Dr. Susan Chinitz, a psychologist with specialties in the areas of infant mental health and developmental disabilities in infancy and early childhood, and a Professor of Clinical Pediatrics at the Albert Einstein College of Medicine, discusses the new Strong Starts Court Initiative, which will enhance the capacity of Family Court to bring positive changes to court-involved babies and their families. (April 2015)

The following is a transcript

SARAH SCHWEIG: Hi, I’m Sarah Schweig of the Center for Court Innovation and today I’m speaking with Dr. Susan Chinitz, a psychologist with specialties in the areas of infant mental health and developmental disabilities in infancy and early childhood. Professor of clinical pediatrics at the Albert Einstein College of

Medicine here in New York, she has extensive experience in child and infant mental health and recently she teamed up with the Center for Court Innovation to craft what’s called the Bronx Infant Court, which aims to enhance the capacity of Family Court to bring positive changes to court-involved babies and their families. Thanks for speaking with me today and welcome.

SUSAN CHINITZ: Thank you, Sarah. Thank you.

SCHWEIG: First off, you’re a psychologist and an expert in infancy studies. What made you start thinking about the justice system and infants? Can you talk a bit about what drove you to look at how court cases handle infants–cases involving infants or families with infants.

CHINITZ: I direct a center up at Einstein, as you said. It’s a therapy program for children under five years of age and many of the children that we work with, a very large proportion of them are child welfare system involved. Children come to attention at such a young age when something pretty significant or dramatic has happened to them and, certainly, that’s the story of young children in the child welfare system. Our clinical population at Einstein has always had a very robust number of children who have had allegations of neglect or abuse, who are in foster care, or otherwise under court supervision. I’ve just had lots and lots of day-to-day experience with these children and their birth parents and their foster parents.

Though the children struggle in their home environments, which I guess by definition is true when they’re child welfare system involved, it also seemed that the courts and the foster care agencies could be more protective of these children if they knew more about babies. Sometimes in the absence of that knowledge, and totally inadvertently of course, the courts or the child welfare system can inflict more harm on the children. So it seemed very important while we were working with the children clinically, to also bring expertise to the systems that are making decisions about them every day.

SCHWEIG: Of course Family Court sees children of all ages. Could you talk a little bit about what makes cases involving infants particularly different or difficult for courts to handle?

CHINITZ: A lot of things–hard to know even where to start but I’ll start with the fact that brain development is happening very, very rapidly during these early stages of development, and we’ve learned through recent developmental neuroscience that children’s brains’ development is very influenced by the environment and the context in which they live. In fact, in the field we say that the brain recruits experience into its developing architecture. Children who have been removed from their parents lose the biggest protection that children have; that bond with a committed and available caregiver. And we know that that loss of a primary caregiver brings with it all kinds of risks to brain development.

It’s really out of nurture and security and engagement of a committed caregiver that we see the brain develops. These children are struggling with attachment disruptions. Sometimes they’re struggling with attachment disorders. If the interaction has been problematic, then they’re subject to exposure to violence very often, instability in their care-giving as they move from caregiver to caregiver. There are just many, many things that go on in the life of a young child during the stage of development of critical capacities; mediated by brain development. It’s also a very important time for the consolidation of a secure attachment, so the whole process of removing babies and moving them around in care is very detrimental to their development.

SCHWEIG: Maybe you can describe the traditional options available for the court and dealing with cases involving infants and then how this new project is aiming to fill the gaps.

CHINITZ: Very interestingly, despite the fact that most children become known to the courts because of abuse or neglect, or exposure to violence, there’s often very little recommendation for relational parent-infant repair work. The typical interventions available through the courts have been parenting classes, which means the parents attend a series of lectures about child development. But we’re not identifying what went wrong in this particular dyad. Was it maternal depression? Was the child just so difficult to manage that a parent just didn’t have enough support?

We have to really understand what was the cause of the need to intervene with child welfare system intervention and then try to remediate that, or even if we can’t remediate all of it, help the parent develop more safe and nurturing parenting skills and help them learn to be with each other in ways that are healing to the child. We remove children but we don’t do the critical work to repair what exactly went wrong. We’re trying to do that. We’re trying to evaluate babies and parents and their relationship through this new project, so that the interventions that are court-mandated will address the particular problems.

Not every family becomes child welfare involved for the same reason, yet we’ve had one intervention of parenting classes. We want to tailor the interventions to much better meet the needs of the babies and the parents. We have to help monitor these babies; there’s a very high level of developmental delay and disability in children known to the foster care system and the courts haven’t always known how to perform developmental surveillance, watching children’s development. What systems are available to remediate that. You have to bring all kinds of expertise to the court in order for the court to be a therapeutic agent that we think it can be through its authority and its involvement with the kids and families.

SCHWEIG: Wonderful. I hear you saying that we’re moving towards looking at the individual relationships between the infant and the parent, instead of just a catch-all approach.

CHINITZ: Right, exactly. Even babies have their own parenting load. There are some easy babies and there are some very, very hard babies. We have to help identify what the baby brings into the interaction in addition to what the parent does.

SCHWEIG: Right. Maybe you could talk a little bit about the mechanism that’s being introduced here to Family Court and how that’s going to work.

CHINITZ: The referrals are going to, at least at the beginning until we are really up and running and see how this all works, the referrals are going to come just through the particular judge who’s been selected through her usual intake process. As she picks up new cases, we will look for the babies under three. In this project we’re going to target children under three. We’ve been asked by our various stakeholders to work with babies who are in foster care but also babies who have not been removed from their parents but are under court supervision due to concerns. We will be looking for children under three whether or not they’re still home with their parents.

Then, we’re going to have an Infant Court team coordinator. A full-time infant practitioner who’s going to work in the Family Court in partnership with the judge. So there will then be already in-house expertise full-time on infant development. This clinician or practitioner will help with the assessments of the babies and the parents, and I should use this opportunity to say that we have very two generational focus in this project. We’re looking to help the life trajectory and life outcomes of the parents as well as the children because children will only do as well as their parents are able to do.

The infant practitioner will help with the evaluation of the parent and the child and will assist the other people planning on the case; the foster agency case worker, and others who do some planning in recommending particular interventions that the court and child welfare system may not be as cognizant of as infant practitioners are. As examples, we have early Head Sart programs that are very, very rich in child development resources. We have home visiting programs, which we know improve the life trajectory of vulnerable children, yet we don’t see courts or foster agencies getting children involved in a early Head Start or involved in home visiting, but an infant practitioner will have a broader array of the knowledge of what’s out there for babies.

The infant coordinator will help with assessment. She will help with referrals. Then we hope to have very frequent team conferences about these children and families that will include the lawyers but will also include the community providers that were working with the families. We’re hoping to get everybody together on a monthly basis to help monitor progress; particularly, to help solve problems so that families are really getting what they need to get. There are no barriers to their getting what they get. That we can keep a close eye on the case and hopefully move a little bit more quickly than usual towards permanency because we’re really front-loading services and we’re giving a lot of attention to the cases early on.

We’re hoping, also, to develop a more collaborative approach and to try to leave some of the adversarial approach behind as everybody puts their heads together to think about how to better serve babies and their families.

SCHWEIG: As a last takeaway, what would you hope to see a few years down the line with this project? Would you like to see it replicated, would you like to see it expanded outside of the Bronx? What’s your vision?

CHINITZ: Babies are such a large presence in the child welfare system and in the courts. In 2013, which is the last year that we’ve got numbers for, there was 711 just in the Bronx alone; babies under two, just in the Bronx alone. That’s a lot of children who are living in very vulnerable situations. Young children remain the largest cohort of kids who become court-involved every year. Yeah, we’d like to see infant expertise in all of the Family Courts. It’s a system that does intervene every day in the life of these children and they should be imbued with expertise.

It should be a place where judges have access to the best information they can have about babies. Yeah, my dream is that we’re in every borough of the city bringing infant expertise to judges and helping evaluate babies so that they get the right service. Like we said, keeping a close eye on cases, moving children to permanency as quickly as possible. That’s really important. A child has to have security with at least one ongoing primary caregiver. We see enormous pain and suffering when children are in limbo. Year after year if they start to have behavior problems, they can’t catch up with their learning problems, we need to bring permanency and security.

Those things; bringing expertise, so decisions are good decisions. Bringing resources to these families as soon as the case becomes identified, so the court can be an agent in positive change and resolving the permanency as early as possible.

SCHWEIG: Wonderful. Well, thanks so much for speaking with me today.

CHINITZ: Thank you.

SCHWEIG: I’m Sarah Schweig of the Center for Court Innovation, and I’ve been speaking with Dr. Susan Chinitz about the complexities of infancy and infants who become involved in family court cases. To learn more about the Bronx Infant Court or the Center for Court Innovation, visit www.courtinnovation.org. Thanks for listening.