1. University of Michigan1 Early Multidisciplinary Assessment Pilot Project http://www.ssw.umich.edu/earlyassessment/ Kathleen Coulborn Faller, Ph.D., A.C.S.W. University of Michigan

2. 2 Auspices Supported by: –Hasbro Children’s Foundation— intervention component –University of Michigan Office of the Vice-President for Research—evaluation component Conducted by: –Family Assessment Clinic—started in 1985 –Child Protection Team—started in 1971

3. University of Michigan3 Why Conduct Early Assessments? (We were tired of being called the Terminators) Patterns in child protection reports. –Since 1994, over 3 million children per year reported to Child Protective Services (CPS). –2004 5.5 million children reported. –About 2/3 are screened in for investigation. –About 25% are substantiated by. –About 1/3 of cases are repeatedly referred.

4. University of Michigan4 Why Conduct Early Assessments? By the time there is decisive intervention by the child welfare system, children are often quite damaged and families cannot be salvaged. Arguably, it is less costly in financial terms if there is earlier assessment and intervention. Early multidisciplinary assessments resonate with Child & Family Services Review findings—Agency risk and safety assessments in 22 of 35 states did not capture underlying problems.

5. University of Michigan5 Target Population for Early Multidisciplinary Assessments Families with at least one child 7 or younger (Hasbro Children’s Foundation) First time substantiated CPS cases Serious cases—because assessments are intrusive for families and labor intensive for staff –Court intervention required –CPS cooperation required

6. University of Michigan6 Outcomes related to child safety, permanency, & well-being Safety= –Fewer re-reports, –Fewer terminations of parental rights Permanency= –With one or both parents –Permanent placement Well-being= –Child Behavior Checklist -CBCL –Child Sexual Behavior Inventory-CSBI –Trauma Symptom Checklist for Young Children- TSC-YC

7. University of Michigan7 Research Design Pilot was conducted in 2 counties with manageable social problems & some resources Target population—50 children Comparison cases—50 children from families matched on type of maltreatment, family composition, race, time of report. Outcomes from: –MIS system—safety & permanency –Worker of record—worker satisfaction; implementation of recommendations –Caretakers of children—child wellbeing

8. University of Michigan8 Intervention Review all background information. Interview all parties: children, caretakers. Children receive at least 2 interviews. Medical exams on all children 7 & under & older children as indicated. Psychological testing/consultation when indicated. Parent-child interactions when indicated. Psychiatric consultation when indicated. Medical consultation & medical specialties.

9. University of Michigan9 Intervention, continued. Substance abuse, domestic violence, criminal history assessed. Educational consultation when indicated. Collateral contacts when indicated. Consultation meeting to address questions and make additional recommendations. Feedback given to the family. Follow-up consultation available to referring worker/agency. Court testimony when needed.

10. University of Michigan10 Placement Status at Follow-up (1 year after assessment completed) Own home RelativeFoster care AdoptionTotal Early assessme nt N=37 75.5% N=5 10.2% N=3 6.1% N=4 8.4% N=49 Compari -son N=16 34.8% N=10 21.7% N=11 23.9% N=9 19.6% N=46 TotalN=53N=15N=14N=13N=95 Chi square(3, N=95)=16.4; p<.001

11. University of Michigan11 Permanency (proxy) PermanentImpermane nt Total Early assessment N=46 93.9% N=3 6.1% N=49 Compari- son N=35 76.1% N=11 23.9% N=46 TotalN=81N=14N=95 Chi square(1, N=95)=6; p<.01

12. University of Michigan12 Other system findings Case open at follow-up. –Early assessment=33%Comparison=33% Court involvement at follow-up. –Early assessment=33%Comparison=33% Termination of parental rights. –Early assessment=30.1%Comparison=52.1% –Chi square(1,N=91)=4.5; p=.035 Re-reports to Child Protective Services –Early assessment=44%Comparison=68.8%

13. University of Michigan13 Sobering findings Project took 4 years instead of 2 to implement. It took over a year for workers to view Early Assessments as a benefit to them. Worker turnover impeded our ability to collect follow-up data on case outcomes. Lack of a social welfare safety-net impeded implementation of the recommendations. Lack of a social welfare safety-net was instrumental in re-referral.

14. University of Michigan14 Conclusions Early Assessments hold promise for serious reports to CPS. Need to replicate findings. Early Assessment must be seen as genuinely useful by the public child welfare workers. Without a welfare safety-net, poor families will continue to be reported to CPS.