2019 QCCQ 16058, 2019 QCCQ 16058

Protection de la jeunesse — 1910376 2019 QCCQ 16058 COURT OF QUEBEC CANADA PROVINCE OF QUEBEC DISTRICT OF [...] TOWN OF [...] Youth Division No: 640-41-001897-153 DATE: April 15, 2019 (written judgment rendered on October 4, 2019) ______________________________________________________________________ BY THE HONOURABLE PEGGY WAROLIN J.C.Q. ______________________________________________________________________ IN THE MATTER OF: X , born on [...], 2003 [SOCIAL WORKER 1], Youth Protection worker, duly authorized by the Director of Youth Protection A working in [...] Applicant and A, deceased Mother and B, residing and domiciled at [...] ______________________________________________________________________ JUDGMENT (Section 95 of the Youth Protection Act ) ______________________________________________________________________ WARNING: The Youth Protection Act forbids the publishing or broadcasting of information allowing for a child or the child’s parents to be identified.

Any person who contravenes this provision commits an offence and is liable to a fine (sections 11.2, 11.2.1 and 135 Y.P.A.). [ 1 ] The Director of Youth Protection (DYP) asks the Court to revise a decision rendered on November 21, 2018, regarding the adolescent X, born on [...], 2003. At that date the Court declared the security and development still endangered and entrusted the adolescent to a Group Home with reintegration in a foster family as soon as possible until April 19, 2019. [ 2 ] The DYP submits that the situation does not allow to return the youth to Mr.

B and recommends to entrust her to a rehabilitation centre with a possible reintegration in a foster family as soon as the situation allows it, until April 30, 2020. Position of the parties [ 3 ] Mr. B is present and represented by Me St-Amand. He admits most of the allegations, and he agrees with the recommendations. [ 4 ] X, who is now 16, is present and represented by Me Jennis. She admits most of the allegations, and she agrees with the recommendations if the placement is in Town A.

Historical situation [ 5 ] The Court reproduces the history of the situation as it was drawn by the undersigned in the previous decision. [ 6 ] On March 3, 2015 , an emergency hearing was held and the Court entrusted X to the foster family of C and D (aunt and uncle). [ 7 ] On March 19, 2015 , the Court was seized with another emergency hearing and entrusted X and her brother to a foster family. [ 8 ] On May 7, 2015 , the Court heard the application for protection. X was 12 years old. The mother passed away in January 2011.

After the death of the mother, the grandmother took care of her until September 2014, when she also passed away. After X and her brother were moved from one family member to another one, but no one was reliable enough. Finally, they went to live with an aunt, Ms. E, in Town B. The aunt was hesitant about a long-term involvement with the children, but she accepted. Mr. B hoped to have a new house soon and to be able to have the children back with him. The children developed some attachment problem.

The Court declares that the security and development of the child are endangered and entrusted her to a foster family until the end of January 2016. [ 9 ] On December 9, 2015 , the Court revised the decision. After being with a foster family in Town B, who decided not to continue, the children were entrusted with Ms. F, an aunt who also gave up. They were entrusted to a cousin for two nights, but it became necessary to separate X and Y. X was entrusted to a foster family in Town C and Y went back with F, in another community. Mr. B reduced his alcohol consumption, but always accepted consumers in his place.

After few behavioural issues and threats and after being entrusted to a rehabilitation centre, X is doing better. The Court entrusted her to a foster family until August 17, 2016.

[ 10 ] On January 13, 2016 , the situation of X was getting worse and the Court was seized with an emergency measure. As she was nowhere to be found, the Court order a warrant under

section 35.2 YPA. [ 11 ] On January 19, 2016 , X had been found and brought to the Group Home but she ran away. The Court entrusted her to a rehabilitation centre. [ 12 ] On March 17, 2016 , the Court noted that it had been necessary to entrusted X to a Group Home because since December 2015, she ran away many times, she displayed suicidal ideation and self-mutilation. During her running away, Mr. B was aware that the DYP was looking for her, but he helped her to hide from the workers.

The Court entrusted her to a rehabilitation centre until August 17, 2016. [ 13 ] On July 20, 2016 , X underwent to a psychological assessment. Because she had a very aggressive behaviour, the child psychiatrist, who follows her since the death of her mother (January 2011), asked to investigate for a potential ADHD and FASD. The rehabilitation centre also noted that the schooling was very difficult even if it’s offered in the centre. The psychologist indicated that her face let think that she could suffer from a FASD and Mr.

B, who was also met, reminds that the mother was drinking a lot during the pregnancy and after the birth. X started walking when she was between 2 and 3 years old and she started speaking when she was between 4 and 5 years old. The psychologist concluded that she is in the mild range of intellectual disability and cognitive potential with signs of ADHD for which she does not have medication. He highly recommended a neuropsychological assessment in conjunction with a referral to Dr.

Kent Saylor, pediatric specialist in FASD at Montreal Children’s hospital. [ 14 ] On August 17, 2016 , the situation of X was revised. She was at the rehabilitation centre since January 2016. Her behaviour improves a lot, but she still needs rehabilitation services. Mr. B continued to reduce his alcohol consumption and had a stable job. He still needs to work to improve his parental skills. The Court entrusted X to a rehabilitation centre until [...], 2017. [ 15 ] On March 3, 2017 , the Court noted a recent improvement in her behaviour. The evidence also showed that X had a strong character.

During the month of January 2017, she ran away and stayed at her aunt’s place, Ms. D. Mr. B was still not able yet to have her back at home. The Court entrusted her to her aunt, D until January 28, 2018. [ 16 ] In July 2017 , as X was entrusted to her aunt with her brother, the DYP was informed that the aunt had alcohol consumption issues. X ran away for one week in July 2017. On August 1, 2017, she was found and entrusted to a foster family in Town B, but she did not respect the rules.

Between August 1, 2017, and September 20, 2017, she was entrusted to three different foster families. [ 17 ] On September 20, 2017 , the Court was seized with an emergency hearing and entrusted X to a rehabilitation centre and recommended that she would be entrusted in the Group Home of Town C. She ran away two hours after her arrival. She was suspected of stealing some food at the grocery store. She was found by the police only on November 11, 2017, while she was intoxicated.

As she revealed being raped, she was brought to the nursing, but ran away upon her arrival at the nursing. [ 18 ] On November 16, 2017 , she was found and entrusted to the Group Home in Town A. The Court was seized with the application for revision, entrusted X to a rehabilitation centre until the end of November 2018, and authorized the reintegration in a foster family in June 2018, if the situation allows it. [ 19 ] On November 21, 2018 , the undersigned was seized with an application for revision. X was still at the Group Home in Town A. Mr. B went few times to see her, and it went very well.

She also came for home visits and she did very well. Doing so, and considering her behaviour did not request any more rehabilitation services, the DYP wished to start a progressive reintegration in a foster family in Town C, but X was very confused regarding the place she would like to live, unable to project herself in the future. She liked being in Town A, but no foster families were available there, and in those circumstances, she would prefer to stay at the Group Home.

The evidence also revealed that X met with the child psychiatrist few times, but the DYP ignored if she was evaluated for ADHD, nor for FASD by a neuropsychiatrist as it was highly recommended in 2016. [ 20 ] To allow the DYP to find the appropriate foster family, the Court maintained X to the Group Home with integration in a foster family as soon as possible. The Court also ordered that a FASD evaluation and a psychological evaluation be performed within two months. Facts [ 21 ] Since the last decision, X stayed at the Group Home in Town A.

She started working at the grocery store, went to school and performs very well. She still had difficulties to manage her emotions and makes crisis sometimes, but generally she is doing very great at the Group Home. [ 22 ] She frequently changed her mind regarding the place where she would like to live. The DYP is still looking for a foster family and specifies in the revision report: […] We want to find the right family for X because she can display behaviours that can be hard to deal with and we will need someone that can be constant with her. The rules will need to be clear and easy to understand.

The consequences will need to be given right after the behaviour so the youth can understand the link between her actions and the consequences that result from them. She is also a youth who needs to be guided to prevent those behaviours. The family will probably need support to manage her reactions and will have to know about her situation. [ 23 ] X was evaluated by Dr. Joseph Beltempo, psychologist. Regarding the approach recommended for the counsellor who will follow her, Dr.

Beltempo says: […] The counsellor/therapist must convey a sense of trust and willingness to develop a constructive treatment alliance before anything else. The balance between professional authority and tolerance is necessary in order to reduce the possibility that she will impulsively withdraw from treatment. In addition, we must explore diverse and multi-pronged therapeutic techniques such as dialectical behaviour therapy and cognitive restructuring ideas about herself.

[ 24 ] Dr. Beltempo concludes: X was able to comply much more collaboratively with the current psychological assessment compared to that of 2016 where she was much more oppositional. Throughout this assessment, we have seen an adolescent coming to increased maturity but being plagued at the same time by underlying attachment issues as well as possible attentional and impulsive traits. She has an underlying depression — in particular dysthymia probably stemming from the separation and loss of her Grandmother with whom she lived with from 6 to 11 years old. Although she lives with her brother in the same Group Home (Town

A) for the past year and a half, according to the workers, X tends to parentify him. She acknowledged that she actually “only wants to protect him and not be his Mother”. They also frequently argue. The attachment (ambivalent-disorganized) issue seems to be pervasive in her relationships with peers, which she needs to keep at bay. X enjoys school but has been showing significant difficulties in being able to pay attention and to learn specific subjects such as Math .

She has agreed to be followed-up on a weekly basis for one hour of psychotherapy with a psychologist or professional counsellor to address her problems of her moodiness as well as her learning problems. Psychological follow-up is available in Town A but not in Town C. She seemed to be very open, compliant and positively allied with the Examiner to the extent that she would probably do well with someone who is able to see the world through her viewpoint and build trust from that.

Although X now shows more maturity and insight as compared to the 2016 assessment she still needs much more trust building with an adult parent figure to be able to come through and deal with some of the existing problems. In terms of her mood, much of her irritability and mood swings seem to stem from feelings of being overwhelmed by the demands of others, such as adults. This must be negotiated in a therapeutic alliance with a focus on the reality testing as well as emotional regulation. 1. X needs to learn how to relax in order to deal with her underlying anxiety and insomnia.

We recommend Jacobson method of Progressive Muscle Relaxation . 2. X needs to reduce the alcohol and drug use . Although X is doing quite well currently she is at high risk for acting out when her sadness and emotions intensify. 3. X needs to address and be more patient to work within limits of her learning abilities at school. We must underline that her motivation and the fact that she loves school must be supported. 4.

Once again, we must recommend a thorough neuropsychological assessment in order to identify her academic strengths and weaknesses as well as whether these deficits may be related to Fetal Alcohol Spectrum Disorder (FASD) . X is fully aware of her Mother’s drinking during her pregnancy as part of the cause. She would like to clarify this question, once and for all. I recommend once again a neuropsychological assessment, as recommended in 2016, be done as soon as possible. [ 25 ] Those recommendations have been explained to X and Mr. B.

The request was made to start the personal follow-up as recommended. [ 26 ] X also went to Town D for her neuropsychological assessment. The neuropsychologist notes the same characteristic as Dr. Beltempo and notes that the FASD evaluation should have done for many years. As Dr.

Beltempo, she concludes to a persistent depressive disorder and a language disorder, but the diagnosis of intellectual disability was not retained. [ 27 ] The neuropsychologist’s recommendations are the following: - Organising an appointment with a medical doctor specialised in FASD; - Helping X find a psychologist or a counsellor she trusts to work on her attachment issues, her depressed affects and her emotional regulation; - Encouraging her to use different relaxation techniques, other than alcohol and drugs, to decrease her anxiety and her insomnia; - Helping X in her academic pursuit by supporting her motivation for school, encouraging her to be more patient in the process and working within the limits of her learning abilities; - Implementing an individualized Educational Plan (IEP) in school so that she could benefit from all the adaptations that are usually put into place for students suffering from a learning disability; - Adaptation of her to work in a quiet place, separate her tasks into smaller parts and avoid giving her too many instructions; - Considering she wishes to become an educator, it would be important for her to meet with a guidance counsellor to think about her future career and the upcoming academic years.

It will be important to help her to find a program that leads to a job that will make her happy. This process could help her to stay motivated in school. [ 28 ] The neuropsychologist concludes: […] considering the cumulative effect of her cognitive and emotional difficulties, her learning process will continue to be much slower than expected for her age. She will probably not be completely autonomous by the age of 18.

Therefore, if we want to give her a real chance at succeeding, it would be interesting to consider extending her schooling up to the age of 21 to enable her to experience success in her academic pursuit and to equip her adequately for her adult life. [ 29 ] The DYP worker also communicated with the school to give them the recommendations. For now she is still waiting for a call return and to start the implementation of the recommended measures. [ 30 ] The request was made for the FASD evaluation, but it appears difficult to make an appointment. The pressure will be maintained to have it done shortly.

[ 31 ] M. B maintained contact with X by phone, and in person each time he came in Town C. He understands that she prefers to stay in Town A. Analysis [ 32 ] The Court notes that the situation continues to evolve positively. X is doing much better, and a lot of questions regarding her needs have been answered. [ 33 ] One question still needs to be answered. It’s the one of the potential FASD.

X wants to know more about that to be able to understand her personal situation and to adapt herself to these specific syndrome if needed. [ 34 ] The Court understands that it could be long to obtain an appointment, but asks the DYP to maintain the pressure to offer this service to X in an urgent manner. [ 35 ] That being said, the Court wants to insist on the facts that most of the other orders have been respected and X is now better prepared for the next steps. The evidence shows that the energy has been put by the DYP worker to obtain the relevant evaluation and to communicate the result.

Now the energy should be maintained to make sure that all the stakeholders will collaborate properly in the best interest of X. [ 36 ] X is able to project herself in the future. She has dreams and, as any other adolescents, she has the right to receive the appropriate help to succeed.

FOR THOSE REASONS, THE COURT: [ 37 ] GRANTS the application; [ 38 ] DECLARES that the security and development of youth X, born on [...], 2003, are still endangered; [ 39 ] ORDERS that the adolescent be entrusted to an institution operating a rehabilitation centre, chosen by the institution operating a child and youth protection centre, with a possible reintegration in a foster family as soon as the situation allows it; [ 40 ] RECOMMENDS that the adolescent be entrusted in the Group Home of Town A and in a foster family in Town A; [ 41 ] ORDERS that X met with a doctor specialized in FASD to confirm or disprove the diagnosis of FASD; [ 42 ] AUTHORIZES this professional to have access to Dr.

Beltempo’s evaluation, Dr. Amira Amane’s evaluation and to the entire medical and schooling files of X; [ 43 ] ORDERS that all recommendations set out by the professional are followed including any other evaluation he or she could suggest; [ 44 ] ORDERS that X benefit from a follow-up with a psychologist or a counsellor she trusts, to work on her attachment issues, her depressed affects, her emotional regulation and her learning difficulties on a weekly basis for one hour of Psychotherapy; [ 45 ] AUTORIZES the psychologist or the counsellor to have access to a copy of Dr. Beltempo’s evaluation and Dr.

Amira Amane’s evaluation; [ 46 ] ORDERS that all the recommendations set out by Dr. Beltempo and Dr.

Amane be followed; [ 47 ] ORDERS the Director of Youth Protection to make sure that the school is aware of the recommendations to facilitate the schooling and that the services are offered according to the recommendations; [ 48 ] ORDERS that the psychological evaluation, the neuro-psychological assessment and the conclusions are explained to the foster family, if it is relevant to help them to intervene with her; [ 49 ] AUTHORIZES the Director of Youth Protection to have information from school upon request; [ 50 ] ORDERS that Mr.

B report in person, at regular intervals, to the Director of Youth Protection to inform her of the current situation; [ 51 ] ORDERS that the adolescent and Mr. B take an active

part in the application of any measures ordered by the Court and cooperate fully with the Director of Youth Protection; [ 52 ] ORDERS that the adolescent attend a school or another place of learning or participates in a program geared to developing skills and autonomy; [ 53 ] ORDERS that Mr. B remain sober in the presence of the adolescent; [ 54 ] ORDERS that all contact between the adolescent and Mr.

B be encouraged, facilitated and the terms and degree of supervision be supervised by the Director of Youth Protection; [ 55 ] ORDERS that the contacts between the children occur on a regular basis if they are entrusted to different villages; [ 56 ] ORDERS that a person working for an institution or body, provide aid, counselling or assistance to the adolescent, Mr. B and her foster family;

[ 57 ] ENTRUSTS the situation of the youth X, to the Director of Youth Protection A, who shall then see that the measures are carried out; [ 58 ] ORDERS the police to collaborate to the execution of the enactment; [ 59 ] THE WHOLE until April 30, 2020. __________________________________ PEGGY WAROLIN , J.C.Q. Me Caroline Daniel, attorney for the Director of Youth Protection Me Caroline Jennis, attorney for the youth Me Félix St-Amand, attorney for the interested party Date of hearing: April 15, 2019