Treating trauma through Early Childhood Court

Retired circuit court judge Lee Haworth. [Herald-Tribune archive/2015]

Retired circuit court judge Lee Haworth. [Herald-Tribune archive/2015]

Program aims to fast track the youngest kids out of child welfare system.

SARASOTA — In the 1970s, retired Circuit Court Judge Lee Haworth was a prosecutor. Back then, when the courts worked on cases that involved domestic abuse, he said, almost no one gave a second thought to the toddlers who witnessed violence in the home.

Now we know better, he said. Three years ago, Haworth was involved in local efforts to bring Early Childhood Court to Sarasota County. The program's goal is to expedite the process of getting children birth to age 3 out of the foster care system and into stable, permanent homes.

"The first three years are the most critical in terms of brain development and attachment," said Kathryn Shea, director of the Florida Center for Early Childhood, a nonprofit that provides therapy and mental health services for children and parents in the ECC program.

Based on a national model, ECC brings early childhood science to the judiciary by focusing on the proven effects of trauma and toxic stress on the developing brain, said Mimi Graham, director of the Florida State University Center for Prevention and Early Intervention Policy.

Families who participate in the program receive child-parent psychotherapy to help experts assess the relationship between the parents and their children and to keep track of the child's development.

"Even if children are removed from an abusive situation there is still trauma there because they are removed from their parents and those are the only people that they know," Shea said. "They're often going to a new home with people they've never seen — that's a real adjustment."

Florida's ECC initiative began in 2013 when Graham received a grant to pioneer the program in Pensacola and Pasco counties. ECC was deemed so effective at helping young children achieve stability and saving the state money that it spread to 16 other counties across Florida.

Children who participated in ECC spent 104 fewer days in the foster care system, and none of the children were re-removed after their cases were closed.

The stakes are highest for these young children, Shea said. Neuroscientists have found that by age 3, 80 percent of a child's brain has been wired and early experiences set the stage for life.

As of February, there were 331 children in out-of-home and foster care in Sarasota County, according to the Family Safety Alliance. Nearly three quarters of those children — 238 of them — were between the ages of birth and 5.

Statewide, the majority of children entering out-of-home care are age 5 or under, and babies make up the largest group at 17 percent, according to 2016 figures.

Despite positive outcomes, lack of funding and an overly strict selection criteria prevented Sarasota's ECC from taking on more cases, Shea said. Only five children have gone through the program since it began. This year, ECC will screen all cases for children between birth and 3, which will allow for more families to potentially benefit. A grant application to bring the program to Manatee County is also in the works.

Kathryn Shea, CEO at Florida Center for Early Childhood. [Herald-Tribune staff photo/Dan Wagner]

Kathryn Shea, CEO at Florida Center for Early Childhood. [Herald-Tribune staff photo/Dan Wagner]

Effects of trauma

Shea and her team of infant mental health experts work to provide Child-Parent Psychotherapy for families who are found to be good candidates for Early Childhood Court. Working closely with the parents and the children helps them assess the best course of action and prevent young kids from languishing in the child welfare system.

ECC's goal is for children to achieve permanency within a year. Permanency can be returning to parents, relative caregivers or adoption. By federal guidelines kids are supposed to achieve permanency within 12 months, but the state and the county run behind that. Last year, only a quarter of all children in the system in Sarasota County hit that goal.

"We want little kids to be in a stable, loving environment," Shea said. "They can't be bounced around from home to home because that's really going to disrupt their development."

The past five years have seen an explosion of research on the long-term effects of trauma and toxic stress in early childhood.

"We used to think that what happened to babies didn't matter because they wouldn't remember," Graham said. "Now we're seeing that it's really imprinted in their brain."

Experiencing trauma and toxic stress in the first three years of life changes the brain's functioning, said Graham, and causes biochemical changes.

Brain scans have shown that trauma and toxic stress inhibit the prefrontal cortex, an area of the brain that is necessary for impulse control, executive function and critical for learning.

By the time children get to school, Graham added, the residual symptoms of early adverse experiences start to emerge. Kids may have trouble understanding directions, controlling their emotions and learning in school.

"Trauma symptoms are often treated as ADHD," Graham said. "We medicate these kids and call it ADHD when oftentimes it's trauma that went untreated."

Because young children who've experienced trauma or abuse can't express what happened or how they feel about it, Shea said, they tend to lash out behaviorally. This is when they start getting expelled or punished in school in ways that are not helpful, Shea said.

"If we have something like Early Childhood Court where we can monitor the children and get them the mental health treatment that they need then the outcome is very positive," Shea said. "If we don't have that intervention and they're never treated for the trauma that occurred the outlook can be bleak."