The Safe Babies Court Team Evaluation: Changing the Trajectories of Children in Foster Care

Background. Of the more than 680,000 children in foster care in the U.S., 31 percent are age 3 and younger. Children in foster care are at risk for poor developmental outcomes, including increased rates of poor health, higher rates of depression and anxiety, more attention deficit hyperactivity disorder and conduct disorders, more problems in school, and increased rates of incarceration and suicide. Children ages 3 and younger face specific vulnerabilities because this is a developmental period of rapid brain growth when young children form secure attachments with caregivers, which ultimately affects their future developmental trajectory. According to the U.S. Department of Health and Human Services, the average time spent in foster care was 19 months in 2018. Both children and families often do not receive the supports they need during this time.

The Safe Babies Court Team™ approach, created by ZERO TO THREE (ZTT), aims to reduce the time children spend in foster care before reaching a permanent, safe home and improve long-term child and family well-being. This approach connects babies and their families with supports and services designed to promote healthy child development and family functioning, while working to ensure a safe and speedy exit from foster care.

Methods. This study is a natural experiment evaluating SBCT in three locations where the courts randomly assigned cases to either a SBCT trained judge or a judge who had no training in the SBCT approach. Researchers compared the time children spent in foster care and the likelihood of recurrence of abuse or neglect for three groups:

• 123 cases that had access to the full SBCT approach
• 598 cases that had access to an SBCT-trained judge but not the full approach
• 1,120 control cases

The experimental study answered two primary research questions:

• Do infants and toddlers who receive the full SBCT treatment or judge only (combined treatment group) spend less time in foster care than their control group peers?
• Do infants and toddlers who receive the full SBCT treatment or judge only (combined treatment group) have lower recurrence rates of abuse or neglect than their control group peers?

Results. Impact analyses provide the first experimental evidence that the SBCT approach had a positive impact on maltreated infants and toddlers and their families.

• Survival analysis models demonstrated that cases assigned to judges trained in the SBCT approach exited foster care sooner than cases assigned to the control condition. The median time spent in foster care was lower for SBCT cases than control—a roughly 4-month difference that was statistically significant (HazardsRatio = 1.48, p<0.01, 95%CI 1.31-1.67).
• While not statistically significant, logistical regressions revealed that cases that received the full SBCT approach were 4 times less likely to experience a recurrence of abuse or neglect than control (β=-1.63, p=.12)

Conclusions and Implications: The goal of SBCT is to achieve timely permanent and safe homes for maltreated infants and toddlers, and this experimental evaluation suggests that achieving both outcomes requires investment in the full SBCT approach. Policy and practice implications will be discussed.