Judges are using brain science to help babies caught in the court system

Ada Calhoun’s reporting was undertaken as a project for the Fund for Journalism on Child Well-Being and the 2015 National Health Journalism Fellowship, programs of the USC Annenberg School of Journalism. 

No one is happy to end up in family court. But the new Miami-Dade County Children’s Courthouse is surprisingly soothing. Light streams through multicolored windows, and children can climb on a bear statue in the building’s atrium.

A peaceful atmosphere also prevails in the courtroom of Judge Cindy Lederman, where the focus is on reducing trauma for young children caught up in the legal system. On a summer morning in Miami earlier this year, Lederman greeted a man looking to regain custody of his toddler daughter. She seemed to know the father and child well—unusual in often-overloaded family courts. The courtroom was also uncommonly crowded. A court coordinator and a psychotherapist were present, along with the usual teams of lawyers and child welfare workers.

The therapist testified that the father and daughter were making progress, and that the child’s anxiety was decreasing. Judge Lederman questioned the father. Other experts weighed in. It was clear the judge liked what she heard.

“You and I have had long talks about this,” Judge Lederman told the father at last. She suggested he would get custody back sooner rather than later. “This little girl needs more than a good father—she needs a great father.”

“Yes, Judge,” he said. He walked out smiling.

A system in crisis

In 2005, Lederman became the first judge to try out a new model of family courts called baby courts—designed to meet the needs of children between the ages of zero and three. There are now more than 30 baby courts across the country. If Lederman has her way, a lot more will soon look like hers.

Proponents of baby courts argue that the traditional system is in crisis. They say the law is in some ways too quick to intervene with parents accused of neglect and abuse—as when child welfare workers make emergency removals of children. Yet at the same time, they say, the legal system gives families too little attention—for example, by failing to provide them with services tailored to their problems.

Judges may try to keep children safe by assigning parents to drug treatment or classes in parenting and anger management. But critics argue this often sets parents up to fail. Many parents charged with neglect don’t have much money and have trouble managing their time and planning ahead. In order to attend classes, they may have to miss work or navigate other logistical hurdles, exacerbating the problems that landed them in court in the first place. Yet they can lose custody if they fail to comply with judges’ orders.

Traditional family-court judges may also make decisions without a complete picture of a child’s situation. Parents’ lawyers may withhold or spin information to protect their clients. And a judge might encounter a family only every three to six months.

All this makes for a fraught process for children in the court system. Children can be reunited with their parents only to be taken away from them again, creating instability that produces even more trauma. And the foster care system frequently shuffles children from one home to another, making it even more difficult for them to feel secure.

By contrast, baby courts treat parents and their children as a unit. They generally employ a court coordinator to analyze the specific needs of each family rather than relying on one-size-fits-all prescriptions. Children frequently go to psychotherapy with their parents and attend early-childhood education programs that aim to prepare them for kindergarten.

Judges informed by the latest research on childhood trauma encourage lawyers, therapists, court coordinators, and child representatives to sort out steps toward reuniting families in monthly meetings outside of court, instead of battling things out during infrequent hearings. Everyone is expected to share the common goal of keeping the child safe—and, if at all possible, bringing the family back together.

“In an overworked court system, you can’t always tell right away what you’re looking at,” says Cris Beam, author of "To the End of June: The Intimate Life of American Foster Care." "So anytime a system a can look at what is really going on here — What supports can we put in place? How can we help the whole family, not just the child? — the better."

The courtroom conductor

There’s an intense energy to Judge Lederman’s courtroom, as lawyers, therapists, and child welfare workers gather to publicly discuss the fate of tiny babies.

“I’m really involved,” says Lederman. “I’m not an umpire, just calling balls and strikes. I’m more like an orchestra conductor.” She often intervenes on families’ behalf. If she hears in court that a child is being bullied at a homeless shelter, she’ll call the shelter to ask how workers plan to put a stop to it.

Lederman asks parents what they’re learning in parenting classes, making it clear that she’s looking for more than a simple course certificate. “I know she went to services,” she says. “I want to know what she learned.”

Experience has taught her to spot less obvious signs of abuse and neglect. Lederman describes meeting an eight-month-old who pulled her own eyebrows out, a one-year-old who wouldn’t make eye contact, an abandoned little girl who yelled out in court, “How is my mommy?” (“Wherever she is, she loves you,” Lederman told the girl.)

“Once a four-year-old who had just entered the courtroom ran up and hugged me,” says Lederman. “I used to think that was sweet. No. It means she has no attachment.”

“I just want to be different than my parents were”

Baby courts rely on attachment theory and new information about child brain development. Many therapists who work with families in baby courts use a tool called the ACE scale to assess patients. The term comes from the CDC-Kaiser Adverse Childhood Experiences Study, an influential 1998 public-health study on trauma. Respondents answer simple questions about whether they’ve had experiences like sexual abuse or having an alcoholic parent.

The 1998 study showed a surprising connection between high ACE scores and a host of psychological, social, and physical problems. People with an ACE score of 4 or more are 390% more likely to have chronic pulmonary lung disease and 1,220% more likely to commit suicide.

When baby court therapists work with clients, they might observe that a mother’s high ACE score could be connected to her parenting difficulties. This helps them pinpoint the right services to stabilize the family, such as therapy, job placement, or visiting nurses.

Toxic stress in childhood can make it hard for people to attach throughout life—and, some argue, to become good parents themselves later on. That cycle can keep the same families in the system generation after generation, according to therapists.

“That’s the importance of inter-generational work,” says Brooke Allman Bubbico, a therapist at the Rose F. Kennedy Children’s Evaluation and Rehabilitation Center at Montefiore. Bubbico is among the service providers receiving referrals from the fledgling Baby Court in the Bronx. “We ask: ‘What did you go through? How can you do it differently?’ No parent wants to hurt or neglect their child. Even the ones who do it don’t want to.”

Even if judges in a baby court ultimately terminate parental rights, they may order therapy for parent and child to heal the relationship, or encourage the father or mother to stay involved.

“Almost every parent we see says, ‘I just want to be different than my parents were,’” says Dr. Anne Murphy, clinical director of the Kennedy center.

So far, baby courts around the country have posted promising results. A 2009 independent evaluation of one baby court found that only 0.5% of 186 children who went through baby courts had a subsequent maltreatment report in the following six months. The University of Miami Linda Ray Intervention Center, which takes therapy referrals for baby court cases, says that 60% of young children who went through its program for developmentally delayed and mistreated young people over the course of five years were able to leave special-education classes and qualify for regular school.

A 2012 paper published in the Children and Youth Services Review found that children served by baby courts wound up in a permanent home within an average of one year—twice as fast as a control group. Reunification rates for children who go through baby courts also appear to be higher. Solid numbers are hard to come by, but various trauma-informed courts, including this one in California, claim that children return to their parents in an average 75% of cases. The national average is closer to half.

Experts say that it’s generally in a child’s long-term best interest for babies to stay with their parents. And baby courts are designed with young children’s emotional development in mind.

“We’re like a broken record,” says Susan Chinitz, an infant mental health consultant to the Center for Court Innovation, which is implementing the Strong Starts Court Initiative baby court in the Bronx: “Through the eyes of the babyJudge Sarah Cooper, who recently started hearing cases as part of the Strong Starts project, says she’s optimistic about its potential.

“I don’t want to keep doing the same thing we’ve been doing,” Cooper says. “This can be a really sad place. Once a month we do adoptions, with balloons and candy, but the rest of the month we’re ripping children from parents’ arms and it’s terrible. If there’s any chance this new way of doing things—with greater court oversight and more tailored service plans—will make things better, I have to try it.”

The case for old-fashioned courts

Not everyone is a believer in baby courts. Some defense attorneys argue that moving away from adversarial proceedings give too much weight to the word of experts with their own preconceptions and agendas.

“The family needs all the protections built into the traditional legal system, not some loosey-goosey guesswork based on hunches and intuition,” says Matthew Fraidin, a University of the District of Columbia law professor. A good defense attorney, lawyers argue, can contextualize the case for the court and get neglect or abuse charges dismissed, avoiding time-consuming and unnecessary interventions.

“In a system which entangles only low-income people and primarily people of color, and which operates in secret,” Fraidin says, “the only way we can hope justice will be achieved is the old-fashioned way: robust presentations of evidence by both sides and a decision by a neutral arbiterLederman disagrees. While she recognizes that defense attorneys have a duty to attempt to keep their clients out of court, she argues that families may be better served by more involvement with the legal system, not less. “That’s the philosophy of a public defender: that it’s all about liberty,” she says. “It isn’t about ethics, or learning what life is about, or changing behavior.”

Through the eyes of the child

To illustrate the insidious effects of neglect, Lederman likes to show a video called the “Still Face Experiment.”

“The way a baby’s brain develops is through socializing: baby coos, mom coos back, baby’s brain makes connections. It’s called “serve and return,” Lederman explains.

In the video, the mother first plays with her baby and then stops responding to the child. The baby starts squirming and crying, waving her arms in front of the mother’s face. When babies live with people who don’t respond to them, their brains can actually develop differently from those who are nurtured, making it harder for them to form strong social bonds or even do basic things like keep track of time.

Lederman says the video offers visual proof that babies are social and need stimulation—and that emotional neglect can cause just as much damage as physical abuse. She tries to help the parents who appear in her courtroom understand this perspective, routinely asking them to see their actions through their children’s eyes. “How do you think your baby feels,” she asks, “when you miss a scheduled visit?”

Some parents resist Lederman’s tactics, arguing that she goes far. One parent accused of beating her baby girlsued Judge Lederman this summer, saying her civil rights had been violated. (The case was dismissed in September.)

But other parents feel that baby courts offer a welcome antidote to an often-impersonal court system. One young mother of two, who asked not to be named because she has an open neglect case, says the Bronx family court already feels kinder to her.

“The last hearing I had, the judge said to me, ‘People in this room believe in you,’” she says. “He listed all the things I’d done right, and he said, ‘You’ve made it this far. We want to see you succeed.’ I actually came out of court smiling. That had certainly never happened before.”

[This story was orginially published by Quartz.]