I hear it frequently from #actuallyautistic advocates: “If we can’t educate these parents, someone should call the county.” It sounds like a good plan on the surface when faced with a video of autism parents applying ABA and filming their children’s torture. Why not get Child Protection involved? It is their very purpose. Wouldn’t that help these children?
What many many caring, empathic, well-meaning people fail to understand is that, in the United States at least, the State is a large part of the problem in the abuse and misunderstanding of autistic children.
As both a former professional social worker and a foster parent, I have witnessed a lot of problems with State care of disabled children. And I want this to be widely understood before we start routinely bringing in the State as our champion.
Foster care and adoption services fail many children throughout this country, but disabilities only serve to accentuate the problems in the system. This system runs on basic principles that many outside of it do not truly understand. Here are some of these principles and the heartbreak they cause.
1. Current medical best practices are always observed and thought to be ideal, despite past experiences.
A parent often uses both intuition and the accumulation of past experiences when working with a child with or without accommodation needs. If a child hates wool sweaters because they itch, wool leaves the clothing rotation. If a child does poorly on stimulant medications, these are not tried again.
This is not the world of the foster parent. Foster parents are told that they are part of a “professional team,” and that they must basically defer to everyone else on that team, even if the professionals involved barely know the child and push the use of drugs and therapies you know to be harmful.
In other words, if you foster an autistic child they will almost certainly be receiving ABA. And possibly be put on powerful medications, even those that produce a lethargic or numbing effect. And if you refuse, you can expect to lose the placement.
This sounds quite harsh, but remember, from the State’s point of view, foster parents are interchangeable. The State succeeds as long as a child is “stable” in a placement, regardless of whether a child is emotionally whole, learning in school, or being prepared properly for adulthood. Which leads me to….
2. The goals of State placement are “Stability” and “Permanency” before all others.
These sound like lofty goals. It is better to help kids find stability in a forever home if they cannot return to their parents than to bounce them from placement to placement. On the surface, this sounds like a no-brainer. But the focus on stability and preserving placements over other goals can have dark consequences as well.
I mentioned medications earlier, and this is a popular method for insuring placement stability. Yes, some kids need a medication to soothe anxiety or to focus or when clinically depressed. But doctors often prescribe powerful anti-psychotic drugs to children who do not experience psychosis to curb aggression. And though a parent will likely limit these drugs if they produce numbing effects, the State might look the other way if they render a child manageable.
This can apply to therapies as well. If ABA therapy makes a child easier to manage, they will receive it for the sake of permanency. On the other hand, a child may desperately need grief counseling, but if working through the grief produces deep and violent or difficult emotional responses in the child, the State is unlikely to make it a priority. After all, a spooked foster parent may terminate a placement.
This is why many foster children are poorly-educated, emotionally under-nourished, and over-medicated. The State’s priority is to maintain stability until a child comes of age at either 18 or 21, depending on the state and the level of disability, not to heal them or prepare them for adulthood, which is why….
3. The State will always favor “professional foster parents” over a “loving couple,” especially with disabled children in care.
There is a basic understanding in the foster community that there are two types of foster parents: the amateurs and the professionals. Though all foster parents are encouraged to see themselves in a professional role, this is the reality of the situation. Some foster parents are in the system to work with a child or two for many years, love them, and hopefully eventually adopt them. Others basically run group homes for foster kids.
The feel good stories that you see on your Facebook feed tend to involve “loving couple” foster parents. They take in one, two, or three kids who need love and permanency.
They surprise the kids with adoption and live happily ever after. These families are the poster children of the foster care community. Now let me tell you what happens the vast majority of the time, especially when disabled children are involved.
The State relies heavily on professional foster parents, often referred to as “foster farmers” because they take in so many foster and/or adopted children at the same time. How can they do this? It is a business model. These families will take in 5-8 children at once and live off of the foster care subsidies. This works especially well with disabled children because the subsidies are higher. A severely disabled child may bring a subsidy of $1200 – $2000 a month, unlike a typical foster subsidy of $500 – $600.
The couple can stay at home all day with the children thanks to these large subsidies and will often seek to adopt. The little known secret in the foster community is that the adoptive parents of disabled foster children continue to receive full monthly subsidies until the children age out of care, often at 21 years! This can be a lucrative business model and provide the State experienced foster parents for children with very high support needs. So what’s the harm???
Well, first of all, “special” foster placements are “worth more” because they require more time and energy from the parents. No matter how good a couple is at foster farming, there is never truly going to be enough attention for 5-8 high-needs children. And they aren’t hiring help because that would destroy the profit margin. These children may be clean, well-groomed, safe, and stable, but they likely aren’t getting much personal attention. And they are the most vulnerable.
Secondly, the foster farmers know that they must maintain a good relationship with State to “stay in business.” This means that, if only subconsciously, they are less likely to push back on harmful therapies or medications or to push for more costly therapies when needed. They are also less likely to be able to offer lasting support to their adopted children as adults when the subsidy dries up.
That said, at least these children have nominal parents and the benefit of a home environment. And that leaves them better off than at the mercy of a case worker guardian while institutionalized because…
4. Social workers will sign anything if it is legal and backed by professionals.
I say this with shame having received a Master’s degree in social work, but it is true. Social Workers are discouraged when working for the State or a private contractor as case managers from using personal professional judgement in any way. They are bullied even when they resist into signing whatever is put in front of them if they wish to keep their jobs.
This is why the vast majority of social workers (myself included) burn out in 1-3 years and either finish supervision to become clinical therapists or quit. I got tired of making the daily choice between getting fired (and I have been) and being a terrible person.
I have talked in previous articles about The Judge Rotenberg Center in Massachusetts and their use of painful electric shocks as well as ABA on autistic and other disabled children. Many of you likely asked yourselves, “what kind of parent would sign a consent form for THAT???”
True, some of the signatures were from impoverished, frightened parents who were misinformed about the nature and consequences of aversive punishments like electroshock. What is rarely discussed, however, is the large number of Social Worker signatories. A lot of the children at the JRC are State children.
Though I tried and failed to find exact numbers on this, it is a widely-known insider secret that institutions, even institutions this cruel, are a last resort for the foster care system when no foster placement can be found. And, unlike my situation with my foster child where I was visiting 1-2 times a week to make sure everything was going smoothly and on the up and up while she received care, most institutionalized children are lucky to get three visits a month from ANYONE: one from the social worker, one from the guardian ad litem (lawyer), and one from the Court Appointed Special Advocate (CASA) if the child is lucky enough to have one. Basically, there is slim-to-no oversight.
And believe me, even with my close eye and constant visits, hospital wards and institutions get away with murder. They use restraint, which leaves bruises. Kids beat each other when there is not enough staff to intervene. Children are over-punished and under-cared for.
And even if a foster parent watches and cares, the facility knows there is only so much they can do. Because these well-meaning people don’t have a sue-able interest in the child, only the State does. And getting a Social Worker to press charges when a child is “well-placed” is about as achievable as getting yourself on a reality TV show for a chance to marry into British Royalty. And believe me when I say that these facilities know it.
Before anyone objects, I am fully aware that there are well-intentioned, kind, loving foster parents in the world; after all, I was one. I would like to be again when I get myself financially prepared to take in autistic children.
That said, these are widely-experienced realities in foster care, even separate from the sad reality of foster parents who actually abuse children, and these realities need to be discussed honestly if the situation ever hopes to improve. As for me, I can only pray that more attention is drawn to the most vulnerable children in foster care.