January 01, 2013

New Birth Assessment Helps Teen Parents in Illinois Foster Care

Claire Chiamulera

The views expressed herein have not been approved by the House of Delegates or the Board of Governors of the American Bar Association, and accordingly, should not be construed as representing the policy of the American Bar Association.

A 1994 consent decree paved the way for better protections for pregnant and parenting teens in the Illinois child welfare system. The decree followed a class action lawsuit, Hill v. Erickson, filed in 1988 claiming the Illinois Department of Children and Family Services (DCFS) failed to provide adequate services or placements for these youth in violation of their rights. 

As part of the consent decree, DCFS agreed to provide pregnant and parenting teens services through a network of teen parenting service providers. The decree led to the creation of a new case management system and the Teen Parenting Service Network to better address the needs of pregnant and parenting teens in foster care in several Illinois counties. 

When funding cuts threatened these efforts in 2009, a motion to enforce the consent decree thwarted the cuts and prompted expansion of services to all pregnant and parenting teens in Illinois state care.

New Birth Assessments

A recent development in the state’s efforts to ensure these young parents and their children receive services is a new birth assessment. Starting in March 2011, when a youth in Illinois state care becomes a parent, either by giving birth or fathering, a referral is made for a new birth assessment. The assessment is conducted by a specialty worker at a local teen parenting service provider within 60 days of a child’s birth. The assessments now occur in 38 of Illinois’s 102 counties. 

The specialty worker visits the parent and baby at their home to assess the parent in four parenting domains and complete two standardized assessments to identify the parent’s service needs. The worker uses the assessment to give the parent information to strengthen parenting knowledge and skills. The information may include child development expectations, guidance on feeding, bathing, and medical care; and tips for communicating and bonding with the baby. 

The worker compiles a report with recommendations and submits it to the department caseworker and a family support specialist within the 60-day timeframe. Some workers also share the recommendations with the youth. Services usually continue for 12-24 months, unless the youth ages out of foster care.


To understand how the new birth assessments are working, researchers at Chapin Hall at the University of Chicago recently evaluated the program. They interviewed the workers who performed the assessments, their supervisors, and 12 teen parents who participated in the assessments. They also reviewed assessment data in the agency records. The review, An Evaluation of the Illinois Department of Children and Family Services New Birth Assessment, uncovered the following themes:

The assessments were largely viewed as a positive experience by the youth and specialty workers. 


  • Valued the process and the support they received. 
  • Found the home visits by the specialty worker helpful and most continued to meet with them weekly or monthly.
  • Reported their workers helped them bond with their babies by teaching them how to read their babies’ cries, how to talk to their babies instead of yelling, and the importance of reading to their babies.
  • Found workers were good resources for addressing parenting of an older child, in addition to the newborn (discipline, potty training, and balancing the older child’s need for attention while caring for the newborn).
  • Found the workers gave support with other life issues, such as planning for the future, developing coping skills, and addressing personal problems.
  • Valued the workers’ help with issues not directly related to parenting but important to their children’s futures, such as enrolling in school and connecting with other services and supports, such as employment programs, crisis nurseries, and health care providers.

Specialty Workers

  • Found assessments uncovered where a young person needed help with parenting.
  • Reported that they were able to provide individualized information to the parents based on the assessments. 
  • Found the assessments created “teachable moments” when the young person is most open to receiving information and learning new skills.

Caseworker involvement is key to successful new birth assessments. 

  • The specialty workers relied on caseworkers to provide background information and social histories for the youth before assessments. They also invited them to attend the first home visit to make the initial contact easier for the youth and pave the way for rapport building. 
  • Caseworker unavailability or unresponsiveness to requests from workers or their supervisors was a barrier to successful assessments as the worker had to spend time learning the youth’s background and gaining the youth’s trust.

Establishing rapport and trust with the youth is critical.

  • Rapport and trust building is an essential first step of the assessment so the youth feels comfortable receiving information and guidance from the specialty worker about parenting. 
  • The youth’s caseworker plays a key role at the first home visit to help foster trust between the specialty worker and youth. 
  • Rapport and trust building is harder if an older child has been removed from a young parent or if termination of parental rights is pending. The worker’s role may expand to helping a youth regain custody or avoiding removal of another child in these situations.

Completing the assessment within 60 days proved challenging.

  • If a relationship did not already exist between the child welfare agency and the youth before the referral for assessment, completing the assessment within 60 days was difficult. The specialty worker needed time to develop rapport and build trust with the youth before starting the assessment.
  • Review of agency data revealed many specialty workers were not meeting the 60-day timeframe. Among assessments that had been completed, the average time for completion was 110 days. Among assessments that were still in progress, the average elapsed time was 141 days.

 Many specialty workers performed expanded roles. 

  • Specialty workers often spent time during home visits making referrals to a variety of services (child care, WIC, crisis nurseries, and adoption networks) and performing crisis intervention (mental health issues, food access issues).
  • Specialty workers also consulted on family planning, often advocating for long-acting birth control methods.

Starting sooner may benefit young parents.

  • Some specialty workers felt the assessment should start two months before a baby’s birth. This would give the worker time to develop rapport without the dual pressure of completing the assessment; increase the chance of meeting the 60-day timeframe; and allow the worker to be more proactive and decrease the need for crisis intervention.

Assessments with noncustodial parents were questioned.

  • The validity of assessments with noncustodial parents in DCFS care was questioned unless the noncustodial parent was going to try to regain custody.


Over 20 years later, the impact of the Hill v. Erickson litigation is still being felt through creative approaches like the new birth assessments. The researchers’ findings show new birth assessments are a promising intervention that is valued by the young parents and the professionals who work with them. The assessments help target services to each parent’s specific needs and engage parents at a critical time—soon after their baby’s birth. Parents often benefit from the relationship with their specialty workers beyond receiving direct help with parenting to broader life issues.

The researchers uncovered areas for improvement that should help refine the program to better serve young parents in care. While it was too early in the implementation of the new assessments to study outcomes, that data will help confirm whether the assessments are having a measurable impact.


Claire Chiamulera, legal editor at the ABA Center on Children and the Law, is CLP’s editor. 


Learn More: 

Access the study online:

An Evaluation of the Illinois Department of Children and Family Services New Birth Assessment, by Amy Dworsky and Melissa Wojnaroski. Chicago: Chapin Hall at the University of Chicago, 2012, available at www.chapinhall.org/sites/default/files/New%20Birth%20Assessment_2_11_21_12.pdf