Thursday, July 11, 2013

In Re D.B. (Cal. Ct. App. - July 11, 2013)

I've never seen a child's gastrointestinal tract play as much of a role in child welfare determinations as it did in this case.

Here's a snippet.  With the warning that it's somewhat messy (as well as lengthy):

"Father and mother are the parents of six children together, with their three youngest, all boys, being the subject of this appeal. Father and mother also have two children each from other relationships. The case began when the Agency filed a dependency petition regarding all of the children in June 2008. In October 2008, the children were adjudged dependents of the court. In support of its order, the juvenile court made a number of findings, including the following: the parents had a relationship characterized by domestic violence that was witnessed and imitated by the children; a female child reported sexual abuse by her half brother; the children reported that the parents used excessive physical discipline; mother had mental health problems requiring therapy; father had a possible drinking problem requiring assessment; father physically abused his children from another relationship; and several children of one or both parents were former dependents of the court.

A reunification period of over a year and a half followed, and during it the boys were placed together in three different foster homes. Status reports filed during this time described worrisome behaviors by the boys. The younger brother suffered possible developmental delays, which may have been due to brain bleeding at birth. The middle brother showed aggression when he was two years old and engaged in 'head banging.' The older brother, according to his foster parents, 'play[ed] with his feces all the time' when he was first placed in their care but stopped by early 2009. . . .

The juvenile court renewed the boys' dependency status at post-permanency review hearings on January 13 and August 9, 2011, and on January 10, 2012, following the filing of status review reports describing the boys‟ progress in their aunt's care. According to these reports, the boys displayed a good deal of aggression when they were

first placed with their aunt, but they became less aggressive over time. The social worker reported at one point that the older brother had shown great improvement in his behavior and emotional regulation, although his preschool continued to work with him on his physical behaviors and socialization skills, and he still at times screamed uncontrollably and acted out sexually. The middle brother suffered from severe diarrhea early on in the placement that was attributed to anxiety. He was asked to leave his preschool because of violent behavior, and he was disruptive at a second preschool placement, where he hit and bit students and teachers. He was 'severely delayed' in his speech, scored 'very low' on an early childhood screening test, and suffered 'severe behavioral and emotional issues' related to anxiety and posttraumatic-stress disorder. The younger brother's behavior was reportedly normal, although he continued to experience developmental delays.

Mother was generally consistent in visiting the boys, but the boys were at times overwhelmed by the visits and experienced 'episodes [of] emotional dysregulation' when they were with mother and were hard to control. Father satisfied the court-imposed conditions to begin visitation. He visited with the boys in November 2010, and in January, February, and March 2011, but then did not visit with them again until August 2011. The two older brothers reacted negatively when father's visits resumed. The older brother (then about five-and-a-half years old) had a bowel movement in his pants during the first resumed visit, had one a few days later at school even though he was not ill, and acted defiantly at home. The middle brother (then about four-and-a-half years old and fully toilet trained) suffered diarrhea for three weeks following the visit. . . .

A new social worker was assigned to the case in early September 2011. Based on discussions she had with the boys' aunt, teachers, and therapists, the social worker became 'extremely concerned' about the boys' behavior and 'the constant re-exposure to the biological parents with whom they experienced extreme violence and neglect,' which led to a 'spike' in 'problematic behaviors,' including aggression, biting, and scratching. The older brother appeared to react the strongest to visits with his parents. He acted out aggressively after a visit with father in late August 2011, and as of late September (a few months shy of his sixth birthday, when he was otherwise a fully toilet-trained kindergartener), he had had a bowel movement in his pants three out of four visits with father. The middle brother reportedly had less ability to focus at school after visits with his parents and became more emotional and aggressive, while the younger brother's behavior could 'escalate very quickly at times.'

The new social worker consulted with the director of the early trauma treatment center at San Francisco General Hospital, who had served as a consultant for the Agency for 27 years and had conferred with a previous social worker assigned to the case. The consultant recommended that all visits between the boys and their parents be terminated. The consultant stated that the boys' behavior showed 'the classic characteristics of children whose brain development and emotional health has been derailed by their early experiences as they show emotional dysregulation, for example, in the form of the inability to control feces when under stress; severe aggression; lack of tolerance for frustration; fear of separation; chronic sleep problems and night terrors; violence towards teachers and peers; and food hoarding.' She believed that visits with the parents were 'a reminder of the traumatic experiences that they experienced when in their care,' and that 'their behaviors represent the trauma they suffered though they cannot articulate their pain.'

In late October 2011, the aunt reported that the older brother had a bowel movement during a visit (apparently with mother) that was so bad his clothes had to be thrown away. He was able to avoid an accident during a different visit (this one with father), but he then had diarrhea for the two days following it. The younger brother, who was almost four years old and fully toilet trained, also soiled his pants two days in a row after visits with father. The middle brother appeared withdrawn at school the day after an October visit with mother, and he pointed to 'angry and sad faces' when his therapist asked him to describe how he felt after the visit. Because of his behavior at preschool, he was on the verge of being expelled just three months after starting there. According to the social worker, all three boys acted out following parental visits, and this pattern continued through early 2012."

I'm no expert on this stuff.  I'm not saying anything about the merits.  But I've read a lot of these opinions.  Lots of different kinds of trauma.  But never before have I seen a case in which there was so much discussion of the kids' poo.