Psychological evidence given in long-running case – 2018vol2#14

See follow up Vol 2 of 2019: Judgment made in long-running case: Care orders granted until 2022 after 100 days of hearing, longer orders refused

 See follow up Vol 1 of 2019: Evidence continues in long-running case in rural town

 See also Vol 2 of 2017: Nearly two years after case started, court sees video of child describing abuse 

 See also Vol 1 of 2016: Care Order applications for four children adjourned pending assessments

A psychologist on behalf of the mother and a clinical neuropsychologist continued their evidence in relation to a care order hearing in respect of four children with two different fathers. The case began in January 2016 and has been adjourned on a number of occasions, with over 70 days’ sittings to date. During the case allegations were made that the father of the younger children had sexually abused one of the older ones.

Father X is the biological father of child C and child D whereas father Y is the biological father of child E and child F. There are two older children, A and B, now adults. B is also the daughter of X. A is the daughter of the mother’s first husband, who is not part of the proceedings.

A number of psychologists on behalf of the CFA had given evidence and are identified as psychologist A and psychologist B.

The psychologist on behalf of the mother

The psychologist saw the mother a number of times between January 2016 and December 2017 and prepared a report in January 2018. In the report he recommended reunification with certain supports put in place and based his recommendation on the mother’s capacity to provide parental care to the children. He said his view was informed by the lack of diagnostic psychopathology on the part of the mother, her consistent presentation during clinical interviews and access and her willingness to attend individual therapies.

The psychologist recommended reunification for child F, increased access with child E and that the views of child C and child D be canvassed. He said a plan would be have to be put together for reunification.

The judge asked: “[What will happen] if they did not want to go home?”

He said: “That would be a matter for the court.”

Counsel for the mother asked: “What is your recommendation for reunification in respect of [child E]?”

He said: “[Child E] could be reunified by increasing access as well as the duration of the access, subject to his tolerance of access. That is for the benefit of [E].” He said the mother did not pose a risk to [E] from his assessment and she also had the capacity to parent [F].

Counsel for the mother asked: “[Psychologist A] does not recommend reunification in this case.  Do you agree or disagree with her finding that reunification should not take place?”

He replied: “I disagree. [Psychologist A], in her evidence, took issue with the mother on a number of things with which I did not agree. [Psychologist A] did not see an attachment between [F] and her mother. I saw [F] embrace her mother and she was pleased to see her. [F] responded appropriately to her mother and her mother to her. That is a relationship where there is warmth and security being displayed.”

Counsel for the mother: “[Psychologist A] felt you had not looked at any of the access visits from an attachment point of view. You implemented the Marschak Interaction Method (MIM) assessment, do you have any view on that?”

He replied: “There is a lot of cross validation with attachment. The MIM assessment takes account of the issues under attachment. Through the behaviours it shows how the mother behaves with the children and that is what is important.” He said the mother had been consistent through all the contact with him.

The psychologist said his overall impression of access was positive and “there was not any access that was not positive.” The mother engaged with the children in an appropriate and positive manner. He said the children were not afraid to express themselves towards the mother and she had appropriate insight.

Counsel for the mother asked: “If someone did not have capacity [to parent] what would we see?”

He said: “I have seen accesses where the parent has attempted to get the child to do something and the child did not, so they [the parent] tries punish the child.” The mother showed flexibility and was attuned to each of the needs of the children.

Counsel for the mother said: “There was a flirtatious quality between [C] and the mother in one access and she [psychologist A] felt it was more a peer relationship.”

He said: “Yes, but it was appropriate given [C’s] age. He is more able to tease his mother and that is a natural part of growing up. I do not see any difficulty with it, as it is part of the adolescent process. I have not seen the mother set boundaries that have not been needed. I do not have evidence of her enforcing boundaries or failing to enforce them.”

The psychologist said the mother could structure interactions in access but “whether she can structure [C] as he grows up needs to be seen. I did not see any reason that the mother would not be able to manage him.”

The judge said: “Access is short and artificial when people are there watching. Boundary setting is wholly different to the boundaries in a home environment?”

He replied: “I accept that. The mother has become less defended over the passage of time.
The quality of accesses is significantly different and that shows change. When access happens regularly it becomes a habit and it goes beyond an outing on show for an hour.”

The judge asked: “Do you believe you have seen her enough to observe changes in her presentation?”  He replied: “Yes, provided that the observations made to me were accurate.”

He said the mother was not overwhelmed by access with all of the children when she celebrated the birthday of child F. She provided structured play and set limits on child E when he was loud. He said child E went under the table and the mother asked him if he wanted company. E said he did not and she recognised this.  She allowed E to self-sooth and did not pull him out from the table. She engaged with F who was argumentative and challenging. He said the mother maintained her parental role and he concluded, “it was a very good access.”

Psychologist A noted there was a different relationship at access with D. During access, his eye contact was occasionally fleeting but there were no difficulties. D was aware of the social worker and he was drawing the social worker into the activity. He felt inhibited by the presence of the social worker.

Counsel for the mother said: “There is a recurring complaint that [C and D] were treated differently. Did you see a difference and was it made by the mother?”

He said: “She interacted differently with the children but not in favour of one. They are different children and she goes to a great deal of effort to relate to [D].  Her relationship with him is becoming now how it was with [C]. [D] teased her.”

The psychologist conducted a risk assessment. He had knowledge of the issues and the fact the children were in voluntary care. The psychologist met the mother in 2015 and she painted a picture of herself being overwhelmed and finding it difficult. He administered psychometric tests and noted that the mother did not yield under the pressure of the tests.

He said the mother’s demeanour was quiet.  She was considerate and approached the conversation in an open manner. She revisited her behaviour about father X and the eldest child. [This referred to the fact that X had abused an older daughter by a previous marriage, who is now an adult.] She described father X as a Jekyll and Hyde character. He explored how the mother responded to the allegations made by the eldest child and how she would have approached it differently.

Counsel for the mother said: “[Psychologist A] said that there was an ambivalence from the mother in respect of the disclosures of abuse of the eldest child against [X].”

The psychologist said: “I understand what the other psychologist says but I would not describe it as ambivalence. The mother was in a difficult position. She was isolated and without support… She had the protection of her daughter [to deal with] and the loss of her relationship with her partner. At the time she was hopeful that things would become resolved in a positive way.”

Counsel for the for CFA asked: “What is your reaction of the information of [X] kissing the eldest child?”

He replied: “You would be shocked and go to GP or health service or social worker and make a report. You would make sure the child is ok and after that you would separate the child from the abuser. She had no difficulty figuring out it was wrong and she asked the child if anything happened in the past.”

Following the kiss, the eldest child was moved to USA. The mother alleged she did not know about the previous abuse until the eldest child made disclosures to social workers in USA in 2005. Social workers in Ireland were subsequently contacted.

Counsel for the CFA said: “She sent the eldest child away but did not do anything with [X]. What would you say about [X] and her behaviour going forward?”

He said: “She [the mother] sought professional advice and was told families can heal.” The mother separated herself from father X but he followed her abroad. She kept the children out of the house to keep father X out of the range of the children. Father X had mental health difficulties and went from periods of drinking to not drinking. “It appeared they lived separate lives.”

The judge said: “You felt the abuse of alcohol was the excuse for the abuse towards the eldest child… drunkenness does not condone behaviour. What is your view of using that as a reason? Did she take immediate behaviour to protect the eldest child?”

The psychologist said she did partially [take immediate action] but she should have made a report to social workers immediately. “The mother never said her behaviour was correct.”

Counsel for the CFA asked: “Would her response to [X] be cavalier? Would your average person carry on like that?”

He replied: “She [the mother] was naïve in the extreme.”

The mother told the psychologist she slept with the female children to ensure their protection following the disclosure but maintained an active sexual life with [X].

Counsel for the CFA asked: “What you think about the mother maintaining her relationship [with her husband] over the children?”

He said: “The treatment of [X] was healthy and this was a protective factor. She is cooperating with the treatment programme and she is looking to educate herself to be more protective.”

The judge asked: “Would it not have been better to have cut ties with [X]?”

He replied: “To maintain a relationship is better for children and is a protective factor.”
The mother did not know why she “could not boot [X] out the door” and this was consistent with what she told the psychologist. He said the mother felt as though she had failed.

The mother was in a relationship for a long time with father X and he was sentenced for child sexual abuse in 2007. She met the father Y online and they spent a lot of time chatting before meeting for dinner. She asked him to move into the home the same year father X had moved away. The children missed their father [X] and did not like [Y]. C and D objected to father Y moving into the home and it took a period of two to three years for things to settle.

The psychologist said: “It would be inconceivable that a new partner would not bring disruption. We do not know how specifically she managed that upset. I did not ask her how she dealt with the rebellion.”

The psychologist said the mother accurately responded to the abuse of D. There had been a conversation in a car park about Y being aroused by D. The psychologist said this would be very concerning with regards to a potential sexual interest and a certain level of risk but that the mother responded immediately. She sent Y out of the home and did not delay.  She did not jump into another relationship following the end of her relationship with Y.

The psychologist said the mother was not aware of the early sexualised behaviour of B [now an adult] until the night B went missing. B was 12 years old at the time. The psychologist said that fact the child was out until the early hours of the morning would generally be inappropriate but in this case it was part of a community activity. The mother understood B was not on her own and was meeting other friends at the fireworks display that started at midnight. He said it was reasonable to allow a child to be out in the countryside at a family type of event.

Counsel for the CFA said: “There is no reason the child could not have been home at 1am when the fireworks were over. The parents are breaching boundaries and allowed for an hour after the fireworks had finished. It was 3.30 am when contact was made with the Gardaí [in relation to B].”

The Gardaí made contact with B and she was examined on suspicion of a sexual assault. Child B underwent a rape assessment and it was inconclusive. The mother’s response to the incident was “it could have been consensual sex and they do not tell you that when you are in hospital with them.” The mother told the psychologist she was surprised that B was sexually active.

Counsel for the CFA said: “We had Garda evidence and the Garda gave her own view that [B] gave her boyfriend oral sex. That statement was withdrawn. The mother made it known that her daughter gave oral sex at 12 years of age and did not seem concerned. How would you approach that with regard to child protection?”

Psychologist: “It is shocking that anyone would say that it is acceptable for someone to know a 12-year-old child to be engaging in oral sex at any time.”

Counsel for the CFA asked: “In respect of [B] and her age, ought the mother to have a better boundary arrangement about [B] having boyfriends and going out?”

He replied: “Yes.”

The judge asked: “Was she providing appropriate boundaries in relation to her dealing with [B]?”

He said: “She [B] said had been able to subvert it [the boundary].”

The mother felt she had neither personal advocacy nor power over the girls. She discussed contraception with the eldest child at age 15.

Counsel for the CFA: “The eldest child had two miscarriages while she was under the age of 17 years. The mother’s response to contraception was ‘let us make sure you do not get pregnant,’ rather than addressing the behaviour?”

He replied: “It speaks in part to the dynamic between the mother and the eldest child.  I do not know much about the preceding conversation…. Her [the mother’s] attitude at the time was that it was something she could not do much about. I believe more effort should have been put in about it.”

Counsel for the CFA said: “You recommend the teenagers be returned to her care. A risk assessment is to be predictive of looking at previous behaviour. The mother was not volunteering that [B] was a victim of a sexual assault and was taken to the rape unit.”

He said: “In that context I am less critical of her for not going into the detail as I pushed the detail.”

The judge said: “You would expect a parent who hears that their 12-year-old child is engaged in sexual activity and has had intercourse would remember that [fact].”

The psychologist said he discussed early sexualised behaviour with the mother but there were questions about the mother’s attitude about those events especially how she viewed them [the events] and her capacity to permit early sexualisation. He said: “I wanted to get her current view and does she hold those considerations.”

The judge said: “Her eldest daughter was sexually abused by her husband.  Both the eldest child and [B] displayed sexualised behaviour. Did this not raise an alarm bell? It surprises me you did not explore that aspect, it would be a likelihood.”

The psychologist said there were deficits in the mother’s parenting especially in the way in which she dealt with and reinforced sexual boundaries. She attended and did a parenting course. He said her ongoing individual therapy would provide her with insight.

The judge said: “In January 2016 you knew about this and you did not draw huge attention to it in first report.”

He said: “Yes, and I did not view the issues as contentious.”

The judge said: “I read your report on its own. You carried out an assessment on her [the mother’s] capacity. The issue would have been relevant to see what happened in the past. Why was the issue of the two girls not something you addressed in your first report?”

He replied: “I did. It was significant to them at the time but less so now.”

Counsel for the mother asked: “This is day 73 of this case. What impact does it have on a person, hearing evidence?”

He said: “It is clearly stressful having every aspect dissected at each sitting. That cannot be easy to sit through and it takes a great deal of determination.  She is anxious to parent and wants to be in their [the children’s] lives. She is committed to being a mother.”

Counsel for the CFA said: “The eldest child had difficulties and was sent to USA. [E] was put into a room when he had difficulties. [These are] patterns of an inability of the parent to cope with children who have problems.”

The psychologist replied: “I need more clarity as to when child E was locked in a room and I would like to see the context of the incidents.”

The children came into care as a result of the non-accidental injury to child F to which the mother never gave an explanation. It was accepted that child F sustained the injury when she was 12 weeks old and there was a lack of satisfactory explanation as to how the injury occurred. The mother said there was a soft spot on child F’s head.  She explained that she left the room and when she returned child F was on the floor. The father’s input was that he did not know what was origin of the injury.  He raised the possibility, to another psychologist, that the mother dropped the child and did not want to admit to it.

The counsel for the CFA asked: “We have no explanation for the injury. What does that tell us about risk?”

The psychologist replied: “We are not able to determine what happened there. We looked at her capacity to provide parenting to children and the dynamics of the relationship of how it occurred.”

Counsel for the mother said: “You said there should be reunification with child F. How do you get to the point to recommend reunification?”

He said: “With non-accidental injury we look at the psychological stresses the parents are under and how they deal with those. The mother responded and behaved as she could in the circumstances.” He said he previously dealt with parents who had made admissions of non-accidental injury and remarked that those parents often become distraught and overwhelmed. He said he did not come across this behaviour with the mother. He said there was no evidence of the mother not paying attention to or being neglectful of child F. The mother was able to structure and engage with child F.  The reciprocity of how child F engaged with the mother was positive.

Counsel for the CFA asked: “you have recommended reunification. What evidence is there that any boundaries would be set for teenagers?”

He replied: “These events happened a long time ago. The mother has been subject to an intense process of scrutiny and she has engaged in therapy. She has shown the capacity to challenge the children and provide boundaries in a context of access. It is under those circumstances that she is able to structure the children. She has taken the abuse of [D] seriously. She acted decisively.”

The judge said: “if she were to be overwhelmed again, could that trigger behaviour that she would not be protective [of the children]?”

The psychologist said: “No. It did happen again and her behaviour was decisive. She is much more able to respond to the children and their needs.”

A number of assessments had been carried out in respect of the children. The psychologist said it had been two years since he had administered the tests and the test results were valid for a year depending on the development of the child.

The psychologist said E had difficulties with communication, self-care and self-direction. Both of his care-givers had alluded to his difficulties. He had significant difficulties with daily living. His oral language and expression scores were low. His aural comprehension score was exceptionally low. The psychologist said E could hold vocabulary in his memory and assign objects in his head. He said the Stanford Binet test focused on intellectual ability and looked at non-verbal as well as verbal ability. E was not able to complete the subtest and was described as a young boy with difficulty understanding things but who could follow direction.

Child E could not be regulated by the clinical neuropsychologist to complete the test and was distracted by external and internal factors. The psychologist said he would be looking to test for autism in respect of E. He said he had previously assessed the children for autism. E declined a new task and persevered with the task he had. He said: “This is consistent with autism.”

Counsel for the mother said: “The clinical neuropsychologist gave his evidence in respect of [E] and he discussed that he had pica [an eating disorder involving ingesting non-nutritional substances] and smearing. What could cause pica?”

The psychologist said: “Pica is generally associated with intellectual disability and autism combined and is a very rare condition. Smearing is typical of people who are unable to express anger or aggression, the causes of which could be anything, the change of environment, trauma or autism.”

E had been admitted into care at age two years and nine months and it was difficult to attribute behaviour to a certain area of time. E engaged in pica when he travelled to the United Kingdom.  The psychologist said going to the United Kingdom could have been stressful for child E and it was expressed through pica and smearing.

Counsel for the mother said: “Trauma can occur from a disruption such as taking a child into care. This child was taken at the hospital and placed with a family with his brother and then taken on his own and placed with another family. What effect can that have on a child?”

The psychologist said: “Any number or none at all [effects].  It depends on the child’s attachment to the mother. If the child is attached it would be a significant disruption as it is the removal from the mother and moving into an uncertain situation.”

The judge asked: “Do you need to have a specific event for trauma?”

The psychologist replied: “There needs to be an experience of a traumatic incident.” He agreed that a child being taken into care or being sexually abused could constitute a traumatic incident. The psychologist said if a routine were disturbed, one could expect a backlash. He said that issues of neglect could cause children to act in a certain manner.

D’s comprehension was below average and this was indicative of a child who had cognitive difficulties. D did “quite well” in oral vocabulary. At school D had difficulties across the dimensions and all of the test results were average. Stress management was high and D’s interpersonal score was low. The psychologist said D “did not attempt to portray himself in a positive light. His ability to understand others could do with some work and he struggles around change.”

He said the sexual behaviour scale was elevated and the high level on the test could indicate concerns about one’s sexual functioning and a preoccupation with sexual manners.  The other concern was noted by the foster parents. The psychologist said his overall picture of D was of “a child who had early developmental concerns and had some cognitive deficits and strengths.”

The same tests were administered to child C as child D.  C’s results were on the average to high average scale of the cognitive range. The psychologist said C “is a bright individual and does not exhibit any executive functioning difficulties.” His reactive anger score was moderately low and this was considered good.

Counsel for the mother asked: “Do you agree or disagree with the clinical neuropsychologist when he says the scores with [C] are indicative of severe mental health?”

The psychologist did not agree. He said: “I do not see any evidence of snapping and any indications of emotional distress. His scores are very close to those of [D].” He said D had neither attachment nor psychological difficulties on the Coventry grid.

The judge asked: “Why do you disagree with the clinical neuropsychologist?”

The psychologist said: “If we are looking at autism the ADOS test would have been more appropriate.” He said the Coventry grid was a tool to aid clinicians in the diagnosis between attachment disorder and autism.

Counsel for the mother: “The conclusion of the clinical neuropsychologist is that [C] is very bright but there is something impacting on him psychologically.”

The psychologist said: “I don’t know where he is getting that from.”

He added he did not see evidence of social anxieties in relation to C. He engaged well with his mother, was friendly and had a good rapport with his mother.

The judge asked: “If the child was trying to hide something and there might be something underlying. Taking his responses, there is a congruency between his responses and those tests. One psychologist says one thing while another says a different thing. Is there a manual or must I sit down with the evidence and try to weigh everything?”

The psychologist said: “We are all trained in different schools. My training is to look at the science. If you not sure, back the one which has the most evidence.”

The judge asked: “Do I have to give greater cognisance to the clinical neuropsychologist since he was there [at the access]?”

The psychologist said: “I was not in the room with the clinical neuropsychologist so I do not know what he saw.”

The clinical neuropsychologist

The clinical neuropsychologist continued his evidence and had prepared a report for the court. He said he was aware of the history of the family and the episode of sexual assault of the children in the care of the mother.

The clinical neuropsychologist reflected on the access notes. He said C’s psychological presentation had changed since the assessment. C was more focused in relation to the mother than he was previously. He had requested to spend time with his previous foster carers. The clinical neuropsychologist interpreted this as “unfinished business” and as part of the formulation process.  It was suggested that the clinical neuropsychologist work with C in relation to dealing with the unfinished business.

Counsel for the GAL asked: “[C’s] access with the mother has increased and he visits her at home, have you reflected on that?”

He replied: “When he visits his mum it is unsupervised. He [C] is sharing a bedroom with a sibling who has made allegations of trauma. He is in a position where he is having strong interactions with his mother. That is a lot for him to take on board.”

D did not want to attend the psychology assessment to address his trauma. The clinical neuropsychologist suggested supervision with the psychologist or communication with a more experienced psychologist who could work with D.  He said: “When I finished in 2016, D was available to do good therapeutic work in relation to his trauma.” It was noted that D was an emotional child and that was evidenced during the assessment carried out by the clinical neuropsychologist. D tried to suppress strong emotions and he had obvious and pronounced responses to certain things. He said D was easy to read and it might be part of his intellectual functioning.

There had been a query of global developmental delay in relation to D’s late toilet training. He said: “There could be cognitive influences and you need to look at all these in true context. When I went to the school, I was struck by the gains [D] had made. I felt the school had a nurturing approach to [D] and embraced him and took on the challenges.”

D made disclosures to the foster carers. The clinical neuropsychologist said: “When you get a disclosure, it is an indication they [the child] feel safe and will be dealt with immediately. When he was in the car with the foster carer he became emotional.”

The clinical neuropsychologist said F was functioning well in relation to her interactions with the mother and her siblings. Child F had been referred for theraplay and it had been decided that such intervention was not required. He said: “I do not know how that conclusion was reached. I would be in opposition to that decision.”

The judge asked: “You recommended theraplay for what purpose?”

He replied: “It is based on attachment trauma, neurobiology and enhanced brain development. It was to further maximise her neurodevelopment in general. If she were exposed to theraplay, that structure could be brought into access [thus] enhancing her environment.”

The clinical neuropsychologist noted that F was an interactive girl who was strong in her own views during access. He said: “Sometimes she needs to be protective and people should not just assume she is stronger and more robust than her developmental age. She is not expected to be high functioning for her years. A lot of children who are chatty can have developmental anxiety as too much is expected of them.”

E experienced difficulties with therapy. The clinical neuropsychologist said the autism assessment was not robust enough to deal with all the challenges E faced.  He said the relationship development intervention (RDI) was the best for E as this assessment had a lot of skill-based activities that could be implemented. He said there was no rationale not to commence RDI and the assessment would provide a good framework in some of the difficulties experienced by E.

The mother had said in the interview there were difficulties with child E’s language and the clinical neuropsychologist wanted to see if child E’s language profile was consistent with an ASD profile. He said: “I did not see that as his oral expression was in the average range, and that would not be typical in someone with an ASD presentation. In relation to oral language it was exceptionally low. [E] obtained scores in the average range.” He said carrying out the assessment with E was “challenging as there had been good contact and then times when he [child E] became dysregulated.”

The judge asked: “Did you give a time frame for the trauma?”

He replied: “There are clear developmental stages. The two to three year time period included the time the child came into care. The trauma is something that foster carers saw.”

When E settled, his foster father “was his go-to person for the physical sensory things.” When he wanted nurturing, he went to his foster mother. E had reported dysregulations across many different environments. He was provided with interventions in the form of a tent at pre-school. Whilst conducting his interview, the clinical neuropsychologist was told by the school that E was a child who struggled and the teacher did not encapsulate him under the auspices of autism. He said: “They have to deal with the child on a daily basis and the teacher was trying to look at things from an emotional perspective.”

There was an incident where E had spent access behind a sofa and this was interpreted as a form of self-regulation. The clinical neuropsychologist said: “When children are feeling overwhelmed, they take themselves to dark spaces and that is the notion of the tent in the school.” The clinical neuropsychologist attributed the climbing of E into small spaces to his “environment affecting him from a trauma and attachment perspective.” He said he saw subtle improvement in E from an attachment perspective.

During the access observations, the clinical neuropsychologist noted father Y presented as someone who was uncomfortable in the situation and the environment. Y had not seen the children with regularity and he struggled to engage with them at their developmental level at access. He did not display good knowledge of child E or child F’s developmental ages and they ignored him. He said: “[Y] tried to engage, but the discourse was minimal but I did not observe good interactions.” The clinical neuropsychologist said Y had anticipatory anxiety for which he was attending his GP.

He said he was not satisfied with the psychologist’s administration of the MIM assessment. He said it did not accord to the standardised way. “My observations of the recordings did not correlate.”

The judge asked: “[Would] you prefer an up to date assessment for the children?”

He replied: “A cognitive assessment has a shelf life for three years but some others have [a shelf life] of six months.

“The nurturing pieces were not in keeping with attachment theory and what was seen was quite a leap forward. I would not have made comments like the psychologist’s. I did not see clear indications of attachment and it was not administered in the standardised way.” There were socially acceptable responses in the assessment.

He said: “I would question why the psychologists used the Rorschach [test] as it is not embedded in significant and acceptable empirical evidence.” He said the Rorschach was a very old test and he had not seen it used in child care cases. The clinical neuropsychologist said he struggled as to how anyone could deduce from ink blots on a page that Y was “a self-preoccupied man who controlled his emotions, had difficulty gathering information and was unlikely to accept other people’s views.”

He said he would not consider the Rorschach test to be a reliable means of assessing the personality of Y. He said ink blot information was readily available online and it affected the reliability.

The clinical neuropsychologist said the incidents of E and D soiling was indicative of a lack of insight by the parents into the difficulties the children encountered. He said: “The mother’s decisions did not factor in where the children were at and I picked that up from my interactions with her… She prioritised her needs over the needs of the children.”

Counsel for the CFA asked: “The mother disagreed with TUSLA and their recommendation that she and her husband could not provide care to the children?”

He said the mother had a well-developed cognitive functioning with no impediments.  Her emotional functioning was a bit contradictory. He felt intervention would take a lot of time and would consist of long-term gradual work. “That would be consistent with my experience with her in the clinical interview that her values are unwavering and resistant to change.” Her views were strong and she was very versed at imparting them. He said the cognitive attributes had been present in the mother for some time and it would take considerable work to facilitate change. The clinical neuropsychologist was aware the mother had previously engaged with therapeutic services.

Counsel for the CFA asked: “Does that shed any light on her progress?”

He replied: “I did not see it [the therapy] integrate in a positive way and I did not explore what type of intervention she had.” The intervention she undertook may not have been the most appropriate to have in relation to the attachment difficulties. The clinical neuropsychologist found the mother’s interaction with him very factual and without nuances.  He said he “did not get a repertoire of emotions” from the mother.

She considered herself well versed in matters. The mother had put forward homeopathy as a cure for autism. The clinical neuropsychologist said in relation to that idea he would not be as judgmental as his peers. He said: “I am aware, if parents are frustrated, they will explore many different interventions and programmes. When she mentioned homeopathy, it stood out to me as something that would not have prevented the development of autism.”

The case was adjourned and will resume in 2019.