Sunday, November 7, 2010

Getting Beyond “Gestapolemics:” What REALLY motivates some child protective services workers

            There is a stereotype about frontline caseworkers for child protective services agencies that is as pernicious as the stereotypes some such workers hold about families.  It’s the one in which caseworkers are portrayed as jack-booted thugs who relish tearing apart families.

            At its worst, this stereotype descends into what Chris Doyle of Ponder, Texas, calls “Gestapolemics” – calling your opponents Nazis.* That’s something I’ve written about before on this Blog.

            This week, there was published something that gives an outstanding insight into how many of those on the frontlines, the people whose 19th Century counterparts proudly called themselves “child savers” really think.  And it’s much worse.

            The insight comes courtesy of someone calling herself “Concerned Social Worker,” (I’ll just call her CSW) in the form of a letter to Annie’s Mailbox, an advice column written by Kathy Mitchell and Marcy Sugar, two former editors for Ann Landers.  And this takes a little setting up.

            First came a letter from Shirley, writing about her friend “Helen” and Helen’s five-month-old infant, “Petey.”  Shirley wrote that

Petey seems to be rather small (about 12 pounds) for a 5-month-old. He seldom lifts his arms or legs or does any of the things my children did at that age. Helen has used a swaddling blanket on Petey since he was born. She makes him take a lot of extended naps, plus at least eight hours of sleep at night. I fear she may have done some harm with this tight bondage, maybe cutting off circulation to his limbs. … Also, Petey has not been checked by a doctor for nearly two months. Is this OK?

            The columnists offered some excellent advice, including this:

The pediatrician should see Petey roughly every two months to check his development. Between 4 months and 7 months, babies should be rolling over, reaching out for things and able to stay in a sitting position and hold up their heads and chests when lying on their stomachs. It’s time to call the doctor if these milestones are not reached by 7 months, or if the child doesn’t use an arm, a leg or one side of the body.
Petey may be just fine, but if you think otherwise, bring this column to Helen and use it to start a neutral discussion.

            But that wasn’t enough for “Concerned Social Worker,” who, in the second letter in this column, said the advice was off the mark.  She wrote:

Having worked as a child abuse/neglect investigator, I can tell you that if Shirley had contacted Child Protective Services, we would have opened an investigation based on Petey's size alone. Keeping the baby wrapped tightly and napping most of the time also sets off alarm bells. If Petey is not given enough attention and stimulation, not to mention food, he could suffer lasting developmental delays or even starve to death.

Petey is likely the victim of physical neglect. Shirley should immediately report Petey's situation to her local Child Protective Services office. Whether or not the child is being neglected, CPS will likely offer Petey's mother some assistance and monitor the family until the situation improves.

            Before I respond, here’s what Mitchell and Sugar said:

Dear Social Worker: Depending on the child's birth weight, 12 pounds is not unreasonably low at five months. And Shirley is only guessing the actual weight. Petey sees the pediatrician regularly, and if he were failing to thrive, it would be noticed. We do agree, however, that the situation bears watching.

            So what we have in CSW is someone who means well, but doesn’t know the basics about baby weight, jumps to conclusions (“A lot of extended naps” turns into “napping most of the time”) and is conjuring up horror scenarios about a baby starving to death even though the baby regularly is seen by a pediatrician and his weight may well be normal.

            Although CSW says “we would have opened an investigation” based on no more than Petey’s quite-possibly-normal weight, CSW has, in fact, already drawn her conclusion: “Petey is likely the victim of physical neglect.”  And even if he isn’t, CSW says CPS would keep the family under surveillance anyway!


           Worst of all, of course, CSW’s approach flunks the balance of harms test.  There is no recognition of the enormous stress a child abuse investigation puts on a family – and the consequences that stress may produce for a five-month-old.  And though CSW paints a benign picture in which CPS would merely “offer Petey's mother some assistance” it would probably be the classic “offer you can’t refuse” involving pointless “counseling” and “parent education.”  The problems increase exponentially, of course, if CSW decides to throw the child into foster care.

          Whether that would happen would depend on things like whether the Petey’s mother is poor, singe and/or a minority, which caseworker shows up at the door, and whether the local newspaper has been whipping up hysteria over child abuse deaths.

           To get a sense of just how harmful that would be for Petey, consider a University of Florida Medical Center study of infants for whom one would think there is much more reason to resort to foster care: those born with cocaine in their systems.  The study compared such infants placed in foster care with those left with mothers able to care for them.  At six months the infants were tested using the same developmental milestones Mitchell and Sugar mention in their column: sitting up, reaching out, rolling over.  Consistently, the children left in their own homes did better – for the foster children the separation from the mothers was more toxic than the cocaine.  (That doesn’t mean children should be left with addicts, but it does mean drug treatment for the mother is a better first choice than foster care for the child.  And, of course, there is nothing like this kind of problem in Petey’s case.)

          CSW’s response also casts doubt on the all-purpose answer to every CPS problem proposed by the National Association of Social Workers: require every caseworker to have a social work degree.


            At least if caseworkers really were jack-booted thugs one could appeal to their consciences.  CSW’s combination of ignorance and self-righteousness is a lot harder to deal with, and it helps explain why child welfare systems are so hard to change.

            Of course not every CPS worker is like CSW.  Some are like the caseworker profiled some years ago by the San Antonio Express News who said

…she worries when she sees new caseworkers, recent college graduates, charged up by the prospect of saving children, snapping photos of unkempt kitchens. "I don't believe in
removing (children) on (the basis of) dirty houses. I just don't," [she] said, joking that her
own home is "practically a referral."

"I always think: 'Where will (the children) go for Christmas?'"

           Two years later, another reporter for the same newspaper wrote about a supervisor who sometimes

has to reassure his childless employees that some parental behavior is normal. He recalls a caseworker appalled by a child's hamburgers-and-chips meals.
"Junk food's not a crime," [the supervisor] said.  Another couldn't believe parents let
their kids eat off the floor. That happens with kids, [the supervisor] said. It's OK.

           I’d use these fine workers’ names, but I’m afraid CSW might be out there, ready to turn them in for child abuse.

*-Sure he coined the word for The Style Invitational, a weekly humor contest in The Washington Post, but I say, if the word fits – use it.