Care order for mother with mental age of a ten year old – 2015vol1#15

A Care Order until 18 was granted for an eight month old child whose mother was described by psychologists as having the mental age of a ten year old. The mother had another child who was in the care of the Child and Family Agency (CFA). The mother was present in court and unusually had an advocate and a foster carer assigned to her. The mother had been known to the social services since she was six years old and was formally taken into care when she was 16 amid allegations of abuse.

The CFA solicitor told the court that the evidence on which the Care Order was being sought was the same as that relating to the previous child who had been taken into care and referred to “static factors that cannot change.”

The barrister for the mother raised the issue of whether the mother had capacity to instruct. The court was told that a psychologist had said she had capacity to instruct but had recommended that she be allowed have “adults with her” that can help her, and that she be permitted to leave the court if she got too upset.

A psychologist gave evidence that he had met the mother when she was about 18 years old and she was moving from a special education system into the “services system”. The psychologist said that the mother had unilaterally removed herself from the services around this time and that there would have been a lot of meetings and case conferences about her.

The CFA solicitor asked the psychologist about the mother’s diagnosis and her difficulties. The psychologist replied that her difficulties were recurring ones and that her involvement with the services was fraught. He said that her ability, in terms of her ability to engage and make use of the services, was compromised because of her abilities and social/emotional makeup. The psychologist went on to say that her past was difficult; she had a history of abuse and being placed in care. He said that she formed close attachments to individual staff members and then she would go onto the next relationship and that this led to bad choices and decisions.

The psychologist said: “When it came to any kind of decision making capacity there was always a problem, there was always risks. The level of input she required was very high. When she left the residential services, that scaffolding was no longer there….she was very much at risk and she was exploited and that’s why we are here.”

The CFA solicitor asked the psychologist whether he could say that the mother’s difficulty managing her own life was foreseeable. The psychologist replied that he saw her as someone who is very compromised in terms of her functioning, with a highly impulsive nature and as someone who has shown a failure to engage with services/individuals and who shows a lack of stability.

The CFA solicitor asked the psychologist what a person with such difficulties does in stressful situations and what the symptoms were of such traits.

The psychologist described the woman as “pre-adolescent, functioning as a ten year old, highly egocentric, her own needs would dictate [other concerns] and her own overriding concerns will dictate how she interacts with the child at access.” He said that the woman’s four year old daughter was beginning to make more sense of the world around her and he said that the mother was “only slightly ahead of the child, in practical terms.” The CFA solicitor asked the psychologist whether the four year old child would pass out her mother in not a huge amount of time and the psychologist replied that he would.

The psychologist said that the mother’s needs were primary and that when she is with the child she will dictate things from her perspective and the child’s needs would be secondary. The psychologist described a “lack of fit between the mother on the one hand and the child on the other. She needs help to choreograph her relationships with the child.” He said that she had to receive a lot of input to deal with rather simple things of a daily nature and that perhaps looking after children was a step too far.

The mother’s barrister interjected to complain that the evidence that was being relied upon related to a time before the woman had children. The CFA solicitor asked the psychologist whether the evidence being given now was different to the situation that prevailed in 2005 when the psychologist was working directly with the woman.

The psychologist replied that it was possible to draw on the evidence of the education of the woman and the fact that she had been involved with the social services for ten years. He said that over the course of those years the mother had made small gains relative to the amount of input and education she received. “I don’t think her status changed much, the same difficulties remain, along with fractious relationships with services, front line staff.”

The CFA solicitor asked whether the psychologist was saying that if at 25 years old the mother was operating at the level of functioning of a ten year old whether at 35 years old she would still be operating at the level of functioning of a ten year old. The psychologist replied that this was the case. The psychologist said that since he first came across the woman she was self- focussed, egocentric and her needs superseded those of others. He also said that she needed a lot of input to manage basic living and that nothing had changed in that regard and he did not see much changing in that regard.

The CFA solicitor told the court that the evidence of the social work department would be that the mother was putting herself at high risk in terms of her sexual exploits and that the argument of the CFA was that if it was not possible for the mother to be safe with the level of support she was receiving, then she could not safely take care of a child.

The mother’s barrister asked the psychologist whether he believed that the mother had the capacity to instruct legal representatives. The psychologist did not think that the mother was capable of giving instructions given that she had difficulty making basic decisions.

Another psychologist had said that the mother did have such a capacity. The mother’s barrister asked the psychologist whether it was possible for the mother to have improved in the ten year period since he had been working with her. He replied that the discussion before the court related to children and that it would be difficult for the mother to look after children given that her emotional needs are primary and the child’s are secondary.

The mother’s barrister pointed out that the psychologist had not observed her with her children. The psychologist replied that he thought that he could predict with some level of certainty how the woman would behave and that it would be very difficult for the mother to change.

When asked by the mother’s barrister about her ability to read and write the psychologist replied that he thought that these were not issues relating to reading/writing but issues relating to the mother’s emotional development. The mother’s barrister pointed out the fact that the mother has literacy difficulties was being put forward as a practical problem for her parenting e.g reading food/clothing labels. The psychologist told the court that it may have been the case that the mother’s literacy problems were insurmountable.

The mother’s barrister noted that the mother demonstrated an extreme mistrust of people in authority and in this regard asked the psychologist, considering the mother had endured abuse at home and possibly in a foster placement, whether he would consider that she might have felt let down by the authorities in light of these circumstances. The psychologist replied that this was possible.

The mother’s barrister pointed out that the only IQ test that was ever carried out on the mother was done by this psychologist and the woman was found to be in the mild range of intellectual disabilities. The barrister asked the psychologist whether IQ tests are entirely reliable in respect of people who had a chaotic background. The psychologist replied that if a person was from a culturally deprived background they might underperform.

A second psychologist gave evidence that she was was hired to do a parenting capacity assessment of the mother. She said that the mother was very suspicious towards her but that the psychologist understood this. This psychologist said that although the mother did not give her very much information at their meetings the assessments did indicate that the mother did not have sufficient knowledge of child development.

For example, the mother could not tell her how old her child was or what to give the child for breakfast or what to do when the child has a temperature, issues the psychologist described as very basic. The psychologist said that there was a high risk that the mother did not have the capacity/knowledge to look after a child.

The psychologist agreed with the previous psychologist who gave evidence and said that the mother most likely had an intellectual disability in the mild range. The CFA solicitor asked the psychologist how such a difficulty would manifest itself in daily living. The psychologist replied that very often people with mild learning difficulties present with impulsiveness, frustration, self-centredness, stubbornness and poor judgment associated with that type of cognitive ability. She also said that it was difficult for people with such difficulties to anticipate the consequences of their actions.

She said that there were high risks associated with minding an eight month old child. The child has certain needs in relation to feeding, eating, being entertained and that the mother might put her needs over the needs of a child. She said that when someone “is so self-centred it will not have a good impact on the child and it will result in unintentional neglect. It is unintentional neglect that we have to take into account.”

The CFA solicitor asked the psychologist whether she thought if the mother were constantly shown how to do something would she be able to do it. The psychologist replied that from the reports and the mother’s cognitive capacity level she did not think that the mother was able to retain that knowledge. The psychologist said that she felt very sorry for the mother. “It has nothing to do with her that her ability is what it is. She is hitting a brick wall, she is constantly facing the same issues. Things are being modelled to her and the same difficulties are recurring.”

The CFA solicitor asked the psychologist whether it would it be possible for the mother to have the baby 24 hours a day. The psychologist said that “if we are looking at capacity, I wouldn’t leave my ten year old looking after children. If there is nothing impairing the child cognitively the time will come where she will surpass her mum.” She went on to say that raising a child would be challenging for the mother in that there would be so many questions that the mother would not be able to answer and it was not possible for the mother to gain more skills in this regard as the issue was one of intellectual capacity.

The mother’s barrister asked the psychologist whether she had considered the circumstances in which the baby had been taken into care. The barrister argued that the taking of the child from the hospital where she was born would likely cause the mother a lot of distress. The psychologist replied that her assessment was completed on the basis of asking the mother questions rather than observing her with her child.

The mother’s barrister asked the psychologist whether, in her experience, people with an intellectual disability such as the mother in this case, could usually take care of their children. The psychologist replied that people of the mother’s ability are usually unable to parent their children. The mother’s barrister further asked the psychologist whether she thought she should conduct an updated assessment. The psychologist replied that cognitive ability does not change.

This barrister asked the psychologist whether she thought that the mother’s difficulties could be overcome with the required supports. The psychologist replied that she would need assistance 24 hours a day because anything could happen, for example the child could wake up in the middle of the night. “We can’t train a person to know how to react in unpredictable situations.”

The psychologist gave as an example an incident where the mother needed to call an ambulance but did not know her own address. She said: “We are dealing with health and safety. There will always be a situation where the mother will not have the formula.” The psychologist said that if the mother did not have help 24 hours a day there was a risk of unintentional neglect.

The judge asked the psychologist at what stage did she think the child would be ahead of her mother? The psychologist replied that from a purely clinical point of view, when the child surpasses 10 years old she would be ahead of her mother.

A social worker gave evidence of the concerns that the social work team had in relation to the mother. These included concerns about the levels of support the mother needed to live independently, lack of family support and a history of difficulties in engaging with support services.

The same risk factors existed in the case as had been prevalent some time earlier. These included cognitive and intellectual functioning; adaptive functioning and volatility; high level of support that she needed to meet her own needs; her own experience of childhood abuse and placement in institutions; relationships and lack of protective judgment around these; lack of family support (which has worsened) and an innate mistrust of social work support.

The social worker also told the court that the mother had had a relationship with a man who had a history of domestic violence and the HSE had sought a protection order or a barring order.

The social worker told the court of an intensive piece of work done with the woman which comprised a 12 week programme, two days a week, helping her to develop parenting skills. She was referred to Barnardos and they undertook an intensive parenting programme too.

The social worker told the court that as the baby’s needs developed it was very difficult for the mother to change with her baby’s needs. The access was impacting on the baby’s nap times and feeding. The mother always had a keenness to learn but each task had to be broken down step by step. The social worker said that if anything changed then she could not adjust and would get frustrated. She said that the intense parenting programme ceased and the social work department concentrated on access being a relaxed and enjoyable experience.

The CFA solicitor asked the social worker whether she thought the mother had the tools or equipment to deal with a child who is constantly developing. The social worker replied that she had not seen the mother’s skills developing.

The CFA solicitor asked the social worker whether she thought it would have been safe for mother to leave the HSE building with the baby and go around town for a
few hours. The social worker replied that it would not have been envisaged due to the mother’s lack of insight into safety issues, “she can get upset and the baby’s needs get neglected.”

The social worker allocated to the baby gave evidence that the baby had arrived early and when the mother had telephoned for an ambulance she was unable to give her address. The social worker said that the mother knew that there was a plan in the social work department to make an application to take the child into care once she was born.

The social worker told the court about the mother’s interaction with the baby at access. She said that the mother suffered from shaking of the hands which can be associated with an intellectual disability. The mother’s cognitive disability struck her when the mother was asked what age her child was and she replied that the child was five years old rather than five months old.

She also said that the mother had difficulty telling the time and determining when to feed the child or reading food labels. She said that when the baby was being weaned the mother did not seem to understand what was happening. The social worker said that they had used a comic strip picture type approach but that the mother couldn’t adjust and adapt and change the nappy in a restaurant situation, for example, after being shown how to change a nappy. She said that there was concern about the mother’s retention of instruction and she described the mother’s difficulties as “fixed risk factors, things that aren’t changing.”

The social worker said that the mother had been shown how to hold a baby but the next stage of the baby’s development was beginning to pose problems; the mother learned how to hold the baby and was trying to hold him in a sleeping position even when he wanted to be sitting up.

The social worker said that the mother’s relationships with men were also a concern. “She just wants someone to love her but she goes for men that tend to exploit her.” The social worker told the court that the mother had relationships with men through Skype. She was taking pictures in access and sending them to men.

The social worker said that one man in particular was of great concern as there was a history of violence against the mother perpetrated by that man and he did not seem to respect the mother or the baby. She added that the mother clearly loved her children.

The social worker said that if the child remained with her mother the child’s health, development or welfare was likely to be avoidably impaired or neglected. She said that the mother herself needed help on a daily basis with the mother’s own foster carer buying her food. The social worker said: “The mother can’t care for herself let alone a child. It’s beyond her capacity.”

The judge granted the order sought.