Court of Appeals of Ohio, Second District, Montgomery
from Common Pleas Court Case Nos. 2016-4187, 2016-4188,
2016-4189- Juvenile Division
MATHIAS H. HECK, JR., by SARAH E. HUTNIK, Montgomery County
Prosecutor's Office, Appellate Division, Attorney for
MARSHALL G. LACHMAN, Attorney for Appellant/Father
M. BARRY, Attorney for Appellant/Mother
1} Following the parents' separate objections to
a magistrate's decision, the juvenile court awarded
permanent custody of three-year-old D.G. to the Montgomery
County Department of Job and Family Services, Children
Services Division ("the Agency"), and legal custody
of D.G.'s siblings, 12-year-old AT. and two-year-old
E.G., to the non-family guardians ("Mr.
& Mrs. H") with whom AT. and E.G. had been living
for more than two years. Mother, who is the parent of all
three children, and Father, who is the
"legal" parent of D.G. and E.G.,  filed separate
appeals from that judgment, which appeals have been
consolidated before this Court. The judgment of the trial
court will be affirmed.
and Procedural Background
2} The Agency first became involved with Mother and
her three children in or about January 2015, following a
referral related to A.T.'s repeated absences from school.
An investigation found that the home where Mother and the
children were living was "very cluttered," with
"little room for an adult to move or a child to
play." (See Case No. 2016-4189, Doc. #73, p.
Other concerns also were recorded, including the "dirty
and unkempt" appearance of both AT. and D.G., the two
older children. (Id.) However, removal of the
children was not found to be warranted at that time.
3} On June 29, 2016, when Mother's mother
("Maternal Grandmother") dropped AT. and D.G. at
daycare, she told the staff that D.G. had a
"sunburn" on his bandaged left leg. Upon unwrapping
that leg, staff at the daycare saw what appeared to be
"a severe second degree burn" that was "not
consistent with a sunburn." (Id.) The daycare
contacted the Agency, which contacted Mother and the police.
Both AT. and D.G. immediately were placed in the Agency's
emergency custody. D.G. was transported to the hospital,
where Mother met with an Agency representative and "gave
several different stories as to what had happened" to
D.G.'s leg, none of which was consistent with the injury.
(Id.) The Agency also became aware of an earlier
injury to D.G., evidenced by a large bruise at the base of
D.G.'s skull detected by daycare staff on June 1, 2016.
4} E.G., an infant, also was removed from
Mother's care and transferred to the Agency's
emergency custody at that time. E.G. was placed with
non-relative caregiver Mrs. H, while AT. initially was placed
with a different caregiver.  On June 30, 2016, the Agency
filed an abuse, neglect and dependency complaint as to D.G.,
as well as neglect and dependency complaints as to AT. and
E.G. By interim order entered that day, the juvenile court
granted temporary custody of E.G. and AT. to their respective
caregivers and temporary custody of D.G. to the Agency. (Doc.
5} Shortly thereafter, the Agency filed an initial
case plan with a stated goal of returning all three children
to parental custody. (Doc. #67.) The case plan noted that
Mother "appear[ed] to love her children very much"
and "ha[d] a strong support system." (Id.)
However, the plan also noted that Mother acknowledged
experiencing mental health issues, lacked independent
housing, had limited income, lived in "deplorable"
conditions, and was in a relationship with Father, who had
been convicted of domestic violence against Maternal
Grandmother and also had two recent child endangering
6} The plan set specific objectives for both Mother
and Father. Mother was to 1) obtain and maintain stable
housing, 2) obtain and maintain sufficient income to support
her family, 3) follow up with recommended mental health
counseling and comply with any recommendations, including as
to medication, and 4) complete a parenting and psychological
evaluation and follow through with all recommendations.
Father was to 1) comply with all conditions of his probation
and receive no new criminal charges, 2) successfully complete
a domestic violence/batterer's intervention program, 3)
follow through with mental health counseling and medication
as indicated, 4) successfully complete a parenting and
psychological evaluation and follow through with all
recommendations, and 5) have stable income and housing and
"financially and emotionally support his children."
(Id.) Both Mother and Father signed the plan
7} On August 24, 2016, a guardian ad litem
("GAL") appointed as to all three children filed a
report with the juvenile court. The GAL reported that AT. had
been moved to live with Mr. and Mrs. H and that both AT. and
E.G. appeared to feel comfortable there. D.G. was in a
different home with a foster family. According to the GAL,
AT. stated that Mother "can't take care of the
[babies] she has." (Doc. #60, p. 2.) The GAL reported
that AT. also recently had "disclosed instances of
abuse" by Father (who is not A.T.'s father.) Mother
reportedly no longer was in a relationship with Father, but
had begun a new relationship. The GAL stated that although
AT. said she "missed" Mother, AT. did not want to
return to Mother's custody. Mother frequently was late
for supervised visits, but did attend those visits and
"appeared to care for" the children. (Id.)
The GAL recommended that the Agency's temporary custody
of D.G. be extended; that Mrs. H be granted temporary custody
of AT.; that Mrs. H's temporary custody of E.G. be
extended; and that Father be ordered to have no contact with
8} Following a hearing on August 30, 2016, the
juvenile court adjudicated AT. and E.G. dependent and
neglected children; adjudicated D.G. a dependent, neglected,
and abused child; granted temporary custody of AT. and E.G.
to Mrs. H through July 1, 2017; and granted temporary custody
of D.G. to the Agency through July 1, 2017. (Doc. #58.) The
court also approved the previously-filed case plan.
9} A semi-annual review conducted by the Agency in
November 2016 reflected that Mother was living with Maternal
Grandmother and was engaged to marry a convicted sex offender
(not Father). (Doc. #55.) Mother was maintaining
"sporadic" contact with the children and was in
counseling, but her income was insufficient to meet the
children's needs. The review concluded that Mother had
made "very little progress" on her case plan.
(Id., p. 6.) Father had been investigated for sexual
abuse allegations involving AT. He had participated in some
domestic violence classes, but had not followed through on
mental health referrals.
10} A similar review conducted in May 2017 showed
that Mother was compliant with mental health services and had
completed parenting classes, but continued to lack
independent housing, staying either with her boyfriend (the
convicted sex offender) or with Maternal Grandmother. (Doc.
#54.) Father was residing with his girlfriend, had no income,
had missed multiple parenting classes and had not completed a
batterer's program, was "inconsistent with his
mental health provider," did not consistently visit his
children, and had "voiced the possibility of moving to
Oklahoma." (Id., p. 2.) The May 2017 review
concluded that a "level of risk" remained as to
placing the children with Mother, and that Father had made
"marginal progress" toward his case plan
objectives. (Id., p. 4.) The Agency recommended that
all three children remain in their current placements, but
suggested that "a permanency review" might be
needed "based on time frames." (Id.)
11} Thereafter, the Agency filed a motion for a
first extension of temporary custody as to D.G. (Doc. #53),
as well as motions for first extensions of temporary custody
to non-relatives with respect to both E.G. and AT. (See
Id., Case Nos. 2016-4188 and 2016-4187, Doc. #47.) All
three motions were supported by affidavits attesting that
Mother had made "some progress" and/or Father had
made "minimal progress" on their respective case
plan objectives, but detailing shortfalls that the Agency
believed to warrant extensions of the children's existing
temporary custody placements. (Doc. #53; Case Nos. 2016-4188
and 2016-4187, Doc. #47.) Following an August 15, 2017
hearing, the juvenile court granted the motions and extended
the temporary custody orders as to all three children through
December 31, 2017. (Doc. #42.)
12} On October 31, 2017, the Agency filed motions,
again with supporting affidavits, seeking second extensions
of temporary custody as to all three children. The following
month, the Agency conducted its semi-annual review. The
report of that review chronicled a variety of medical issues
afflicting each child, including A.T.'s diagnoses of post
traumatic stress disorder (PTSD) and attention deficit
hyperactivity disorder (ADHD) and her hospitalizations due to
self harm and flashbacks; E.G.'s diagnoses of
celiac disease and "global developmental
delays" and his participation in speech, occupational,
and physical therapy; and D.G.'s diagnoses of Chiara
malformation and developmental delays and his participation
in speech, occupational, and physical therapy. (Doc. #39.)
The report disclosed that Mother's visits with AT. had
been "suspended" and that Father was "no
longer involved" in visits with E.G. and D.G.
(Id.) Mother continued to have visits with both
boys, although D.G. displayed "very flat effect"
[sic] during those visits. Mother had no independent housing
and worked "only a few hours a week." She recently
had completed a parenting psychological assessment, based on
which the assigned psychologist "did not support
unification." (Id.) Father had completed a
parenting class and a program for batterers, but he had no
known income or stable housing, he had not completed a
parenting psychological assessment or anger management, and
he was "refusing to take medications."
(Id.) Father was on probation as a result of
"threatening the case worker and the deputy" during
a supervised visit, and he had not been in contact with the
13} The review concluded that the existing
placements of all three children remained safe and
appropriate. Based on Mother's recent psychological
assessment results, the Agency on November 28, 2017 moved for
permanent legal custody of D.G. (who remained with the same
foster family), and that legal custody of AT. and E.G. be
given to Mr. and Mrs. H, their existing custodians.
14} In a report filed on November 29, 2017, the
children's GAL described her recent individual visits
with each child. (Doc. #37.) AT. was struggling in school and
with "delicate" mental health after revealing
incidents of past sexual and psychological abuse.
(Id., p. 3.) The GAL reported that AT. had not seen
Mother in over a year based on the recommendation of
A.T.'s psychologist, who believed that visits with Mother
were triggers for AT.'s "mental health crises"
(i.e., "episodes of hospitalization and/or
breakdowns"); such episodes could be triggered by visits
or voice communications with Mother, or "even if [AT.]
is only reminded of [Mother] by smell o[r] the mention of her
15} The GAL described E.G. as "clean and
happy," but "atypical in appearance."
(Id.) According to the GAL, E.G. was "extremely
small for his age and ha[d] not reached many of his
age[-]related goals." (Id.) E.G. was deemed
"likely * * * [to] require special services for the
foreseeable future." (Id.) D.G. had undergone
surgery for Chiari malformation and was progressing well
physically, but was at risk for developmental disabilities.
The GAL described D.G. as "walking * * *[, ] playing * *
*[, ] well cared for and content." (Id.) All
three children reportedly were bonded with their caregivers.
Both boys continued to have visits with Mother.
16} Mother missed her first appointment with the
GAL, but did appear for a rescheduled appointment. Mother
expressed determination to "fight for all three of her
children," and said she believed that her separation
from AT. was not in A.T.'s best interest. Mother had
attended medical appointments for and visits with both E.G.
and D.G. and asserted that she was "learning to
engage" with them. (Id.) Mother continued to
live with Maternal Grandmother and work part-time. She had no
contact with Father or with AT.'s father. Mother said she
"would have taken action" had she realized that AT.
was being sexually abused. (Id., p. 4.) Mother
denied being in a relationship, but said she had a helpful
"friend," the man previously identified as her
boyfriend and a sex offender. (Id.) Mother claimed,
however, that the friend's conviction "was a
mistake." (Id.) She said she would be willing
to "remov[e] him from her life" if necessary to
reunite with her children. (Id.)
17} AT. reportedly told the GAL that she did
"not wish to return to the care of her mother and wished
to remain with Mr. and Mrs. H. (Id., p. 5.) The GAL
expressed "multiple concerns" about reunifying any
of the children with Mother, including a concern that Mother
was "cohabitating with a sex offender despite her
denial." (Id.) Mother told the GAL that she
(Mother) would have "no concern leaving the children,
including AT.," in that man's care while Mother was
at work. (Id.) The GAL also was concerned about
Mother's "minimiz[ing] AT.'s trauma" and
Mother's lack of awareness at the time of the alleged
abuse. Further, the GAL doubted Mother's ability to
consistently schedule and attend the children's necessary
appointments. "Most importantly," the GAL doubted
Mother's ability to provide adequate parental care for
the medical, developmental, and/or mental health issues of
all three children.
18} The GAL's report subsequently was amended
after AT. again was treated at the emergency room for
flashbacks following contact "with Mother and other
maternal relatives." (Doc. #26, p. 2.) The GAL opined
that "contact with mother is detrimental to [A.T.]'s
mental health well-being." (Id.)
19} The matter was scheduled for a dispositional
hearing on January 31, 2018 as to the pending motions for
permanent and legal custody. (Doc. #36)
20} On January 31, 2018, a juvenile court magistrate
held a hearing at which both Mother and Father appeared.
D.G.'s foster mother ("Foster Mother) testified that
D.G. had been living with her since June 2016, when he was
just over one year old. Foster Mother said that when D.G.
arrived in her care, he "was covered * * * in bug
bites[, ]* * * had a large burn on his leg[, * * *
and had] light bruising sporadically on his body." (Tr.,
Vol. I, p. 16.) She said he later had "chronic ear
infections" and was "sick almost
continuously," eventually leading her to take him to an
immunology specialist. (Id., p. 21.) Foster Mother
said that D.G. had been hospitalized three times for various
ailments while in her care. (Id., p. 25.) One of
those was for brain surgery in November 2016, to treat Chiari
malformation, a condition in which part of D.G.'s brain
protruded out of his skull and "down in his neck."
(Id., p. 23.) She said that D.G. would need
continued monitoring for that condition in order to detect
headaches, balance issues, speech impairment, or other
altered motor functioning that could be signs of a new
problem. (Id., pp. 23-24.)
21} Foster Mother also expressed concern about
D.G.'s "emotional state." (Id., p.
16.) She said that from the time he arrived in her home, D.G.
behaved differently than other foster children for whom she
had cared. For example, when she tried to put D.G. to sleep,
"[h]e just kept waking up and jerking * * *."
(Id.) She opined that D.G. "didn't [seem
to] feel like it was safe to go to sleep."
(Id.) In addition, "it would take an hour to
change his diaper because he would fight so violently";
"[h]e would claw at me. He would kick at me, and he
would scratch. He would like be swinging his arms, trying to
hit me. * * * [H]e acted like someone who was afraid of
everything." (Id., p. 17.) At the time of the
hearing, D.G. continued to have behavioral outbursts
"[m]ultiple times a week," including hitting adults
and other children. (Id., p. 27.) D.G. had begun to
see a counselor for help with managing those issues.
22} Foster Mother described developmental delays
that affected D.G. When he arrived in her care, "[h]e
couldn't sit up yet on his own. * * * He wasn't
walking." (Id., p. 16.) He could "kind
of" crawl, but not a "normal crawl"; "his
balance was really bad," and "he would fall over
when trying to sit up. (Id.) At the time of the
hearing, D.G. was participating in speech therapy, physical
therapy, and occupational therapy, and was "catching up,
but * * * still somewhere between six and twelve months
behind where he should be for his age." (Id.,
pp. 19-20.) Foster Mother said that D.G. had been diagnosed
with "complex developmental trauma" that
contributed to his delays. (Id., pp. 20, 28-29.)
23} Foster Mother said that she and her husband were
interested in adopting D.G. They had two biological children,
one of whom was grown and out of the house, and two other
adopted children. (Id., p. 32.) Foster Mother said
that D.G. was "really * * * attached" to the other
children in the home. She described D.G. as being "like
our birth child. * * * We just really love him."
(Id., p. 31.)
24} Dr. Rhonda Lilley, a clinical psychologist,
appeared as the Agency's expert witness. Dr. Lilley
testified that she met with Mother on three occasions - on
December 22, 2016, with Mother alone, and again in March and
June 2017, when D.G. and E.G. also were present with Mother.
During the first meeting, Dr. Lilley conducted a clinical
interview to learn about Mother's background, "what
led her to be involved with Children Services,"
"her issues and concerns," and to "explore
[Mother's] mental history[, ] and * * * strengths and
weaknesses as a parent." (Id., pp. 42-43.)
Mother also was asked to complete various psychological tests
at that time. (Id., p. 43.)
25} During the two later visits, Dr. Lilley focused
on observing Mother's interactions with D.G. and E.G. She
said that the March 2017 visit was "very brief * * *
because of the distress of one of the children."
(Id.) The June 2017 visit then was scheduled to
allow Dr. Lilley to witness more interaction with the
children. At that time, Dr. Lilley also sought updated
information about Mother's employment, housing, and life.
26} Dr. Lilley identified a report she prepared
based upon her clinical interview with, and her observations
and testing of, Mother. (State's Exh. 1.) The report
recorded Dr. Lilley's assessment that Mother displayed
"excessive" defensiveness, indicative of a person
"who tends to deny a lot of responsibility for [her]
behavior." (Id., p. 48.) Dr. Lilley said that
Mother's "limited insight" into her
"dysfunctional" behavior could affect her parenting
ability, leaving Mother less likely to "see a reason to
change" and "more likely to make decisions that are
in [her] own best interest rather than in the interest of
[her] children." (Id., pp. 49-50.) Dr. Lilley
termed that "a significant concern," manifested
through examples such as Mother's blaming AT. for causing
D.G.'s leg burns by placing him in a swing, and
Mother's defending Father instead of advocating for AT.
with respect to A.T.'s allegations of sexual abuse.
(Id., pp. 50-51.) Dr. Lilley noted that at the time
of the interview, Mother was involved with a man who
"had a history of sexual abuse of a minor," yet
Mother claimed the prior abuse history was not her
partner's fault because "the child had lied about
her age." (Id., pp. 52-53.) Dr. Lilley
expressed concern about Mother's failure to acknowledge
the "red flag" indicating that the man posed a
potential risk to her children. (Id., p. 53.) Dr.
Lilley said that Mother's pattern with regard to people
she brought into her life "creates a high risk
factor" as to "providing a safe environment for her
children[, ] * * * where the child's interest and needs
are primary rather than secondary." (Id., p.
27} As to the results of the Parenting Stress Index
("PSI") test Mother completed, Dr. Lilley noted
that Mother did not identify any life stressors, despite
"not having a job," her children being absent from
her home, A.T.'s refusal to visit Mother, and D.G.'s
having recently been diagnosed with Chiari malformation.
(Id., pp. 55-56.) Dr. Lilley stated that
Mother's failure to recognize those factors as stressors
could indicate a lack of empathy or ability to make
accommodations. She said that Mother did report feeling
"strongly bonded with her children." (Id.,
28} Dr. Lilley said that on another psychological
test, Mother described "feelings of persecution"
related to the custody issues with her children.
(Id., p. 59.) Mother "did express regret"
about her selection of partners around her children and about
having AT. "assume some of the parenting
responsibilities" while AT. lived with Mother.
29} According to Dr. Lilley, her interview with
Mother revealed that Mother "had some very difficult
life experiences," including abuse, that "likely
have affected her emotional well-being" and her
parenting. (Id., p. 60.) Mother reported "a
long pattern of * * * living with her mother, trying to live
on her own unsuccessfully, and then back living with her
mother." (Id., p. 61.) As of June 2017, Mother
again was living with Maternal Grandmother. Mother provided
no history of long-term stability in housing or employment.
Dr. Lilley observed that "it's very hard to provide
a stable environment for your children if you don't have
a stable residence, if you don't have a stable income
from which to support them. Those are two critical elements
in providing a safe and consistent environment" for
one's children. (Id.) Dr. Lilley concluded that
Mother tended "to be dependent upon others,"
including "considerable dependency" on Father
during their relationship, as well as dependency on Maternal
Grandmother. (Id., pp. 61-62.)
30} Regarding her observations of Mother with D.G.
and E.G., Dr. Lilley reported that Mother arrived 30 minutes
late for the March 31, 2017 visit. While awaiting
Mother's arrival, Dr. Lilley observed E.G. and D.G.
engaging in "very positive" interactions with their
caregivers. (Id., p. 63.) After Mother arrived,
however, E.G., the younger son, was "so distressed"
to be separated from his caregiver that Dr. Lilley
"terminated the parent/child interaction."
(Id., p. 62.)
31} During the rescheduled June 23, 2017 visit, Dr.
Lilley began with Mother and the caregivers in the same room
with E.G. and D.G. When the caregivers left, E.G.
"whined a little bit, but * * * did not act
distressed." (Id., p. 64.) Dr. Lilley said the
boys at first exhibited "no reaction" to
Mother's presence; "They didn't run to her. They
didn't smile in greeting with her." (Id.,
p. 66.) E.G. eventually engaged in play with Mother, while
D.G. "played more independently;" D.G.
"didn't avoid contact" with Mother, but
"he didn't actively engage her in play.
(Id., p. 65.) Although Dr. Lilley felt that Mother
initially did not react "very proactively," she
later "did a good job of getting each one of the kids a
toy to play with." (Id.) It was Dr.
Lilley's understanding that AT. had refused to
participate in the March and June 2017 visits with Mother.
32} Based on her observations during the June 2017
visit, Dr. Lilley concluded that Mother "was bonded with
her sons, * * * cared very much about them, and * * * wanted
to have a relationship with them." (Id., p.
66.) However, E.G. and D.G. "did not demonstrate a
strong attachment or even a strong bond" to Mother.
33} Dr. Lilley diagnosed Mother as having an
adjustment disorder with both depression and anxiety, as well
as a personality disorder, "undifferentiated with
dependency features." (Id., p. 67.) She opined
that the combination of those disorders created
"significant concerns" regarding Mother's
"decision making, problem solving, [and] tendency to
make decisions that are in [Mother's] own best
interests." (Id., p. 68.) Dr. Lilley stated
that such "entrenched" behaviors amount to
"risk factors for * * * an environment where the
parent's needs may come first rather than the
child's, where the parent's need for love and
security may come at the expense of the child's needs for
safety and security." (Id.) She testified that
caring for children with special needs "would increase
and exacerbate the risk." (Id., p. 70.)
34} Dr. Lilley said she hoped that with
"adequate treatment," Mother "could overcome
some of the problematic aspects of her personality
dynamics," but "it is not a short term
process." (Id., p. 68-69.) Dr. Lilley opined
that such entrenched characteristics "aren't cured
in * * * even six months of counseling" (Id.,
p. 69.) On cross-examination, she termed the prospect of
Mother overcoming such issues in five months "[h]ighly
unlikely" and "very doubtful." (Id.,
pp. 70, 71.)
35} Also on cross-examination, Dr. Lilley stated
that "the issue was never whether [Mother] loved her
children or whether she wanted to parent them. The issue was
capacity to parent, which is where I found her lacking."
(Id., p. 73.) She noted that since A.T.'s birth,
has failed to demonstrate financial stability, interpersonal
stability, relationship stability; has consistently made
choices that were in the best interest of herself rather her
children. That's a ten-year period. For every ten years
of dysfunction, we need almost an equivalent amount of
intensive therapy * * * so that we can say this person is not
a risk factor for themselves and/or for their children.
(Id., pp. 73-74.)
36} On re-direct, Dr. Lilley reiterated that, as a
"[g]eneral rule," in order to expect significant
progress, "for every year of dysfunction, we want at
least a year or two of intensive therapy. Not months or
weeks. Years." (Id., p. 76.)
37} The Agency's final witness was Cathie
Stokes, a child services caseworker who had been involved
with Mother and her family "off and on since January
2015." (Id., p. 78.) Stokes said the Agency
opened a case in October 2015 after a referral alleged
"deplorable conditions in [Mother's] home" and
raised concerns about A.T.'s school attendance.
(Id.) The investigation at that time found
Mother's home to be "in pretty poor shape," but
not bad enough to warrant A.T.'s removal. (Id.,
p. 79.) Instead, the Agency developed a case plan "to
work with [M]other to address the concerns."
(Id.) Ultimately, however, the children were removed
from the home in June 2016, and had not returned to
Mother's care or the care of their respective fathers
38} Stokes testified that when the children were
removed in June 2016, AT. was placed with a relative, D.G.
was placed in foster care, and E.G. was placed with Mrs. H, a
non-relative caregiver. In August 2016, after the relative
proved unable to pass a home study, A.T.'s placement was
changed to the home of Mr. and Mrs. H, where A.T.'s
brother E.G. already was living. D.G. had remained in the
same foster home since June 2016, and E.G. and AT. had
remained with Mr. and Mrs. H.
39} Stokes said that Foster Mother lived in a large
home with adequate space for D.G., and that Foster Mother had
expressed interest in adopting D.G. Stokes said that from her
observations, D.G. appeared to be "[v]ery much"
bonded with both Foster Mother and her husband, as well as
with their biological and adopted children. (Id., p.
82.) Although Stokes testified that D.G. had special needs,
including Chiari malformation and related brain issues,
global developmental delays, and complex developmental
trauma, Stokes had no concerns about his foster parents'
ability to meet those needs. She said D.G. recently had
started to see a psychologist.
40} Stokes expressed similar confidence in
E.G.'s and A.T.'s placement with Mr. and Mrs. H,
despite each child's special needs. She said that AT. had
been in counseling one or two times a week for seven months
for PTSD and anxiety. Stokes said that, because AT. "has
experienced so much trauma," counselors "are using
trauma-focused cognitive behavioral therapy" to help her
work through that trauma. (Id., p. 85.) According to
Stokes, AT. had had "multiple emergency room
visits" and been hospitalized twice, most recently in
the fall of 2017, due to experiencing "flashbacks"
where she became "out of touch with reality, [wa]s in
danger of hurting herself, bec[a]me aggressive with herself
and others." (Id., pp. 84, 86-87.) Stokes said
that A.T.'s therapist had recommended that AT temporarily
not have contact with Mother because Mother seemed to be a
"trigger" for those flashbacks. (Id., p.
85.) AT. had begun taking prescribed medication to help
address her condition, and "seem[ed] to be doing
better." (Id., p. 87.)
41} Stokes said that AT. had "struggled for the
past semester" in school due to the consequences of her
flashbacks. AT. was in an online school program and on an IEP
due her special needs. Again, Stokes said that AT.
"seem[ed] to be doing better" on her new
medication. (Id., p. 90.) Stokes testified that AT.
also had been referred for genetic testing for "possible
genetic issues," and that both AT. and E.G. were being
examined for "possible alcohol-related neuro
developmental disorders." (Id., p. 84.)
42} Turning to E.G., Stokes testified that he was
"in physical, occupational[, ] and speech therapy for
some global developmental delays." (Id., p.
88.) She said that E.G. also had been diagnosed with celiac
disease, hearing issues, weakness on one side of his body,
and "vestibular ataxia, where his balance is off."
(Id.) Stokes said she had no concerns about the
ability of Mr. and Mrs. H to meet E.G.'s special needs.
43} Stokes stated that the Agency was seeking
permanent custody of D.G. She confirmed that the goal of the
original case plan developed by the Agency had been
reunification of each child with Mother or his or her
respective father. (Id., pp. 92-93.) Stokes
testified that Mother had agreed to the case plan's
objectives for her, including that Mother continue to attend
counseling; have a medication evaluation and follow through
with any recommendations; complete a parenting and
psychological evaluation and follow through with any
recommendations; obtain and maintain stable income and
housing; complete a parenting education class; sign releases
of information to the Agency; visit the children regularly;
and attend the children's medical, educational, and
mental health appointments, as recommended by the providers.
The counseling and medication objections were included
because Mother "admitted that she had experienced mental
health issues," and later was diagnosed with adjustment
disorder. (Id., p. 94.) No medication had been
recommended for Mother, and she had been mostly compliant
with counseling. (Id., p. 95.)
44} Stokes said that the Agency supported Dr.
Lilley's recommendations. (Id., pp. 96-97.)
Mother had been employed for over eight months in the same
part-time job and admitted that her income was not sufficient
to provide for the children's needs. According to Stokes,
she had been referring Mother for other job opportunities for
over a year and a half, "but I don't believe she
ever did follow through," except with one call to
Goodwill. (Id., p. 99.) Mother previously had one