Behind Closed Doors – A Story of Neglect, Study notes of Public Health

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INVESTIGATIVE TEAM

Child, Youth and Senior Advocate

Norman J. Bossé, QC

Lead Investigator

Wendy Cartwright

Contributors

Gavin Kotze Mélanie Leblanc Marcelle Woods

Legal Counsel

Christian Whalen

Reviewers

Hélène Albert, Robert Eckstein, Dr. Sarah Gander

Communications

Heidi Cyr

Cover Art

Kyle Peters Published by: New Brunswick Child and Youth Advocate Government of New Brunswick P.O. Box 6000 Fredericton, NB E3B 5H Canada January 2019 ISBN 978-1-4605-1985-1 (Bilingual print edition) ISBN 978-1-4605-1986-8 (English version online) ISBN 978-1-4605-1987-5 (French version online)

Adequate Protection?.................................................................... 24

• Issue 2: A) Did Family Enhancement Services effectively address the negative consequences of chronic neglect the children were exposed to?............................... 24 B) After the file transfer to Child Protection Services, was there continuity of care with an increased use of authority for the children who were victims of severe and chronic neglect?............................................................ 24 - Findings................................................................................. 26 - Recommendation 2........................................................................ 26 Quality Control.......................................................................... 27
• Issue 3: Did the Department Meet Its Own Practice Standards to Protect the Children?.............. 27
• Table 1: Practice Standard Violations..................................................... 29 _- Findings................................................................................. 30
• Recommendation 3........................................................................ 30_ Getting Past the Door.................................................................... 31
• Issue 4: Evasion of appointments – Was every possible effort made by the social workers to see the children?........................................................... 31 _- Findings................................................................................. 34
• Recommendation 4........................................................................ 34_ The Children Today...................................................................... 35

Appendices............................................................ 36

A) The Office of the Child and Youth Advocate................................................ 36 B) Review Process..................................................................... 36 C) Multiple Response Standards in Child Protection and Family Enhancement Services (2011)...................................................................... 37 D) Family Services Act Section 31(1)....................................................... 38 E) Glossary of terms................................................................... 39 Behind Closed Doors ii^ A Story of Neglect

FOREWORD

Pursuant to my authority, as set out in the Child, Youth and Senior Advocate Act (CYSAA) , I am providing this investigative review and report concerning a serious case of child neglect of five young children whose parents were charged with failing to provide the necessaries of life, in contravention of Section 215(2)(a)(ii) of the Criminal Code of Canada. Both mother and father were sentenced to a period of two years imprisonment and the children were placed in foster care. It should be stressed that while this is a public report, it does contain detailed information about these children and those who cared for them. Although we have taken great care to protect the privacy of the children and their caretakers, we cannot guarantee that interested parties will not be able to identify them or others charged to care for them. The identities of the children and those others who care for them or provided services were anonymized. Nevertheless, I would request that readers and interested parties, including the media, respect their privacy and not focus on identifying individuals and locations involved in the matter. This investigation and report was not prepared in an attempt to find fault or to assign blame, but rather it is written as a testament to what happened and ultimately to indicate failing or gaps in a very complex child welfare system in New Brunswick. Many hours have been dedicated to this effort by my staff in an effort to record the tragic disintegration of this particular family. In hopes of providing a pathway to identifying the gaps in the system, recommendations are offered in an effort to move the system and its administrators in a positive direction to bring about changes for the benefit of all children living behind closed doors. When children are receiving child protection services, there is an expectation that they will be safe and protected. I trust that this report and the recommendations which emerge from it will improve the safety of all vulnerable children under the protection of our child welfare system. Finally, I hope and trust that the young children who are the subject of this review, investigation and report will not be further traumatized when they are finally able to read and appreciate these findings and recommendations. Norman J. Bossé, Q.C. Child, Youth and Senior Advocate Province of New Brunswick “Sometimes the strongest among us are the ones who love beyond all faults, who smile through silent pain, cry behind closed doors and fight battles nobody knows about.” Author Unknown Behind Closed Doors

Recommendation 2:

That the Department of Social Development address chronic neglect seriously and adequately to protect children by:

• ensuring that the Structured Decision Making®^ (SDM®) pathway assignment of either Family Enhancement Services (FES) or Child Protection (CP) is appropriate for the needs of the family and that the family’s history with the Department of Social Development is considered in relation to the pathway assignment.
• ensuring that transition to Child Protection from Family Enhancement Services results in an increased use of authority.

Recommendation 3:

That the Department of Social Development:

• undertake a review of workloads to ensure that social workers have the time necessary to manage their caseloads effectively.
• have mechanisms in place to ensure that Child Protection workers receive all core training before taking on a caseload.
• develop a quality assurance policy to require regional offices to forward cases in which practice standards are known to have been unmet to the Department for review and recommendation by clinical reviewers.
• make statistics from the Clinical Auditing Team available to the public.

Recommendation 4:

That the Department of Social Development take immediate steps to ensure that all Child Protection and Family Enhancement Services social workers understand the legislative authority allowing them to enter any premises to remove a child whose security or development may reasonably be believed to be in danger. Additionally, and equally importantly, that the Department of Social Development review its governing legislation, the Family Services Act , to ensure that the Act’s provisions are in accordance with the findings of the Supreme Court of Canada in the case of K.L.W.; the wording in the Act should not require an unduly high threshold in regard to the need to ascertain the serious and imminent danger to the security or development of the child before entering premises. Behind Closed Doors

Behind Closed Doors –

A Story of Neglect

On May 17, 2016, what was intended to be a routine eviction in Saint John, turned into something far more shocking than anyone could have foreseen or imagined. Four Sheriff’s officers arrived at a house to execute an eviction that day. As they entered, a pungent and overwhelming stench of human and animal waste pervaded the air around them. Soon after, the severity of the situation became even more apparent from the scene that lay before their eyes. It alarmed the officers so much so that they immediately contacted Child Protection and the Police Force for assistance. Likely most alarming, was the human and animal excrement that was widespread throughout the house… on the floors, walls, furniture, and even the ceiling. In the bathroom, feces covered the counter, bathtub and toilet. No toilet paper could be found. On some walls, children had smeared feces and stamped their tiny handprints everywhere. Nothing was untouched by this waste; it was also caked on several teddy bears lying in a pile in front of the toilet. A visual scan of the house revealed that much destruction had come to pass under this roof. Broken furniture was found in most rooms and many of the walls were punctured with holes the sizes of big and little fists. On the floors, finding an unobstructed path proved challenging as in addition to the feces, dirty clothes were strewn everywhere, unhinged doors lay about, fleas were spotted in different areas, and puddles of purple paint covered many areas. In the kitchen, the only food consisted of a rotting turnip, a single cabbage, three boxes of Kraft Dinner, a package of Lipton's Sidekicks and several condiments. Cigarette butts covered the windowsills and a bong along with two pipes was observed. Amidst this squalor, were five young children, some hiding and all in various states of undress and filth. They were accompanied by their young mother, Melissa, who was paralyzed by the shock of being discovered. A dog and two cats were also present. Nathan (8 ½), Meghan (6), Adam (3 ½), Jacob (2) and Hannah (6 months) were thin, pale, small in stature, and did not speak. Some children had sores around their eyes and all had feces encrusted on their faces and bodies. Nathan eventually came out from his hiding spot behind the couch. His hair was shaved into a mohawk and dyed with red paint made to look like blood. He wore no pants, but had on a Ninja Turtle shell and began running around uncontrollably, swinging his nunchucks. These were constructed of what appeared to be pieces of an old shower rod with jagged edges. Later, Nathan would disclose that he wore this costume to, "protect my family from the bad guys who are after us." At one point, Nathan attempted to jump out a window but was caught by an officer who grabbed his arm in time. The baby, Hannah, appeared very lethargic and slow to respond. Although six months old, her size and development were later described by one of the police officers as more like that of a one-month-old. Behind Closed Doors

Department came at age fourteen, when a Child Protection file opened on the report that a family member allegedly attempted to sexually molest her. A few years later, now in a relationship with Rick, Melissa became pregnant and delivered her oldest child, Nathan, about one month before her 17th birthday. Being a pregnant teenager, Melissa was followed closely by a Public Health Nurse to support her in having a healthy pregnancy. About one month before Nathan was born, this nurse phoned to make a referral to Child Protection as Melissa was not following through with her appointments and was using marijuana. The call was recorded as a general information call and did not warrant an investigation. The day after Nathan's birth, another Public Health Nurse made a referral to the Department, concerned about the young age of his parents who continued to use marijuana, and their inability to care for a newborn. Because hospital staff did not indicate any concerns with Nathan’s care and because Public Health would be supporting the family, the information provided did not warrant investigation and was screened out. A Family on the Move

(May 2013-Aug 2013)

Despite several other referrals made to the Department from different sources, a file did not officially open for the family until five-year-old Nathan disclosed to his kindergarten teacher that his father gave his mother a black eye. The teacher, along with a vice-principal, phoned the Department to relay this information alongside other concerns, including Nathan smelling of marijuana and his frequent absences. School staff described Nathan as a sickly and pale child with a hesitant voice who often spoke in a babyish tone and who never smiled. His appearance was often unkempt and his clothes ill fitting. The school would regularly supplement Nathan's lunch with extra food and provide nutritious snacks to curb his hunger. During the winter months, Nathan was frequently given warm clothes to wear as those from home were inadequate in the colder weather. Most notably, Nathan was a boy who was exhausted much of the time. On many occasions, his teacher would catch him sleeping while sitting cross-legged on the floor during morning circle. Often, he would be sent to the nurse's office to nap and would need to be awakened for lunch. Nathan's explanation for this fatigue was that he regularly stayed up all night watching scary movies on television. Other troubling observations from school staff were Nathan's underdeveloped social skills and his teeth that appeared to be rotting. His parents were extremely difficult to reach to discuss these matters as they never returned calls, communicated via his agenda book, nor attended parent-teacher interviews. Fortunately, the referral about Melissa's black eye met the criteria to open a file under Family Enhancement Services, a collaborative approach under the Child Protection program aimed at engaging the family in restoring and maintaining the child's security and development. As mentioned previously, the FES social worker assigned to work with Melissa was her former school social worker, Jodi, and as such, was familiar with the challenges faced by Melissa as a youth. Jodi worked with Melissa and her three children, Nathan, Meghan and Adam for a period of just over one month before they were evicted because of disagreements with the landlord. During this time, Jodi referred Nathan to Early Intervention, a program to support families with children at risk of having developmental delays. The assigned worker, however, mentioned having difficulty reaching Melissa to begin the Behind Closed Doors

appointments. Jodi also tried, unsuccessfully, to secure a New Brunswick Housing (N.B. Housing) home for the family, as Melissa was in constant conflict with her neighbours. During the short period of Jodi's involvement, Social Development received several referrals from neighbours to alert them about the poor supervision of the children outside of the home, including three-year-old Meghan toddling onto busy roads. Like the school, however, Jodi also had trouble meeting with Melissa, who was often not at home for their scheduled visits or would have countless excuses such as having the dates confused. Jodi would later acknowledge that perhaps she should have doubted Melissa's truthfulness, that, "She was getting away with telling stories; she knew what to say." In hindsight, Jodi realized that she should have seen the family more often, but she was often caught up in the paperwork that accompanied her everyday work. Jodi's supervisor reported at times having to urge Jodi to go out to see the family. No one was home when Jodi arrived at the house for a scheduled visit in late August of 2013. Later, Melissa left a voicemail message saying that they had been evicted. Several weeks afterwards, the landlord wrote to Income Assistance to complain of the condition that Melissa left the house in with dirty diapers everywhere, colouring on the walls, and a clogged toilet. He also shared that he was concerned for the safety of the children. This information was passed on to Jodi by the Income Assistance worker.

(Sept 2013-Jan 2014)

The family's move required a case transfer from Jodi to Leslie, who worked as an FES social worker in a different region. The two women visited the family in their new home approximately one month after the eviction from the previous house, but already, there was a detectable odour of feces which Melissa blamed on the dog. During this visit, a range of issues was discussed such as: the family's isolation in this smaller village, Melissa not having a driver's license, there being little family support with Melissa's mother farther away and Rick living in Saint John for work. Although closer now to Rick's family, Melissa expressed that she did not find his mother to be very helpful. The matter of the children's rotting teeth was also addressed and Melissa agreed to make the necessary dental appointments. After consulting with her supervisor, Leslie added several items to the family's case plan including: guidance with budgeting, transportation to various appointments and hiring a parent-aide to help once per week with setting routines. At the following home visit, approximately one and a half months later, Leslie and a social work student smelled marijuana which Melissa denied using. At this point, Nathan had been seen once by the Early Intervention worker, and a referral for speech therapy was in place for him at school. Still outstanding, though, were the children's dental appointments. During this visit, Melissa informed Leslie that they had secured an N.B. Housing unit and were moving back to their previous town in January. In the following month, Nathan's school made two referrals to the Department as he was consistently sleeping in class, and had disclosed that sometimes he and his three-year-old sister, Meghan, were left at home, alone. Leslie addressed these concerns with Melissa who denied leaving her children unsupervised. The recently assigned parent-aide was only able to see the family once, during her introductory visit with Leslie, as Melissa cancelled the following visits. In early January 2014, Leslie spoke with Jodi, the family's former social worker, to notify her of the family's upcoming return. Jodi had been seconded to a different position and therefore Amanda, another social worker on the team, would be assigned to work with them. Leslie visited the family shortly after they settled into their Behind Closed Doors

Eventually, the Department decided to investigate a referral from the school's vice-principal who called to report that Nathan's hand hurt from being pulled out of bed by his father. Around this time, Nathan began missing many days of school. The family's first FES social worker, Jodi, had returned to her original position from her secondment and was re-assigned to work with the family. During her time on the file, five new referrals came in from Melissa's neighbours about the children playing unsupervised outside, near busy roads and late at night. In addition, another parent had reported seeing Nathan outside trying to poke other children with butter knives, although this incident did not warrant the Department's investigation. On an unannounced visit at the end of May, Jodi discovered that the house appeared empty as the family had moved after being evicted from their N.B. Housing home. The family owed over $2000 in rent and had caused $6000 in damages to the property. Photos shared by N.B. Housing depicted much of the house in ruins with dog excrement throughout. Jodi, who recently learned that Melissa was pregnant with her fifth child, expressed deep concern for the children during an FES case transfer meeting with Leslie, who would again be working on the file because of the family's move to a house within her region.

(June 2015-Sept 2015)

In early June, both Jodi and Leslie visited the family in their new home. Melissa was alone with the four children as Rick only came home every other weekend. During this visit, the social workers made several disturbing observations. Jacob, now fifteen months old, spent the entire visit gated in his bedroom with no interaction from Melissa. In addition, Nathan (almost 8) and Meghan (5) were not yet registered for the upcoming school year, and none of the children had been seen by a dentist, contradicting what Melissa had told Amanda a year prior. Leslie noted that the household appeared to be in a constant state of mayhem, a noticeable contrast from her previous involvement one and a half years ago. While determining what services and supports to put in place, Leslie discovered that Early Intervention involvement had ended that January because Melissa was never home. This individual shared with Leslie that she was concerned about all the children so Leslie put in another referral for Early Intervention once she received Melissa's consent. During her carriage of the file, Leslie was notified of two new referrals. The first coming from the RCMP regarding complaints from neighbours that Nathan was intimidating children outside with a tent pole, and the second from a parent in the community who regularly spotted Nathan and Meghan playing at the ball diamond for hours, unsupervised. Due to these new referrals, Leslie presented Melissa with three choices at the following home visit: a parent-aide, Family Group Conference, or Permanency Planning Committee. At the following home visit to discuss the three options, Leslie found marijuana cigarette butts within the children's reach. When she spoke about the risks of the children having access to these, Melissa informed her that the family was moving to Saint John.

(October 2015-May 2016)

In early October, Leslie travelled to Saint John to transfer the file to Tom, an FES social worker, in a meeting with both Melissa and Rick in their new home. The next meeting was cancelled by Melissa and rescheduled for late October. Emily, another FES social worker newly assigned to the case, arrived at the house for this visit. After knocking for several minutes, no one answered the door, prompting Emily to leave Melissa a note to call her. Two days later, Emily met with Melissa and her children in their home for the first time. In a short period, she observed that the family struggled in several areas. Overall, the house was in a state of chaos with the Behind Closed Doors

children running about, beyond Melissa's control. The younger ones wore only diapers and were visibly filthy. Prior to this visit, Nathan’s school made a referral about his fighting with classmates who teased him because he smelled of urine. Melissa agreed to work with Emily to make a case plan, identifying goals that supported the family's various needs. At Emily's subsequent visit one week later to sign this plan, the situation she witnessed presented many grave concerns and several safety hazards. Before her eyes, Emily saw one child almost fall out of a window as it was open and did not have a screen. Fortunately, she caught him in time. While surveying the rest of the house, Emily remarked at how unclean it was and came across holes in walls, dangerous roofing tools within the children's reach, cigarette butts everywhere and beds without sheets. All the children were very dirty and in need of a bath. Melissa placed Adam (3) in the bathtub, but then left him unattended, seemingly unaware of the risk this posed. Later, Emily discovered that Melissa could deliver her baby at any point, but had no obvious preparations for a newborn, including a crib. The next day, Emily consulted with her supervisor, Kevin, about the alarming circumstances surrounding the family and they decided to hire a family support worker (FSW) to work with Melissa on proper supervision, setting routines, and providing a safe environment for her young children. That same day, Emily and Kevin made an unannounced visit to the family home. This angered Melissa, who was obviously annoyed at the surprise visit. Emily and Kevin discussed transferring the file to Child Protection because of all the concerns presented and Melissa's unwillingness to cooperate with the case plan. In the end, Melissa finally agreed to have an FSW in her home. Later that day, Emily contacted the hospital to alert them of Melissa's impending delivery and requested that they notify the Department when she was admitted. When Family Support Worker (FSW) Elaine arrived for her first visit with the family the following weekend, no one was home prompting her to call the Department's After-Hours Emergency Social Services (AHESS) who directed her to try again tomorrow. The following day, Elaine went to the family home again, but still no one was home. AHESS advised that she try later that evening. Melissa and the children were at home when Deborah, another FSW, went to the home that evening. During this visit, Deborah watched as Melissa placed two of her children in the bathtub and closed the door, leaving them unsupervised. When she told Melissa this was unsafe, Melissa flew into a rage and yelled, causing Deborah to leave. After speaking with her supervisor who told her to stay and help with the nighttime routine until the children were in bed, Deborah returned to the house. Melissa was again verbally hostile, so she left for the final time. After that, Janet, a different FSW, went to the house and encountered the same issues with Melissa who aggressively yelled at her, too. Janet left the house and spoke with her supervisor who then told AHESS that she would not have her support workers subjected to Melissa's belligerent behaviour. On November 10th, the family's file officially transferred from Family Enhancement Services (FES) to Child Protection (CP). On this same day, Melissa was admitted to the hospital to deliver Hannah, her fifth child. Hannah was born prematurely at 35 weeks’ gestation and had significant feeding issues. As such, she was kept in the Neonatal Intensive Care Unit (NICU) for two weeks to support her healthy development and ensure she was feeding and breathing properly. As requested, the Department was notified of her birth. Because Emily was away on vacation, the family's file was tasked to FES social worker, Robin, to oversee during Emily's absence. At Robin's first home visit one week following Hannah's birth, she noted that the children were quite soiled with dirt and grime all over their bodies. Melissa prepared them for a bath but neglected to clean Jacob after removing Behind Closed Doors

One teacher noted that Nathan and Meghan both seemed to arrive at school in a state of "confusion and shock." Each day, Meghan took about one hour to warm up before talking. In this first hour, she always seemed cold, her body visibly shaking. By January, Nathan still wasn't familiar with the location of classroom supplies, routines, students' names nor that of his teacher. Over the course of the year, school staff would make many disturbing observations about the children. As well, through various remarks made by Nathan and Meghan, the staff would learn alarming details about their lives. Unintentionally, the siblings divulged that they ate only once daily, bills weren't paid, Melissa could not afford taxis, and that drugs were purchased and used at home. Because of the family's financial stress, Nathan told an educational assistant (EA) that he worked at the garage beside his house, earning $100 per week to clean. He also detailed a time when Melissa slept all weekend, leaving him to drink seven beers because there was little else in the fridge. On many occasions, the school made referrals to Social Development, however, as remarked by one individual, "We had a sense that Social Development didn't care; they never told us what they did with the information we sent and we don't trust that they did anything." The school principal, with twenty years of experience in the field of education, stated, "They were definitely a red flag family, in my top two families of concern over the years." Others were concerned, too In addition to issues raised by the school, a constable of the local police department in the town the family had moved from notified Social Development of a complaint from Melissa's previous landlord who claimed the family had left the house in a horrific state with feces found throughout. The family's doctor office also phoned Sharon twice to inform her that Melissa had missed Hannah's one-month, two-month, and four-month Well-Baby appointments. On the second call, a detailed voicemail was left saying that Hannah’s medical care with this doctor would cease if Melissa continued to miss more appointments. As well, Sharon was contacted by Melissa's income assistance worker who told her that the family was facing eviction and the landlord was concerned for the children's safety. This worker was alarmed by Melissa wearing slippers to her last appointment in February, and that she regularly spent $450 per month on taxis to send the children to and from school. No one is seeing the children For a variety of reasons, Sharon faced many obstacles in seeing the family and as a result, did not meet the Department's contact standards. The Risk Assessment done on the family placed them at a High Risk, requiring Sharon to have three face-to-face contacts per month with Melissa and her children. The contact standards also dictate that for a high-risk family, the social worker must make three collateral contacts each month. Not including the two visits where the case was transferred from Robin to Sharon, and then from Sharon to Alex, Sharon was only successful in seeing the family twice in seven tries. Whether the visits were scheduled or unannounced seemed to make no difference. The outcome was the same each time with Sharon knocking on Melissa's door to no avail. When no one answered, Sharon would leave Melissa a note asking her to phone to reschedule their appointment. On one of Sharon's attempts to visit, she could hear Rick inside the house with the children, however, Melissa had left a note for her saying that she was visiting her ill mother and Rick did not wish to meet with Sharon without her (Melissa). Sharon did not insist on going forward with the visit regardless. Behind Closed Doors

A range of factors prevented Sharon from meeting with the family, however, many related to her workload. At the time, her team, normally consisting of four social workers and one supervisor, was reduced by half. Her caseload included nine families of multiple children with very complex and high needs, and one with an out of control teenager whom she said took up "a lion's share" of her time. Looking back, Sharon's supervisor, Lauren, reflected that Melissa's file could have benefitted from more attention, but the reality was they gave it the time they were able to, as they were in "putting out fires mode with the other families." Melissa always seemed to have an excuse for missing their scheduled visits. Moreover, she was not receptive to CP services, so none were put in place. When later asked about meeting Departmental contact standards, Sharon acknowledged, "Other work priorities make it almost impossible to meet this standard." In fact, Sharon admitted she was so busy that her file notes were neither complete nor up to date. To redistribute the team's workload, the family's file transferred to newly hired CP social worker, Alex, four months after Sharon received it from FES. Unbeknownst to Alex, his first visit with the family alongside Sharon in late March 2016 would be only one of two encounters with them. The second of the two would fall on the day the family was evicted from their home on May 17, 2016. Like Sharon, Alex experienced significant challenges in seeing the family despite many endeavours to do so. In the almost two months that Alex managed this file, he tried but failed to see the family a total of eleven times, with eight unsuccessful unannounced visits and three unsuccessful announced visits. Melissa would constantly cancel their scheduled visits and ‘forget' the rescheduled ones, or offer an excuse about having confused the dates. Her landlord who worked at the garage next door, rarely saw the family leave the house so it was likely that Melissa managed to evade Alex's attempts at contact simply by not answering the door. All through Alex's involvement, referrals were made to the Department regarding the safety and welfare of the children. The first was a call from a City Police Officer because Nathan was found lingering alone outside a restaurant in the city and subsequently returned home. Shortly after that, Meghan's teacher phoned Alex directly to let him know that both Meghan and Nathan had missed about half of their school year, that they were often tardy, took taxis to and from school and that they would not pass their grades. She also discovered a burn on Meghan's cheek from playing with a hot spatula. Next came a referral from Medicare to alert Alex about the children's health insurance coverage having been expired for the past two years with no response from Melissa when Medicare tried to contact her. When Alex failed to see the family at home, he tried to visit the children at school, without success as they were never there. About two weeks before the family's eviction, Melissa contacted the Department to tell them she was being evicted in three days. She also contacted her previous social workers, Jodi and Leslie, asking desperately if they knew of NB Housing availability in their respective districts. In a panic, she told them that she did not have money for rent, bills, or taxis and that Rick wasn't living with or supporting them. She also confessed that she had no place to go with her five children after eviction. Both social workers contacted Alex to apprise him of Melissa's upsetting situation. After receiving this news, Alex spoke with Melissa and planned for her to phone her landlord requesting to stay at the house longer. He then consulted with his supervisor and decided to refer Melissa to Fresh Start SJ Services for women facing eviction. He also planned to hire a human services counsellor to help Melissa find a place to live. On this same day, Alex visited the home, but again there was no answer. Behind Closed Doors

That first night in foster care, Meghan, devastated by the day’s earlier events, cried herself to sleep while Betty rubbed her back. For the first two months, she never left Nathan's side, even waiting outside the bathroom door for him. Unlike Nathan, however, Meghan eventually made good progress in adjusting to their new reality with more and more of her cheerful disposition revealing itself every day. Unfortunately, this progress would not continue. Several episodes of very concerning behaviour by Nathan caused Betty to end his placement prematurely, something she had never done in her eighteen years of fostering. After he tried to hang himself with a scarf from a bunk bed, she was constantly worried that one day she'd discover him lifeless, causing her many sleepless nights. Also during this time, Nathan repeatedly banged his head against a wall, hoping to give himself a coma so that he could sleep away the time before returning to his mother's care. Betty recalls telling social worker Mary, "He needs help, he really needs help, he scares me." Two months after being placed in Betty's care, Nathan was moved to the Observation Unit in the Centre for Youth Care, where Mary explained, "They worked with him on how to be a child." Nathan made excellent strides in his new placement, however, in his absence, Meghan's progress regressed and she became angry and bitter, mourning for Nathan. Betty described her as "Lost… grieving all over again." Fortunately, after his discharge from the Observation Unit, Nathan and Meghan were reunited, but at a different foster home now. An interview with Evelyn, a foster parent who cared for the three youngest siblings, shed light on how Adam, Jacob and Hannah coped with the change. Rather worrisome, was her recollection of the children cowering and hiding themselves for the first while. They also rarely asked about their parents. Every day for the first month, Hannah would scream throughout the night, suffering from persistent night terrors. These eventually ceased, but Evelyn remembers thinking that at their peak, she wasn't sure she could continue having this infant in her care. They also discovered that Hannah had an extreme fear of dogs, even in stuffed animal form. Like the night terrors, this phobia also resolved with time and Hannah blossomed into an affectionate and social little girl who eventually caught up with her developmental milestones. Four-year-old Adam was described by Evelyn as "a poster child for why you foster." No one could understand him and he was extremely aggressive, particularly at daycare. It took considerable convincing, but in the end, Melissa and Rick agreed to medicate Adam for ADHD. Shortly after starting medication, Evelyn described him as "a little sponge who loved learning." With medication, structure and routine firmly in place, Adam's aggression diminished over time, resulting in a marked improvement in his behaviour. Another distinctive change happened at the dinner table. When Evelyn first took the children into her care, Adam would stand in the kitchen, "vibrating" while waiting for food and then subsequently gorge on everything, his hunger insatiable. With time, he learned to slow down and focus his attention on other fun things, rather than on when his next meal would be. Jacob, two-years-old at the time, had some very significant behaviours. Evelyn remembered him as being lethargic and regularly "zoning out", which was also corroborated by Mary who described him as, "going vacant." Like his brother, Adam, Jacob could be quite aggressive. He rarely spoke, and when he did, made poor eye contact. Often, Jacob could be found crouching in tight spaces and would involve himself in risky play without fear of hurting himself. At times he would laugh inappropriately in different situations. These unusual behaviours led to an assessment for autism. He was not diagnosed as autistic and interestingly, all of these behaviours resolved over time. Behind Closed Doors

The Visits

After the children were taken into care, part of the case plan included supervised visits with both parents, Melissa and Rick. The written observations made by Family Support Workers (FSW) hired to supervise these visits uncovered a vast array of troubling circumstances, with no progress made on the parents' part to improve their chances of getting their children back. Who's watching the children? Frequently, the accompanying FSW had to alert Melissa of safety hazards the children were exposed to such as: Jacob running with box cutters, Hannah stuffing small toys in her mouth or eating cat food, Jacob and Adam fighting around hot oil on the stove, Hannah grabbing electrical wires, Jacob carrying a bag of cigarette butts, and all the kids rowdily jumping on the furniture. When warned of these risks, Melissa generally did not respond, and it was left to the FSW to remove the kids from danger. Quite often, Melissa would shut the youngest three children in the living room, choosing instead to focus her attention on Nathan and Meghan. There were many reports of several of the children almost choking on food or other objects, with Melissa completely oblivious. Several factors contributed to her negligence towards the children, the most significant being that Melissa spent a substantial amount of time on her phone, therefore missing much of what was happening around her. More than safety risks went unnoticed with Melissa. Hannah was regularly left unsupervised in her highchair for long periods of time, usually until prompted by an FSW to be removed. In the beginning, she would reach out for Melissa, but after being ignored too many times, began seeking affection only from the FSWs. Very sadly, Hannah took her first steps in front of her mother who did not notice as she was texting at the time. The Siblings Are Not Treated Equally During these visits, it was obvious that Melissa and Rick only wanted to visit with Nathan and Meghan, and that having Adam, Jacob and Hannah present was an inconvenience. Melissa would frequently have one or both older children on her lap who pushed the younger siblings off if they too, tried to cuddle. When Melissa stood up, Meghan made a habit of clinging to her legs, rendering her immobile and unable to pay attention to the others. Anticipating an upcoming unsupervised visit on Christmas, Meghan excitedly told an FSW that, "Mom will lock Jacob and Adam in the bedroom like she always does, then she will lie in bed all day with Nathan and me." To try to get Melissa's attention, Adam and Jacob resorted to constant and violent fighting, often with closed fists. Quite often, they would direct their frustration and aggression on the cat. There were also occasions when these two were unfairly disciplined by Melissa. At one point, Nathan kicked Adam in the face, but it was Adam who was put in a time-out while Nathan was consoled by Melissa after the FSW reprimanded him for his actions. Another time, Meghan picked up Hannah and dropped her on the floor, causing her baby sister to bump her head. Instead of soothing Hannah who was left to cry, Melissa chose to cuddle with Meghan. In fact, Melissa seldom comforted her kids when they injured themselves, likely because she was on her phone. At the end of the visits, Adam, Jacob and Hannah generally received one quick kiss from their parents, while Nathan and Meghan were smothered with hugs and kisses and promised that they would get special toys and treats on the following visit. Behind Closed Doors