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Protocol to investigate child abuse in foster care
Child Abuse & Negkcr, Vol. 7, pp 287-295, Printed m the USA. All rights reserved
PROTOCOL
Copyright
0145.2134183 $3.00 + .oO C 1983 Pergamon Press Ltd.
TO INVESTIGATE CHILD ABUSE IN FOSTER CARE
MARILYN Hennepin
1983
CAVARA,
County
Community
M.S.W.
AND CAROL
OGREN,
M.A.P.A.
Services, 300 South Sixth Street, Minneapolis,
MN 55487
Abstract-Hennepin County Community Services, a large urban agency in the midwestem United States, developed specific procedures for investigating complaints of abuse and neglect of children in foster care in 1980. During the period from May 1980 through November 1981, approximately 125 complaints of abuse and neglect in foster homes were investigated. This article discusses the Protocol, including the institutional abuse meeting, investigation by an independent third party, and statements of finding. Factors that appear to be significant in abusing foster parents are marital status, if the foster parents had children of their own, length of time licensed, and presence of previous complaints. Victims were slightly more likely to be male, aged 4-12. Many victims appeared to have adjusted well to the foster homes. Information is presented on how the abuse was reported. Recommendations include: investigations conducted by an objective third person, commitment of the administration, and enlistment of legal personnel and foster parents during implementation. Also included are prevention of abuse through comprehensive screening and then training of foster parents, social workers’ close contact with foster parents and foster children, avoiding high risk placement, forbidding corporal punishment, and sensitizing social workers to abuse-neglect of children in foster care. R&ume-Les Services Communautaires du Comte d’Hennepin desservent une grande zone urbaine du Minnesota; ils ont redigB une s&ie de recommandations et une marche P suivre pour les cas oti l’on doit faire une enqu&te suite & des plaintes pour s&vices et nCgligence exercts & l’kgard d’enfants placts en foyer nourricier. Pendant la ptriode de mai 1980 a novembre 1981, les Services ont rqu environ 125 plaintes concernant une forme ou l’autre de maltraitance dans des foyers nourriciers. Le protocole d’enqu&te comprend, entre autres, une confrontation des personnes impliquCes dans les cas de violences, une enqu&te par une instance independante et une description des faits obse&s. Les facteurs de risque qui semblent significatifs dans le cas de parents nourriciers sont les suivants: Ctat civil (ma&, divorct, etc.), pr&ence dans la famille nourriciere d’enfants du couple, degr6 d’anciennetk de l’autorisation de prendre des enfants en pension et existence de plaintes semblables antkrieures. Les victimes sont un peu plus souvent des garqons que des filles et leur Lge va de 4 B 12 ans. Un grand nombre d’entre elles donnent l’impression d’&tre bien adaptCes au foyer nounicier, en fait. Les auteurs d&rivent comment les voies de fait ont &tC d&non&es. Les recommandations sont les suivantes: l’enqu&te doit &tre conduite par une tierce personne tout & fait neutre, 1’Administration doit se sentir concern&e, de m&me que les parents nourriciers. Les directives du groupe comprennent egalement une mtthode t&s approfondie de selection des parents nourriciers, des recommandations concernant leur formation; elles incluent aussi des suggestions au sujet des contacts entre travailleurs sociaux; enfants placks et parents nourriciers qui doivent Ctre trts frequents et approfondis; les auteurs donnent kgalement des conseils sur comment s’y prendre pour Cviter des placements g risque tlevC, comment interdire les chdtiments corporels et comment sensibiliser les travailleurs sociaux a la possibilik de s&vices et nCgligence chez les enfants placis en foyer nourricier.
OVER
THE LAST FEW YEARS, there has been a growing awareness of the institutional In 1980 in response to this awareness, the Hennepin County Community Services Department developed a Protocol for the Znvestigation of Znstitutional Abuse and Neglect of Children. Although the Protocol applies to child abuse that takes place in any residential facility or home licensed for the care of children, or any facility or home providing day care for children, this paper will examine only the abuse that occurred in family foster homes. Its purpose is to alert the professional community to the extent of the problem of foster care abuse and the need for agencies to develop procedures to prevent it when possible and investigate it when it occurs. The Protocol placed the responsibility and authority for investigation with Child Protection Intake social workers. This was a departure from the past practice of having abuse abuse
Presented
of children.
at Fourth
International
Congress
on Child Abuse and Neglect, 287
Paris, France,
September
1982
Marilyn
288
Cavara
and Carol Ogren
investigated by the foster care licensing worker (home finder) or the child’s social worker (case manager). It was considered necessary, however, as it ensured that the investigations were conducted by social workers who were experienced in child protection investigations and who had no vested interest in the outcome of the investigation.
THE PROTOCOL
The Institutional
Abuse Meeting
The first step in the Protocol requires that the person who receives the allegation of abuse or suspects child abuse immediately notify Child Protection Intake. The intake worker notifies the supervisor of the Intake Unit, and convenes an “institutional abuse meeting.” If there is any imminent danger to the child (alleged victim), or other children in the home, the meeting will be convened immediately. If not, it is scheduled for the next working day. The following staff are required to be present at the meetings: the Child Protection Intake worker responsible for the investigation, the social workers of all children in the foster home, the foster home social worker, and each of their supervisors. If any of the social workers are unavailable, it is the responsibility of the supervisor to designate another social worker to participate. If a supervisor is unavailable, another supervisor or a superior must attend. This requirement is rigorously enforced, and it has been an important factor in gaining staff acceptance of and commitment to the Protocol. The purpose of the meeting is to review all pertinent information about the foster parents and the child victim, and the circumstances of the alleged abuse. It is chaired by the Child Protection Intake supervisor who has responsibility for determining what action will be taken to protect the child and the authority to assign all investigative and reporting tasks to the various Departmental staff present at the meeting. Such assignments may supersede the routine line of supervision. The Intake supervisor may determine that the situation does not warrant further investigation for institutional abuse, and the matter is referred to licensing staff for disposition.
The Investigation
and Report
Where there is an allegation of physical or sexual abuse, the local police are immediately notified in accordance with state law. The parents of all children in the home are notified of the complaint. The time at which this takes place and the detail of information provided will vary with the circumstances of the complaint. After the investigation is completed, the Child Protection worker completes the report on the investigation and submits it to the Department of Public Welfare and the Foster Home Licensing Division. A copy is maintained by the Child Protection Division. The report includes the following: 1. A summary of the institutional abuse meeting. 2. A detailed narrative of the investigation and documented evidence. 3. A detailed statement of the findings which must be one of the following: l Substantiated.. An admission of the fact of abuse or neglect or a confirmation deemed valid (i.e., bruises) l Not Substantiated: The complaint, although it may have been made in good faith, is found to have no substance l Unable to Substantiate: Insufficient evidence for a substantiated report is present, but there remains reason to suspect abuse or neglect.
Investigating
child abuse in foster care
289
Decision Once the report is completed, a decision is made by the Foster Home Licensing Division on the status of the home’s license, based on the findings. One or more of the following actions may be taken: l
l
l
l
l
No Action: If the complaint is not substantiated, or if there is no concern over the foster parent’s care, no licensing action will be taken. Increased Monitoring: If abuse is not substantiated, but the investigation has raised concerns about the home, the licensing social worker and the child’s social worker may be required to visit the home more frequently and more carefully monitor the child’s progress. Contracting: A contract is signed by the agency and foster parent, in which the foster parent agrees to fulfill specific expectations such as obtaining additional training. This action is usually taken if the investigation determined that physical abuse was not present, but corporal punishment, which is prohibited by licensing provisions [l] and department policy, was used. Probation: The license is made probationary for a specified period of time, during which the foster parents are required to take specific actions, such as obtaining more training or counseling. This action can be appealed in a quasi-judicial setting. Revocation: Foster parents can also appeal this action. Foster parents whose license has been revoked cannot reapply for five years.
IMPLEMENTATION
PROBLEMS
The Department encountered a number of problems in its implementation of the Protocol. Initially, there was resistance to the Protocol as follows: Foster home workers, who viewed themselves as advocates for the foster parents, saw the Protocol as evidence of a lack of support for foster parents who cared for difficult children, often without sufficient resources. The children’s social workers, who also had established close working relationships with foster parents, shared similar concerns. Child Protection workers found the investigations to be extremely time consuming and very detailed. Ordinarily, the intake worker conducts an investigation to ascertain if there is sufficient reason to provide Child Protection intervention and transfer it for ongoing services; in institutional abuse cases, a determination needs to be made, not only as to whether abuse has occurred, but as to who is the perpetrator. Many of the social workers and their supervisors resisted receiving assignments from a supervisor who had no line authority over them. There was also discomfort among all the workers because at various steps in the process, they were in a position to closely observe the work of their colleagues. Foster parents were also resistant, accusing the Department of not trusting them, of judging them guilty before they could tell their side. Initially, there was a large number of “unable to substantiate” findings; workers relied very heavily on facts which could be proven and hesitated to rely on their professional judgment in drawing conclusions from these facts. This created some difficulties if licenses were revoked and the revocations were appealed.
STUDY
FINDINGS
Following is a report of the abuse that occurred in foster homes from May 1980 through November 1981 and a discussion of the characteristics of the perpetrators, in comparison with the characteristics of the general population of foster parents.
290
Marilyn
Cavara
and Carol Ogren
The first and most obvious result of the Protocol was the large number of investigations. There are approximately 570 foster homes in Hennepin County. During the l&month period, 125 investigations were conducted. This appears to be two to four times the number of investigations conducted in counties that do not emphasize institutional abuse investigations 12, 31. As was noted previously, social workers were initially reluctant to make a finding of substantiated abuse without irrefutable evidence. Thus, the authors have chosen to look at both “substantiated” and “unable to substantiate” incidents, in the belief that they are more representative of institutional abuse.
Sexual Abuse During the l&month period, there were five incidents of substantiated sexual abuse and six that were unable to be substantiated. Both heterosexual and homosexual abuse occurred and ranged from inappropriate exploitive touching to sexual intercourse and sodomy. There were a number of factors in these incidents that proved to be quite surprising and were contrary to what might be expected. In many cases, the children did not give any outward signs that the abuse was occurring; there was no deterioration in their behavior, or evidence of increased disturbance. To the contrary, many of the children showed marked improvement while in the foster home. Academic performance improved, children became active in athletic functions and after school activities. Most of the foster parents were well liked and respected by the social workers who had children in their homes, and they were considered excellent foster parents due to the marked improvement of the children placed in their care. Children were reluctant to tell their social workers the abuse had occurred, even when asked specifically. The following is a sample of complaints investigated. Willi~lm, age 16, told his therapist in a group session that while in a foster home for two years. the foster father, age 60, sexually abused him and other boys in the home. At the time the complaint was received. there were three boys living in the foster home. They were immediately removed from the home and interviewed; other boys who had been in the home were subsequently interviewed. From these interviews it was learned the foster father had performed anal and oral sex with some of the boys in addition to inappropriate sexual touching.
In the 11 cases studied, all the perpetrators were male. Of the 18 victims, 9 were male and 9 were female. One victim was under 3 years of age; 7 were between 4 and 12; and 10 were 13 or older. The children reported the abuse to the following: school (1); parent, friend or neighbor (4); social worker (1); other community professional (5). A fact of considerable concern in all the incidents of abuse or neglect is that children did not readily go to their social worker for help. In these 11 situations, 3 of the foster parents had been investigated previously under the Institutional Abuse Protocol, although not necessarily for sexual abuse. This is remarkable in view of the short time period the Protocol had been in effect. This indicates the importance of conducting a very thorough investigation, and of monitoring homes very closely after a complaint has been received if it is not substantiated. The demographic characteristics of the abusing fathers did not appear significantly different from the overall population of foster fathers, with the exception of the length of time they had been licensed foster parents. Four out of the 10 foster fathers had been licensed more than 10 years, compared to an overall percentage in the foster parent population of 19. Of these 11 families, 7 had their licenses revoked, 2 withdrew from the program, and no action was taken on 2.
Investigating
child abuse in foster care
291
Neglecf There were 8 substantiated incidents of neglect, and 20 unable to be substantiated. Neglect allegations were the most difficult to substantiate due to the lack of physical evidence. Foster parent neglect usually takes the form of failing to provide adequate supervision, resulting in injury to a child, leaving the child in the care of an inadequate substitute provider, or medical neglect. Following is an example of foster parent neglect: Cker, age 11, lived with his single foster mother for 5 years. When she was hospitalized for a leg amputation, Chet told his social worker he was concerned about the extra care Iris foster mother would require when she returned from the hospital. When asked what he was doing for the foster mother now, he listed the following: rubbing and washing her back and legs, soaking her feet, preparing her insulin and medication, wasking and brushing her hair, giving enemas to her, washing all the clothes, and doing all the dishes.
In the 28 cases studied, the foster mother was considered the perpetrator in 19, foster father in 2, and both in 7. There were 50 victims, 31 male and 19 female. Seven (14%) were aged O-3; 27 (54%) were 4-12; and 16 (32%) were 13 or older. Following is information on whom the neglect was originally reported to by the child, or by whom it was observed: school, 3 (11%); parent, friend or neighbor, 11 (39%); social worker, 7 (25%); other community professional, 5 (19%); anonymous, 1 (4%); and self-reported, 1 (4%). This information is significant in that it shows that the most frequent reporter is the child’s parent or family; yet the agency is probably least likely to believe parents, as they may have an interest in discrediting the foster family. A low reporting rate to the child’s social worker is also seen. This raises a deep concern, since many of the children in foster care do not see their family with any frequency, if at all. To whom can they turn? Of these 28 foster homes, abuse investigations had previously been conducted on 7 of these families. Physical Abuse Physical abuse in foster homes tends to not be as severe as that usually observed in other child protective situations, and is usually a result of discipline that has been carried too far. Following is an example of physical abuse in a foster home: Three siblings, John (age 4), Gwen (age 2), Jane (age I), and two siblings, Jason (age 5) and Justin (age 2) had been physically abused and neglected, according to two neighbor families who called the Department. Corporal punishment was observed, involving both foster parents-spanking, slapping, punching 4-year-old with closed fist on face, throwing 2-year-old through open back door, and picking the children up by one arm. The foster mother demanded to be called “Mommy,” or the children would be spanked. The foster father had stated, “Get down or I am going to chop your head off,” and again, “I am going to hold your legs and dunk you in the toilet and flush it.” Eight neighbors, in addition to the two that called, came to the Department to volunteer info~ation about the abuse of these children. Several had seen black eyes and hand prints on the children’s faces. They stated they had asked the foster parents about these and had been told the children had fallen or that they (the foster parents) did not know how the marks were received.
There were 16 cases of substantiated physical abuse, and 26 were found unable to be substantiated. There were 60 victims (35 male and 25 female) of the following ages: 4 (7%) were O-3 years of age; 35 (58%) were 4-12; 18 (30%) were 13 and older. The ages of 3 (5%) were unknown. The breakdown of individuals observing the abuse, or individuals to whom the children reported abuse is similar to that for neglect: school, 3 (7%); parent, friend or neighbor, 15 (36%); social worker, 11 (26%); community professional, 9 (21%); anonymous, 1 (2%); selfreported, 3 (7%).
292
Marilyn
Cavara
and Carol Ogren
There were only six previous institutional abuse investigations on these families, which is lower than in the other two categories. For the 20 abusing or neglecting foster fathers there did not appear to be any characteristics significantly different from the general population of foster fathers. In these instances, the following licensing actions were taken: revocation, 2; withdrawal, 6; probation, 1; contracting, 2; no action, 9.
Significant
Characteristics
of Foster Care Abusers
Marital status of mother. Insofar as the abusing foster mothers were concerned, the most significant factor was their marital status. Seventeen, or 46% of the 37 mothers were single, compared with 30% of the general population of foster mothers. This number is particularly interesting in view of the fact that the Department is very selective in licensing single parents. Of the married couples that apply to be licensed, 44% are accepted; of the single persons who apply, only 22% are licensed. The following licensing actions were taken: revocation, 4; withdrawal, 9; probation, 2; contracting, 3; increased monitoring, 4; no action, 13. In two instances the foster parents had withdrawn from the program before the Department received the complaints.
Length of time foster famiIy licensed. In looking at the characteristics of the 51 families investigated for neglect or physical abuse, two other factors appear significant: The first is the length of time the families were licensed. The study population appears to have been foster parents for a greater length of time, as can be seen in the Table below. There are a number of possible explanations for this: 1. Foster parents who have been licensed longer may receive more difficult children. 2. Foster parents may “burn out” after a certain period of time. 3. Agency staff may have more confidence in more experienced foster families, thus providing them with less help and support. 4. More experienced foster parents may be reluctant to ask for help. 5. The greater number of children in a foster home increases the likelihood of lodged complaints.
Fosterfamily childless. The second significant finding was that these families were less likely to have children of their own than in the general population of foster parents. Only 94 (17%) of the families in the overall foster parent population do not have children of their own. Seventeen (34%) of the 51 study families are childless.
Table 1. Length Time Licensed Less than 1 year l-3 years 4-5 years 6- 10 years 11 or more years unknown 1 (2%)
of Time Licensed: Study Families All Foster Families Study Families 5 13 10 12 10
(10%) (25%) (20%) (24%) (20%)
Compared
All Foster 78 226 60 95 111
to
Families (14%) (40%) (11%) (17%) (19%)
293
Investigating child abuse in foster care CONCLUSIONS
AND RECOMMENDATIONS
Criteria for Investigation It is essential that agencies develop procedures for the immediate investigation of all suspected incidents of abuse or neglect. While the procedures developed will vary with the size and structure of the agency, the following criteria should be met: 1. The procedures should require that the investigation is conducted by an objective party with no vested interest in the outcome. 2. It is essential that the procedures have the support and commitment of the administration of the agency. 3. There should be a centralized person or unit in charge of maintaining the information gathered as part of the process. 4. Legal help should be enlisted during the development of the procedures to ensure compliance with all applicable laws. 5. A format should be developed as to how the final report is to be written, including clear definitions of terms. Suggestions for Implementation
of Investigations
In developing these procedures, an agency may anticipate some implementation Following are some suggestions to alleviate them, based on Hennepin County’s
problems. experience:
1. Because the procedures will generally cut across organizational lines, a certain amount of territorialism and interdivisional rivalry can be expected. Leadership and commitment from management is necessary to avoid such problems. 2. Resistance on the part of foster parents can be mitigated by involving foster parent organizations once the Protocol has been developed. 3. The discomfort of the investigating social workers can be lessened by providing training in advance of the implementation of the new procedures. Training should include the following: (a) social workers should be sensitized to the needs of the children and the foster parents so children are not traumatized by the process and foster parents made any more anxious than necessary; (b) social workers need to understand the importance of the investigation so they will be as detailed and conscientious as possible; (c) social workers need permission to make judgments based on their findings and addressing this issue at the beginning should result in more valid conclusions as well as greater consistency. Prevention
of Abuse of Children in Foster Care
Based on the Department’s experience of the last two years, agencies apparently can develop and improve practices to help prevent abuse of children in foster care. Following are specific actions which can be taken.
Screening. Screening of foster parent applicants must be very comprehensive to eliminate potentially abusive foster families. Home studies should include individual interviews with all family members, including the taking of social histories, an evaluation of motivation, child rearing practices, and family relationships. References should be obtained as well as reports from the family physician and school. In addition, the following steps should be taken: 1. The names of all applicants should be cleared with District, Courts to determine if a criminal record is present.
Juvenile
and
Municipal
294
Marilyn
Cavara
and Carol Ogren
2. The use by applicants of chemicals, including both alcohol and drugs, should be thoroughly discussed as part of the home study, and social workers should be trained to identify danger signals. 3. Since the vast majority of child abusers were once victims themselves, social workers should determine whether the prospective foster parents were ever abuse victims.
Close contact with foster families. Foster home social workers must maintain close contact with foster families, paying particular attention to changes in the families that can result in additional stress. In most agencies, there is only yearly contact required between the licensing workers and families. Hennepin County requires quarterly contact.
Avoiding high-risk placements. The authors recommend further study to determine if there are factors which make some foster parents more likely to abuse the children in their care. In addition to studying abusive foster parents, data on victims should also be collected including their placement history, presence of abuse in their own or previous foster families, etc.
Agencies
must not overload foster families.
Corporal punishment not allowed. Most of the physical abuse was the result of excessive corporal punishment; yet many agencies allow corporal punishment of children in foster homes. As Jeanne Giovannoni states, The public view seems to be: “It’s all right to hit your child but not too hard; in fact, it’s all right to hurt your childbut not too badly.” This issue needs to be faced more squarely than it is at present. As long as we as a society condone corporal punishment of children, we must admit that we are also willing to place some children in danger of being hurt badly [4].
Training. Training for both foster mothers and fathers should be mandatory, and particularly address alternative methods of discipline, since much of the physical abuse is “excessive discipline.” Foster parents who care for sexually abused children must be prepared for dealing with the seductive behavior such children present. Those caring for physically abused children should be informed of their potential aggressive, provocative behavior. Abused and neglected children can also be apathetic or clinging, and this can be very trying for foster parents.
Stress. Agencies must be very aware of the stress that foster parenting do whatever is possible to alleviate it.
places on families,
Offer help. Foster parents must be encouraged to ask for help. Training programs stress that foster parents are expected to ask for help with difficult children.
and
should
Child udvocate. The agency must provide an “advocate” for the child in placement. Social workers must be trained to develop a relationship with the foster child alone, apart from the foster family. This requires frequent contact between the child and social worker.
Investigating
child abuse in foster care
295
Social workers alert to signs of abuse Social workers must be made aware of the extent of abuse that occurs in foster homes, and should be trained to be alert to any signal that a child may be abused. They should be trained to be inquisitive and ask specific questions of the child such as, “What are the ‘rules’ of the house?” “ What happens when you break a rule?” Do you have any privacy?” “ Does the foster parent enter your (the child’s) room? If so, under what circumstances?” Questions such as these can be asked in a nonthreatening way, and yet provide the social worker with some insights into the family dynamics.
Social workers should be required to visit with the children alone.
Social workers should be required to make occasional
unannounced
visits to the foster
home.
Consult with child’s parents. Parents of children in foster care should be encouraged to give their opinions on the care the child is receiving. As noted earlier, parents and neighbors were most likely to report abuse. Frequent visitation should be encouraged, not only to promote the relationship between parent and child, but to provide the child with another advocate.
Exit interview. After a child has left a foster home, an “exit interview” should be conducted. At this point, very specific questions of the child should be asked regarding his or her experience in the foster home. At the time of a new placement, social workers should interview children about previous placements to ensure that each child has an opportunity for exit interviews. The social worker’s “advocacy” role should be stressed.
Respond to abuse or neglect. All acts of abuse or neglect must be responded to with appropriate licensing action and, if appropriate, criminal prosecution. If the actions of the foster parents are not serious enough for such action, yet undesirable, contracting, additional training, or counseling should be utilized.
REFERENCES 1. Standards for Foster Care and Group Family Foster Care, 12 Minn Code Agency R. Set 2.001 (D) sota Department of Public Welfare, St. Paul, MN (1978). 2. Fosfer Home Child Protection, Special Services for Children Study, Vera Institute of Justice, New (1981). 3. BOLTON, JR., F. G. and GAI, D. For better or worse? Foster parents and children in an officially maltreatment population. Children and Youth Services Review 3:37-53 (1981). 4. GIOVANNONI, J. M. and BECERRA, R. M. Defining Child Abuse. The Free Press, New York
(8) (i), MinneYork, NY p. 4 reported
child
p. 243 (1979).
PROTOCOL
Copyright
0145.2134183 $3.00 + .oO C 1983 Pergamon Press Ltd.
TO INVESTIGATE CHILD ABUSE IN FOSTER CARE
MARILYN Hennepin
1983
CAVARA,
County
Community
M.S.W.
AND CAROL
OGREN,
M.A.P.A.
Services, 300 South Sixth Street, Minneapolis,
MN 55487
Abstract-Hennepin County Community Services, a large urban agency in the midwestem United States, developed specific procedures for investigating complaints of abuse and neglect of children in foster care in 1980. During the period from May 1980 through November 1981, approximately 125 complaints of abuse and neglect in foster homes were investigated. This article discusses the Protocol, including the institutional abuse meeting, investigation by an independent third party, and statements of finding. Factors that appear to be significant in abusing foster parents are marital status, if the foster parents had children of their own, length of time licensed, and presence of previous complaints. Victims were slightly more likely to be male, aged 4-12. Many victims appeared to have adjusted well to the foster homes. Information is presented on how the abuse was reported. Recommendations include: investigations conducted by an objective third person, commitment of the administration, and enlistment of legal personnel and foster parents during implementation. Also included are prevention of abuse through comprehensive screening and then training of foster parents, social workers’ close contact with foster parents and foster children, avoiding high risk placement, forbidding corporal punishment, and sensitizing social workers to abuse-neglect of children in foster care. R&ume-Les Services Communautaires du Comte d’Hennepin desservent une grande zone urbaine du Minnesota; ils ont redigB une s&ie de recommandations et une marche P suivre pour les cas oti l’on doit faire une enqu&te suite & des plaintes pour s&vices et nCgligence exercts & l’kgard d’enfants placts en foyer nourricier. Pendant la ptriode de mai 1980 a novembre 1981, les Services ont rqu environ 125 plaintes concernant une forme ou l’autre de maltraitance dans des foyers nourriciers. Le protocole d’enqu&te comprend, entre autres, une confrontation des personnes impliquCes dans les cas de violences, une enqu&te par une instance independante et une description des faits obse&s. Les facteurs de risque qui semblent significatifs dans le cas de parents nourriciers sont les suivants: Ctat civil (ma&, divorct, etc.), pr&ence dans la famille nourriciere d’enfants du couple, degr6 d’anciennetk de l’autorisation de prendre des enfants en pension et existence de plaintes semblables antkrieures. Les victimes sont un peu plus souvent des garqons que des filles et leur Lge va de 4 B 12 ans. Un grand nombre d’entre elles donnent l’impression d’&tre bien adaptCes au foyer nounicier, en fait. Les auteurs d&rivent comment les voies de fait ont &tC d&non&es. Les recommandations sont les suivantes: l’enqu&te doit &tre conduite par une tierce personne tout & fait neutre, 1’Administration doit se sentir concern&e, de m&me que les parents nourriciers. Les directives du groupe comprennent egalement une mtthode t&s approfondie de selection des parents nourriciers, des recommandations concernant leur formation; elles incluent aussi des suggestions au sujet des contacts entre travailleurs sociaux; enfants placks et parents nourriciers qui doivent Ctre trts frequents et approfondis; les auteurs donnent kgalement des conseils sur comment s’y prendre pour Cviter des placements g risque tlevC, comment interdire les chdtiments corporels et comment sensibiliser les travailleurs sociaux a la possibilik de s&vices et nCgligence chez les enfants placis en foyer nourricier.
OVER
THE LAST FEW YEARS, there has been a growing awareness of the institutional In 1980 in response to this awareness, the Hennepin County Community Services Department developed a Protocol for the Znvestigation of Znstitutional Abuse and Neglect of Children. Although the Protocol applies to child abuse that takes place in any residential facility or home licensed for the care of children, or any facility or home providing day care for children, this paper will examine only the abuse that occurred in family foster homes. Its purpose is to alert the professional community to the extent of the problem of foster care abuse and the need for agencies to develop procedures to prevent it when possible and investigate it when it occurs. The Protocol placed the responsibility and authority for investigation with Child Protection Intake social workers. This was a departure from the past practice of having abuse abuse
Presented
of children.
at Fourth
International
Congress
on Child Abuse and Neglect, 287
Paris, France,
September
1982
Marilyn
288
Cavara
and Carol Ogren
investigated by the foster care licensing worker (home finder) or the child’s social worker (case manager). It was considered necessary, however, as it ensured that the investigations were conducted by social workers who were experienced in child protection investigations and who had no vested interest in the outcome of the investigation.
THE PROTOCOL
The Institutional
Abuse Meeting
The first step in the Protocol requires that the person who receives the allegation of abuse or suspects child abuse immediately notify Child Protection Intake. The intake worker notifies the supervisor of the Intake Unit, and convenes an “institutional abuse meeting.” If there is any imminent danger to the child (alleged victim), or other children in the home, the meeting will be convened immediately. If not, it is scheduled for the next working day. The following staff are required to be present at the meetings: the Child Protection Intake worker responsible for the investigation, the social workers of all children in the foster home, the foster home social worker, and each of their supervisors. If any of the social workers are unavailable, it is the responsibility of the supervisor to designate another social worker to participate. If a supervisor is unavailable, another supervisor or a superior must attend. This requirement is rigorously enforced, and it has been an important factor in gaining staff acceptance of and commitment to the Protocol. The purpose of the meeting is to review all pertinent information about the foster parents and the child victim, and the circumstances of the alleged abuse. It is chaired by the Child Protection Intake supervisor who has responsibility for determining what action will be taken to protect the child and the authority to assign all investigative and reporting tasks to the various Departmental staff present at the meeting. Such assignments may supersede the routine line of supervision. The Intake supervisor may determine that the situation does not warrant further investigation for institutional abuse, and the matter is referred to licensing staff for disposition.
The Investigation
and Report
Where there is an allegation of physical or sexual abuse, the local police are immediately notified in accordance with state law. The parents of all children in the home are notified of the complaint. The time at which this takes place and the detail of information provided will vary with the circumstances of the complaint. After the investigation is completed, the Child Protection worker completes the report on the investigation and submits it to the Department of Public Welfare and the Foster Home Licensing Division. A copy is maintained by the Child Protection Division. The report includes the following: 1. A summary of the institutional abuse meeting. 2. A detailed narrative of the investigation and documented evidence. 3. A detailed statement of the findings which must be one of the following: l Substantiated.. An admission of the fact of abuse or neglect or a confirmation deemed valid (i.e., bruises) l Not Substantiated: The complaint, although it may have been made in good faith, is found to have no substance l Unable to Substantiate: Insufficient evidence for a substantiated report is present, but there remains reason to suspect abuse or neglect.
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Decision Once the report is completed, a decision is made by the Foster Home Licensing Division on the status of the home’s license, based on the findings. One or more of the following actions may be taken: l
l
l
l
l
No Action: If the complaint is not substantiated, or if there is no concern over the foster parent’s care, no licensing action will be taken. Increased Monitoring: If abuse is not substantiated, but the investigation has raised concerns about the home, the licensing social worker and the child’s social worker may be required to visit the home more frequently and more carefully monitor the child’s progress. Contracting: A contract is signed by the agency and foster parent, in which the foster parent agrees to fulfill specific expectations such as obtaining additional training. This action is usually taken if the investigation determined that physical abuse was not present, but corporal punishment, which is prohibited by licensing provisions [l] and department policy, was used. Probation: The license is made probationary for a specified period of time, during which the foster parents are required to take specific actions, such as obtaining more training or counseling. This action can be appealed in a quasi-judicial setting. Revocation: Foster parents can also appeal this action. Foster parents whose license has been revoked cannot reapply for five years.
IMPLEMENTATION
PROBLEMS
The Department encountered a number of problems in its implementation of the Protocol. Initially, there was resistance to the Protocol as follows: Foster home workers, who viewed themselves as advocates for the foster parents, saw the Protocol as evidence of a lack of support for foster parents who cared for difficult children, often without sufficient resources. The children’s social workers, who also had established close working relationships with foster parents, shared similar concerns. Child Protection workers found the investigations to be extremely time consuming and very detailed. Ordinarily, the intake worker conducts an investigation to ascertain if there is sufficient reason to provide Child Protection intervention and transfer it for ongoing services; in institutional abuse cases, a determination needs to be made, not only as to whether abuse has occurred, but as to who is the perpetrator. Many of the social workers and their supervisors resisted receiving assignments from a supervisor who had no line authority over them. There was also discomfort among all the workers because at various steps in the process, they were in a position to closely observe the work of their colleagues. Foster parents were also resistant, accusing the Department of not trusting them, of judging them guilty before they could tell their side. Initially, there was a large number of “unable to substantiate” findings; workers relied very heavily on facts which could be proven and hesitated to rely on their professional judgment in drawing conclusions from these facts. This created some difficulties if licenses were revoked and the revocations were appealed.
STUDY
FINDINGS
Following is a report of the abuse that occurred in foster homes from May 1980 through November 1981 and a discussion of the characteristics of the perpetrators, in comparison with the characteristics of the general population of foster parents.
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Cavara
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The first and most obvious result of the Protocol was the large number of investigations. There are approximately 570 foster homes in Hennepin County. During the l&month period, 125 investigations were conducted. This appears to be two to four times the number of investigations conducted in counties that do not emphasize institutional abuse investigations 12, 31. As was noted previously, social workers were initially reluctant to make a finding of substantiated abuse without irrefutable evidence. Thus, the authors have chosen to look at both “substantiated” and “unable to substantiate” incidents, in the belief that they are more representative of institutional abuse.
Sexual Abuse During the l&month period, there were five incidents of substantiated sexual abuse and six that were unable to be substantiated. Both heterosexual and homosexual abuse occurred and ranged from inappropriate exploitive touching to sexual intercourse and sodomy. There were a number of factors in these incidents that proved to be quite surprising and were contrary to what might be expected. In many cases, the children did not give any outward signs that the abuse was occurring; there was no deterioration in their behavior, or evidence of increased disturbance. To the contrary, many of the children showed marked improvement while in the foster home. Academic performance improved, children became active in athletic functions and after school activities. Most of the foster parents were well liked and respected by the social workers who had children in their homes, and they were considered excellent foster parents due to the marked improvement of the children placed in their care. Children were reluctant to tell their social workers the abuse had occurred, even when asked specifically. The following is a sample of complaints investigated. Willi~lm, age 16, told his therapist in a group session that while in a foster home for two years. the foster father, age 60, sexually abused him and other boys in the home. At the time the complaint was received. there were three boys living in the foster home. They were immediately removed from the home and interviewed; other boys who had been in the home were subsequently interviewed. From these interviews it was learned the foster father had performed anal and oral sex with some of the boys in addition to inappropriate sexual touching.
In the 11 cases studied, all the perpetrators were male. Of the 18 victims, 9 were male and 9 were female. One victim was under 3 years of age; 7 were between 4 and 12; and 10 were 13 or older. The children reported the abuse to the following: school (1); parent, friend or neighbor (4); social worker (1); other community professional (5). A fact of considerable concern in all the incidents of abuse or neglect is that children did not readily go to their social worker for help. In these 11 situations, 3 of the foster parents had been investigated previously under the Institutional Abuse Protocol, although not necessarily for sexual abuse. This is remarkable in view of the short time period the Protocol had been in effect. This indicates the importance of conducting a very thorough investigation, and of monitoring homes very closely after a complaint has been received if it is not substantiated. The demographic characteristics of the abusing fathers did not appear significantly different from the overall population of foster fathers, with the exception of the length of time they had been licensed foster parents. Four out of the 10 foster fathers had been licensed more than 10 years, compared to an overall percentage in the foster parent population of 19. Of these 11 families, 7 had their licenses revoked, 2 withdrew from the program, and no action was taken on 2.
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Neglecf There were 8 substantiated incidents of neglect, and 20 unable to be substantiated. Neglect allegations were the most difficult to substantiate due to the lack of physical evidence. Foster parent neglect usually takes the form of failing to provide adequate supervision, resulting in injury to a child, leaving the child in the care of an inadequate substitute provider, or medical neglect. Following is an example of foster parent neglect: Cker, age 11, lived with his single foster mother for 5 years. When she was hospitalized for a leg amputation, Chet told his social worker he was concerned about the extra care Iris foster mother would require when she returned from the hospital. When asked what he was doing for the foster mother now, he listed the following: rubbing and washing her back and legs, soaking her feet, preparing her insulin and medication, wasking and brushing her hair, giving enemas to her, washing all the clothes, and doing all the dishes.
In the 28 cases studied, the foster mother was considered the perpetrator in 19, foster father in 2, and both in 7. There were 50 victims, 31 male and 19 female. Seven (14%) were aged O-3; 27 (54%) were 4-12; and 16 (32%) were 13 or older. Following is information on whom the neglect was originally reported to by the child, or by whom it was observed: school, 3 (11%); parent, friend or neighbor, 11 (39%); social worker, 7 (25%); other community professional, 5 (19%); anonymous, 1 (4%); and self-reported, 1 (4%). This information is significant in that it shows that the most frequent reporter is the child’s parent or family; yet the agency is probably least likely to believe parents, as they may have an interest in discrediting the foster family. A low reporting rate to the child’s social worker is also seen. This raises a deep concern, since many of the children in foster care do not see their family with any frequency, if at all. To whom can they turn? Of these 28 foster homes, abuse investigations had previously been conducted on 7 of these families. Physical Abuse Physical abuse in foster homes tends to not be as severe as that usually observed in other child protective situations, and is usually a result of discipline that has been carried too far. Following is an example of physical abuse in a foster home: Three siblings, John (age 4), Gwen (age 2), Jane (age I), and two siblings, Jason (age 5) and Justin (age 2) had been physically abused and neglected, according to two neighbor families who called the Department. Corporal punishment was observed, involving both foster parents-spanking, slapping, punching 4-year-old with closed fist on face, throwing 2-year-old through open back door, and picking the children up by one arm. The foster mother demanded to be called “Mommy,” or the children would be spanked. The foster father had stated, “Get down or I am going to chop your head off,” and again, “I am going to hold your legs and dunk you in the toilet and flush it.” Eight neighbors, in addition to the two that called, came to the Department to volunteer info~ation about the abuse of these children. Several had seen black eyes and hand prints on the children’s faces. They stated they had asked the foster parents about these and had been told the children had fallen or that they (the foster parents) did not know how the marks were received.
There were 16 cases of substantiated physical abuse, and 26 were found unable to be substantiated. There were 60 victims (35 male and 25 female) of the following ages: 4 (7%) were O-3 years of age; 35 (58%) were 4-12; 18 (30%) were 13 and older. The ages of 3 (5%) were unknown. The breakdown of individuals observing the abuse, or individuals to whom the children reported abuse is similar to that for neglect: school, 3 (7%); parent, friend or neighbor, 15 (36%); social worker, 11 (26%); community professional, 9 (21%); anonymous, 1 (2%); selfreported, 3 (7%).
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There were only six previous institutional abuse investigations on these families, which is lower than in the other two categories. For the 20 abusing or neglecting foster fathers there did not appear to be any characteristics significantly different from the general population of foster fathers. In these instances, the following licensing actions were taken: revocation, 2; withdrawal, 6; probation, 1; contracting, 2; no action, 9.
Significant
Characteristics
of Foster Care Abusers
Marital status of mother. Insofar as the abusing foster mothers were concerned, the most significant factor was their marital status. Seventeen, or 46% of the 37 mothers were single, compared with 30% of the general population of foster mothers. This number is particularly interesting in view of the fact that the Department is very selective in licensing single parents. Of the married couples that apply to be licensed, 44% are accepted; of the single persons who apply, only 22% are licensed. The following licensing actions were taken: revocation, 4; withdrawal, 9; probation, 2; contracting, 3; increased monitoring, 4; no action, 13. In two instances the foster parents had withdrawn from the program before the Department received the complaints.
Length of time foster famiIy licensed. In looking at the characteristics of the 51 families investigated for neglect or physical abuse, two other factors appear significant: The first is the length of time the families were licensed. The study population appears to have been foster parents for a greater length of time, as can be seen in the Table below. There are a number of possible explanations for this: 1. Foster parents who have been licensed longer may receive more difficult children. 2. Foster parents may “burn out” after a certain period of time. 3. Agency staff may have more confidence in more experienced foster families, thus providing them with less help and support. 4. More experienced foster parents may be reluctant to ask for help. 5. The greater number of children in a foster home increases the likelihood of lodged complaints.
Fosterfamily childless. The second significant finding was that these families were less likely to have children of their own than in the general population of foster parents. Only 94 (17%) of the families in the overall foster parent population do not have children of their own. Seventeen (34%) of the 51 study families are childless.
Table 1. Length Time Licensed Less than 1 year l-3 years 4-5 years 6- 10 years 11 or more years unknown 1 (2%)
of Time Licensed: Study Families All Foster Families Study Families 5 13 10 12 10
(10%) (25%) (20%) (24%) (20%)
Compared
All Foster 78 226 60 95 111
to
Families (14%) (40%) (11%) (17%) (19%)
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Investigating child abuse in foster care CONCLUSIONS
AND RECOMMENDATIONS
Criteria for Investigation It is essential that agencies develop procedures for the immediate investigation of all suspected incidents of abuse or neglect. While the procedures developed will vary with the size and structure of the agency, the following criteria should be met: 1. The procedures should require that the investigation is conducted by an objective party with no vested interest in the outcome. 2. It is essential that the procedures have the support and commitment of the administration of the agency. 3. There should be a centralized person or unit in charge of maintaining the information gathered as part of the process. 4. Legal help should be enlisted during the development of the procedures to ensure compliance with all applicable laws. 5. A format should be developed as to how the final report is to be written, including clear definitions of terms. Suggestions for Implementation
of Investigations
In developing these procedures, an agency may anticipate some implementation Following are some suggestions to alleviate them, based on Hennepin County’s
problems. experience:
1. Because the procedures will generally cut across organizational lines, a certain amount of territorialism and interdivisional rivalry can be expected. Leadership and commitment from management is necessary to avoid such problems. 2. Resistance on the part of foster parents can be mitigated by involving foster parent organizations once the Protocol has been developed. 3. The discomfort of the investigating social workers can be lessened by providing training in advance of the implementation of the new procedures. Training should include the following: (a) social workers should be sensitized to the needs of the children and the foster parents so children are not traumatized by the process and foster parents made any more anxious than necessary; (b) social workers need to understand the importance of the investigation so they will be as detailed and conscientious as possible; (c) social workers need permission to make judgments based on their findings and addressing this issue at the beginning should result in more valid conclusions as well as greater consistency. Prevention
of Abuse of Children in Foster Care
Based on the Department’s experience of the last two years, agencies apparently can develop and improve practices to help prevent abuse of children in foster care. Following are specific actions which can be taken.
Screening. Screening of foster parent applicants must be very comprehensive to eliminate potentially abusive foster families. Home studies should include individual interviews with all family members, including the taking of social histories, an evaluation of motivation, child rearing practices, and family relationships. References should be obtained as well as reports from the family physician and school. In addition, the following steps should be taken: 1. The names of all applicants should be cleared with District, Courts to determine if a criminal record is present.
Juvenile
and
Municipal
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2. The use by applicants of chemicals, including both alcohol and drugs, should be thoroughly discussed as part of the home study, and social workers should be trained to identify danger signals. 3. Since the vast majority of child abusers were once victims themselves, social workers should determine whether the prospective foster parents were ever abuse victims.
Close contact with foster families. Foster home social workers must maintain close contact with foster families, paying particular attention to changes in the families that can result in additional stress. In most agencies, there is only yearly contact required between the licensing workers and families. Hennepin County requires quarterly contact.
Avoiding high-risk placements. The authors recommend further study to determine if there are factors which make some foster parents more likely to abuse the children in their care. In addition to studying abusive foster parents, data on victims should also be collected including their placement history, presence of abuse in their own or previous foster families, etc.
Agencies
must not overload foster families.
Corporal punishment not allowed. Most of the physical abuse was the result of excessive corporal punishment; yet many agencies allow corporal punishment of children in foster homes. As Jeanne Giovannoni states, The public view seems to be: “It’s all right to hit your child but not too hard; in fact, it’s all right to hurt your childbut not too badly.” This issue needs to be faced more squarely than it is at present. As long as we as a society condone corporal punishment of children, we must admit that we are also willing to place some children in danger of being hurt badly [4].
Training. Training for both foster mothers and fathers should be mandatory, and particularly address alternative methods of discipline, since much of the physical abuse is “excessive discipline.” Foster parents who care for sexually abused children must be prepared for dealing with the seductive behavior such children present. Those caring for physically abused children should be informed of their potential aggressive, provocative behavior. Abused and neglected children can also be apathetic or clinging, and this can be very trying for foster parents.
Stress. Agencies must be very aware of the stress that foster parenting do whatever is possible to alleviate it.
places on families,
Offer help. Foster parents must be encouraged to ask for help. Training programs stress that foster parents are expected to ask for help with difficult children.
and
should
Child udvocate. The agency must provide an “advocate” for the child in placement. Social workers must be trained to develop a relationship with the foster child alone, apart from the foster family. This requires frequent contact between the child and social worker.
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Social workers alert to signs of abuse Social workers must be made aware of the extent of abuse that occurs in foster homes, and should be trained to be alert to any signal that a child may be abused. They should be trained to be inquisitive and ask specific questions of the child such as, “What are the ‘rules’ of the house?” “ What happens when you break a rule?” Do you have any privacy?” “ Does the foster parent enter your (the child’s) room? If so, under what circumstances?” Questions such as these can be asked in a nonthreatening way, and yet provide the social worker with some insights into the family dynamics.
Social workers should be required to visit with the children alone.
Social workers should be required to make occasional
unannounced
visits to the foster
home.
Consult with child’s parents. Parents of children in foster care should be encouraged to give their opinions on the care the child is receiving. As noted earlier, parents and neighbors were most likely to report abuse. Frequent visitation should be encouraged, not only to promote the relationship between parent and child, but to provide the child with another advocate.
Exit interview. After a child has left a foster home, an “exit interview” should be conducted. At this point, very specific questions of the child should be asked regarding his or her experience in the foster home. At the time of a new placement, social workers should interview children about previous placements to ensure that each child has an opportunity for exit interviews. The social worker’s “advocacy” role should be stressed.
Respond to abuse or neglect. All acts of abuse or neglect must be responded to with appropriate licensing action and, if appropriate, criminal prosecution. If the actions of the foster parents are not serious enough for such action, yet undesirable, contracting, additional training, or counseling should be utilized.
REFERENCES 1. Standards for Foster Care and Group Family Foster Care, 12 Minn Code Agency R. Set 2.001 (D) sota Department of Public Welfare, St. Paul, MN (1978). 2. Fosfer Home Child Protection, Special Services for Children Study, Vera Institute of Justice, New (1981). 3. BOLTON, JR., F. G. and GAI, D. For better or worse? Foster parents and children in an officially maltreatment population. Children and Youth Services Review 3:37-53 (1981). 4. GIOVANNONI, J. M. and BECERRA, R. M. Defining Child Abuse. The Free Press, New York
(8) (i), MinneYork, NY p. 4 reported
child
p. 243 (1979).