Articles from "Nurture Notes", Spring 2010

New Jersey Division of Youth and Family Services v. L.L.

Mary M. McManus-Smith, Esq.
Chief Section Counsel – Family Law
Legal Services of New Jersey

In late February, the New Jersey Supreme Court handed down the decision in New Jersey Division of Youth and Family Services v. L.L., which clarifies the standards required for vacating or terminating a Kinship Legal Guardianship and reuniting the child with a parent.

Kinship Legal Guardianships (KLG) were legislatively created in 2002, to provide financial support and state recognition for relative caregivers. The legislation incorporates two potentially conflicting principles: (1) termination of parental rights and adoption are not needed to establish permanence for a child who lives with a relative caregiver; and (2) when a parent has been adjudicated to be unable to appropriately parent his or her child, the alternative living arrangement ordered by the court must be more durable than a traditional custody order as between two fit parents. So, the legislation makes clear that the standard for ending a KLG and returning custody to a parent is significantly more stringent than that for modifying a custody order.

The Supreme Court held that the statutory language describing the standard to vacate a KLG clearly requires that a parent must prove by clear and convincing evidence that both (1) the parent has overcome or eliminated the incapacity that led to the original award of KLG, and (2) that termination of the KLG is in the best interest of the child. The Court further articulated that under the best interest prong of the standard, a trial court must focus on the safety of the child. The Court pointed to DYFS regulations for factors that may assist trial courts in assessing the safety needs of the child. Those factors include:

1. The child’s age;
2. The duration of the Division’s involvement with the child, prior to the granting of kinship legal guardianship;
3. The total length of time the child was in out-of-home placement;
4. The length of time the child has lived with the guardian, prior to and after the granting of kinship legal guardianship;
5. When kinship legal guardianship was granted;
6. What the original harm or risk of harm to the child was;
7. The parent’s present fitness to care for the child;
8. Any subsequent allegations of abuse or neglect received by the Division and their findings; and
9. What plan is proposed for the child if the guardianship is vacated.

The Court pointed to additional factors that may assist trial courts in determining whether termination of the KLG is in the best interest of the child. Those factors include:

“the child’s wishes; the nature and quality of the parent-child relationship during the kinship legal guardianship; the future relationship anticipated between the child and the guardian; the preservation of sibling relationships; the practical impact of vacating the kinship legal guardianship on the child’s day-to-day life (i.e. changes in school, community and friends); and any other relevant factor bearing on the best interests of the child.”

A 2007 study by the Center for Law and Social Policy reveals that kinship caregivers provide greater stability than foster care and are more likely to result in healthy, well-adjusted children. Children in kinship care have fewer behavioral problems, fewer school disciplinary issues and are less likely to run away. They also have a more positive perception of their placement than children in non-kin foster placements. See, T. Conway & R.Q. Hutson, Center for Law & Social Policy, “Is Kinship Care Good for Kids?” (March 2, 2007). (available online at www.clasp.org/publications/is_kinship_care_good.pdf)

Only one other case involving the status of Kinship Legal Guardianship has reached the New Jersey Supreme Court. By articulating clear standards for the termination of a KLG, this Supreme Court decision may, in fact, encourage the use of Kinship Legal Guardianships.





 
What Is He Trying To Tell Us?
Relationship Instability and Aggression in Pre-school Children

Judith Wides, MA, M.Ed.

Small children who are involved in custody battles, foster care placement and the stress of relationship instability sometimes display overly aggressive behaviors at school. It is helpful for pre-school teachers to think of aggression in young children as a form of communication. Their actions highlight their unique neurological profile, their ability to tolerate stimulation, their relationship patterns, and their exposure to media.
Children who experience early relationship instability are particularly vulnerable if they are pre-verbal or verbally delayed. Many court-involved children have been witness to or victims of domestic violence. In addition they may have suffered other forms of abuse and neglect. Frightened and unhappy children may resort to aggression to communicate their needs and/or protect themselves.
Traditionally, educators have used a model called Applied Behavior Analysis to look at behavior that has been deemed problematic or challenging. Applied Behavior Analysis is particularly valuable in assessing the repetitive disruptive, aggressive and disquieting behaviors often seen in emotionally fragile children. In the classroom, Applied Behavior Analysis allows the teacher to view behaviors in a non-judgmental and functional framework.
When using the model of Applied Behavior Analysis or ABC for short, the understanding is as follows. The A is the antecedent and represents what happens before the identified behavior occurs and where it happened. This includes the setting and the individuals who are present. B represents the behavior itself. C represents the consequence of the behavior. Consequence is a word that is often interpreted to mean punishment. In this case it does not mean punishment. It means what happens as a result of the behavior. What did the child gain from the behavior, attention? access to a toy? release from a disliked activity? physical contact with a peer or teacher?
The critical task for teachers is to identify the triggers that cause the child to utilize a particular behavior in a specific setting. It boils down to recognizing what happens before a problematic behavior occurs, mapping the characteristics of the behavior and then recognizing the outcome of the behavior. A typically developing child will generally avoid behavior that will result in a physical restraint by a teacher. A child who is experiencing relationship instability may bite a teacher with the intent of landing herself in a holding for safety because she does not know any other way of seeking physical contact.
Teachers who have a student who bites in their midst are pretty good at predicting when he or she is most likely to strike. They know the Antecedents well. Often they can predict how well a child’s day will proceed by observing the dynamic between the parent or caregiver and the child as the pair enters the classroom in the morning. The ritual of entering the room, settling in and saying goodbye illustrates for the teacher how well rested they are, and their state of relationship synchrony or discord.

The information gleaned from observing the morning ritual is helpful in planning a successful day for the child. Consider the child who has a history of biting. What might we predict on a morning when the parent roughly removes the snow boots and winter coat and then storms off without a kiss or even making eye contact with her child? The parent shows real signs of stress and frustration. Will the child be more likely to aggress against other children or teachers that morning? Is he likely to lash out when he is tired, hungry, or over excited? Do certain children trigger his tendency toward aggression? Is there a particular toy that always causes him to get into conflict? If you can manage to keep in mind that small children often lack the capacity to communicate in ways other than physical expression you will be better equipped to educate and protect the children you serve.
Finally, all of us who work with children know that consistency, flexibility and creativity are the keys to managing challenging behaviors. It is helpful to keep in mind that children who bite, kick, push and wrangle furniture are desperately trying to communicate something about their internal experience. They need us to see what they are doing on multiple levels.
In closing it is important to reaffirm that it is no small miracle that educators who work with behaviorally challenged children often have very good ‘gut’ feelings about managing those children. However, utilizing an organized framework like Applied Behavior Analysis can help teachers and caregivers alike in understanding on a micro level the range of factors that effect behavior. Mapping out behaviors in the context of analysis allows for the construction of intervention plans that help a child feel safe and contained at school. When a child learns to experience a greater sense of stability and control at school it is often the first step in creating an opening for improved relationships with everyone in the child’s life, including an improved sense of self worth and self efficacy.




 
Child Sexual Abuse: Problematic, Yes; Traumatic, Not Necessarily

Jean Mercer, Ph.D.
Richard Stockton College of New Jersey

Susan Clancy’s important book “The Trauma Myth” (New York, Basic Books, 2009) is drawing the critical fire of a number of people who have not given it the careful reading it deserves. Some of these critics have claimed that Clancy argues against any deleterious effects of sexual molestation in childhood--- that she defends pedophiles, and even that she is a pedophile herself or that she blames child victims for the behavior of sexually-exploitative adults. These statements are nonsense, and I am going to attempt to counter them.

“The Trauma Myth” emphasizes repeatedly the clear evidence that childhood experiences of sexual exploitation by adults are associated with a long list of later problems, including mood disorders, anxiety disorders, personality disorders, relationship and sexual problems, eating disorders, self-mutilation, and so on. Because one in five children is reported to have experienced sexual abuse (and probably there are more, unreported, cases), such abuse is responsible for significant numbers of mental health problems. It’s important that we learn how to prevent it and to treat its results, not only for the sake of individuals but for the mental health of the whole population. To prevent child sexual abuse and treat problems that result from it, we need to have a real understanding of how these experiences cause bad outcomes. However, much work in this area is based on the assumptions of trauma theory, which attributes many mental health problems to the past experience of severe pain and fear, and trauma theory may not provide a good framework for understanding the impact of sexual molestation in childhood.

Clancy is not the first to point out that children’s sexual experiences with adults are not necessarily experienced as traumatic (severely painful or terrifying) at the time when they occur. But her interview research with adults who had been molested as children clearly showed a continuum of child experiences, ranging from terror and pain at one end, through puzzlement without distress in the middle, to physical and emotional gratification at the opposite end. In fact, most of her interviewees reported that in childhood, at the time of the event, they were not frightened or in pain. The abuser’s actions did not involve force or even penetration of any kind, but were generally limited to rubbing, kissing, or fondling of genitals, nor did most of the abusers threaten the children in any way. Nevertheless, those adults, as well as the ones who had experienced trauma, reported symptoms related to their experiences, and now felt that the sexual event had had a deplorable effect on them.

The question Clancy raises is this: if the abused children did not at the time experience the event as traumatic, how can we explain the connection to their present symptoms? We can’t do this in any simple way by means of applying trauma theory. To make trauma theory work in this context, we would have to add to it the concept of repressed memories-- to say, for example, that the adults Clancy interviewed were really terrified and hurt, that they have repressed and can’t report that part of the experience, but that in its repressed form the memory still affects their mental health. Taking that approach, however, we would come up against an even more complicated issue: why is it that people who were actually hurt and terrified (according to independent evidence) don’t repress what must be a hideous memory? Using the repressed memory concept, then, we find ourselves having to explain why a really terrible experience is remembered with all the emotional factors intact, but a less painful and frightening situation leads to repression of memories of emotion. Although U-shaped functions of this kind are not unknown in psychology, this one does not seem to make much sense.

Clancy concludes from this line of reasoning that trauma theory and the concept of repression are not good ways to explain the most common situations involving childhood sexual abuse and its aftermath in adulthood. Because they are not good ways, they have not done much to help us either prevent or treat the effects of child sexual abuse. We need to explore these matters much more carefully, and, Clancy says we need to make sure that our explanation involves the child’s point of view, which has generally been ignored. To understand that children’s group and individual characteristics affect the sex abuse situation is a far cry from “blaming” the child.

Clancy makes several points about children’s understanding of the world and the ways it can make the child’s view of non-painful sexual abuse rather different from an adult’s. She stresses the ignorance of children about sexuality and their failure to comprehend what an adult wants or what he or she is doing. Why heavy breathing and a red face, for instance? A child has probably observed these things before, but in quite different contexts. The puzzled conclusion may simply be that this is strange and perhaps it’s one of those embarrassing things that you get in trouble for talking about, so best to just keep it to yourself.

Importantly, Clancy also emphasize that there are characteristics of individual children that may make them more likely to be the victims of repeated abuse which they do not report. No, she does not say these children are “seductive”; what she does say is that they are lonely, unsupervised, and grateful for adult attention. They respond to the fascinated attentiveness of the potential abuser as a delightful experience, in sharp contrast with the indifference their caregivers may show. Without experiences of pain or fear, why should they reveal what seems to them like a romance to familiar adults who will probably cause some trouble?

Finally, Clancy says something that is for many readers the unspeakable: that given a kind, careful adult who treats them well, children may enjoy sexual experiences (we are not talking about penetration here, of course). I was reminded of a story I heard from a friend some years ago. She had left her 3-year-old boy with a 13-year-old boy babysitter, and when she came home she became aware that some sort of sex play must have been going on. All she could think of was to give the 3-year-old the old bromide, “if someone touches you and you don’t like it, just tell them to stop”--- to which the 3-year-old replied enthusiastically, “I liked it! When can he babysit me again?” And there you have it in a nutshell; sexual activity of the right kind is pleasurable for everybody at every age. Sexual predators know that very well, and if we want to stop their exploitation of children, we need to be honest about it too, and not to expect children to “tell on” someone who gives them pleasure.

“The Trauma Myth” is a serious effort to deal with child sexual abuse and its aftermath. I’ve had space here to give only the highlights of Clancy’s argument, but the book contains much more of interest, including a discussion of abuse prevention programs as they now exist. I hope readers will give “The Trauma Myth” the careful attention it deserves.
The Value of Play during Infancy and Early Childhood

Connie M. Tang, Ph.D.
Richard Stockton College of New Jersey

We are probably all quite familiar with the old saying that “all work but no play makes Johnny a dull boy.” Before we delve into the issue of play in infants and young children, let us think about the importance of play in adults’ lives: Can you imagine life that is all work but no play? Granted, as adults, our style of play has progressed to grander versions, such as playing with our beloved iPhone or the newest electronic gadget, or playing an online game. But the function of play stays the same: We play to relax, to experience excitement, to have fun, and to be rejuvenated. In infancy and early childhood, play serves all of the functions in adulthood, and more. During these earliest stages of human development, play is leisure, but play is also work.

That is right! For infants and young children, their job is to play. I bet that makes all of us quite jealous. If we say that the most important thing for adults is to work, for school age children is to study, then the most important thing for infants and young children is to play. Playing is preparation for studying, much like studying is preparation for work. So how does play prepare infants and young children for the world of studying, and later working as adults? First of all, playing promotes physical development. Through play, infants and young children get to practice their gross and fine motor skills. They learn to perfect their ability to walk, run, jump, to hold a pen, to glue things together, and to use a pair of scissors.

Second, play is important for infants’ and young children’s cognitive development in terms of thinking and language. According to Swiss psychologist Jean Piaget’s cognitive developmental theory, infants think with their sensations and motor activities, whereas pre-school children think with images, words, and other types of symbols. At the preschool age, children still cannot think things through without acting them out. In order for children’s thinking to mature so that they can mentally problem solve, they first need to have plenty of practices with “acting out”. The more they tangibly experience how things work in real life, the more they are able to imagine how things can work. Play is also critical for infants’ and young children’s language development. Like many other aspects of development, language is believed to have a sensitive period, and this period often includes infancy and early childhood. That is why starting from the first words around age one, children progress rapidly into speaking in simple sentences at age two, and speaking in more complex sentences at age three or four. By the end of the preschool period, children usually display a great deal of knowledge regarding phonology, semantics, syntax, and pragmatics, and their speech can be adult like. Evidence for language having a sensitive period also lies in the finding that learning a second language is often the easiest during infancy and early childhood. Therefore, encouraging infants and young children to play “house” and to play with one another encourages their language development.

Finally, play is important for social and emotional development. When infants and young children play with one another, they learn to take turns, to negotiate, to empathize, and to look at things from someone else’s point of view. When infants and children play “house”, they often “act out” experiences and emotions that they are not able to express verbally (which incidentally is a premise for play therapy), thereby allowing them the opportunity to learn to label their emotional experiences with words. In short, through play, infants and young children not only experience joy, excitement, and the relief of tension; they also learn how to share, to team play, and to get along with others.

Now that we have established the importance of play, we will turn our attention to the types of play and how these play types can make unique contributions to certain aspect of development. There are generally six types of play (Santrock, 2010).

Sensorimotor play mostly describes infants’ play, when they engage in behaviors such as tracking a moving mobile and shaking a rattle. Sensorimotor play is important for infants’ physical and cognitive development.

Practice play occurs throughout life, when we repeat a newly learned behavior, such as climbing stairs or practicing bowling swings on Wii. Practice play augments physical development.

Pretense or symbolic play occurs mostly during the preschool years, such as when boys pretend to be police officers arresting bad guys. Pretense play is very important for cognitive and social development.

Constructive play occurs most often during the preschool and elementary school years, combining the features of sensorimotor, practice, and pretense plays. It is the type of play when children create a product or a solution. Many preschools (such as the Free-to-be Childcare Center at Stockton College) engage children in constructive play when they design themed projects, such as the bird project, the box project, and the concept “big” project. Since constructive play often combines sensorimotor, practice, and pretense plays, it promotes physical, cognitive, and social development.

Social play involves interacting with peers and occurs throughout life. Social play can be further classified into unoccupied, solitary, onlooker, parallel, associative, and cooperative plays. The terms given to these subtypes of social play are quite self explanatory, although I would like to mention cooperative play in particular. Cooperative play is when children and adults do things together as a group. Many themed projects designed by preschools, such as the previously mentioned bird project, box project, and the concept “big” project, can also be cross-classified as cooperative play. Overall, social play stimulates social development throughout the human life span.

Games are defined as activities that are pleasurable, involve rules, and often entail competition. Games are played most often during the elementary and middle school years, such as water balloon tossing and board games. Depending on the type of games, games can be valuable for physical, cognitive, and social development.

In the recent decades, several new trends in the area of play surfaced. Two, in particular, are relevant to our discussion on the value of play in infants and young children. First, television has become an important part of American life. Other than sleep, young children spend time watching television more than any other activity. Then, is television watching play? A distinctive feature of television watching that is different from all of the other types of play is that television watching is passive, whereas traditional types of play are active. I would therefore argue against classifying television watching as play. With today’s television programming becoming more interactive, however, I am open to a mind change. Until then, I regard television watching as leisure, but not play.

Second, today’s toys have multiplied in number, style, and kind, and are becoming ever more specialized. Just about anything that you might encounter in real life, there is now a toy version of it, such as toy microwave oven, toy vegetables, toy cash register, etc. Having so many toys and so many choices are of course welcomed news to sparkly young eyes, although one has to wonder whether this trend is also beneficial to infants and young children’s growth and development. I wonder, for example, whether already possessing a plastic telephone will diminish a young child’s motivation to take a banana and use it as a telephone, thereby decreasing imagination during pretense play. Likewise, many experts of child development have opined that multi-purpose toys (such as blocks) are best. Trends come, and trends pass, but across the human life span, play will continue. For infants and young children, play will always be the most important thing in their day to day life.

Reference:
Santrock, J. W. (2010). Children (11th ed.). Boston, MA: McGraw Hill.










Hudson Perinatal Doula Fellowship Program
Summer 2010
Inspire. Engage. Empower.

Learn the healing arts of labor support; experience the community of supportive women;

Hudson Perinatal is a 501 (c) 3 non profit agency serving the needs of childbearing families in Hudson County, NJ. Through the State of New Jersey's Access to Care program, we are immediately seeking applicants for the HUDSON COUNTY DOULA FELLOWSHIP. Running part time from June 15-August 15, 2010, this community based doula program will be part of the solution to improving better birth outcomes for Hudson County.

WHAT IS A DOULA?
An expectant mother receives medical care and medical management from a health care provider in pregnancy, labor and birth. A doula, a Greek word meaning 'to serve women,' works alongside a medical care provider to compliment the woman's pregnancy through therapeutic touch, relaxation practices and stress reduction tools. Doulas continue to make a difference in improving maternity care.

The Hudson County Doula Fellowship is a life changing, affirming, and exciting program of learning to serve pregnant women in Jersey City and their families at their pre natal, labor and post partum time. Doulas no not provide medical or clinical care, and work alongside a laboring woman and her partner and medical caregiver. In pregnancy, a doula mentors an expectant mother in asking questions at prenatal medical visits, creating healthy food choices, sharing stress reduction practices and being a resource for other social, emotional and physical needs. During labor, a doula uses comfort measures to support the laboring woman alongside the midwife or doctor. Finally, in the postnatal time, a doula assists in breastfeeding support, empowering strategies in newborn care and the emotional transition to motherhood.

WHAT IS THE HUDSON PERINATAL DOULA FELLOWSHIP PROGRAM?
Women selected to participate in the Hudson Perinatal Doula Fellowship program receive at no cost, a national doula training program from DONA International. In addition to the DONA curriculum the Hudson Perinatal Doula Fellowship will receive at no cost more extensive training and education in a myriad of topics from breastfeeding peer counseling skills, childbirth education, massage/therapeutic touch, integrative nutrition and the wise woman tradition of being present at labor and births. Unique to this training, the doula workshops includes the foundations of creating helping, empathetic relationships, healing arts for labor and gentle body work to embrace that pregnancy is in fact a rite of passage. The Hudson Perinatal Doula Fellowship program covers all training costs, required books, doula supplies for comfort measures at births, the fee for DONA International certification, and coaching to submit the paperwork for your national doula certification. Finally, the Hudson Perinatal Doula Fellows will be mentored on working with their expectant clients and the births. In short, it is a supportive and encouraging program with providing an incubator of information and inspiration for your success.

WHAT IS THE TIME COMMITMENT OF THE HUDSON PERINATAL DOULA PROGRAM?
This program is designed to help you flourish honoring your other vocations and family commitments.
The Hudson Perinatal Doula Fellowship runs June 15-August 15, 2010. Applications are accepted immediately on a rolling basis and can be downloaded atwww.HudsonPerinatal.org The fellowship will be open to 35 women who commit to the time frame of program.
1) In addition to the DONA Doula Training dates, which are full days, 8 am-5 pm June 21-24, 2010, the women awarded the Hudson Perinatal Doula Fellowship commit to six hours a week from June 15-August 15, 2010 either
Mondays, from 10:00 am-4:00 pm
OR
Tuesday and Thursday evenings, 6:30 pm-9:30 pm.
The program will acknowledge adult learning styles and be taught in an experiential, engaging manner. We value the work in the world you have already done.... In short, you are bringing your gifts to the entire training and enhancing yourself and every woman you will serve. We are excited and thrilled to serve you so you can participate in the timeless, compassionate art of serving women. You bring value to people's lives and entering the art of doula work is truly a sincere commitment in changing access to health care and better birth outcomes for women, men, babies, and our community.
2) In addition to the nurturing workshop attendance, reading materials and resource acquisition, the selected doulas will commit to immediately serving three expectant women and attending those three births in Jersey City at medical centers.

WHO CAN APPLY TO THE HUDSON PERINATAL DOULA FELLOWSHIP PROGRAM?
You can! No pre-requisites required, just a sincere commitment to the dates listed above. No prior experience is required, just an enthusiasm to commit to the community of other doulas and the needs of pregnant women in Jersey City. Arriving on time and staying for each workshop date is required and an obligation to graduate from the program.

WHAT MAKES THE HUDSON PERINATAL DOULA FELLOWSHIP PROGRAM DIFFERENT THAN OTHER DOULA TRAININGS?
Unlike basic birth doula trainings, the Hudson Perinatal Doula Fellowship will expand your content knowledge and confidence in social justice, women's health, perinatal health disparities and the healing arts.
We look forward to getting to know your passions and your possibilities. Please download the application as a tool of self inquiry and self reflection. We embrace your journey and the unique gifts you offer this world and will offer all women. You will be welcomed on this path of doula work in the deepest of gratitude.

WHERE IS THE LOCATION OF THE HUDSON PERINATAL DOULA FELLOWSHIP PROGRAM?
Jersey City, NJ; easily accessible from mass transportation.

WHOM DO I CONTACT FOR MORE INFORMATION:
Jill Wodnick, M.A., CD(DONA) Community Doula Coordinator, Hudson Perinatal
Jwodnick@hudsonperinatal.org

HOW DO DOULAS IMPROVE BIRTHS?
In their book, Mothering The Mother: How a Doula Can Help You Have a Shorter, Easier, and Healthier Birth, Marshall Klaus, John Kennell and Phyllis Klaus summarize scientific studies which have been carried out on the advantages of doula-assisted births.
Reduced the overall cesarean rate by 50%
Reduced the length of labor by 25%
Reduced oxytocin use by 40%
Reduced the use of pain medication by 30%
Reduced forceps deliveries by 40%
Reduced requests for epidural pain medication by 60%
Reduced incidences of maternal fever
Reduced the number of days newborns spent in NICU (neo-natal infant care unit)
Reduced the amount of septic workups performed on newborns
Resulted in higher rates of breastfeeding
Resulted in more positive maternal assessments of maternal confidence
Resulted in more positive maternal assessments of maternal and newborn health.
Expectant parents can find a doula by searching www.DONA.org or other pregnancy websites.