The number of abused and neglected children in the United States has increased dramatically over the last ten years. Children’s Protective Services (CPS) have been expected to respond with limited resources. Concerned community leaders have begun to team up with receptive CPS officials to develop public/private partnerships to respond to this problem.

In 1993, the Harris County Children’s Protective Services (HCCPS) Fund, an organization of concerned leaders in the corporate community, commissioned a Task Force, comprised of professionals from child welfare, social services, legal and medical organizations, as well as business and community leaders, to examine these issues closer. The HCCPS Fund Board directed the Task Force to develop strategies and make recommendations for improving services for children entering CPS custody. Upon closer examination of local studies, the Task Force found that the CPS system lacked a comprehensive assessment and evaluation process. The current system forced caseworkers and the courts to make decisions about placement and treatment based on "subjective" observations. Collection and evaluation of demographic, case background, and child assessment data was also lacking.

The Task Force recommended The Children’s Crisis Care (4C) Pilot Program. The 4C was developed as a collaborative partnership between the HCCPS Fund, HCCPS, the Texas Department of Protective and Regulatory Services (TDPRS), and the CIVITAS ChildTrauma Programs in the Department of Psychiatry at Baylor College of Medicine.

On March, 1 1996, The Children’s Crisis Care Center began as a two-year pilot program funded almost entirely by dollars raised in the Houston community by members of the Task Force. During the first 22 months of the Pilot Program, over 370 children removed from their families have received an initial, six-month, and one-year CIVITAS/4C Core Assessment. This quantitative, multidimensional evaluation provides information about the emotional, behavioral, cognitive, social/family and physical functioning of the child. In turn this information is used to guide placement and service decisions. This collaborative pilot has proved to be very economically and clinically successful. The 4C has made important and meaningful changes to the foster care system in Harris County, including decreasing emergency shelter care stays, as well as the amount of time spent in foster care.

The focus of this workshop is the process factors that are deemed to be crucial to this, and other, successful collaborative partnerships with multidisciplinary and cross institutional components. Creating effective models for administration, communication, team building, multidisciplinary training, distributing leadership; disseminating decision making; and team building.

As a result of its success, The Children’s Crisis Care Center and CIVITAS/4C Core Assessment Process will become a permanent program on March 1, 1998 and taken to scale in Harris County by the year 2000. Additional opportunities to "export" this process in Texas and other states will be discussed. Key to an effective scaling process is paying attention to the process that has driven the 4C program and not just the specific assessment protocols.

Bruce Perry, MD, PhD, Senior Fellow, CIVITAS Initiative; Suzanne Muchin, Executive Director, CIVITAS Initiative; Warren Cook, Project Manager, Nethaven Division, Computer Associates, 909 Las Colinas Boulevard, East, Irving, TX 75039, (972-556-7451); Jana Rubenstein, M.Ed.,LPC, Director, CIVITAS Academy; Leecia Welch, J.D., ChildLaw Scholar.

Thousands of hard working, well-intended people with diverse educational backgrounds, working in hundreds of separate systems in the public and private sectors are addressing the complex problems of child abuse and neglect. Despite this, enduring solutions seem elusive. One of the limiting factors is the difficulty of interdisciplinary communication. These interdisciplinary communication problems are magnified by inefficient mechanisms for distributing practical, up-to-date information.

CIVITAS Initiative has placed a priority on the process of translating primary disciplinary information into practical, accessible and useful interdisciplinary information. In our view, the process of translation-- organizing, synthesizing and processing facts is the key to turning information into knowledge.

The purpose of this workshop is to introduce the Cybrary of Child Development and Maltreatment, an electronic library and communications network designed through a unique partnership between CIVITAS Initiative and Computer Associates International, Inc. The core strength of this unique resource is that it will make ‘translated’ materials available. Key information in all disciplines will be presented in formats that facilitate interdisciplinary and cross-institutional communication.

The Cybrary is a model for the ‘library’ of the future. Its purpose is to develop an electronic archive that allows any person or group of people access to information, consultation, and educational materials regarding children, child development, and various aspects of abuse and neglect via the Internet. These materials will be available in a variety of formats and presented at a variety of levels of complexity.

The Cybrary targets three primary groups: 1) professionals working in child-related areas (e.g., pediatrics, education, juvenile justice, social work), 2) adults raising and providing direct care to children (e.g., parents, grandparents, foster parents, child care providers), and 3) children themselves. Within the Cybrary, individuals can ‘steer’ themselves to resources (e.g., video, brochures, articles, interactive chat rooms, online consultation) that match their current needs.

The Cybrary will archive and make available cybercasts of training in a host of disciplines. Live interactive consultation will be available for individuals in rural or other resource-limited settings. The Cybrary will have mechanisms to create local resource banks for communities to organize portions of the Cybrary for the specific collaborative and educational needs of a given community. The innovative technologies made available by Computer Associates, our corporate partner, will allow resource-limited settings to benefit from expertise from across the nation. The Cybrary utilizes this network of professionals, the CIVITAS Academy, to collect and translate crucial information from a variety of disciplines. CIVITAS Initiative staff and affiliated Academy instructors will create the content for the Cybrary by identifying suitable materials already existing and by creating new materials where "gaps" exist.

Complementing the Cybrary’s electronic archive are "hard copies" of written materials (e.g., chapters, curriculum), videotapes, CD-ROMs and slides.

Suzanne Muchin, Executive Director, CIVITAS Initiative; Leecia Welch, J.D., ChildLaw Scholar;
Jana Rubenstein, M.Ed. LPC, Director, CIVITAS Academy; Bert Jensen, Partnership Coordinator,
CIVITAS Initiative; Bruce Perry, M.D., Ph.D., Senior Fellow, CIVITAS Initiative

CIVITAS Initiative is a national organization based in Chicago and Houston. Founded by Jeff Jacobs in 1992, the mission of CIVITAS Initiative is to help high-risk children by improving the systems that protect, educate, heal and enrich children and families. While our focus is abused and neglected children, our mission will catalyze the creation and distribution of practical, enduring solutions to promote the optimal development of all children. The primary approach to effecting systemic change is to establish and maintain partnerships with the public systems dedicated to identify, protect, heal and educate high risk and maltreated children.

The purpose of this workshop is to present the strategies of CIVITAS Initiative for establishing innovative, effective partnerships with individuals, institutions, and corporations in the public and private sectors.

In this process, CIVITAS Initiative has identified several problem areas impeding progress: 1) lack of basic knowledge regarding child development and maltreatment, 2) inability to ‘translate’ key concepts of child development and the principles of effective programs into systemic change or public policy and 3) ineffective communication of key principles and facts across disciplines and to the public.

CIVITAS Initiative creates collaborative partnerships with individuals, organizations, and agencies in the public and private sectors to design and distribute innovations in assessment, information management, service delivery and education. CIVITAS Initiative projects are developed with a special focus on the need to take successful innovations "to scale." Therefore, only those CIVITAS programs, processes or activities that demonstrate measurable success and are practical will be exported.

The CIVITAS Academy provides educational support and services. The Academy instructors are selected from a distinguished national pool of professionals from many disciplines and academic institutions (e.g., University of Michigan School of Social Work, Baylor College of Medicine). The Academy faculty works with CIVITAS staff to develop and provide innovative interdisciplinary training activities. These educational services range from post-graduate training for lawyers, judges, social workers, physicians and teachers to prestigious graduate training fellowships. Over the last two years, CIVITAS sponsored training activities have reached over 20,000 professionals in a variety of fields including juvenile justice, public policy, pediatrics, pediatric law, social work and law enforcement.

Thousands of children in the United States are referred to Children’s Protective Services (CPS) for allegations of abuse and neglect each year. Due to this maltreatment, children placed into protective custody are often at high risk for physical, emotional, behavioral, cognitive, developmental, and social problems. Despite this, systematic evaluation of the strengths and weaknesses of children is rarely proactive. Services and placement decisions tend to be subjective and reactive. Placement disruptions and ineffective service delivery that result from this reactive process are costly in economic and human terms.

In 1993, the Harris County Children’s Protective Services Fund Board, a private organization comprised of leaders from the corporate community, funded the development and implementation of a proactive assessment model for children entering the CPS system. This model, Children’s Crisis Care Center (4C), was developed by an inter-institutional, multidisciplinary work group led by the CIVITAS ChildTrauma Programs at Baylor College of Medicine. Once developed, the 4C staff working in with CIVITAS ChildTrauma Program staff and CPS staff from 4 of 16 units in Harris County, TX provided immediate screening evaluations on all children entering state custody.

The CIVITAS/4C Core Assessment process uses reliable, valid psychological measures with a trauma history and clinical interview to make quantitative assessment of the child in emotional, behavioral, cognitive, physical, social and family domains. This Core Assessment allows objective estimates of each child’s and guides the matching of services, treatment and placement to the child’s specific needs. Reporting and staffing processes are designed to be practical and useful to caseworkers, judges, teachers, foster parents and other professionals working with these children.

Due to the economic and clinical success of this pilot program, it is being expanded and taken "to scale" in Harris County. This pilot program, originally funded by CIVITAS Initiative and the CPS Fund Board, is now being integrated into the CPS system using the re-direction of existing funds. By the Year 2000, the CIVITAS/4C Core Assessment Process will be used in all children placed into custody in Harris County -- approximately 1100 children per year.

Through systematic data collection and storage in a database designed by the 4C Program, analysis of factors common to the 4C population has been possible. Preliminary findings of the impact of abuse and neglect on children under the age of six years suggests that developmental delays, particularly in verbal skills, are frequent. Approximately 79% of children tested within the first 30 days after entering custody (Initial Evaluation) displayed developmental difficulties which warranted further evaluation. At least 23% of the children brought in for Initial developmental screening were deemed untestable, due to behavioral or emotional problems sufficient to prevent assessment.

Children between the ages of 6 and 18 years appeared to have difficulty with verbal skills as well, with 36% of the population performing significantly higher on verbal skills than non-verbal on standard measure of intellectual functioning. More than 85% of these children endorsed at least mild levels of Posttraumatic Stress symptoms. Twenty-two percent endorsed severe to very severe PTSD symptomatology.

The CIVITAS/4C Assessment Process will allow more systematic evaluation of the heterogeneous and complex effects of abuse and neglect in childhood. Systematic and quantitative data will allow the development of more effective models for assessment, intervention and prevention.

Mr. Conrad, a clinical social worker, is responsible for the day-to-day administration of all CIVITAS program activities. His responsibilities also include assisting in the development of assessment and treatment programs for maltreated children and providing stress debriefings for Child Protective Services caseworkers impacted by secondary trauma.

Computer Associates is the primary corporate partner with CIVITAS Initiative and has assumed financial and technical responsibility for developing and maintaining the Cybrary on a pro bono basis.

Dr. Dobson has overall staffing and administrative responsibility for the Children’s Crisis Care Center. Dr. Dobson’s Research has focused on issues of gender, race, and poverty. In the area of Child Welfare, her clinical research interests are on the long-term effects of foster care on the lives of children.

Mr. Jensen develops and manages CIVITAS partnerships focusing on individuals, organizations and agencies in the public and private sectors. Mr. Jensen, a graduate of the University of Missouri was a special agent for the Federal Bureau of Investigations (FBI) for nearly thirty years. Mr. Jensen also served on the Special Agent Advisory Committee to the Director of the FBI, and was awarded the FBI Humanitarian Award.

Mr. Mahoney conducted developmental assessments on children six months to six years of age referred by the Children’s Crisis Care Center Project. His other responsibilities included co-leading weekly music and movement groups for The CIVITAS Healing Arts Project. As the Burnett-Bayland Project team leader he conducted group therapy for juvenile offenders.

Ms. Matorin’s responsibilities included: conducting psychological evaluations for the Children’s Crisis Care Center Project; evaluating and providing services for children in the CIVITAS Clinic; and conducting research on the long-term sequelae of childhood sexual abuse, dissociation, and adult sexual victimization.

Ms. Milan conducted developmental screenings for the Children’s Crisis Care Center Project (4C). She also coordinated the CIVITAS sponsored children’s groups at the battered women’s shelter. Ms. Milan’s principal area of clinical interest is traumatized infants and toddlers.

Suzanne Muchin, Executive Director, CIVITAS Initiative

Ms. Muchin manages the day to day operations of CIVITAS Initiative. She is a graduate of Tufts University majoring in International Relations. Upon graduation she taught eighth grade Spanish, English as a Second Language, and Special Education in the South Bronx. Ms. Muchin served as the National Program Director for Teach For America.

As Senior Fellow, Dr. Perry develops and implements CIVITAS’ mission and programmatic activities. He serves as the Thomas S. Trammell Research Professor and Vice-Chairman for Research in the Department of Psychiatry at Baylor College of Medicine and Chief of Psychiatry at Texas Children’s Hospital in Houston, Texas.

Ms. Pfeiffer conducted developmental screenings for the Children’s Crisis Care Center Project (4C) with children who are under 6 years of age and psychological assessments on children 6 and older. Ms. Pfeiffer co-lead several Music and Movement classes for children referred from the CIVITAS clinic and the 4C Project.

Ms. Rubenstein manages the CIVITAS Academy, a national training institute "without walls" that is engaged in the continuous process of testing, refining and distributing information and programs designed to improve the lives of children. She coordinates interdisciplinary training initiatives in child development and maltreatment as well as program development of pilot programs designed to improve the systems that protect, nurture, educate and enrich children.

Dr. Runyan is a clinical psychologist with extensive experience in research and clinical activities. As the Research Coordinator for CIVITAS, Dr. Runyan collaborates with Dr. Perry and other CIVITAS staff investigating the effects of abuse and neglect on children. Dr. Runyan also participates in CIVITAS Child Trauma Clinic assessment and treatment activities.

Ms. Schick is a psychometrician who conducts developmental screenings for children, 6 and under, referred to our clinic. Ms. Schick also participates in the assessment of children referred to the CIVITAS Child Trauma Clinic. Her administrative responsibilities for the 4C project include program management and overseeing the development of new assessment protocols.

Ms Welch graduated from Northwestern University and attended Loyola School of Law in Chicago and graduated magna cum laude in the first class of CIVITAS ChildLaw Fellows.