Judge directs neuro-feedback therapy for three siblings in care – 2021vol2#16

A judge in a rural town made a direction that three siblings of primary school ages should receive specialist neuro-feedback therapy to help them to function in a calm state of mind. All three siblings were in the same foster placement, but this was under strain as a result of their traumatised behaviour. The court heard that the specialist therapy, aimed at reducing their stress and which was extremely expensive at a cost of €30,000, was in excess of the limit that the Child and Family Agency (CFA) could sanction. The therapy involved 30 sessions for each child and was to take place in the children’s foster home.

Day one

The children’s social worker informed the court that this particular neuro-feedback therapy had not been used in Ireland before but had been used in the Boston trauma centre. The three children were in a very secure and suitable foster placement but their behaviour and emotional dysregulation was a risk to the placement continuing.

The social worker said that the children’s mother had died two months previously. She described the foster family as being a “perfect match” for these children at this time. The foster father was a farmer and the children were interested in learning from him. The alternative placement, in the event of a placement breakdown, was a residential placement which would cost €5,000 to €7,000 a week. The proposed neuro-feedback therapy would involve the therapist coming to the children’s home for each of the children to receive 30 sessions at a cost of €9,000 per child.

The judge asked if this intervention would help maintain the foster placement and if it was possible the children might learn how to farm from the foster father. The guardian ad litem (GAL) described neuro-feedback therapy for the court. The aim of the therapy was to calm the children’s stress response. This involved the placing of electrodes on the children’s heads and these electrodes were connected to the therapist’s computer. The intervention was capable of producing quick results but it was essential that the therapy be maintained.

The GAL told the judge that the children had experienced trauma and that they also had additional disabilities. The objective of the therapy was to help the children to function in a calm state rather than in a state of extreme stress. The therapy aimed to offer tools to the children to enable them to deal with their stress and prevent severe mental health issues in adult life. The therapist was available to come to the children’s homes during the summer months and this would help the children to prepare to cope better when the new school year started in September.

The lawyer for the CFA asked the GAL where the data from this treatment would be processed and retained. The GAL said it was her understanding that a confidentiality clause was included in the contract.

The judge made a direction that the proposed therapy be undertaken with the children as outlined to the court. He also directed that no data regarding the children’s therapy be processed without leave of the court.

The case was listed for a review after five months.

Day two

When the case resumed, the children’s social worker reported that the neuro-feedback therapy had commenced and that two of the children were responding noticeably and the third sibling’s response was less remarkable. She stressed that the therapy was key to the successful continuation of the foster placement.

The social worker informed the judge that two of the children had started a new school placement but that both were on reduced school hours. One child had been referred to the Child and Adolescent Mental Health Service (CAMHS). There was a difficulty with transporting two of the siblings to school. Despite applications made, it had not proved possible to get school transport for the children and two social workers were currently transporting the children to school. Communication had been initiated with both the Department of Education and Skills (DES) and Bus Éireann but without success.

Judge: “We are wasting resources putting social workers on transport duty.”

The judge directed that the DES be served with a Notice of Motion asking it to either come up with a proposal regarding school transport or alternatively to come to court. The matter was set to be returned for consideration to the court a month later. The judge added that it was disgraceful that this problem should arise now that the children were in an ideal placement.

The social worker said the eldest sibling was aggressive towards the foster mother occasionally. He had started the neuro-feedback therapy three months previously and the recalling of early childhood experiences had been a cause of trauma. An occupational therapist provided a lot of exercises and therapy and there were monthly meetings held for the children’s core group of professionals. The neuro-feedback therapy was set to continue.

Day three

The matter came before the court one month later. The Notice of Motion regarding the school transport difficulty had been served on the DES. Subsequently the matter had been resolved and the DES had provided approval and funding for the children’s transport to school. The social worker thanked the judge for his intervention in the matter. The case was listed for a review after five months.