Early assessment of the conditions that led to the child’s placement in foster care, the strengths of the family and the likelihood of reunification within 12 to 15 months. Concurrent planning is based on a sound  differential assessment and prognostic case review that are culturally respectful and based on the family’s history and current functioning. The case review and assessment assist in identifying the family’s strengths, needs and core problems. These processes allow the caseworker and/or permanency team to make some tentative assumptions about the family’s capacity to benefit from reunification services and the need for an alternative plan.  
The importance of beginning the case planning process with a differential assessment and prognostic case review related to reunification is well explained by Fred Wulczyn:

The bedrock assumption underlying child welfare policy is that children are better off if raised by their natural parents. This preference for the role of natural parents is codified in law and provides the rationale for retaining reunification as a core outcome for children placed in foster care. Parents have the fundamental right to direct the care, custody, and control of their children, and it is presumed that, until or unless proven otherwise, they will act in a child's best interest. . . Due in large part to the legal and policy framework protecting parental rights, family reunification remains the primary permanency goal for most children who come into the child welfare system.

Source:  Wulczyn, F. (2004).  Family Reunification. The Future of Children:  Children, Families and Foster Care. Retrieved March 29, 2010

What is differential assessment?
The National Resource Center for Permanency and Family Connections defines differential assessment as:

Individualizing our understanding of the individual, family or group in the context of their present circumstances, past experiences, and potential for future functioning

Deepening our family-centered understanding of the child in the context of family, culture, and community

Strengthening our understanding of the personal, interpersonal and environmental context in which children and families exist and interact

Source:  NRCFCPP. (n.d.) Concurrent Planning Curriculum: Module 2: Differential Assessment to Prevent Foster Care Drift. Retrieved March 29, 2010

What is a prognostic case review?
A prognostic case review considers factors that make timely reunification more or less difficult and more or less likely.   

What information should inform the differential assessment and prognostic case review?
The National Resource Center Permanency and Family Connections identifies the following types of information to be gathered in a comprehensive assessment process:

• Initial assessments of safety/risk and reasons for child welfare intervention and placement
  
• Assessments of family functioning:  assessments of parents, children and family systems that examine family history, current strengths, presenting problems, and underlying needs
  
• Prognostic case reviews to determine the need for additional services and placements with resource families
  
• Child evaluations
  

Source:  NRCFCPP. (n.d.) Concurrent Planning Curriculum: Module 2: Differential Assessment to Prevent Foster Care Drift. Retrieved March 29, 2010

What are the characteristics of meaningful comprehensive family assessments?
The National Resource Center for Permanency and Family Connections identifies the following characteristics of comprehensive family assessments:

• Collaborative: focus on doing with, not for
• Dependent on extensive family input
• Build on resources, strengths and potential capacity
• Identify and explore the core problems that brought the child into care
• Explore underlying history and needs
• Consider the child in context of family, culture and community
• Elicit the parent’s perception of the problems and what they would like to see happen
• Describe child protective services’ and the courts’ perception of problems and recommendations
• Build on what may have been learned in other assessments
• Include an assessment of the family’s environment, physical health, and psychological factors
• Explore social networks: friends, family, buddies, and acquaintances
• Explore relatives and resources for support, placement, and possible permanency
• Ongoing
• Explore options for the present and the future
• Include a plan that articulates who does what and when
• Explore alternative options for safety, permanency and developmental well-being 
• The comprehensive family assessment can be used to enhance the motivation to change and can create windows of opportunity for movement into the process for change. 

Source:  NRCFCPP. (n.d.) Concurrent Planning Curriculum: Module 2: Differential Assessment to Prevent Foster Care Drift. Retrieved March 29, 2010

What factors have been identified as poor prognostic indicators for reunification?
Concurrent planning models frequently use some type of uniform assessment to identify families whose chances for reunification may be initially perceived as being limited. Many programs use strengths assessments and poor prognosis tools developed by Katz and her colleagues, but some have developed their own tools. The most commonly used poor prognosis indicators are the following:  

• Parent has previously killed or seriously harmed another child.
• Parent has repeatedly and with premeditation harmed a child.
• Parent's only visible support system is a drug culture, with no significant effort to change over time.
• Parent has significant, protracted, and untreated mental health issues.
• Parent's rights to another child have been involuntarily terminated.

Source: Lutz, L. (2000). Concurrent planning: Tool for permanency: Survey of selected sites. New York: Hunter College School of Social Work, National Resource Center for Permanency and Family Connections.
At least one study, however, has found no relationship between poor prognosis indicators and the likelihood of family reunification (D'Andrade, Choice, Martin, & Berrick, 2001).

How should indicators of poor prognosis for reunification be used?
The National Resource Center for Permanency and Family Connections advises that agencies should use poor prognosis indicators as only one part of a comprehensive family assessment, along with other assessment tools such as strengths, risk, and safety indicators. A differential diagnosis that includes all these tools may be more effective in helping caseworkers gather and assess all relevant information to determine services and concurrent planning needs.

Source:  National Resource Center on Foster Care and Permanency Planning. (n.d.). Concurrent Planning Curriculum Module 2: Differential assessment to prevent foster care drift. Retrieved March 29, 2010

Training on Differential Assessment

The National Resource Center for Permanency and Family Connections training on concurrent planning includes a module, “Differential Assessment to Avoid Foster Care Drift.”  This module describes comprehensive family assessment and differential assessment. 


Differential Assessment Tools and Guidelines

Arizona’s Reunification Prognosis Assessment Guide
This assessment guide is used to identify children in need of concurrent planning.  The guide provides a list of conditions, designated “Poor Prognosis” indicators, which make timely reunification difficult or unlikely.  The completion of the Reunification Prognosis Assessment occurs within 45 days of the child’s initial placement in out of home care.  The caseworker completes the guide on both parents and in consultation with his/her supervisor. If any of the poor prognosis indicators are marked “yes”, a concurrent plan is recommended. At a minimum, concurrent case planning activities must be implemented.  If a concurrent permanency goal is not identified, the Reunification Prognosis Assessment Guide is reviewed and updated at each case plan staffing.

Kansas’ Concurrent Planning Assessment Matrix
This tool is designed to identity children in need of a concurrent planning placement based on a  family assessment. The assessment is completed at the time the case is open. It seeks to balance a child’s need for permanency with recognition that parents have the capacity for growth and change and that reunification efforts continue in earnest. It is expected that some children living in concurrent planning resource families will reunify. The tool is ideal for team decision making as well as supervisory conference.

Kentucky: 
Concurrent Planning Screening and Self Study
In Step 1, the  caseworker completes the "Concurrent Planning Screening Matrix," (a quick check off list). If the case meets one of the criteria, the case may be appropriate for Concurrent Planning and the caseworker goes to Step 2. If the case does not meet the one of the criteria, the worker does not complete Step 2. There may be a case that meets the criteria required on the "Concurrent Planning Screening Matrix," but there is a judicial determination that Reasonable Efforts to reunite are not required. These cases may not have a permanency goal of Return to Parent, but the caseworker may proceed toward another permanency goal. In Step 2, the  caseworker completes the "Strengths in Families" and "Poor Prognosis Indicators" Worksheets on each parent. The caseworker, in consultation with the supervisor, makes the determination that the case should become a Concurrent Planning Case. The intake worker is responsible for completing Steps One and Two. If a case is not determined to be appropriate for Concurrent Planning during the intake phase, the ongoing caseworker is responsible for completing Steps One and Two at any time when:

• More information is available, or
• Circumstances change and
• There appears to be a poor prognosis for reunification.

Poor Prognosis Indicators
A checklist of indicators under the following topics: catastrophic prior abuse, dangerous lifestyle, significant child protective service history, and inherent deficits.

Strengths in Families Worksheet 

A checklist of strengths under the following topics: parent-child relationship, parental support system, past support system, family history, parent’s self-care and maturity and child’s emotional, cognitive and social development. 

North Carolina’s Family Assessment of Strengths and Needs is used as part of its concurrent planning practice The assessment of family strengths and needs must take place in the first 30 days of a child’s placement in foster care.

US Children’s Bureau’s Comprehensive Family Assessment Guidelines for Child Welfare
address the components of comprehensive family assessment, show the linkages to service planning and service provision, and illustrate how child welfare agencies can support their use.  The guidelines: 

• Define and describe the comprehensive family assessment process in child welfare;
• Articulate the assumptions of quality practice that support the comprehensive family assessment;
• Identify the key points in the casework process when comprehensive family assessment and re-assessment are needed;
• Suggest how the comprehensive family assessment can be used to develop service plans and inform recommendations to the Dependency Court regarding the need for care, custody, and control of the child;
• Provide a case example that illustrates the process of comprehensive family assessment; and
• Identify organizational and administrative supports necessary for effective comprehensive family assessment.

Johnson, M. et al. (2006).  Family Assessment in Child Welfare Services: Instrument Comparison.

National Resource Center for Permanency and Family Connections. (2002). The Family-Centered Assessment Guidebook: The Art of Assessment.
Provides guidance on assessment with respect to the following:

• The family telling their story
• Parenting
• Family fears
• Family resources and strengths
• Kinship/neighbor care options, family connections, support systems
• Child needs
• Child mental health
• Parental mental health
• Parental/child substance abuse
• Domestic violence in the home
• Employment/vocational
• Educational
• Housing/basic needs
• Medical/dental
• Successful visitation
• Reunification/case closure