Full care order for five young children deferred while parents attend course – 2013vol3#26

A full Care Order for five children under the age of 10 was deferred in a provincial city in a case where the HSE was seeking a full Care Order, on condition the parents attended a residential parenting course. The two oldest children were already in foster care with relatives. A Supervision Order had previously been granted for the three younger children. The father had been criminally prosecuted for hitting one of the children with a brush and had received a suspended sentence.

Outlining the HSE case in a case that went on for six days, the solicitor said that independent professionals involved in the case recommended full Care Orders for all five children until eighteen. The parents were contesting the full Care Orders but said they might agree to a short term Care Order.

The HSE solicitor said that the whole family had been offered a place at a residential parenting centre in order to deal with the issues that had arisen. However, as the parents were not agreeing to take up the place, the HSE were seeking a full Care Order for the five children.

The mother acknowledged the couple had made mistakes in the past with the older children. “We are doing things differently now,” she said. “Since the experts came on board I have got better at dealing with issues.”

Responding to questions from her own solicitor, the mother said she had not had a good relationship with the HSE. “I felt they were not listening to us. After the Interim Care Orders we were told we could take the boys home, but we couldn’t. I didn’t trust the HSE. We bonded more with the doctor and psychiatrist doing the therapeutic work, we built up trust.”

In response to being reminded that her older child, child A, was in care following the discovery of unexplained injuries, the mother said that she would never lay a finger on her children.

A social worker told the court that she had called to the family home with a public health nurse and found the parents outside the house and the two babies, children D and E, lying on the couch with nothing in place to prevent them falling.

The social worker said that the mother had been in a neighbour’s house and the neighbour had said that the children had been left alone for half an hour every day since they were born. The father’s solicitor told the court that while it was admitted that the children had been left alone, it was disputed that they were left alone for that length of time.

The father’s solicitor asked his client if he thought he and his partner could manage all five children at the moment. “I don’t think we could manage A and B at the moment. We could in two or three years,” the father replied.

A psychologist told the court that she conducted psychometric testing on the parents. She said that this assessment gave an indication of intellectual and emotional functioning and risk and could show whether someone could follow advice or recommendations.

She concluded that the mother was of a low to average intellectual ability and had low morale and a mood disorder, finding it very difficult to be positive and having very little power of reflection. The psychologist said that for a person of this description the pace with which you can make recommendations about behaviour change is slower than normal and you have to structure things to suit that personality style.

She said mood lifters or anti-depressants would make a big difference to the mother. Another psychologist said that she would process information as well as most people but that her understanding was not good so concrete, simplistic language was best.

In relation to the father, the psychologist said that she found it very difficult to steer him away from the topic of the HSE. She said that the father was in the borderline range of intellectual ability. She said that he would find it difficult to take on information, and that things would have to be written down for him and checked that he understands.

The psychologist further concluded that he had low emotional expression, low rumination, low sensitivity and a zero tolerance attitude to anger which meant that he did not recognise anger as an acceptable emotion in himself or others.

The psychologist said that both parents had a similar personality profile and both would benefit from mood stabilisers. She said it was unusual to have the same deficits in both parents. She said that the father was “quite a vulnerable person, low in psychological mindfulness. One would not see the impact of one’s behaviour on one’s actions.”

Another psychologist said that the father had an extremely low IQ, bordering on a mild learning disability. She said that he was “not a problem solver. It might be difficult for him to apply rules of parenting” and that he would struggle with behavioural management of children. She said that it would be extremely difficult for him to follow complex instructions.

The court was told that the father was attending anger management therapy but the psychologist said that although anger management therapy was useful it is more of a surface treatment and that the father had much more deep-seated issues. A more deep-seated therapy would hopefully involve better relationships with professionals and he could model this to his children, she said.

Asked about the professionals’ assessment of his overactive mind and difficulties with impulse control, the father said he accepted that he had difficulties and that he had made some wrong decisions, including not letting social workers into the house. “When I see a social worker my stress levels go up.” He said he had done a lot of work over the past year with a counsellor in dealing with that.

The solicitor for the GAL asked the father what he thought of the evidence that had been given that the environment at home and how parents manage their mood has a significant impact on children’s behaviour. The father said that he did not know what this meant.

Asked if he accepted the need to change, the father said: “I mean it because I’m lost too. When you listen to all the evidence I recognised it probably is my fault.”

The GAL’s solicitor told the court the GAL was recommending care orders until the children were 18 because they needed certainty, structure, routine and safety. The parents had not demonstrated they could provide a safe, nurturing environment for the children.

A paediatric physiotherapist gave evidence that the parents worked very well with her. She said she was aware that the parents did not have such a good relationship with other professionals in HSE. She said: “They might be people of a different level of education but they are responding well and they are well able to change and learn. They are capable and able.” Huge changes had been made by parents she said.

The physiotherapist said that it was not her opinion that the children suffered from a lack of stimulation. She also said that the fact that the parents admitted that they needed support “shouldn’t be pointed out as a negative but it should be positive. If they see that they need the right help they are well able to help and care for their children.”

The physiotherapist said: “If more money were put into support we may not be here in the first place. If parents would have got that service, what we deliver earlier, with [the older children], if that had been given to other children, we probably wouldn’t be sitting here at all. The diagnosis of the child is being made to fit the system rather than the system fitting the child.”

The physiotherapist added: “Everyone brings up their children according to their own experiences. They have not experienced the childhood which we are now asking them to give their children.”

A social worker from an independent parenting centre told the court of her concern when she found out that one of the children needed to wear a helmet due to chronic head banging. She said that the father did not demonstrate concern as to what was causing the head banging but he wanted to put a helmet on to stop the bruising.

The same social worker described one of the younger children, child E, as having a “flat effect”. She said that she was “on the periphery, almost in her own world.” She described an incident from a home visit where child C pulled the fireguard back from the fire and wandered in front of the fire. She said that after child C’s behaviour became “heightened and dangerous” the mother became upset and asked the social worker whether she thought she needed support. The social worker said that boundaries should have been put in place much earlier.

A social worker gave evidence that an intensive parenting course had been provided to the parents in the family home. The father’s solicitor pointed out that the course consisted of ten parenting classes. He said that none of the material covered each week was repeated and new material was introduced each week. The judge said that he saw no evidence of repetition and said that it could be the curriculum for a night course in child psychology.

A social worker gave evidence of a contact visit between the parents and the children. She said that while the visit started well, within 20 minutes the parents were not able to manage children A, B and C. She also informed the court of a disclosure made by child B that his parents had hit him.

She said that contact visits generally very much depended on the form that the father was in and gave an example of a contact visit where the father did not greet the children for the first 20 minutes. She gave evidence of another contact visit when child A didn’t want to come into the room and he kicked his mother and was quiet and standing by a wall. When the child didn’t respond to what the father was saying, the father turned around and started cursing and saying there was something wrong with the child. Child A then kicked the social worker and everyone became very upset.

The social worker told the court that the parents had agreed to do a parenting assessment course but that they had later retracted their consent to do the course. The GAL had suggested that, given the parents’ distrust of the HSE, the parents complete a parenting course given by an independent residential parenting centre.

The social worker said that she had eighteen years experience of working as a social worker and that, in her experience, it is common for there to be feelings of mistrust between families and social work departments but that it is usual that this is overcome and people can develop a working relationship. However, she said that she had not managed to establish a relationship with the father in this case and she said: “He doesn’t understand why his children are in care. He doesn’t seem to want to listen to explanations as to why his children are in care.” She said that there had been no contact since the last child protection conference.

The father’s solicitor asked the social worker whether there was any formal view, from the HSE’s point of view, as to how to communicate with the parents on foot of the report of the psychologist which had described both parents as suffering from borderline personality disorders and communication difficulties. The social worker replied that there was no formal decision regarding methods of communication but that the doctor’s report had formalised a view that was already the view of the social work department. She said: “Some of the information was known but there wasn’t a team decision to do anything differently. It’s been hard to get to the stage of actively working with the family.”

Asked by the judge whether the social work department could have done things differently or whether the father was so awkward that it was not possible to engage him, the social worker replied “the child protection conference was very much about giving information back in a concrete way. I’m not sure I could have done anything differently as the father had very firm views of the HSE and it was difficult to move him beyond that.”

Various witnesses gave evidence of the father’s fixation with the HSE. A psychologist said that it was very difficult for him to engage with children while he is still so focused on the HSE.

When the psychologist was asked did she believe that the family could make progress while living in the community she answered: “No”.

The solicitor for the mother asked the psychologist whether one would have to tailor what one says to take into account the intellectual ability of the parents. The psychologist said: “You might have to repeat things and give examples, do things logically, sequentially and structured. You can’t guarantee that the advice would go in but someone in the low to average range would be able to follow advice given bluntly if they were minded to.”

When asked about the relationship between the physiotherapist and the parents, the psychologist said that the physiotherapist “was extremely positive about a small range of behaviours. In my opinion it was distorting other things that were going on. In my opinion this wasn’t good for the parents, giving them a skewed picture. There is a tricky relationship between the parents and professionals involved.”

The manager of the residential parenting centre which had offered the family a place gave evidence of a home visit and said that the father appeared to be very cross and didn’t speak to the visitors for 15 minutes on one visit. She said that child C came to the window and his face was filthy, covered in mucus and phlegm. She said that child D, who was a toddler, was sitting in the hallway staring absentmindedly. She said that she picked up child D and said her babygro was very wet, her hair was wet and she had such a full nappy that she had dried faeces up her back and that her back and bottom was red and raw.

She said that, in her opinion, child D had been “sitting in hallway for quite some time [and was] sticky, drenched, covered in faeces, under-stimulated.” The same witness said that on other visits she had found the situation in the house to be better. She said that, in her view, there was “ongoing, low level neglect.”

The psychologist told the court that she felt that time had run out and she suggested that the family take up the offer of the placement in the independent parenting centre that had been offered to them.

A social worker gave evidence that she believed that it was unlikely that the parents would be able to care for the children at home. She said that she did not believe that children’s needs were being met consistently and that she would worry about their development.

The judge said that that the fact that “children might get less than the best from their parents is not a ground to take children into care. Children are entitled to sufficient care rather then optimum care. Parents who are less than the best need not be subjected to having their children taken away from them.”

A social worker said: “I think all the children should be in care up to eighteen. I really believe the style of parenting is predominantly impulsive and reactive rather than responsive. I haven’t seen the father stop and think what the best thing to do is. We haven’t been able to effect change in that respect. As long as this behaviour continues there is a risk to the children in remaining in the house.”

The social worker told the court that access had been suspended recently as the social work department thought that the father was behaving too unpredictably.

Judgment was reserved. When the judge delivered it some weeks later, he said he was giving them a last chance to attend the parenting course with the independent residential parenting centre, and they agreed they would attend.