306: Enhancing Assessments: Getting to Underlying Issues Shauna Reinhart, MPA; PA Child Welfare Training Program & Jeannette Rice; Children’s Advocacy Center of Lawrence County Friday, November 16, 2018

Agenda Welcome and Introductions Making Connections Underlying Issues Tools Domestic Violence Closing

Overview I was hired to do infant/child development – What’s that got to do with underlying issues? Why is underlying issues a concern? Child Welfare Family Centers What is your role? Prevention Unique Role

Learning Objectives Identifying underlying issues & their influence on families, children and youth; Describing methods, situations and processes that help facilitate the use of screenings by Family Center staff; and Delineating key elements of the domestic violence cycle, domestic violence screening tools and the impact of domestic violence on infants and toddlers.

Underlying Issues: What Are They and Why? What is an underlying issue? What is the root cause of the concern? It is not just about children. It also includes: Adolescents; Parents; and Family. Why? Safety, Permanency and Well-Being. Why me? You have a unique role as a home visitor.

Tools for Identifying Underlying Issues Critical Thinking Strength-Based, Solution-Focused Questioning Enhancing Assessments Toolkit Screening and Assessing Looking and Listening Relationship with Families

Critical Thinking Tune into self; Challenge assumptions; Consider: the arguments, alternatives and context; Know the source of the information; and Assume a posture of relative skepticism.

Strength-Based, Solution-Focused Questions Exception Questions Coping Questions Scaling Questions Miracle Questions Indirect Questions

Enhancing Assessments Toolkit The Matrix The Tools The Resources Facilitated Discussion Guide

Parents As Teachers Model DoVES: Domestic Violence Evaluation Scale Edinburgh Post-Natal Depression Life Skills Progression http://www.lifeskillsprogression.com/home/index Toolkit http://www.pacwcbt.pitt.edu/Resources/PA%20Enhancing%20Assessments%20Toolkit.pdf

Why Focus on Domestic Violence? 25% of participants in the Evaluation of Pennsylvania’s Developmental Screening Project endorsed incidents of IPV within the past year. 38.9% of participants have taken our survey or thought that they needed a PFA at some point in their lives. These families, who are currently receiving services from Children and Youth, have children under 5 years in their home. Source: Child Welfare Education and Research Programs (2011). Caregiver Interviews: A Portrait of Pennsylvania's CYS-Involved Families (Report No. 6). Pittsburgh, PA: University of Pittsburgh, School of Social Work.

Brain Development Brain development happens rapidly from birth to age 5. Brain development is encoded in a person’s genes, but it is strongly influenced by the environment. The brain develops new “circuitry” based on what has already been established. New pathways lead to new skills. Children rely on their parents to have their basic needs met to help their bodies and brains grow and develop.

Stress Learning to cope with stress is an important part of a child’s development. A child between the ages of birth and five is especially vulnerable to the effects of stress. A young child cannot cope with the negative effects of stress without relying on a supportive relationship with a parent or caregiver. Not all stress is bad. Some stress is a normal part of life. “Toxic stress” occurs when a child is subjected to high levels of stress for extended periods of time. This type of stress is extremely detrimental to development.

Stress (continue) Infants cannot regulate their own stress response. They rely on parents and caregivers to help and calm and self-soothe, especially during the first year. A child’s ability to cope with stress in the early years has consequences for physical and mental health throughout life. The relationships children have with their caregivers play a critical role in the development of the stress response system during the early years of life. The presence of a sensitive and responsive caregiver can protect infants and toddlers from experiencing excessive stress – even children who tend to be temperamentally fearful or anxious – and help them cope better.

Self-Regulation Self-regulation develops slowly over the first few years of life. From birth, children are learning about regulating their emotions as well as their actions by watching their parents.

Adverse Childhood Experiences (ACE) Study Dr. Vincent Felitti www.cdc.gov/ace One of the largest investigations ever conducted looking at relationships between childhood maltreatment and later life health and well-being. Collaboration between CDC and Kaiser Permanente’s Health Appraisal Clinic in San Diego.

Cycle of Abuse DENIAL Phase 1 Tension Building Phase 2 Experience of abuse (e.g. hitting, slapping) Phase 3 Misinformation Stage DENIAL

Types of Domestic Violence Physical Sexual Using Intimidation Using Emotional Abuse Using Isolation Minimizing Denying and Blaming Using Children Using Male Privilege Using Economic Abuse Using Coercion and Threats

Closing and Contact Information Questions Transfer of Learning Workshop evaluations Shauna Reinhart, Child Welfare Training Program, shr30@pitt.edu Jeannette Rice, Children’s Advocacy Center- Lawrence County, jrice@jamesonhealth.org