A baby’s death while sleeping in a parent’s bed inevitably triggers a heavy response: State social workers asking hard questions. Police officers checking out the “death scene” for anomalies. Coroners and hospital physicians examining the infant’s body for a possible cause.
Though it brings added agony for already devastated parents, the possibility of criminal intent must be ruled out.
A shift in state practice may also have made it more likely that more of these cases will end in a painful and punitive place.
The state, in 2017, notified police and hospitals that “a pediatric death without an immediately apparent cause is sufficient evidence to establish reasonable cause to believe that neglect or abuse may have occurred.” As such, they “should file” a complaint known as a “51A report,” referring to the state statute about potential abuse and neglect of a child.
The requirement of an automatic referral was also aimed at making the decision to investigate more fair across socioeconomic lines, as the directive noted it wanted to minimize the impact of “any implicit racial or social biases that otherwise may influence a decision to contact DCF.”
The immediate result, experts believe, was that more parents, especially lower-income parents, were facing probes at the most tragic moment in their lives.
A DCF investigation begins with a social worker and a supervisor being assigned to the case. The social worker collects information and makes a recommendation, and the supervisor must approve or reject any finding of child neglect. These two individuals have considerable power at the start of these probes to set the tone with families, and to point the official response in a punitive or a compassionate direction.
A finding of child neglect, traumatic to parents already grieving their loss, isn’t common — but it happens with some regularity.
In a recent seven-year period, child neglect findings were made against 31 parents or caregivers, which is roughly one in four of the infant sleep deaths brought to DCF’s attention.
A neglect finding often leads to other painful steps. The mother’s or both parents’ names go into DCF’s central registry that includes perpetrators of abuse and neglect and can affect future employment. Many parents fear that DCF’s involvement could also lead to the removal of their older children into foster care — a not unreasonable concern in Massachusetts, which places children in foster care at a higher rate than the national average, a study showed.
The agency’s decisions can be highly subjective, based on the staffers’ level of experience or how much they factor in potentially problematic aspects of the parents’ background, say longtime child protection specialists.
They also say that compliance with the state directive to refer all unexplained infant deaths to DCF can be spotty, influenced by individual judgments among hospital staff and police as to whether a fatality seems due to the parents’ negligence. The Globe found that of the 162 sudden unexpected infant deaths from 2017-2021 in Massachusetts, about 40 percent were not brought to the attention of DCF.
“We’re all trying to become more aware of our intrinsic biases,” said Dr. Alice Newton, medical director of the child protection program at Massachusetts General Hospital. “But people can develop stereotypes — it’s hard to avoid.”
Training for DCF staff on how to handle such deaths is sporadic, at best. The Massachusetts Center for Unexpected Infant & Child Death has since 2018 worked with DCF to train small groups of social workers to better support families and avoid making decisions about parents based on how they show grief. But the sessions are voluntary. DCF said 93 staff members out of the agency’s about 4,000 social workers, managers and attorneys - or 2 percent - have been through this training since 2020.
Critics of DCF’s system for handling such cases say changes need to happen, even as they recognize that most social workers try to be humane amid their highly difficult work.
But the push to refer such sudden infant deaths to DCF often can create a prosecutorial approach with questions inevitably designed to see if the parents did something wrong, said Tom O’Loughlin, a former police chief in Milford who has worked in law enforcement for more than 30 years.
“That’s the presumption,” O’Loughlin said. “And [parents] are expected to rebut that at the most horrific moment in your life. ... You’re at such a deficit, it doesn’t border on unfair. It can be unfair.”
He speaks from personal experience. He lost his infant son to SIDS in 1992, though he said co-sleeping was not a factor. His family was treated respectfully, he said, but he saw how easily DCF could come at it in a different way, inflicting added pain. O’Loughlin objected several years ago to the new directive from the state Child Fatality Review Team that all unexplained infant deaths should get an automatic referral to DCF.
O’Loughlin said DCF often has to complete its investigations within a few days, before the full results of autopsies — which can take months — are available.
DCF has also tried to reduce subjectivity in its decision-making in other ways, though some child welfare specialists say the results have been mixed.
New “risk assessment” tools have also been rolled out and updated over the years, which require social workers to go through a standard checklist for all families they encounter. Such an analysis includes the orderliness and safety of the home, as well as if drugs or alcohol were found. Parents’ past medical records and potential criminal backgrounds are examined. DCF also asks social workers to see that each child, if under a year old, “has a dedicated and safe sleep environment.”