Section 2, Chapter 5 (Child Abuse and Neglect Reports), Subsection 5 – Juvenile Assessments

Section 210.148, RSMo. defines a juvenile with problem sexual behavior as ‘any person, under fourteen years of age, who has allegedly committed sexual abuse against another child’.

For the purpose of Juvenile Assessments sexual abuse by children under fourteen (14) years of age is defined as any sexual or sexualized interaction with a child including, but not limited to, acts that are age or developmentally inappropriate and:

Involve force or threats of the use of force;
Are intrusive;
Are unwelcome;
Result in physical injury or cause emotional trauma to the victim child; or
Are coercive or manipulative.

Juvenile Assessments will be screened in by the Child Abuse and Neglect Hotline Unit when any child under the age of fourteen (14) is alleged to have committed an act of sexual abuse against any person under the age of eighteen (18).

5.5.1.1 Sexual Behavior

It is common for children to engage in some form of sexual behavior. Some of these behaviors can usually be considered normal. However, children can exhibit a variety of problem sexual behaviors that can be addressed with appropriate intervention. The key for assessing whether Children’s Division intervention is appropriate is whether the sexual behavior becomes abusive. A family assessment and services approach is utilized to identify the child and family’s treatment needs and to assure the safety of victim children impacted by the child’s sexual behavior. Child sexual behaviors can be a difficult topic of conversation for many families. Families may be naturally defensive and protective of children who have exhibited problem sexual behavior. It is important staff be sensitive to terminology when engaging and working with families in which a child has been identified as having committed an act of sexual abuse against another child. Staff should refrain from using language such as perpetrator and sexual offender, especially when working with the family.

Normal versus Problem Sexual Behavior

In order to identify the appropriate level of intervention, it is important to be able to differentiate between normal or typical sexual exploration and development versus problem sexual behavior. It is common for young children to exhibit curiosity about their own and others’ bodies.

Normal sexual exploration will generally include some or all of the following characteristics:

- Occurs between playmates;
- Occurs between children of the same general age, physical size, social and emotional development;
- Is age and/or developmentally appropriate for the children involved;
- Is unplanned, not forced, and does not occur with frequency;
- No physical or emotional trauma are suffered;
- Is redirected with adult intervention.

Problem sexual behaviors may include some or all of the following characteristics:

- Repeated behaviors;
- Extreme or inappropriate masturbation;
- Use of aggression, force, weapons, threats, or coercion;
- Use of alcohol or drugs to induce cooperation or incapacitate the child;
- Exposing the victim child to pornography;
- Taking photos or video recordings of sexual conduct;
- Distribution of photos or recordings of sexual conduct to others, especially without the knowledge or consent of the participants;
- Causes physical and/or emotional harm;
- Incidents involving children of different age or developmental levels;
- Does not stop after adult intervention; and/or
- Accompanied with strong, upset feelings such as anger or anxiety.

5.5.2 Juvenile Office Referrals

Reports in which the child has committed an act of sexual abuse and caused serious physical injury and/or used a weapon must be referred to the Juvenile Office prior to initiating the Juvenile Assessment. These are reports in which there is a greater likelihood of juvenile court intervention due to the nature of the delinquent act. Therefore, it is imperative that staff coordinate with the juvenile office and law enforcement prior to conducting any interviews.

Serious physical injury is defined as: physical injury that creates a substantial risk of death or that causes serious disfigurement or protracted loss or impairment of the function of any part of the body.

Juvenile Assessments should be referred to the juvenile office under the following circumstances:

When the parent/caregiver of the alleged child initiator does not engage in the assessment process;
When there is no evidence that the parent/caregiver is taking steps to prevent future problem sexual behavior;
When there is a repeated incident of problem sexual behavior by the child; or
The assessment reveals that the child’s behaviors are of such severity that the child cannot be safely maintained in the home and/or community.

5.5.3 Family Assessment and Services Approach

Juvenile Assessments will involve a wide array of behaviors, locations, and family compositions. Thus, it will be important for staff to carefully consider each report on a case-by-case basis and be mindful of the following:

Establishing rapport with the family. Rapport begins with honesty of staff and respect for the family. Staff should fully and openly explain the purpose of the Division’s contact with the family.
The Juvenile Assessment process should be fully explained. Staff should clarify their role as well as the expectations that exist for the family. Emphasis should be placed on the Division’s desire to help the family, as opposed to finding fault.
Recognition should be given to the fact that families are more likely to change when they are invested in a plan for change, rather than being asked to comply with the mandates of others.
This process must focus on the family as a system, rather than on any individual within the family. Therefore, parents and children will be given the opportunity for full inclusion in all phases of the family assessment process.
Full inclusion includes giving parents and children equal and active voices in identifying the issues, safety planning, and further treatment needs.

5.5.3.1 Conducting the Assessment

For all Juvenile Assessments, staff may utilize the Children with Problem Sexual Behaviors Assessment Tool (CD-214) and the Children with Problem Sexual Behaviors Safety Plan(s) (CD-215) as guides with the family of the alleged child initiator.

Safety of all the child(ren) in the home shall be an ongoing priority during the assessment process. Staff shall also assess whether the alleged child initiator will have access to any other children outside of the home.

5.5.3.1.1 Reviewing Prior History

Staff should pay particular attention to the history of the alleged child initiator. Risk factors for problem sexual behavior include exposure to violence, experiencing trauma, witnessing sexual acts, and inadequate supervision due to parental mental health, substance use disorder, and domestic violence concerns.

5.5.3.1.2 Reporter Contact

Reporters will often call the hotline in response to disclosure of sexual abuse by the victim child. The reporter may have limited information regarding the alleged child initiator and his/her household composition. Contact with the reporter is essential to help determine what initial steps to take in order to assure safety of all children in the report.

5.5.3.1.3 Parental Notification

Pursuant to Section 210.145, RSMo., a parent must be notified prior to interviewing any child involved in a Juvenile Assessment. This includes the child victim(s), the alleged child initiator, and any non-victim children. Consent should be obtained from a parent prior to interviewing the alleged child initiator. If consent cannot be obtained, a referral to the juvenile office may be necessary in order to assure safety of all children involved and to ensure the problem sexual behavior is addressed.

5.5.3.1.4 Face to Face Safety Assurance

Every child identified as an alleged victim on the CA/N-1 must be seen face to face within the following Response Priority Level timeframes:

- - Priority Level 1 = three (3) hours
  - Priority Level 2 = twenty-four (24) hours
  - Priority Level 3 = seventy-two (72) hours

When the alleged child initiator does not reside in the same household as the victim child(ren), staff should utilize all resources available to assess the living arrangements of the alleged child initiator. If the alleged child initiator resides with other children, every effort should be made to see the children living in the same home as the alleged child initiator in the timeframes outlined above. Assuring the safety of all children is essential to prevent further victimization by the alleged child initiator.

The Chief Investigator, or their designee, will be responsible for verifying the safety of all children involved is assured within the above response timeframes. All efforts should be made to see the alleged child initiator within 24 hours. If the victim child(ren) does not reside in the same home as the alleged child initiator and there is no indication that the victim(s) is in danger of serious physical harm or threat to life, the Chief Investigator, or designee, may determine that the victim child(ren) be seen within 72 hours. At times, this may require the utilization of staff other than the assigned staff depending on the complexities of the report.

5.5.3.1.5 Child Interviews

Victim Children

When possible, staff should begin by interviewing the victim child(ren). Staff will need to assess whether an in-depth interview is appropriate at the point of initial contact with an alleged victim child, or if it would be more appropriate to make arrangements for a forensic interview through a Child Advocacy Center (CAC). The needs of the child victim(s) should not be overlooked. However, this may require a delicate balance with the needs of the alleged child initiator. Staff should utilize supervisor consultation to determine the appropriateness of a CAC referral.

Each county office is strongly encouraged to work with their local CAC to develop protocols to assist with the completion of Juvenile Assessments.

Staff should assist the victim’s family in obtaining any necessary medical examinations for the victim child, which may include a Sexual Assault Forensic Examination (SAFE).

Things to Consider Prior to Making a CAC Referral:

- - The intent of a Juvenile Assessment is to focus on assessment and treatment of the alleged child initiator as opposed to making a determination of whether sexual abuse occurred.
  - Whether law enforcement or the juvenile office is already involved.
  - The severity of the sexual abuse act and potential for the need of juvenile court intervention.
  - Is a CAC needed to help develop the safety plan?
  - Is a referral necessary to obtain a SAFE exam or other CAC services?
  - What impact, either positively or negatively, would a forensic interview have on engaging the family of the alleged child initiator in the treatment process?

Alleged Child Initiator

In addition to interviewing the alleged child initiator about the allegations in the Juvenile Assessment, staff should also assess for potential abuse and neglect of that child. If the child discloses that they have been a victim of abuse or neglect, staff must report this to the Child Abuse and Neglect Hotline Unit (CANHU) to set up a separate Child Abuse/Neglect Report. It may be appropriate to refer the alleged child initiator for a forensic interview if they disclose they are victims of abuse or neglect.

If staff determines the alleged child initiator had care, custody, and control of the victim child, the response track should be changed to an Investigation. In the event the track is changed to an Investigation, staff shall notify the alleged child initiator’s parents of this decision. Staff shall also provide the alleged child initiator and his/her parents the Description of the Investigation Process (CS-24) within twenty-four (24) hours.

Non-Victim Children

Non-victim children that live in the home of the alleged child initiator should be interviewed regarding their knowledge of the allegations in the report. Staff should assess whether these children are also victims of abuse, especially in cases alleging sibling sexual abuse. If the alleged child initiator does not reside in the same home as the victim child and the other children in the victim’s home have no contact with the alleged child initiator, staff should use their discretion when making a decision on whether to interview those children.

Interviewing Children Alone

Children should be interviewed alone whenever possible. It is important to remember that Juvenile Assessments do not involve allegations of parental abuse or neglect, but do involve allegations of possible juvenile delinquency. Therefore, staff should grant a parent’s request to be present during interviews of their children.

5.5.3.1.6 Home Visit

Staff shall complete a minimum of one visit to the home of the alleged child initiator. If the child resides in more than one household, it may be necessary to visit each home to assess environmental factors that may affect child safety.

When the victim child and the alleged child initiator do not reside in the same household, it may be necessary for staff to complete a home visit with the victim child and his/her family, depending on their individual needs.

Staff should offer Family Centered Services as appropriate to the victim’s family, along with any referrals to community services, such as counseling. Sensitivity should be given to the victim’s family during the assessment process and open communication is strongly encouraged.

5.5.3.1.7 Parent/Caregiver Interviews

All parents and/or caregivers of the alleged child initiator should be interviewed and included in the assessment process when possible. Each parent/caregiver may have unique insight into the causes for their child’s behavior. Assessing each parent/caregiver’s protective capacities will also help guide intervention decisions. It may be necessary to include each parent/caregiver in the safety plan for their child.

Parents/caregivers also play a vital role in their child’s treatment. Staff should be prepared for a wide range of parental reactions to their child being named in a Juvenile Assessment. It is imperative to family engagement that the child’s parents be assured that the Children’s Division is responding with the goal of providing services, not to be punitive. Staff should acknowledge that this is a difficult topic for any parent to discuss and education should be provided to the child’s parent/caregiver(s) regarding child sexual behaviors. The child’s parent/caregiver(s) should also be reassured that treatment services are often successful in preventing future incidents.

When the victim and the alleged child initiator are not siblings, staff should interview at least one of the victim child’s parents/caregivers. This will assist in providing information regarding the incident(s) as well as information regarding the victim child’s well-being. The victim’s parent/caregiver(s) may also be helpful in providing information regarding compliance with safety plan(s). At times, it may be necessary to include the victim’s parent/caregiver(s) in the development of a safety plan for the victim, depending on the family’s individual circumstances. Staff should be prepared for the victim’s parent/caregiver(s) to have a wide range of emotions in reaction to their child being a victim of sexual abuse. Nothing in Section 210.148, RSMo. precludes the victim’s parent/caregiver from contacting law enforcement or the juvenile office to report the abuse.

5.5.3.1.8 Safety Planning

If any child identified on a Juvenile Assessment is found to be unsafe in the home, staff must follow the policy in Section 1, Chapter 9, Safety Assessment Outcomes and Safety Planning.

A safety plan should be completed for every child who has been found to have a problem sexual behavior. The Children with Problem Sexual Behaviors Safety Plan(s) (CD-215) may be utilized. A safety plan should be completed when the following has occurred:

- - An act of sexual abuse has been witnessed by an adult;
  - There has been a disclosure from the child victim;
  - When the child has admitted to problem sexual behavior; or
  - When a parent/caregiver is concerned that their child is exhibiting problem sexual behavior.

Factors that may contribute to increased risk for future incidents of problem sexual behavior include:

- - Younger children reside in the same home;
  - The child resides with children and/or adults who are vulnerable due to limited physical, developmental, and/or intellectual capacity, with other children known to be sexual abuse victims or with other children known to have sexual behavior problems; or,
  - The parent/caregiver is unable or unwilling to provide adequate supervision.

The safety plan should be behaviorally specific and should take the following into account:

- - Each living arrangement of the child; and
  - All situations in which the child may have access to other children.

The safety plan should be mutually agreed upon between staff and the family. All individuals involved in implementing the safety plan must be contacted by staff to ensure they are in agreement to the plan.

The Children with Problem Sexual Behaviors Safety Plan(s) (CD-215) is composed of the following sections:

- - Individuals involved. Who are the core adults and children involved in the assessment?

- - What is needed to keep all the children in the home safe?
    - Close supervision?
    - Re-arrangement of bedrooms?
    - Separation of children?
    - Or some other tangible intervention?
  - Who will be responsible for supervising the children? List all individuals who will help supervise the children and their relationship to the alleged child initiator. It is best to avoid utilizing other children or siblings in the supervision plan.
  - Describe the specific steps that will be taken to supervise the children. Staff should be cognizant that constant supervision of a child is a very difficult task to achieve. There are many things that can interfere with an adult’s ability to keep children in line of sight at all times. Staff should consider the following:
    - How will the children be supervised at night?
    - How will the children be supervised when the caregiver has to use the bathroom or take a shower
    - How will the children be supervised when the caregiver has to prepare meals?
    - How will the children be supervised when they play outside?
    - How will the children be supervised at the bus stop?
    - How will the children be supervised when the caregiver needs to leave the home?
    - How will the parent/caregiver get a break from the stress of providing a high level of supervision?
    - How will the child be supervised at school and/or daycare?
    - Does the school and/or daycare need to be notified of the concerns?
  - If bedrooms need to be re-arranged, describe the specific steps that need to be taken. Staff should be aware of the current sleeping arrangements of all family members and consider the following:
    - Does anyone need their own room?
    - Who should not share a room?
    - Do the adults need to move to help with supervision needs?
  - If the children need to be separated, describe the specific steps that need to be taken. When the alleged child initiator and the child victim(s) reside in the same household, it may be appropriate for the children to be separated into different households, especially if the victim child(ren) are expressing fear or exhibiting signs of trauma. Consideration should be given to the least restrictive plan possible while balancing the needs of all children involved. Other factors that may make separation an appropriate plan include:
    - Other safety interventions have been attempted and have not been successfully in curtailing the behavior
    - The parent(s)/caregiver(s) are unable or unwilling to provide the necessary level of supervision required to safely maintain all of the children in the home
    - The child’s behavior poses a serious risk to others and the child cannot be safely maintained until further assessment and intervention planning is complete.

If separation must occur, it is preferable for the alleged initiator child to leave the home. If the children are going to be separated, staff must assess whether the alleged child initiator will have access to other children as a result of the new living arrangement. When at all possible, reunification of the children should not occur until recommended by the treatment provider of the child victim(s) and the alleged child initiator.

Staff should consider the following:

- - - Which child(ren) will go stay somewhere else?
    - Where will they stay?
    - Are there children in the other home?
    - What will visits look like?
    - What needs to occur before the child(ren) can return home?

If children are going to be separated as a result of the safety plan, staff must complete a walk-through and background checks for the alternate living arrangement.

- - Describe the specific steps that will be taken to monitor access to media. Access to media that is violent or sexual in nature should be closely monitored anytime there is a concern for sexual boundaries or sexual harming behavior.

Staff should consider the following:

- - - What devices in the home have internet access?
    - Who is allowed on each device?
    - Where can devices be used?
    - Do the devices have parental control settings?
    - How will exposure to adult content on television, movies, or music be handled?
  - Describe the household rules. Household rules should be created, or modified, anytime there is a concern for sexual boundaries or sexual harming behavior. Clear and consistent rules regarding privacy and personal boundaries will help decrease the potential for future incidents and will help adults model appropriate behavior.

Examples of household rules include:

- - - Older children will not be responsible for baby-sitting or supervising younger children;
    - Alarms will be installed on bedroom doors;
    - Children will not share beds;
    - Rules regarding who may be allowed in whose bedroom and under what circumstances;
    - Only one person will be allowed in the bathroom at a time;
    - All household members will close the door when using the bathroom;
    - Children will knock before opening a closed door;
    - Children will have no access to adult sexual materials;
    - All household members will respect each other’s boundaries, including touch, physical affection, personal space, etc.
    - Clothing must be worn in all common areas of the home;
    - Clothing must be worn at bedtime;
    - No tickling or wrestling;
    - No computers, phones, tablets, gaming, or other devices with internet access will be allowed in bedrooms;
    - Parents/caregivers will model open communication among family members. No secrets will be allowed.
  - What additional steps are necessary to ensure the safety of everyone in the home? It is important to remember each Juvenile Assessment will involve unique circumstances. There may be additional steps the family feels would be helpful in assuring the safety of all the children.

Who should notify staff in the event the safety plan fails and another sexual abuse act occurs?

There may be times when it is not appropriate for the alleged initiator child to remain in the community. In these situations, staff should outline the steps needed to seek the appropriate placement for the child.

- - What additional services or supports does the family need?

Staff should consider:

- - - What services were identified through the assessment process?
    - Has the family identified any natural supports that can be developed?
    - Utilization of the genogram or eco-map may be useful in identifying resources for the family
  - Who will be helping to implement the safety plan? Outside of the individuals involved in the assessment, who else was identified as a helper in the safety plan? Have they been contacted and agree to helping the family keep the children safe?
  - How will the parents/caregivers communicate the safety plan to the children? All the children in the home need to know the safety plan. This will provide an opportunity for the parents/caregivers to demonstrate open communication as well as boundary expectations. Staff should assist the parent/caregiver in talking to the children if necessary.

At a minimum, the safety plan should be re-evaluated at each home visit. If the child is involved in any treatment, the safety plan should be shared with the service provider. Staff should update the safety plan as needed. Multiple safety plans may be necessary if there are multiple living arrangements involved. When the child victim(s) do not reside in the same household as the alleged initiator child, staff should consider if a safety plan specific to the victim(s) is necessary to help protect them from future harm.

5.5.3.1.9 Safety Network Contacts

Due to the sensitive nature of Juvenile Assessments, staff should exercise discretion in the information provided to safety network contacts regarding the involvement of the Children’s Division. It is best practice to notify the parents of the alleged initiator child regarding what collateral contacts will be made and to be transparent about the reason(s) for contacting specific collaterals. Staff are strongly encouraged to contact school or daycare personnel that have day-to-day interaction to obtain information about the child’s functioning and/or behavior. There may be times when staff will need to assist the child’s parent/caregiver(s) in working with the school or daycare to address any safety or supervision concerns that result from the child’s problem sexual behavior.

5.5.3.1.10 Chief Investigator 72 Hour Review/Supervisory Consultation

If there have been no safety threats identified in the home of the Alleged Child Initiator and no Safety Plans are needed, staff will contact the Central Consult Unit within seven (7) calendar days and follow policy as outlined in Section 1, Chapter 9, Safety Assessment Outcomes and Safety Planning.

If staff have identified safety threats within the home and there is a need for services, staff will consult local with the Chief Investigator within seventy –two (72) hours of the report. The Chief Investigator should review any safety planning within the first 72 hours.

Due to the complexities of Juvenile Assessments, the Children’s Service Supervisor plays a vital role. The Children’s Service Supervisor should regularly consult with staff to assist in determining the level of contact and ensuring the safety plan is being appropriately monitored.

5.5.4 Children in Out-of-Home Care

There may be times when a Juvenile Assessment is received on a child who is in the custody of the Children’s Division. Staff assigned the Juvenile Assessment should work closely with the child’s case manager and the Family Support Team in completing the assessment. The Guardian ad Litem (GAL) should be notified prior to interviewing the alleged child initiator.

5.5.5 Out of Home Investigations (OHI)

There may be times when a Juvenile Assessment is received on a child who is the victim on an open OHI report. It will be the responsibility of staff assigned the Juvenile Assessment to complete assessment and safety planning process. However, both staff members shall work together to coordinate the best approach to assuring child safety and completing the investigative process of the OHI report.

5.5.6 Non-Caretaker Referrals

For referrals that do not meet the criteria for a Juvenile Assessment, staff should follow policy and procedure for non-caretaker referrals. If during the course of the assessment, staff determines the child does not meet the criteria for a Juvenile Assessment due to age, staff should cease the assessment process and follow policy and procedure for a non-caretaker referral.

5.5.7 Juvenile Assessment Conclusion Summary

The following should be included in the FACES Conclusion Summary on all Juvenile Assessments:

Brief Summary about what took place in the report;
Why the conclusion was made;
Why the Victim child is Safe, Safe With Plan, or Unsafe;
Any services alleged child initiator is participating in (if applicable);
Any services the family is participating in (if applicable);
If a case was opened, why the case was opened and anticipated actions.

5.5.8 Timeframes for Completion

Juvenile Assessments should be completed within forty-five (45) days.

CHILD WELFARE MANUAL

Section 2, Chapter 5 (Child Abuse and Neglect Reports), Subsection 5 – Juvenile Assessments

Section 2 (Intake)