Visitation Considerations and Young Children

WHY IT MATTERS

The first consideration when removing babies from an attached caregiver is balancing the current “harm” with the potential “harm” of being separated
from their caregiver.

A baby’s first years of life are almost entirely about building trust and security. Through experiences with caregivers, a baby develops expectations about the dependability of attachment figures to provide comfort, support, nurturance and protection in times of need. Attachment behaviors develop within the first three years of life. Early brain development scientists refer to the serve and return¹ nature that needs to be present in order to develop a sense of security and trust with others. When babies are removed from their primary caregiver during these critical developmental periods, the ability to form positive relationships later in life may be compromised and difficult to attain.
The largest percentage of children placed in foster care are children between the ages of zero and five.

Twenty-six percent of the foster care population is less than four years old.² This group is the least likely to reunify with their parents and over 25% of these children will re-enter care after initial discharge. For babies and young children who have been abused and neglected, a nurturing relationship helps buffer stress and supports coping. While the removal of a baby from their mother’s or father’s care is required to protect them from harm, disrupted relationships are painful. If the parent is their attached caregiver, babies can experience reduced thresholds for stress management which further compounds toxic stress the baby already struggles with due to the abuse or neglect. The first consideration when removing babies from an attached caregiver is balancing the current “harm” with the potential “harm” of being separated from their caregiver. Can the baby stay with the parent if the appropriate resources are put in place to support the parent in safely caring for their child? If not, and removal is imminent, can the baby be placed with a relative or fictive kin member with whom the baby already has a relationship? What else can be done to reduce the negative impacts on the child of separation from their caregiver? A primary buffer is to ensure frequent and quality visitation with their parent(s).

All children in foster care deserve frequent and quality visitation with their parents as it is safe and appropriate to do so. However, it is vital for young children as they are developmentally unable to “hold a memory” of their parent from day to day. Evidence suggests that visitation is linked to improved permanency and well-being and withholding visitation should not be used as a threat or punishment for a parent, as it irrevocably harms the child. Benefits of frequent visitation include: strengthening of the parent-child relationship; ease of pain of separation and loss for the child and parent; enhancement of a parent’s motivation to do well; involves parents in their child’s everyday activities; helps parents gain confidence and practice new skills; allows for coaching and modeling positive parenting skills; provides information to the court on the family’s progress to determine whether reunification is the best permanency option for the child; and, helps with the transition to reunification.³

Summary of Attachment

Infants are strongly biologically predisposed to attach to caregivers
Adults are strongly biologically predisposed to attach to their babies (biological or otherwise)
Once babies reach a cognitive age of 7–9 months, their attachments begin to consolidate and focus in on specific individuals
Attachment is a process which develops over the first several years of life based upon nurturing experiences with caregivers
Attachments may be different with different caregivers, but all babies need one consistent, loving adult who they can depend on to keep them safe and secure.

ADVOCATES IN ACTION

Research shows that regular, frequent visitation increases the likelihood of successful reunification, reduces time in out-of-home care, promotes healthy attachment, and reduces the negative effects of separation for the child and the parent.⁴

Ensure that visits are in the child’s best interest. Unless the court finds evidence that visitation or supervised visitation places the child at risk, parents should be visiting their children. However, if there is any doubt, advocate for a thorough assessment of the child, parent and their relationship to understand possible concerns. Recommend a mental health clinician who can evaluate what is in the best interest of the child if there are any doubts about the visit’s impact on the safety and well-being of the child.
Consider what makes a quality visit for a young child. For example, avoiding traveling long distances for either party for a visitation will allow for more frequent visitation and will prevent a young child from disruption to their routines for a visit. The environment where the visit takes place is ideally in a family setting, or if that is not possible, a “family-like” setting which allows the parents to interact in regular routines with the baby such as feeding, bathing and napping. The environment should also have appropriate toys and books for the parent to use with baby and space to get down on the floor with baby and play. If a home setting isn’t available as the first option, recommend that visits occur in an environment that closely resembles a home setting (e.g., preschool class, an early childhood provider’s office, church classroom, etc.).
Engage the foster parent and/or relative care providers in the visits by getting their buy-in to support the visits. In a number of places, foster parents receive training and support to supervise visits in their home so birth parents can be involved in the child’s daily routines. For kinship caregivers, advocate for training and assistance so they can be involved in concurrent planning, support the parent-child relationship and teach and model parenting skills.
Ensure the frequency, length and timing of visits to promote attachment. Infants and toddlers need to spend significant time with parents, ideally daily for infants and every two-to-three days for toddlers. To minimize the impact of separation from a parent during the initial removal, a visit with the child should be scheduled as soon as possible and no longer than 48 hours after removal.
Encourage visitation activities that promote parent-child attachment and support the child’s development. Visits that facilitate engagement in routines between the parent and child such as feeding, bathing, diapering, etc. have been shown to increase attachment and a sense of security for the baby. Request that parents receive services that educate them about their infant or toddler’s specific developmental needs. Programs such as Home Visiting⁵, Early Head Start and other early intervention programs⁶ can provide opportunities for parents to interact with their child in a supervised setting while also learning to support the child’s development.
Recognize the emotional impact visits can have on the child. It is important to recognize that a young child’s emotional dysregulation during or following a visit does not necessarily mean that the parent did something harmful during the visit. Separation from a caregiver to a parent and then separation back from a parent to a caregiver can be confusing and overwhelming to a young child. Some ways to alleviate these disruptive transitions include having the visits in the caregiver’s home and initially in the presence of the caregiver so that the child has their sense of security intact. Ensuring that the visits are happening frequently with a stable routine in place that the parent carries out with the child will help them have a sense of control during the visit. Helping the parent understand what the child is going through during these periods and encouraging them to be patient, comforting and soothing, will help both parent and child.
Ease transitions between “physical” visits with parent. Provide something that the child always has with them to remind them of their parent whether it is pictures of them, their voice recorded on a recordable story-book, a piece of their clothing, etc. Work with foster parents who may feel that the visits are emotionally hard on the child to understand how they can help with the transitions by preparing the child for the visit, staying for the initial first minutes of the visit if possible and talking positively about the parent to the child between visits.
Ensure that visits are well documented. Caseworkers or visitation supervisors are required to carefully document the family’s progress (or lack thereof) during visits, emphasizing the objectives of the visitation plan, the interactions between parent and child, and evaluate the risk to the child and the parent’s ability to care for child. Review these records regularly and when possible observe visits to make sure these considerations are in place. Providing a summary of visits in court reports and to a judge will be an important consideration in reunification, especially for young children who can’t communicate for themselves.

Provide something that the children always have with them to remind them of their parent, whether it is pictures of them, their voice recorded on a recordable story-book, a piece of their clothing, etc.

BRIGHT SPOT

Host Visitation Program CASA of Westchester County, New York

In 2012, CASA of Westchester County had an enviable problem – too many people who wanted to volunteer to help children and families in their community, but not enough cases to go around. The solution happened to coincide with a Court Improvement Project (CIP) with a focus on improving the quality and quantity of visits for children and youth in foster care. Consequently, the Host Visitation program in Westchester was “born.” Host Visitation is a model based on research that shows how essential it is for children and families living apart from one another, to have frequent and ongoing contact. It is an intensive, time limited three to six-month service that is used to enhance visitation plans that are already in place by increasing the frequency and duration of visits. A key to the program is the use of Visit Hosts. Visit Hosts are professionally trained community volunteers who assist families by supervising and supporting them as they visit one another. So with the “extra” volunteers or with volunteers that didn’t have quite enough time to serve as a CASA but wanted to help their community, the Host Visitation program was offered up as an alternative volunteer opportunity.

Volunteers participate in a 15-hour training and are assigned to one family. They supervise the visits and coach the family using the “Coached Visitation” model developed by Dr. Marty Beyer. Visits Hosts learn how to guide parents as they cope with their own feelings, respond to the unique needs of their children and build on the strengths in each family. Coached visitation helps parents plan for each visit, making visits meaningful to families, in a natural environment and community-based whenever possible. The primary goal is to increase parental capacity and skills in order to move the family from coached visitation to unsupervised visits or permanency. Host Visitation is designed to serve families in a variety of settings, including but not limited to the department’s offices, parks, libraries, malls, restaurants, community centers, and homes. Decisions about visit settings are made in conjunction with case managers. Host staff work collaboratively with department staff to assess a caregiver’s ability to progress visitation, such as moving into the community, increasing duration or frequency of visits, as well as behavioral changes as outlined in goals.

Volunteer retention for the program has been high and volunteers work with each other to ensure that visits are covered when they are on vacation or unavailable. CASAs are able to observe visits only with the consent of DSS staff and the parent(s). For that reason, policy and procedures around the volunteer hosts is clear that they communicate primarily with department staff and that their observation notes, etc. are kept in the child and family’s case records. Since September 2012 to March 2018, 151 families have been served by this program and 54 volunteers have been trained to be Visit Hosts.
For more information, contact training@casaforchildren.org

To learn more: https://www.martybeyer.com/content/visit-coaching

SELECTED RESOURCES

Advocates for Children of New Jersey, Family Visitation: Key to Safe Reunification for Children in Foster Care ⁷

This report highlights findings from a study that looked at the quantity and quality of visits for children in foster care on the likelihood they would be reunified with their families. It provides a number of recommendations for consideration including increasing the quantity of visits, especially for younger children.

Children’s Law Center, University of New Mexico, Parent-Child Visitation ⁸

This is a useful bulletin that describes best practices around visitations including what responsibilities different roles play in ensuring beneficial visits.

National Resource for Permanency and Family Connections, Organizational Self-Study for Parent-Child and Sibling Visits ⁹

This self-study assessment tool can be used by agencies to review the core principles of parent-child and sibling visiting. The tool is designed to review overall agency readiness, assess administrative policies, and identify strengths and challenges in your parent-child and sibling visiting practice. Sharing this tool with an agency who is struggling on “best practice” visitations, can help shape their technical assistance needs.