SYNCHRONY Project Targets Foster Care's Youngest At-Risk Children
Within the foster care system, the most vulnerable age group is made up of the youngest wards—children age birth to 5 years who have been abused and neglected. The SYNCHRONY Project’s goal is to identify these young children and provide preventive psychiatric support to both them and their families in order to break a chronic cycle of maltreatment.
“There are known genetic and environmental factors that predispose children to long-term risks for mental health conditions,” says John Constantino, MD, psychiatrist-in-chief at St. Louis Children’s Hospital and lead investigator for the SYNCHRONY Project. “Children in the foster care system typically represent some of the highest-possible accumulations of risk factors for psychopathology. The longer you wait to provide preventive treatment, the more of the brain has developed and the less likely it is that you will be able to offset those risks and change the long-term outcomes for these children.”
Funded by a grant from the Children’s Service Fund of St. Louis County, the SYNCHRONY Project is a collaborative effort among Washington University, the St. Louis County Family Court and the Children’s Division of the Missouri Department of Social Services. Washington University psychiatrists, psychologists and child psychiatry fellows conduct a minimum of two, two-hour sessions that include participation by the physical custodian/foster parent, biological parent(s), other related family members, Children’s Division worker and Family Court representatives. The evaluation includes direct observation of the parent/child relationship and the goal is to determine the minimum array of supports necessary to ensure safety, to allow the child to thrive and grow emotionally, and to prepare parents to manage children’s care on a daily basis.
Once the assessments are completed, the SYNCHRONY Project teams make their recommendations to the court. These may range from medical confirmation that the home situation remains very high risk to recommending a strategy for reunification of the child and his/her parents. Each strategy attempts to capitalize on the family’s strengths and encompasses specific social, medical, therapeutic or interventional supports to aid children’s emotional and cognitive development. Goals for the children are always established and a follow-up plan devised regarding their developmental progress and the ability of the families to provide adequate support and appropriate interaction with the child. If the goals aren’t met, the intervention plan can be revised, in concert with the court and the Children’s Division.
“Unfortunately, the case loads of child welfare workers and deputy juvenile officers are so high that it’s often difficult for them to acquire and synthesize all the information that can be assembled in an in-depth clinical evaluation,” says Dr. Constantino. “Within the community, it’s often difficult to secure consultation from clinical experts who have a special interest in infancy and early childhood. We can provide both through this project.”
Another aspect of the project is the availability to families of an intense, group-based parent education program developed by Washington University psychiatrists over the past 20 years. The program combines hands-on “experiential” education with evidence-based methods for training parents to promote the social and emotional health of their young children.
In the future, Dr. Constantino hopes to expand the SYNCHRONY Project to include young children living with their families who have been reported for abuse and neglect but for whom investigations did not yield clear evidence substantiating the allegations.
“These children have almost as high a likelihood for developing serious adverse outcomes as those whose cases are substantiated,” he says. “In some ways they are less protected than the children under court jurisdiction because there is no ongoing surveillance. We want to direct them to the resources that will help support the families and prevent recurrence of severe adverse life events.”
Physicians wishing to inquire about the SYNCHRONY Project may contact the Division of Child Psychiatry at 314.747.6772 or Children’s Direct at 800.678.4357. Current eligibility criteria are children age birth to 5 years entering, placed or transitioning out of foster care in St. Louis County who have unmet needs for mental health services and/or whose parents would benefit from the type of intensive parent training offered by the program.
To learn more about all the services available to the children of St. Louis County and supported by the Children’s Service Fund, visit http://keepingkidsfirst.org/.
