Thursday, July 15, 2010

Does Chapin Hall want YOU (investigated for child abuse)?

In the previous post to this Blog, I said that home visiting programs like the Nurse Family Partnership or Healthy Families America have such strong support in the child welfare community that they should be called "goody-two-shoes prevention." The people whose 19th Century counterparts proudly called themselves "child savers" like these programs because they enormously expand the scope of intervention into families. Advocates of family preservation like them because the intervention is voluntary, and such programs really can be helpful.

Almost the only dissenters are a few on the political right who see it as a way to impose government child-rearing standards and take away children when the parents don't comply. Absurd, of course – except for the fact that every once in awhile, someone from the mainstream of American child saving says something to fuel those very fears.


A little over a decade ago, for example, one of the most zealous crusaders against family preservation, Elizabeth Bartholet, suggested making home visiting programs like Healthy Families America mandatory – specifically for what she described as their "surveillance" value. Under Bartholet's spy-in-every-living-room scheme, parents would be required to admit the visitors and the visitors required to turn in any parent who falls short of Bartholet's standards for child rearing. Bartholet, a self-proclaimed liberal, explains that this "would simply provide society with a realistic means of enforcing" child maltreatment laws.

Which brings me to Dr. Deborah Daro, advocate-turned-"scholar."

In the previous post to this Blog, I discussed the extremist agenda of the group now called Prevent Child Abuse America when Daro was the group's "research director." Daro now is a "research fellow" at the Chapin Hall Center for Children, a place which claims to be a center of objective scholarship but I would argue has a checkered record in that regard.

Last February, Daro wrote an Issue Brief discussing the most recent National Incidence Study of child maltreatment (NIS-4). In addition to taking the findings of the study out of context (our own analysis is available here), toward the end of the Brief, Daro offers her own four-point plan for exactly what government should do in response to the data. Point three calls for "Universal assessments of all new parents that carry the dual mission of assessing parental capacity to provide for a child's safety, and linking families with services commensurate with their needs."

But Daro is remarkably vague about what this means. Does "universal" mean every new parent must be assessed, or has the opportunity to be assessed? If it's the latter, what happens to the parent who says no – does that make her automatically suspect? Who does these assessments? Are they also mandated reporters of child abuse? Before "volunteering," how much is the parent told about the risk of letting someone who may be a mandated reporter of child abuse into the home to "assess" her "capacity to provide for a child's safety"? The brief article doesn't say.

Daro's other writing, including a much longer article about a variety of prevention strategies, doesn't answer these questions either. That article suggests that what Daro has in mind is what they're trying to implement in Durham, North Carolina, as part of something called the Durham Family Initiative. The goal is to get a home visitor into the home of every newborn, apparently within 48 hours of the mother's discharge from the hospital. The visitor would complete "the standard risk assessment protocol" and do a "comprehensive psychosocial assessment." The goal is to "expand coverage to the families of newborns that are not now offered or do not accept these visits" [emphasis added].


Once again this remarkably vague description (especially for "scholarly" writing) is all the reader gets about how the process works. So we don't know if the visitor is a mandated reporter of child abuse and what happens if, after knocking on the door, the new parent tells the visitor to go away.

And even if this is purely voluntary, there is a huge difference between stopping by to offer help and stopping by with "the standard risk assessment protocol" to assess "parental capacity to provide for a child's safety" – both of which sound remarkably like what Child Protective Services workers do after they've received a report alleging maltreatment.

Of course Daro couches all this in the language of help. The point of the process, she writes is to "ensure that the family is linked to a medical provider and that any immediate needs identified though the risk assessment are addressed through an appropriate service referral."

And I'm sure Daro would argue that family preservation advocates should favor this approach, since, if it gets families "services" and prevents maltreatment, no one will report them and their children won't be taken away. But that assumes the assessment instrument is strictly objective and all these friendly "home visitors" can check their prejudices at the door. We've learned through the failure of Structured Decision Making, a similar set of assessment tools used by CPS workers that was found by this excellent study to be permeated with racial and class bias, just how dangerous "help" can be when the prerequisite for getting it is submitting to a "comprehensive psychosocial assessment." And the failure of the CASA program illustrates the danger of letting overwhelmingly white middle-class strangers pass judgment on overwhelmingly poor disproportionately minority families.

In short, what Daro is talking about is sending what are likely to be overwhelmingly white, middle-class professionals into homes they can identify with, and a whole lot of homes they can't – the homes of poor, minority families, in a way that may be voluntary in name only, even when these families have not even been accused of maltreating their children.

In other words, a spy in every living room.

And, indeed, if point three of Daro's agenda was the velvet glove, point four is the iron fist: "Creating child welfare systems that have the capacity to work with parents who require mandatory intervention to insure their child's safety and the willingness to remove children in those cases in which parents are either unwilling or unable to change." As if somehow we don't have that already.


So does this mean the critics on the right were right about home visiting programs?

I don't think so. These programs have been around for a long time. I'm aware of no evidence linking them to increased removals of children from their homes – and there is evidence, with varying degrees of strength depending on the program – linking them to better outcomes for children. I don't think an entire program should be condemned because a few extremists want to pervert it.

But there also is an obligation on the part of mainstream supporters of these programs, like the Children's Defense Fund, the Child Welfare League of America and, especially, Prevent Child Abuse America, to take the initiative and speak out, loudly, against the extremists in their midst. They need to say that they won't tolerate having the program distorted the way people like Bartholet and Daro suggest.

And I haven't heard that yet.


The other question here is why does a "scholar" have an advocacy agenda? According to the recent Youth Today story on evidenced-based evaluation of youth service programs:

Mark Dynarski, vice president and director of the Center for Improving Research Evidence at the research company Mathematica, said a researcher must be neutral in carrying out any study, "very transparent" about the methodology of the evaluation, and then should step out of the way and "let the debate ensue." Even if there are significant findings, researchers "don't want to be over strong" in reporting them, Dynarski said. "Over-strong discussions are a kind of advocacy." Researchers must "stay in the line of science and let the policymakers pick up from there."

But at Chapin Hall, it seems, the line between advocate and scholar can be blurry – sometimes it's even indistinguishable. And that makes the "scholarship" suspect.