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Cherishing Children

Early intervention helps brain development in traumatized babies

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Many infants placed in foster care begin their fetal development influenced by prenatal drug and alcohol exposure, which often results in neurological damage. When it comes to addressing potential neurological damage in infants, early intervention is critical because adequate intervention may assuage the damage and place the babies back on track developmentally. Children Encouraged by Relationships in Stable Homes (CHERISH), a six-month long program that has been offered through Bellevue, Washington’s Kindering Center for the past seven years, specializes in caretaker education and the neurodevelopmental therapy of babies from birth to age 3. The program helps children learn how to bond with the next foster parents in their lives, fill in the gaps in their psychological development, and continue to progress normally.

Aiden, a former CHERISH client.

According to Julie Fisher, CHERISH’s lead clinical social worker, 80% of foster kids enter the system with prenatal substance exposure. There are examples of children who came into foster care whose parents went through cycles of drug use and abstinence and thus parented sporadically, so these children have unstable feedback regarding which cueing measures are effective. “These infants are hard to soothe because they don’t know how to get attention. Instead of being too calm or too quiet, they’re constantly acting out because they’re insecure,” Fisher notes. Other infants at CHERISH have learned from inattentive parenting that crying to indicate needs such as hunger will not result in their needs being met, so they’ll simply stop cueing. “If you’re a very young child, and your needs are getting met by your caregiver, you trust that person and you allow them to interpret the world for you. If you don’t have that trust and secure relationship, you can’t develop. You learn that you’re the only person that you can count on—which is pretty terrifying as a toddler,” Fisher says.

The CHERISH program, whose two dedicated staff members serve approximately 200 babies and toddlers each year, consists of six months of home visiting. “Our goal is to provide the child’s foster parent with preventative intervention and to facilitate the creation and maintenance of a secure attachment between the foster parent and child.” Young traumatized individuals have difficulty forming secure attachments, Fisher says. “Most kids come into foster care with insecure attachments, so we’re working with the primary caregiver to develop a different attachment pattern,” she says.

The experts from CHERISH perform a thorough assessment of each child’s history, including medical concerns and abuse they have experienced. In order to measure improvements, CHERISH uses PIR-GAS, the Parent Infant Relationship Global Assessment Scale, and compares scores from the beginning and end of the six-month period. “We ask about their eating habits, if they’re scared of the bathtub,” Fisher says, explaining that by asking specific questions, the therapists can create a sophisticated idea of the types of trauma the child has experienced. Caregivers of traumatized children who do not know how to self-regulate by indicating needs by crying or other cues need support in learning how to anticipate the child’s needs and regulate for them. Oftentimes, a child will regress to a younger age each time she or he moves, making it impossible to catch up.

Katie and Jake are former CHERISH clients. They are adopted siblings who have no blood relationship to one another.

In order to help the family, a therapist from CHERISH will create an individual family service plan and involve the whole family, including siblings. “A lot of interventions with caregivers regard the education of things that aren’t necessarily verbal, because children ages 0 to 3 don’t communicate that way. For those ages, movements like playing, touching, and rocking are so important,” says Fisher.

Because the parent-child relationship figures so prominently into the child’s ability to develop and gain autonomy, CHERISH encourages the child’s primary caregiver to maintain ties to the child’s birth parent. “It’s very important to keep these visits alive and well,” Fisher says. “Although many caregivers may perceive the visits as disruptive or a thorn in their side, we emphasize how important it is in the children’s lives for the [biological parent] to be able to play a role. It’s part of the healing process.”

Are children with histories of such trauma able to have secure relationships and progress normally after the intensive intervention provided by CHERISH? “Absolutely,” says Fisher. “There’s so much hope for [children] ages 0 to 3. The human brain grows to 90% of its ultimate size by age 3, and then the neural pathways get pruned. Birth to 3 is critical. Once you’ve had a secure attachment experience, you can take that information to the next relationship with your next caregiver. It’s so important to intervene early.”

Laural Hobbes is an editorial intern at CWLA.

'Listening' Campaign

In April, the American Bar Association’s Center on Children and the Law launched “The Kids are Listening,” a nationwide campaign to ensure that lesbian, gay, bisexual, transgender, and questioning (LGBTQ) youth in foster care receive appropriate legal rights and protections. The campaign teaches lawyers, judges, and other adults involved in children’s lives about the impact their actions have on these youth. The center provides trainings and free resources and works with service practitioners to make their community a better and safer place for LGBTQ foster children. Visit #.

Foreign Visitors

The National Foster Parent Association, a CWLA member agency, recently hosted a delegation from Bulgaria to discuss the country’s plan to “deinstitutionalize” all children in the foster care system by 2020, which they hope to accomplish by expanding family preservation services, strengthening adoption programs, and creating a foster care system. The four delegates and two interpreters spent three weeks in the United States and visited Washington, DC, Seattle, Denver, and Austin to observe child welfare and family social services in the United States.

Awareness Through Art

In celebration of May’s designation as National Foster Care Month, Catholic Community Service, a CWLA member agency, planned to host the “Foster a Future” Chalk Art Festival in Juneau’s Nugget Mall on May 22 and 23. Solo artists or groups of up to three were invited to create works of chalk art to publicly raise awareness for the more than 2,000 Alaskan children in foster care. The group hoped amateur and established artists alike would help educate the community about opportunities to adopt and support children in foster care.

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