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Cry for Help: Why Infants and Toddlers in Child Welfare Need Special Care

happy dad holding surprised babySo many of us have watched the young children we know – our own children, nieces and nephews, neighbors, or friends – grow from small, sleepy infants to rambunctious, laughing toddlers.  It’s truly amazing to think of all the learning and growth that happens during those early years.

Unfortunately, we know that not every child is happy and healthy. In fact, almost 200,000 children under the age of three come into contact with the child welfare system in the U.S. annually.i Infants and toddlers who have been abused or neglected face a variety of significant threats, such as cognitive delays, attachment disorders, difficulty showing empathy, poor self-esteem, and social challenges – problems that are exacerbated when they are removed from their homes and shuffled between multiple foster homes.ii The first three years are a time when a child’s brain is developing at life-altering rates and when early intervention can significantly reduce developmental damage.

So what are state child welfare agencies doing to support these very young children who have been maltreated? A new report, “Changing the Course for Infants and Toddlers: A Survey of State Child Welfare Policies and Initiatives,” written by Child Trends and ZERO TO THREE, answers that very question. And although there are some promising practices here and there, we found that state child welfare agencies need to do more to align policies and practices with the science of early childhood to ensure that the unique needs of infants and toddlers are met.

One key finding from the survey is that few states have policies that differentiate services or timelines for infants and toddlers versus older children. The needs of infants are drastically different from the needs of adolescents. Without appropriate services or timelines that keep up with the rapid pace at which infants and toddlers grow and change, their development may get off track. For example, very young children need more frequent visitation with birth parents, swift timelines between screenings and services for health and developmental concerns, greater involvement of birth parents in services for their young children, and more frequent case reviews, court hearings, and case worker visits. Generally, states are not differentiating how they approach care for these very young children. Thirty-one states do not routinely hold case reviews, permanency hearings, other court hearings, or family group decision-making meetings on a more frequent or expedited basis for infants and toddlers in foster care, as compared to other age groups. Only nine of the 40 states that dictate the frequency of face-to-face visitation between birth parents and their children in foster care require more frequent visitation for infants and toddlers in care compared to older children.

We also found that relatively few states have implemented promising approaches to meeting the unique developmental needs of infants and toddlers. Although there are some great approaches out there – appropriate timeframes for health and developmental screenings; timely referrals to specialists; required training for all levels of agency staff, foster parents, court personnel, and biological parents about the developmental needs of infants and toddlers; more frequent face-to-face visits with birth parents for infants and toddlers; polices prohibiting the placement of young children in congregate or group care settings – these approaches are few and far between across the states. For example, only three states (Alaska, Hawaii, South Dakota) require training on developmentally-appropriate practices for infants and toddlers who have been maltreated for all child welfare staff, including case workers, supervisors, administrators, and other staff.

A recent report from the National Academy of Sciences summarizing research on maltreatment underscores the urgent need for better policies: the impacts of abuse and neglect can last for a lifetime. As our report shows, we know what to do and we have to get it right. We must support our youngest and most vulnerable children right from the start with the services and assistance they need to cope with the impacts of their maltreatment. Surely every child deserves the chance to learn, grow, and laugh during their early years.

Carol Emig                                                  
President, Child Trends                   

Matthew Melmed
Executive Director, ZERO TO THREE


[i] Administration for Children and Families. (2012). Child Maltreatment 2011. Washington, D.C.: U.S. Department of Health & Human Services.

[ii] Cohen, J., Cole, P., & Szrom, J. (2011). A call to action on behalf of maltreated infants and toddlers. Washington, DC: American Humane Association, Center for the Study of Social Policy, Child Welfare League of America, Children’s Defense Fund and ZERO TO THREE.


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