Presentation for: Presentation for: 1 1 st st International Society for Child International Society for Child Indicators Conference Indicators Conference June 28 June 28 th th , 2007 - Session 23 , 2007 - Session 23 By By Sandra J. Altshuler, Ph.D., L.I.C.S.W. Sandra J. Altshuler, Ph.D., L.I.C.S.W. Amber Cleverly-Thomas, M.S.W. Amber Cleverly-Thomas, M.S.W. How Are Drug-Endangered Children Faring? Mining Agency Records for Measuring Well-Being
Transcript
Presentation for:Presentation for:11stst International Society for Child Indicators International Society for Child Indicators
A Collaborative Response for Drug-endangered Children:
Empowering A Community to Protect Children from Methamphetamine*
This project was supported by Cooperative Agreement Numbers 2003-JS-FX-K083 and 2005-JL-FX-K122 awarded by the Office of Juvenile Justice and Delinquency Prevention, Office of Justice Programs, U.S. Department of Justice. The Spokane County DEC Team stewards are: Spokane County Sheriff’s Office, Spokane Police Department, Spokane County Prosecuting Attorney’s Office, Child Protective Services (Washington Department of Social and Health Services, Division of Children and Family Services), Partners with Families and Children—Spokane (formerly Casey Family Partners—Spokane), Lutheran Community Services Northwest, Spokane School District 81, Educational Service District 101, Washington Department of Corrections, and Counseling Resources for Youth and Families. Special thanks are extended to Esther Larsen, J.D., Karen Winston, M.S.W., and Kyle Bunge, M.S.W.
Spokane County DEC Spokane County DEC PartnersPartners
(see logic model also)(see logic model also)
Spokane County Sheriff’s OfficeSpokane County Sheriff’s OfficeSpokane Police Department Spokane Police Department Spokane County ProsecutorSpokane County Prosecutor
Child Protective ServicesChild Protective ServicesPartners with Families and Children Partners with Families and Children
Lutheran Community ServicesLutheran Community ServicesSpokane School District 81Spokane School District 81
ESD 101ESD 101Department of CorrectionsDepartment of Corrections
What is the Drug What is the Drug Endangered Children Endangered Children
(DEC) Program?(DEC) Program? A A collaborative effortcollaborative effort to address the needs to address the needs
of children identified as drug endangered. of children identified as drug endangered. A A partnershippartnership among law enforcement, among law enforcement,
Child Protective Services, prosecutors, and Child Protective Services, prosecutors, and agencies providing services to children. agencies providing services to children.
GuidelinesGuidelines for the delivery of services to for the delivery of services to drug endangered children.drug endangered children.
A system for A system for identifyingidentifying and and monitoringmonitoring the the well-being of children identified as drug well-being of children identified as drug endangered. endangered.
Who is a Who is a Drug Endangered Child? Drug Endangered Child?
Any child living Any child living in an in an environment environment where adults where adults are are manufacturing, manufacturing, selling, and/or selling, and/or using drugsusing drugs..
Evaluation MethodologyEvaluation Methodology
Research questions:Research questions: What is the level of interdisciplinary What is the level of interdisciplinary
collaboration achieved by the collaboration achieved by the Spokane County DEC Team in its first Spokane County DEC Team in its first year of functioning? year of functioning?
(see article included in packet)(see article included in packet)
To what extent are the needs of drug To what extent are the needs of drug endangered children being endangered children being addressed? addressed?
Evaluation MethodologyEvaluation Methodology
Sources of dataSources of data (includes administrators, line (includes administrators, line staff, and case records):staff, and case records):
Spokane County Sheriff’s OfficeSpokane County Sheriff’s Office Spokane Police Department Spokane Police Department Spokane County ProsecutorSpokane County Prosecutor Child Protective ServicesChild Protective Services Partners with Families and Children Partners with Families and Children Lutheran Community ServicesLutheran Community Services Spokane School District 81Spokane School District 81
Evaluation MethodologyEvaluation Methodology
The Perry et al (2003) schema for assessing The Perry et al (2003) schema for assessing neglected children includes 6 life domains, neglected children includes 6 life domains, plus we added last 2:plus we added last 2: Physical/medicalPhysical/medical Trauma historyTrauma history DevelopmentalDevelopmental Social/familySocial/family Mental health/emotional/behavioralMental health/emotional/behavioral Cognitive/ academic: “school functioning”Cognitive/ academic: “school functioning” Child welfare historyChild welfare history Demographics Demographics
Evaluation MethodologyEvaluation Methodology
Instrumentation—Measure of Physical/Medical Instrumentation—Measure of Physical/Medical HealthHealth
Was a “Kids Screen” completed by Was a “Kids Screen” completed by DCFS?DCFS?
Pediatric Exam Pediatric Exam HeightHeight WeightWeight Head CircumferenceHead Circumference
Does child have a “medical home” or Does child have a “medical home” or identified pediatrician?identified pediatrician?
Evaluation MethodologyEvaluation Methodology
Instrumentation—Measure of TraumaInstrumentation—Measure of Trauma Trauma Symptom Checklist for Children Trauma Symptom Checklist for Children
(ages 8-16) or Trauma Symptom Checklist for (ages 8-16) or Trauma Symptom Checklist for Young Children (ages 3-12) (Briere, 1996)Young Children (ages 3-12) (Briere, 1996) parent or caretaker report, standardized, strong parent or caretaker report, standardized, strong
Instrumentation—Measures of Development IInstrumentation—Measures of Development I Battelle Developmental Inventory (ages 1-8) Battelle Developmental Inventory (ages 1-8)
(Newborg et al., 1984)(Newborg et al., 1984) Parent/caregiver report, plus observation, time Parent/caregiver report, plus observation, time
Personal-socialPersonal-social Adaptive functioningAdaptive functioning Total motor (gross and fine) skillsTotal motor (gross and fine) skills Total communication (expressive and receptive) skillsTotal communication (expressive and receptive) skills Cognition Cognition
Evaluation MethodologyEvaluation Methodology
Instrumentation—Measures of Development IIInstrumentation—Measures of Development II Ages and Stages QuestionnaireAges and Stages Questionnaire
CommunicationCommunication Gross motorGross motor Fine motorFine motor Problem solvingProblem solving Personal/SocialPersonal/Social
Evaluation MethodologyEvaluation Methodology
Instrumentation—Measure of Family HistoryInstrumentation—Measure of Family History Adverse Childhood Experiences Adverse Childhood Experiences (Felitti, et al., (Felitti, et al.,
1998) 1998) Parent report of growing up with:Parent report of growing up with:
Recurrent physical abuseRecurrent physical abuse Contact sexual abuseContact sexual abuse Domestic violenceDomestic violence Recurrent severe emotional abuseRecurrent severe emotional abuse Parental substance abuseParental substance abuse Imprisoned parentImprisoned parent Parental chronic mental illnessParental chronic mental illness Loss of at least one parent during childhood Loss of at least one parent during childhood
DCFS report of female caregiver history of DCFS report of female caregiver history of childhood abuse or neglectchildhood abuse or neglect
Evaluation MethodologyEvaluation Methodology Instrumentation—Measure of Mental Health: Instrumentation—Measure of Mental Health:
Selected parts of variety of Selected parts of variety of standardized measuresstandardized measures
Assesses domains of:Assesses domains of: HopefulnessHopefulness Problem severity Problem severity InternalizingInternalizing ExternalizingExternalizing DelinquencyDelinquency
Evaluation MethodologyEvaluation Methodology
Instrumentation—Measure of Mental Health: Instrumentation—Measure of Mental Health:
Social FunctioningSocial Functioning Ages and Stages Questionnaire: Social-Ages and Stages Questionnaire: Social-
Emotional (Squires, Bricker, & Twombly, 2003) Emotional (Squires, Bricker, & Twombly, 2003) (ages 0-6)(ages 0-6) Parent/caregiver reportParent/caregiver report standardized, strong validitystandardized, strong validity The child’s total score is compared with an The child’s total score is compared with an
empirically derived cutoff point. If the child’s empirically derived cutoff point. If the child’s score is higher than the cutoff, it suggests the score is higher than the cutoff, it suggests the child should be referred for further mental child should be referred for further mental health evaluation.health evaluation.
Evaluation MethodologyEvaluation Methodology
Instrumentation—Measurement of School Instrumentation—Measurement of School FunctioningFunctioning
Mining of school data (ages 5-18)Mining of school data (ages 5-18) GradesGrades # of schools attended# of schools attended Attendance/Truancy historyAttendance/Truancy history Discipline historyDiscipline history Special Education Status and disabilitySpecial Education Status and disability Retention historyRetention history
Evaluation MethodologyEvaluation Methodology
Instrumentation—Measures of Child Welfare Instrumentation—Measures of Child Welfare HistoryHistory
# of CPS referrals for each child, # accepted for # of CPS referrals for each child, # accepted for investigationinvestigation
Assigned risk tag Assigned risk tag (0=no risk, 5=highest risk)(0=no risk, 5=highest risk)
Reason for referralReason for referral Relationship of each referral reason to drugs Relationship of each referral reason to drugs Parent’s drug of choice, including poly-drug useParent’s drug of choice, including poly-drug use
#, length of previous out-of-home placements#, length of previous out-of-home placements Type of current placement (non-related, kinship, Type of current placement (non-related, kinship,
etc.)etc.) Permanency plan and current legal statusPermanency plan and current legal status
Evaluation MethodologyEvaluation Methodology
Instrumentation--DemographicsInstrumentation--Demographics Age Age (at time of referral to DEC program)(at time of referral to DEC program) GenderGender SESSES EthnicityEthnicity Was child placed with sibling?Was child placed with sibling? Family Structure at time of Family Structure at time of
placementplacement
Evaluation MethodologyEvaluation Methodology
Data Analysis PlanData Analysis Plan Univariate analysesUnivariate analyses
Assess for normalcy Assess for normalcy Simple descriptive summariesSimple descriptive summaries
Exploratory analysesExploratory analyses Isolate any demographic variables that correlate with either Isolate any demographic variables that correlate with either
enhanced or degraded outcomes (appropriate to the measurement enhanced or degraded outcomes (appropriate to the measurement level of each variable)level of each variable)
To understand the natural history of the study participants, To understand the natural history of the study participants, baseline values for DEC participants will be examined from date of baseline values for DEC participants will be examined from date of admission to the DEC program to determine if characteristics of the admission to the DEC program to determine if characteristics of the population sample changed during the time frame of the study population sample changed during the time frame of the study (thereby hoping to reduce the need for a separate comparison (thereby hoping to reduce the need for a separate comparison group and maximize the internal validity of the data collected).group and maximize the internal validity of the data collected).
Future analyses (dependent upon above results) to Future analyses (dependent upon above results) to determine predictors of outcomes (e.g, impact of ACEs, child determine predictors of outcomes (e.g, impact of ACEs, child welfare history, etc.)welfare history, etc.)
FindingsChild Demographics I
M SD Min Max
Age, in months (at time of referral to DEC)
61.66 43.99 0 197
N Percent N/A or Missing
Number of children enrolled 399
Number of families 215
Gender
Male 219 54.9
Female 180 45.1
SES 399
Family Structure (at time of removal) 15 3.8
Mother Only 185 48.2
Two Parent Household 164 42.7
Mother / Paramour 22 5.7
Father Only 11 2.9
Father / Paramour 2 0.5
FindingsChild Demographics II
N Percent N/A or Missing
Ethnicity 6 1.5
White/Caucasian 274 68.7
African American 22 5.5
Hispanic/Latino 13 3.3
Native American 35 8.8
Bi-Racial/Tri-Racial 42 10.5
Asian/Pacific Islander 1 0.3
Other 6 1.5
FindingsChild Welfare History I
M SD Min Max
Number of CPS referrals, per child 5.78 4.88 0 24
Number of referrals accepted for investigation, per child (N=394)
3.81 2.86 0 14
Assigned Risk Tag (0-5) 4.54 0.75 0 5
Number of total O-O-H placements 1.44 1.19 0 7
Length of most recent O-O-H placement (in months) (N=112)
6.63 10.87 1 52.42
FindingsChild Welfare History II
N Percent N/A or Missing
Reason for Referral 7 1.8
Physical abuse only 14 3.6
Sexual abuse only 4 1.0
Neglect only 320 81.6
Neglect and other abuse 17 4.3
Abandonment 5 1.3
Referral on sibling 32 8.2
Type of Current Placement 7 1.8
Non-relative foster care 151 38.5
Kinship foster care 125 31.9
In-home dependency w/ parents 8 2.0
Group home 63 16.1
Other (hospital) 7 1.8
Not placed into state custody 38 9.7
FindingsChild Welfare History III
N % N/A Missing
Child has enrolled sibling in DEC program
292 72.9 142* 35.6
Child placed with sibling immediately
184 71.6
Child placed with sibling within 30 days
192 77.7 152** 38.1
Number of enrolled children in each family
One 107 49.3
Two 64 29.5
Three 25 11.5
Four 17 7.8
Five or more 4 1.9* Of the 142 missing, 107 children did not have siblings, and 38 were never placed. There was an overlap of 15 children. ** An additional 10 children were returned home within one month.
FindingsChild Welfare History IV
N Percent N/A or Missing
Case Status 3 0.01
CPS case open 259 65.4 0 0.00
Dependent 201 77.6
Shelter care 15 5.8
Legally free (TPR) 34 13.1
Guardianship 6 2.3
CPS case closed 137 34.6 4 3.00
Returned, dependency
dismissed60 45.1
Returned, never
dependent56 42.1
Adopted 17 12.8
FindingsChild Welfare History V
N Percent N/A or Missing
Was primary referral reason due to parental drug use?
10
Yes 281 72.2
No 108 27.8
Parent’s drug of choice 27 6.7
Meth Only? 195 52.4
Poly-Drug, including meth and/or alcohol 115 30.9
Alcohol only 13 3.5
Other (heroin, cocaine, prescription, marijuana) 49 13.2
FindingsPhysical/Medical Findings
Yes NoN/A or
Missing
N Valid %
N Valid %
N Valid %
Was KidScreen completed by DCFS? 240 67.0
118 33.0
41 10.3
Was a medical completed following placement?
241 71.3 97 28.7 61 15.3
Was Growth WNL (Height/ Weight/Head Circumference)?
80 44.7 99 55.3
220 55.1
FindingsTrauma History I
TSCYC (35-110), t-scores* by domain (N=40)
M SD Min Max
Anxiety 64.67 19.00 40 110
Depression 68.27 18.44 41 110
Anger 67.18 17.44 41 110
Posttraumatic Stress 73.79 23.31 42 110
Dissociation 65.03 17.71 43 109
Sexual Concerns 64.62 23.60 46 110
*Domains excluding PTS: t-score less ≤ 64 is considered normal, 65-69 are *Domains excluding PTS: t-score less ≤ 64 is considered normal, 65-69 are potentially problematic, and ≥ 70 are clinically significant. For PTS: t-score potentially problematic, and ≥ 70 are clinically significant. For PTS: t-score ≤ 64 is considered normal, 65-69 are “often associated with at least one ≤ 64 is considered normal, 65-69 are “often associated with at least one elevated PTSD symptom cluster,” and ≥ 70 suggest relatively severe elevated PTSD symptom cluster,” and ≥ 70 suggest relatively severe posttraumatic disturbance (Briere, 1996)posttraumatic disturbance (Briere, 1996)
FindingsTrauma History II
TSCYC: Results of T-test analysis of changes in levels of trauma symptoms (N=25)
M SD t (df)
Anxiety -8.48 14.13 3.00 (24)**
Depression -8.92 16.93 2.60 (24)**
Anger -5.72 16.48 1.74 (24)
Posttraumatic Stress -10.52 17.55 3.00 (24)**
Dissociation -6.08 19.10 1.60 (24)
Sexual Concerns -5.60 20.86 1.30 (24)
**p = .01**p = .01
FindingsDevelopmental Assessment I
BDI (0-100), by domain Percentile Range
M SD Min Max
Personal-Social (N=102) 31.34 27.33 1.0 99.9
Adaptive Functioning (N=101) 29.39 28.86 .04 99.9
Total Motor Skills (N=121) 33.29 31.68 0.4 98.0
Communication (N=121) 35.14 28.51 1.0 98.0
Cognition (N=121) 26.24 26.40 0.1 99.0
Overall BDI Score 27.19 27.86 0.1 97.0
FindingsDevelopmental Assessment II
Children qualifying as having “developmental deficiencies”*
*Z-score of 1.5 or below indicates a performance deficit (Newborg, Stock, *Z-score of 1.5 or below indicates a performance deficit (Newborg, Stock, Wnek, Guidubaldi, Svinicki., 1984)Wnek, Guidubaldi, Svinicki., 1984)
FindingsDevelopmental Assessment III
BDI: Results of T-test analysis of changes in Z-scores
Number of DEC clients who received counseling services (at LCS)
115 28.8 0 0
Number of Counseling Closures 68 65.9
Reasons for case closure
Treatment completed 22 32.4
Discharge at Clients request 8 11.8
Discharge against agency advise 5 7.4
Failure to return 13 19.1
Moved away 10 14.7
Other 8 11.8
Discharge at Clinician Request 2 2.9
FindingsCounseling Services II
M SD Min Max
Number of Individual Sessions (N=111)
19.29 21.82 1 107
Number of Case Management Contacts (N=111)
7.10 12.76 0 57
Number of Therapeutic Aide Contacts (N=111)
3.98 11.57 0 57
Therapeutic Aide Units (in 30 minute increments) (N=111)
114.63 86.77 3 241
FindingsSchool Functioning I
M SD Min Max
Grade at Placement
Number of Schools Attended
Number of Grades Repeated
N % N/A or Missing
Does student qualify for special education?
Yes
No
Is student still enrolled in District 81?
Yes
No
FindingsSchool Functioning II
M SD Min Max
Number of Days Enrolled
School Year Prior to Placement
School Year At Time of Placement
School Year Following Placement
Number of Excused Absences
School Year Prior to Placement
School Year At Time of Placement
School Year Following Placement
Number of Unexcused Absences
School Year Prior to Placement
School Year At Time of Placement
School Year Following Placement
FindingsSchool Functioning III
M SD Min Max
Number of Excused Tardies
School Year Prior to Placement
School Year At Time of Placement
School Year Following Placement
Number of Unexcused Tardies
School Year Prior to Placement
School Year At Time of Placement
School Year Following Placement
Number of Days Absent Due to Suspension
School Year Prior to Placement
School Year At Time of Placement
School Year Following Placement
FindingsSchool Functioning IV
M SD Min Max
Becca / AttendanceActions
School Year Prior to Placement
School Year At Time of Placement
School Year Following Placement
Disciplinary Actions (not including attendance actions or out-of-school suspensions)
School Year Prior to Placement
School Year At Time of Placement
School Year Following Placement
FindingsLaw Enforcement Activities I
Yes NoN/A or
Missing
N Valid %
N Valid %
N Valid %
Did law enforcement file an AEP at time of referral or placement?
286286 72.672.6 108108 27.427.4 55 1.31.3
Was AEP filed as a result of parental arrest?
8686 30.130.1 200200 69.969.9 113113 28.328.3
Was the child’s parent arrested (by child)?
122122 30.830.8 274274 69.269.2 33 0.80.8
Was at least one parent arrested (by family)?
6262 29.129.1 151151 70.970.9 22 0.90.9
Was the arrest drug-related (by child)?
106106 86.986.9 1616 13.113.1 277277 69.469.4
Was the arrest drug-related (by family)?
5454 87.187.1 88 12.912.9 153153 71.271.2
FindingsLaw Enforcement Activities II
N Percent N/A or Missing
Which parent was arrested (by child)?
277277 0.00.0
Mom / mother figure 7575 70.870.8
Dad / father figure 1616 15.115.1
Both parental figures 1515 14.214.2
Which parent was arrested (by family)?
161161 74.974.9
Mom / mother figure 3232 59.359.3
Dad / father figure 1212 22.222.2
Both parental figures 1010 18.518.5
FindingsProsecution I
N Percent N/A or Missing
Was mother’s case referred for prosecution? (N=42) 173 173 80.80.55
Yes 3030 71.471.4
No 1111 26.226.2
Pending 11 2.42.4
Was father’s case referred for prosecution? (N=22) 193193 89.89.88
Yes 1717 77.377.3
No 55 2.32.3
Pending 00 0.00.0
Was mother charged with a felony? (N=31) 184184 85.85.66
Yes 3131 100.100.00
No 00 0.00.0
Was father charged with a felony? (N=17) 198198 92.92.11
Yes 1717 100.100.00
No 00 0.00.0
FindingsProsecution II
N Percent N/A or Missing
What was the outcome of the mother’s case? (N=30) 185185 86.86.00
Convicted by plea 1515 50.050.0
Found guilty 44 13.313.3
Not adjudicated 22 6.76.7
Dismissed 33 10.010.0
Pending 44 13.313.3
Referred (e.g. drug court) 22 6.66.6
What was the outcome of the father’s case? (N=17) 198198 92.92.11
Convicted by plea 1212 70.670.6
Found guilty 00 0.00.0
Not adjudicated 00 0.00.0
Dismissed 00 0.00.0
Pending 44 23.523.5
Referred (e.g. drug court) 00 0.00.0
Other 11 5.95.9
Evaluation LimitationsEvaluation Limitations
Secondary Data Analysis: did not to Secondary Data Analysis: did not to introduce any new instruments for introduce any new instruments for data collection, above and beyond data collection, above and beyond what DEC partners already collectwhat DEC partners already collect
Difficulty in accessing data from Difficulty in accessing data from partnerspartners
This study occurred in Spokane, This study occurred in Spokane, Washington, and may not be Washington, and may not be generalizable to other areas or regions generalizable to other areas or regions
Further InformationFurther Information Regarding DEC Projects Regarding DEC Projects
Ongoing collaborative effortsOngoing collaborative efforts National DEC Alliance and alliances in National DEC Alliance and alliances in
other states and regionsother states and regions Website for Washington state: Website for Washington state:
www.wadecalliance.orgwww.wadecalliance.org Washington State DEC AllianceWashington State DEC Alliance
Sustainability of the DEC Sustainability of the DEC ProjectProject
Translating promising Translating promising practices into policy changespractices into policy changesResearch/evaluation presented Research/evaluation presented
to demonstrate measurable to demonstrate measurable outcomesoutcomes
Outcomes drive changes in Outcomes drive changes in policypolicy
Sustainability of the DEC Sustainability of the DEC ProjectProject
National commitmentNational commitment Advocate for policy changes and Advocate for policy changes and
funding for therapeutic foster care, funding for therapeutic foster care, quality day care, good health care, and quality day care, good health care, and safe housingsafe housing
Market prevention through a strong Market prevention through a strong national media campaignnational media campaign
Advocate for policy changes to Advocate for policy changes to strengthen the child protective service strengthen the child protective service systemsystem
DEC DEC ContactsContacts
Spokane County Sheriff’’s Office Spokane County Sheriff’’s Office Esther Larsen, J.D., Project Director Esther Larsen, J.D., Project Director 1100 West Mallon 1100 West Mallon Spokane, WA 99206 Spokane, WA 99206 (509) 477-5709 (509) 477-5709 [email protected]@spokanecounty.org
Partners with Families and Children Partners with Families and Children Karen Winston, M.S.W.Karen Winston, M.S.W.Project Coordinator Project Coordinator 613 South Washington 613 South Washington Spokane, WA 99204 Spokane, WA 99204 (509) 473-4830(509) [email protected]@inhs.org
Lutheran Community Services NWLutheran Community Services NWHeike Lake, M.S.W.Heike Lake, M.S.W.210 West Sprague Avenue210 West Sprague AvenueSpokane, WA 99201Spokane, WA 99201(509) 747-8224(509) 747-8224
Department of Children and Family Department of Children and Family ServicesServicesAmber Cleverly-Thomas, , M.S.W. Amber Cleverly-Thomas, , M.S.W. DEC Service Coordinator DEC Service Coordinator 1313 North Atlantic, Suite 20001313 North Atlantic, Suite 2000Spokane, WA 99201Spokane, WA 99201(509) 362-2537(509) [email protected]@hotmail.com
Educational Service District 101Educational Service District 101Astri Zidack Astri Zidack 4202 South Regal 4202 South Regal Spokane, WA 99223Spokane, WA 99223(509) 789-3800(509) [email protected]@esd101.net
Project EvaluationProject EvaluationSandra J. Altshuler, Ph.D., L.I.C.S.W.Sandra J. Altshuler, Ph.D., L.I.C.S.W.Counseling Resources for Youth & Counseling Resources for Youth & FamiliesFamilies108 N. Washington108 N. WashingtonSpokane, WA 99201Spokane, WA 99201(509) 326-1668(509) [email protected]@gmail.com
Information and photos Information and photos provided by:provided by:
Spokane Police DepartmentSpokane Police Department
Spokane County Sheriff’s Office Spokane County Sheriff’s Office
