States can improve supports for infants and toddlers who are in or at risk of entering foster care
This report and survey are a collaborative effort between Child Trends and ZERO TO THREE.
To understand what policies and services are already in place for infants and toddlers in care and at risk of entering care, as well as where the child welfare field can leverage the opportunities provided by the Family First Act, Child Trends fielded the 2019 Survey of Child Welfare Agency Policies and Practices for Infants and Toddlers in, or who are Candidates for, Foster Care. The survey, supported by ZERO TO THREE (ZTT) and the Health and Human Services Administration (HRSA), aimed to understand the current array of policies and practices intended to serve this population, and how this array may have shifted since the initial fielding of the survey in 2013. The goal of the survey and report were to identify and share innovations in policy and practice and highlight key challenges that child welfare agencies face in meeting the needs of very young children who have experienced maltreatment. By collecting and sharing such information, we hope to support agencies in strengthening their approaches to serving this population.
With the Family First Act, states have a new opportunity to use federal funds to support children who are at risk of entering foster care (also known as candidates for foster care) and their families. Healthy early development requires stable, nurturing relationships with caregivers (Center on the Developing Child, 2007). For young children who are safe and supported, staying with their families rather than entering foster care is particularly beneficial.
Although the 2019 survey was fielded early in the implementation of the Family First Act, its findings show where states have existing strengths and infrastructure to provide prevention services to families with infants and toddlers. Findings also shed light on where states need to increase their capacity to provide a robust array of services for infants and toddlers who are candidates for foster care, as well as their families.
Three overarching themes emerged from the 2019 survey.
State policies and practices for maltreated infants and toddlers and their families have not changed significantly since the 2013 survey was administered.
In 2013, we learned about many potential areas for improvement by child welfare agencies serving maltreated infants and toddlers. For example, we found that few states were implementing best practices for meeting the urgent developmental needs of infants and toddlers. These needs include greater frequency of visitation when young children are in foster care (as compared to other age groups) and the provision of training on early childhood development for adults who support young children in foster care, including agency staff, foster parents, and court personnel (Jordan, Szrom, Colvard, Cooper, & DeVooght, 2013).
In 2019, services and supports for maltreated infants and toddlers and their families remain largely the same as in 2013. For example:
- In 2019, no states reported that policies require more frequent caseworker visits for infants and toddlers in foster care, relative to children in care from other age groups. This is consistent with findings from the 2013 survey, in which just one state reported more frequent caseworker visits.
- In 2019, a little over half (57 percent) of states reported that the initial permanency hearing for infants and toddlers in foster care must occur within 12 months of initial removal; in 2013, 49 percent of states reported that the initial permanency hearing must occur within this timeframe.
- Barriers remain around the implementation of the Child Abuse Prevention and Treatment Act (CAPTA) requirement for referring maltreated infants and toddlers to Individuals with Disabilities Education Act (IDEA) Part C services. As in 2013, these barriers include parents, caregivers, and court personnel lacking familiarity with Part C, lacking the training needed to recognize the developmental needs of infants and toddlers, and/or being hesitant to use Part C services. In both 2013 and 2019, states reported using similar strategies to overcome barriers: leadership engagement and collaboration, delineation of roles and responsibilities, and formal information sharing.
Despite areas of strength, fewer states have implemented policies or practices to support candidates for foster care as compared to children in care. The Family First Act is an opportunity to expand services to candidates.
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In the 2019 survey, states were consistently less likely to report that services and supports were offered to, or required for, candidates for foster care, as compared to infants and toddlers currently in foster care and their families. Even if infants and toddlers do not enter into foster care, they and their families may still benefit from the same kinds of supportive services available to children and families with child welfare system involvement. This aligns with our 2013 comparisons of services and policies for infants and toddlers in care and those with a finding of maltreatment but not removed from their home.
For example:
- Nearly all states reported that adherence to health visit and/or screening schedules for well-child visits, immunizations, and dental visits is required for infants and toddlers in foster care. However, only one quarter of states (or fewer) reported that adherence to schedules for these components of health care is required for children who are candidates for care.
- Nearly two thirds of states reported that referrals are required within a specific timeframe when potential physical or developmental problems are identified for children in care, but only one third reported this requirement for infants and toddlers who are candidates for care.
- States indicated that initiatives to support children’s physical and emotional health (such as care coordination and integrated behavioral health care) are required, promoted, and/or offered about half as often or less for candidates for foster care than for infants and toddlers in care.
Although we expect to see a wider range of services and requirements for children in foster care and their families due to court involvement, it is clear that there is opportunity for states to strengthen and expand policies, services, and supports to candidates for foster care and their families. The Family First Act provides new opportunities for children and their families to access mental health, substance use disorder, and parenting services that prevent entry to foster care. This is critically important: Children fare better when they can safely stay with their families, which prevents the trauma of removal and the upheaval of foster care entry and maintains children’s connection to their families and caregivers (Casanueva et al., 2012).
State child welfare policies and practices could better address the unique developmental needs of infants and toddlers.
While all children in foster care may benefit from expedited or more intensive services and supports to promote healthy development, infants and toddlers are in a uniquely sensitive developmental period (Center on the Developing Child, 2007) and may especially benefit from additional supports.
We asked respondents whether some policies and practices differ for maltreated infants and toddlers and maltreated children of other age groups. We learned that states overwhelmingly do not differentiate their policies and practices by age. This finding is consistent with the 2013 findings. For example:
- Few states reported that aspects of dependency court involvement routinely occurred on an expedited basis for infants and toddlers in foster care, as compared to children of other age groups. Only three states reported that case reviews were routinely held on an expedited basis, and only four reported that permanency hearings were held more quickly for infants and toddlers. Four states reported that court review hearings were expedited.
- Only two states reported that family group decision making was held on an expedited basis for infants and toddlers in foster care, as compared to children of other age groups.
- Of the nine states that reported that they require pre-removal conferences before an infant or toddler is removed from the home, none reported that the timeframe for the pre-removal conference for infants and toddlers differed from the timeframe for children of other age groups.
- Of the four states that reported requiring expedited notification of adult relatives when infants or toddlers are removed from their parents’ custody (i.e., more quickly than the 30 days required by the Fostering Connections Act), none reported that the timeframe for infants and toddlers differed from that for children of other age groups.
Related Content
- Changing the Course for Infants and Toddlers: A Survey of State Child Welfare Policies and Initiatives
- Applying the Research and Evaluation Provisions of the Family First Prevention Services Act
- Trauma-informed care initiatives show promise for improving practice in the child welfare system
- Early care and education can help young children overcome trauma
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