David’s mother, Suzanne, was not quite twenty-six years old when she conceived him. David was Suzanne’s third child; the other two were ages two and five. David’s father was a construction worker, making just slightly more than necessary to keep the family above the poverty level. The family constantly struggled to make ends meet; no matter how hard they tried, they never seemed to be able to save much money. They barely managed to rent a small house on the outskirts of a small city.
During the second month of Suzanne’s pregnancy, her husband had a car accident and died after almost two weeks of hospitalization in intensive care. The little savings that they had accrued quickly went to pay for hospital bills and funeral expenses, and still there were bills left to be paid. Suzanne began to receive TANF and tried to learn how to live even more frugally. She had been about twenty pounds overweight before her pregnancy, so she reasoned that dramatically reducing her food intake would be both advantageous to her figure and help with her food budget. Suzanne managed to keep only two prenatal visits because she could not afford a sitter to watch her other children, did not own a car, and lived miles from the health clinic.
David weighed only 4.9 pounds at birth and needed all of the special hospital and aftercare necessary for an infant born at low birth weight. The costs for this totaled $21,000. From the beginning of his life, David was colicky and easily irritated, and he seemed to his mother to always be awake and moving. David needed more attention and care than her other children, and Suzanne began to resent her newest child. The stress of living in poverty and having a difficult child made it harder for Suzanne to nurture David. Just after his first birthday, Suzanne lost control and hit David harder than she ever had before. Despite her promises to herself to never lose control with David again, he increasingly suffered beatings from his mother.
David entered kindergarten at age five, and his teachers quickly referred him for an evaluation. He was diagnosed as having severe learning disabilities and hyperactivity, conditions often associated with children born with a low birth weight. Although David was receiving special education services from the school system (an estimated extra cost of $6,000 per year), he fell so far behind that he needed to repeat first grade (an additional $6,000).
Meanwhile, David’s mother found him harder to control at home as he got older and larger. She had made some attempts to work and get off TANF but could never make enough money to buy all of the necessities for her family and pay for health insurance. Also, it was hard to arrange for child care for David while she worked because he was so hard to manage. Eventually, Suzanne stayed on TANF and became increasingly angry and resentful toward David.
David’s third-grade teacher noticed several large bruises on David’s arms and reported suspected child abuse to Child Protection Services. This agency conducted a thorough investigation and ordered a number of services for David and Suzanne, including counseling and after-school child care (at an estimated cost of $20,000). By now, however, David’s siblings were adolescents who had also lived for years in poverty and were acting out their own anger and frustration. The stresses on Suzanne continued to increase, as did the beatings of David.
When David was ten years old, he was removed from his home and placed in a foster home for four years (at an estimated cost of $20,000). David had trouble getting along with his foster parents and was moved several times. When he was age fourteen, he rejoined his family. By then, David was an angry and frustrated adolescent who could not succeed at school or maintain healthy peer relationships. When he was age sixteen, he dropped out of school and decided to work full-time. However, because he was a high school dropout with learning disabilities and poor reading skills, David could find only minimum-wage jobs. Soon he realized that the only way to make money was through a life of crime, and he began dealing drugs and breaking into houses. At age eighteen, David was caught for armed robbery and brought to trial and was found guilty. He served a ten-year jail sentence (at an estimated cost of $350,000). By the time David was twenty-eight years old, he had consumed over $417,000 in publicly funded services, not to mention the cost of payments to his mother on TANF.
In the textbook you read the case study about “David.” Now you are going to take the role of one of the following human services professionals that were likely involved with David and his family, and explain how you would intervene with David, his mom, and/or his siblings. (If you think there is another role that you want to use, that is fine.) Be specific when you explain when you would intervene and how David’s story just might have turned out differently because of your intervention.
What are some ethical concerns that may arise? How would you address those concerns?
Roles of Human Services Professionals
- School counselor
- Health advocate
- Child protective services worker
- Foster care placement worker
- Foster parent
- Home visitor
- Juvenile court worker
Be sure to use specific information from the text to support your answers. (When referencing the text, APA paper formatting and citation style must be used.)