behaviors from the child that the foster parents are not prepared to handle.   Of all the people who move through the lives of foster children, none are in a better position to affect multiple placements than foster parents.  That effort begins by helping the child acclimate to his new home. 

Annette Jones and her colleagues at the University of Buffalo recently interviewed 35 certified, experienced foster parents to gain insight as to what works to help foster children adjust to a new foster home.  The foster parents described several approaches to making their newly arrived foster child feel welcome.  Briefly, these foster parents…

·         emphasize that the foster home is now also the child’s home. 
·         help the child make the home “their own” by surrounding them with their own possessions.
·         commit themselves to handling whatever behavior problems might arise during the initial adjustment period. 
·         do not insist that the child refer to them as “mom” and “dad.”
·         do not refer to their children as “foster” children thus making it easier for the child to feel a part of the family.
·         set up a daily routine so the child knows what to expect from day to day.
·         allow the child to freely express his loyalty to his biological parents.
·         relieve parentified children from their responsibilities to care for younger siblings, thus allowing them to return to their “childhoods.”


Other efforts to reduce the foster cycling include excellent foster parent training, confidence that family reunification will be successful, and a quicker road to permanence with a family, whether family reunification, adoption, or guardianship.  

Sibling groups. Together? Or Apart?

I recently met with a grandparents group in El Mirage to discuss a number of issues they were having while caring for their grandchildren.  Some grandparents were concerned that their grandchildren had been separated between kinship placements and asked me to research policies on keeping siblings together. 

“Sibling” is generally defined more by relationship than by their genetic relatedness. Unrelated children who have lived in the same family together are “siblings” more than children who share the same parents but have not lived together. 
An article from the Child Welfare Information Gateway (January 2013) highlights the pros and (a few) cons of siblings placed together.

The benefits of keeping siblings together are obvious:  siblings provide a sense of safety and emotional support.  As a foster child myself, I was always placed with one (or more) of my three older brothers.  This gave me an ever present feeling of protection when surrounded by strange people in an unfamiliar environment.  Research indicates that these supportive relationships last throughout childhood and into adulthood, i.e., forever.  In addition, research indicates that siblings placed together have a higher probability of family reunification than siblings placed in different foster homes. 

Siblings placed together also tend to have better academic performance than separated sibs.   Having the children in the same placement also makes communication between placement, children, case managers, and birth families easier than having to include two or more placements in the communication loop. 

But there are some roadblocks to placing children together, the most obvious of which is the size of the sibling group -- the most common reason for not placing siblings together.  Sibling groups of three, four, five, or more may be difficult, if not impossible, to place because of the licensing requirements for differing numbers of children.  Siblings may also be separated if one (or more) of the children needs a higher level of care than other siblings, requiring a therapeutic foster home which may not be able to care for all of the children.

In addition to the number of siblings and required level of care, research has uncovered other factors that discourage keeping some siblings together.  They include:  serious behavior problems in one child that may place siblings/foster siblings in danger; and the tendency of siblings placed together to focus on each other and ignore the foster family’s efforts to include them in family activities.  Separating siblings may also provide "parentified" children, who have spent their lives taking care of younger children, an opportunity to find their own childhoods. 

The take-away from the research is that keeping siblings together is best but, in the end, this decision, like all foster care decisions, should consider the best interest of each of the children. 

For more information about this topic, visit:  www.childwelfare.gov