An alleged child starvation case near Longview is one of more than a dozen cases — including one death — that have state officials reviewing how adopted children are placed and treated.
The number of abuse cases is small compared to all adoptions. But a string of high-profile child starvation cases last year — including one from May accusing Jeffrey and Rebecca Trebilcock of starving their five adopted children at their Bunker Hill-area home — has state officials alarmed.
"Starting in the beginning of 2011 we started seeing a cluster effect of these types of cases," said Mary Meinig, director of the state's Family and Children's Ombudsman office, who included a section about adoption abuse in her annual report, released last week.
Many of the cases include starvation. "We have so many great adoptive homes in the state, but then we also have these. ... I think it's apparent that it needs to be looked at."
"We want to jump start this as quickly as possible," said Denise Revels Robinson, assistant secretary of the state Department of Social and Health Services. "There's a sense of urgency here. Not crisis, but urgency, because these are very serious issues."
One adopted child, 13-year-old Hana Williams of Sedro Wooley, died in May from hypothermia and starvation after being left outside as punishment. The Trebilcock's adopted son, then 13, landed in emergency room in March so severely malnourished that he weighed just 49 pounds, according to court documents.
Officials are concerned at the severity of these cases, the apparent spike in them and that so many seem to involve adopted children. The adoption cases are particularly concerning because screening by the state or private adoption agencies should catch unfit parents before children are placed.
Dr. Frances Chalmers, a Mount Vernon pediatrician who consults with DSHS, began to get a "nagging feeling" that something was up and started tracking starvation cases herself. Meinig started doing the same, finding 15 adoption or guardianship cases since 2009 that involved starvation or severe abuse. Eleven of those cases were in 2011.
Not all the cases listed in Meinig's report became public because, unlike the Trebilcocks, not all the parents were criminally charged. All are horrific, though, including cases where children were beaten with wooden boards embedded with nails, sexually abused and severely malnourished.
While Hana Williams' death is the most serious and disturbing case, "even the kids who don't die are significantly traumatized," Chalmers, said.
Adoptions, concerns increasing
Officials aren't sure if the surge of cases in 2011 is the start of a disturbing new trend — but they're working to find out. A work group of child experts - ordered by Gov. Chris Gregoire — will look at adoptions, including foreign adoptions, as well as abuse by withholding food.
Among other topics, they'll investigate:
• Are neglect and abuse — including withholding food — on the rise and are they more prevalent in adoptive homes?
The state hasn't tracked withholding food cases before. Anecdotally, though, the number of cases seems to be rising. Of the five criminal withholding food cases statewide in 2011, four involved adoptions.
It's also possible that increased social worker training — and publicity about the most horrific cases — may have led to more cases being reported last year, said DSHS Spokeswoman Sherry Hill.
• Did a rapid increase in adoptions let some unfit parents slip through the cracks?
In recent years, state and federal law encouraged quicker adoptions to move children out of foster care and into permanent homes. Meinig said they need to examine if it's also lead to unfit parents being approved for adoption.
In 2002, there were 1,074 adoptions of Washington children in foster care or other child welfare programs. By 2009 that number nearly doubled to 2,091. The increase from 2008 to 2009 alone was 66 percent. Nationally, the increase from 2002 to 2009 was only 12 percent.
• Does the adoption process itself need to be reworked?
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Child welfare officials screen parents adopting through the state foster care system and license private adoption agencies, but state workers do not screen private adoptions or adoptions in other states or countries. Some of the cases highlighted by Meinig included non-Washington adoptions or families who had no prior contact with state Child Protective Services. The state group will investigate if more oversight is needed.
• Does age, race or gender play a role in abuse of adopted children?
Some of the cases highlighted by Meinig involved foreign and/or cross-race adoptions. Officials don't know if that played a role in these cases, but want to examine it further. Three of the Trebilcock's five adopted were from Haiti.
There isn't one simple answer, though, because abuse itself is so complex.
"Nobody's going to say during screening that ‘If I don't like them, I'm not going to feed them,' " Meinig said. "And I don't think anyone actually envisions that they're going to do this. I think it's a progression thing that happens."
Local case, common threads
The Trebilcocks deny they starved their children and are fighting the charges in both the criminal and child dependency courts. (See related story.)
But Meinig said the allegations in the case bear several of the hallmarks common in all the cases she reviewed.
The five adopted Trebilcock children, ages 8 to 14, told investigators they were denied food. Kitchen cabinets had alarms on them and the children were punished for "stealing food," they said. Other family members, though, appeared well-fed, according to investigators.
"There was plenty of food" in all the cases, Meinig said. "These were really purposeful withholding and punishment and control. ... Food is kind of the ultimate control."
The Trebilcock children also told investigators they were beaten and made to stand outside, isolated from the rest of the family - another commonality Meinig found in many of the cases. The Trebilcocks also were home-schooled, which some officials say can be a way hiding the signs of starvation.
"Food withholding as a form of abuse has been around forever, from its mildest form of a misbehaving child being sent to bed without dinner to really severe cases of withholding that lead to medical problems," said Dr. Chalmers, who helps train social workers to look for signs of abuse. "So I've been trying to think about ways we could identify these kids before they die or end up in the hospital for malnutrition."
Reluctance to call
State officials hope the group of child experts can meet by early February and complete its work by May.
Any recommendations will be forwarded to DSHS, which will brief the governor's office as well as the Legislature, Revels Robinson said.
The state's budget crunch doesn't leave much extra money for new programs or enforcement, but Revels Robinson said she believes many of the recommendations could be relatively inexpensive. Some of the changes could be a change of emphasis in screenings, for example. Additional or substitute training also could provided to social workers at little cost, she said.
Officials also stress one of the best defenses against child abuse is for people to speak up when they suspect it. Too often people are afraid to "cause trouble" and then live to regret it, they said. And while there may not be immediate action from one report or call, that doesn't mean the calls are ignored, they said.
"We really do rely on the eyes and ears of the community to alert us," Revels Robinson said.
Hana Williams — the 13-year-old who died in May — "had a number of friends and family who now say ‘I wish I'd called earlier,'" Chalmers said. "We really need to encourage people to be less reluctant to make those calls."