'Baby courts' considered to heal traumatized infants

TALLAHASSEE, Fla. – An expert on childhood trauma urged members of the Florida Children and Youth Cabinet on Thursday to promote a "baby court" model in which judges, lawyers and caseworkers put the needs of traumatized infants and toddlers before any other considerations.

Mimi Graham, of Florida State University's Center for Prevention & Early Intervention Policy, told cabinet members that babies in troubled families can experience trauma that follows them the rest of their lives.

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"What happens to young children does not go away," Graham said. "It's the pipeline to (the Department of Juvenile Justice) and the Department of Corrections. It leads to mental-health problems and so many societal problems --- and we have reams of research that shows this connection."

Early childhood trauma can lead to physical and mental health problems, crime, addiction and academic woes, Graham said, but baby courts can alter that trajectory.

The Children and Youth Cabinet, which includes the heads of all state agencies that deal with children, observed a baby court Wednesday in Pensacola.

"As we saw yesterday, all those families had substance-abuse issues," Graham told the cabinet members. "They also all had underlying trauma. And we know unless we heal the trauma, they continue to struggle with these adversities throughout the lifetime."

Infants under a year old make up nearly 20 percent of children in the child-welfare system; children under age 5 make up 54 percent.

According to the U.S. Department of Health and Human Services, 90 percent of children coming into the child-welfare system have been exposed to trauma --- abuse or neglect, domestic violence, the loss of a parent to death or incarceration, or someone in the home with mental-health or substance-abuse problems. The number of adverse childhood experiences was almost double for children in poverty.

"If we look at what we're doing --- it's really not working," Graham said. She said the number of children coming into Florida's child-welfare system had risen by 10,000 over the last four years.

What's more, the percentage of Florida children who were reunified with their parents and then forced to re-enter the child welfare system increased from 13.2 percent in 2008 to 15.4 percent in 2011. But nationally, the percentage went down, from 13.2 percent in 2008 to 11.8 percent in 2011.

Miami-Dade Circuit Judge Cindy Lederman, who co-founded the Miami Child Well Being Court, said an understanding of child development is critical to breaking the cycle of dysfunction from one generation to the next.

The components of the Miami model include using child-development research to make decisions and provide services. For instance, Lederman said, "We have realized that the moms we see do not even smile at their babies. … They don't know how to play because their mother never played with them."

Lederman said those parents need intensive one-on-one coaching to learn how to bond with their children.

The cabinet members watching Graham's presentation saw a video of a baby who endured two minutes of her mother watching expressionless. The infant soon showed clear signs of distress, which continued until her mother stopped the experiment to smile, speak lovingly and hold out her arms. But if the parent never gives those assurances, Graham said, the child's emotional and intellectual development will be permanently affected.

Lynne Katz, director of the Linda Ray Intervention Center at the University of Miami and a co-founder of the Miami Child Well Being Court, said the model is based on the understanding that the court will "put the child and the child-parent relationship at the core of everything we do. … The Miami model represents a paradigm switch. Other professionals now have a clear understanding of how their actions will impact the child."

Lederman said every legal decision about dependent children has a developmental component.

In a sample of 33 parent-child pairs who participated in the Miami Child Well Being Court docket between 2006 and 2012 and who completed the clinical intervention, none had a new report of maltreatment in subsequent years, according to an evaluation conducted last year,

"Although the sample is small, this outcome is striking," the evaluators noted.