How does the Safe Babies Court Team™ approach improve outcomes for infants and toddlers?

Infants and young children are most vulnerable to child abuse and neglect, with more than one-quarter (28.5%) of victims of maltreatment under age 3. These same children frequently experience further trauma as a result of their family’s involvement in the child welfare system, which at worst can include lengthy separations from their families and multiple placements. Research and experience have shown that separating children from their families creates lasting trauma, usually lifelong. Community-based and universal family supports can help keep children safe and families together, and ultimately prevent the need for court involvement.

However, when court involvement is necessary, the Safe Babies Court Team™ (SBCT) approach is focused on minimizing trauma and its impact on early development by improving how the courts, child welfare agencies, and related child-serving organizations work together to support young children and their families. The SBCT approach is a systems change initiative headed by ZERO TO THREE, a national organization working to ensure that babies and toddlers benefit from the family and community connections critical to their well-being and development. The initiative began in several sites in 2005 and has expanded to more than 80 across the country.

Each SBCT works at both the family and systems level. Family teams — composed of family members, attorneys, case planners, and service providers — come together at least once a month to identify and remove barriers to reunification, helping to expedite services (and ideally, permanency) for infants and young children. In addition, community court teams — led by judges and composed of community stakeholders — review patterns across cohorts of individual cases to address structural issues in the child welfare system that prevent families from succeeding.

Broad involvement of community systems and stakeholders, and the focus on systems change as a vehicle to better support families with young children, make this approach highly compatible with a broader, more preventive 21^st century approach to child welfare. Policy and other systems changes resulting from SBCTs may ultimately benefit families at risk before they reach the court system. In addition, integrating the core components of the SBCT approach as standard practice for all dependency courts — rather than as a specialized approach for some — has the potential to address the needs of all families, ultimately reducing trauma and expediting permanency for all children who come into contact with the child welfare system.

Evidence of effectiveness

In 2014, the U.S. Children’s Bureau provided a grant to ZERO TO THREE to develop the Quality Improvement Center for Research-Based Infant-Toddler Court Teams (QIC-ITCT), which provided technical assistance and training to participating sites. Today, the project is called the Infant-Toddler Court Program and is operated by ZERO TO THREE and partners with funding from the federal Health Resources and Services Administration. SBCTs currently operate in local communities in 27 states. SBCTs have been independently studied, most recently as part of the QIC-ITCT project. Evaluations have identified many benefits of this approach, including the following:

• • Improved safety. More than 99% of infants and toddlers served by SBCTs did not experience maltreatment within the 12-month period following the initial substantiated allegation — a recurrence rate of 0.7%.¹ The Children’s Bureau national standard for recurrence of maltreatment is 9.1%.

• • • • Faster time to permanency. Children served by SBCTs exit foster care significantly faster than comparison groups. In a recent evaluation of QIC-ITCT sites, 92.7% achieved permanency within 12 months, more than double the Children’s Bureau national standard (40.5%).

• • Preserved family relationships. Children are more likely to achieve permanency with a member of their biological family. In the same evaluation of QIC-ITCT sites, 58.5% of the children with closed cases were reunified with their parents and 29.3% were placed with relatives (87.8% combined). Nationally, in the most recent year for which data are available (2017), approximately 66% of children exited foster care to reunification, guardianship, or to live with relatives.

• • Placement stability. At QIC-ITCT sites, 94.2% of children in care for less than 12 months had no more than two placements, compared to the national median of 86%. Additionally, 79.4% of children in care from 12 to 23 months had no more than two placements (vs. the national median of 66%).

• • Increased service delivery. A high percentage of service needs are met for both children and their families. Services commonly provided to SBCT families include developmental, mental health, and substance use screening. Particular emphasis is placed on Child-Parent Psychotherapy (CPP), as 93.9% of children in SBCT sites who needed CPP received this service. This is in contrast to Child and Family Services Reviews showing that 66% of children of all ages in the child welfare system receive needed mental/behavioral health services.

• Cost savings. A cost analysis found that up to two-thirds of the program’s average cost per child could be directly generated from savings to jurisdictions due to children’s shortened stays in foster care. The same study showed that SBCTs were able to leverage substantial in-kind support.
• Racial equity. For several outcomes of the program – placement stability, length of stay in foster care, and receiving services in a timely manner – an evaluation found that children of all races and ethnicities were served equally well.

Core components

Safe Babies Court Team™ sites implement 12 core components in ways that respond to the unique needs and resources of their local communities. Although these components represent the ideal, ZERO TO THREE recognizes that not all core components can be implemented at once, and supports considerable flexibility in adapting them to local communities.

The first two components focus on key team members. Site development typically begins with a judicial leader who is interested in implementing a court team in his or her community. Within their courtrooms, SBCT judges set a standard of dignity and respect for birth parents and keep teams focused on achieving timely permanency. Their leadership off the bench can galvanize an entire community to action. Each team then employs at least one full-time community coordinator, a child development expert who works with judicial leaders to lead SBCTs and coordinate services and resources for infants, toddlers, and their families.

Other core components include a focus on supporting and strengthening the relationship between infants and toddlers and their families, the activation of a community court team focused on the big picture, and the participation of a family team focused on individual family issues. The approach also reflects elements of effective casework practice, such as valuing birth parents, focusing on concurrent planning and limiting placements, viewing foster parents as mentors for the birth family, holding pre-removal conferences and regular family team meetings, having more frequent court hearings to address challenges early and often, and advocating for frequent family time. SBCT communities also must assess and build a continuum of accessible mental health services for families.

The final two core elements focus on ZERO TO THREE’s support for sites. SBCT jurisdictions receive training and technical assistance on topics, such as infant and toddler development, parenting interventions, trauma, and parental substance use. Each site also participates in evaluation activities by entering data into the SBCT database, which offers a dashboard of real-time information, site-by-site and in aggregate, on key indicators to support continuous quality improvement.

Key success factors

ZERO TO THREE staff and sites identify the following as some of the key contributors to success of the SBCT approach:²

• • Full-time, dedicated community coordinator. The community coordinator is the “glue” that holds many community SBCTs together. A full-time, dedicated staff person provides the necessary focus and capacity to bring family and court teams together consistently and sustain progress toward their goals. ZERO TO THREE has found that this role is best served by keeping caseloads small — no more than 20 families per full-time community coordinator.   
  • Seed funding and early sustainability plans. Finding initial funding for an SBCT, particularly a full-time, dedicated community coordinator, is often a challenge. Sites have used different sources to get started, including foundations, Court improvement programs, county and state funds, partnerships with community-based agencies, Title IV-E, the Crime Victims Fund established under the Victims of Crime Act, and hospital conversion funds. Once a site is initially funded, ZERO TO THREE also encourages sites to begin thinking about sustainability right away. By developing early sustainability plans, 10 of 12 of the initial QIC-ITCT sites were able to continue their work when federal funding ended.

• • Knowledge of and focus on infant mental health. Understanding the importance of infant mental health, and the impact of trauma, is a critical building block for the SBCT approach. Community coordinators note that bringing this information to the broader community provides teams with a common language to discuss the experiences of young children, and helps to develop local buy-in.³

• Community engagement. SBCTs are often headed by judicial leaders, but may also be initiated by the child welfare agency or other community leaders. Regardless of the origin, engagement and commitment among a broad group of community stakeholders is essential. When sites encounter resistance — for example, from parents’ attorneys concerned about the impact of concurrent planning on their clients — cross-site connections can help. Facilitating conversations between attorneys or judges and their peers in established SBCT communities has proven to be an effective strategy.
• Parent voice. Parents and parent advocates are critical participants in every SBCT initiative. They are essential members of family teams and community court teams at every site. Many sites also employ parent partners who have experienced the child welfare system to support new families through the process. On a national scale, parent leaders (including birth, foster, and relative caregivers) provide trainings and advise ZERO TO THREE on program design and development.
• Strong data collection and evaluation support. Each SBCT site enters data into a common database and has access to a dashboard of real-time information on 20 key indicators. Sites are encouraged to “know their data story” — what the data say about how well their community supports infants, toddlers, and their families — and assemble a team to collectively interpret the data and establish a vision for how to respond to what is learned.
• Willingness to experiment and innovate. SBCTs are learning labs. The small caseload size enables SBCTs to nimbly test new approaches and solve problems, while robust data and evaluation support from ZERO TO THREE helps sites understand and tell the story of the impacts of those changes. Several sites have been able to achieve policy changes that benefit all children as a result of this pilot approach.

Jurisdictional examples

When former prosecutor Hope Bristol became an Administrative Family Judge in Broward County, Fla., she says she initially brought her “prosecutorial personality to the bench.”⁴ But when she observed the same families repeatedly experience the removal of their children, and youth formerly in care reappearing as young parents with infants in care, she knew that something needed to change. Judge Bristol convened all stakeholders — parents’ attorneys, the foster parent association, the child welfare agency, and other providers — to develop a plan. After six months of careful consideration, the Broward County SBCT was launched in January 2016.

Her courtroom today looks very different than it did prior to SBCT. Changes to the physical space – including a table where everyone sits together at the same level, shelves of stuffed animals and books, a play rug and easels, a resident therapy dog, and plentiful snacks — help to create a child- and family-friendly environment. Hearings are strength-based, and everyone in attendance gets a chance to speak. The resulting changes have not been limited to Judge Bristol’s courtroom. After observing the SBCT’s success, other judges in the dependency division have begun implementing similar approaches to reduce the stressful, adversarial nature of hearings for families. The SBCT caseload has been decreasing overall, in part because the local child protection team is removing fewer children and opting to provide more preventive services to families in the home, whenever possible.

The State of Florida’s Early Childhood Court (ECC) initiative is based on the SBCT approach and its predecessor, the Miami Child Well-Being Model.⁵ Launched in 2014 at three pilot sites, ECC has since expanded to 23 sites across Florida and is the primary focus of the state’s Dependency Court Improvement Panel, a statewide workgroup. One unique element of Florida’s approach is the establishment of a statewide network for local community coordinators, which provides ongoing learning opportunities as well as a critical source of support, as these one-of-a-kind roles can be somewhat isolating and therefore challenging.

The ECC initiative has achieved significant results, particularly in the area of timely permanency. ECC children attained permanency through reunification 8.5 months sooner, and permanent guardianship 7.5 months sooner, than non-ECC children. A recent analysis found improved safety outcomes, as well. Florida’s Dependency Court Improvement Panel recently developed best practice standards that are awaiting approval from the state Supreme Court. More information and resources are available on Florida’s Early Childhood Courts website and the Florida State University Center for Prevention & Early Intervention Policy website.

More information about each of the QIC-ITCT demonstration sites can be found on the Infant-Toddler Court Teams website.

1 ZERO TO THREE. December 2017. The Evaluation is in: The Safe Babies Court Team Approach is Changing Lives. Washington DC.
2 The content in this section is based on interviews with ZERO TO THREE staff: Janie Huddleston, director of the National Infant-Toddler Court program; Patricia Cole, senior director of federal policy; and Darneshia Bell, technical assistance specialist, QIC-ITCT project, on April 1 and April 16, 2019, unless otherwise noted.
3 Interviews with Desiree Caporaso, community coordinator of Safe Baby Court Teams in Milford, Conn., (May 6, 2019); Lisa Maddocks, community coordinator, Circuit 13 Early Childhood Court in Tampa, Fla., (April 24, 2019); and Carrie Toy, Florida Office of the State Courts (April 25, 2019).
4 Content in this section is based on an interview with Broward County Administrative Family Judge Hope Bristol on May 17, 2019.
5 Content in this section is based on an interview with Carrie Toy, Florida Office of the State Courts, on April 25, 2019.