Gen AI in Child Welfare Redux: Making the Knowable Known

By Molly Tierney, Managing Director and Child Welfare Lead in Accenture’s North America Public Service Practice??

In a recent blog on GenAI in Child Welfare, I shared my thinking about the urgent need to put new tools to use for caseworkers who, without them, enter into decision making poorly informed and, too often, are driven by confirmation bias related to the allegation they have in hand.

I hope for a turn of events in which caseworkers have a host of information that allows them to see parents as whole people with complex lives that include magnificent capabilities and enormous challenges. Providing caseworkers a balanced view of a family and their circumstances might help them avoid the plethora of negative errors that plague our field: children coming into foster care when they could have been left safely at home with their family of origin.

A well-respected colleague made a wise observation of the risks of deploying generative AI to help. It could tip the opposite way, increasing the power imbalance between caseworkers and families and invading the privacy of the families we serve.

These are very good points that deserve thorough review.

It’s important that we are honest about the balance of power in child welfare. There isn’t one. In a safety assessment, the caseworker has all the power, and the parent has none of it. Naming this is important because if we can admit it, we might get the caseworker to wield their power more gently. That being said, using gen AI or not using gen AI will not alter that dynamic. Only humans can, and they might be better positioned to do so if they are more informed and prepared to share information that they have.?

Privacy is a noun that Miriam Webster defines as “the quality or state of being apart from company or observation” and “freedom from unauthorized intrusion.” Presuming the presence of this “freedom” in child welfare is a misunderstanding about child protection. When an agency believes a child may be in harm’s way, we—literally, all of us who live in the United States—authorize them to take action. No member of the family should have an expectation of privacy once child protection is in the room.

But we all know child protection arrives too late in the cycle. If we want to help families, the trick will be knowing someone needs help as early as possible.

It reminds me of an experience I had when I was leading an urban child welfare jurisdiction. Among the challenges we faced were the deaths of infants. Like all jurisdictions, part of our post-mortem process was to have a Child Fatality Review. The committee who convened for these reviews included child welfare, public safety, public health and leadership from every hospital in town. The purpose of the review was epidemiology: could we determineactions that might prevent future deaths? In one particular annual review, a pattern leaped off the page with statistical clarity: a substantial portion of the infants who died were born from mothers who were under the age of fifteen at the time of delivery.

This is challenging data to look upon. The age of consent for sex in most states is sixteen. The literature concludes that, for girls who are pregnant before they turn sixteen, the odds are overwhelming that they have been victimized. And even if the context of the pregnancy did not align with these facts, a girl parenting at that age is going to have a really hard time keeping her life together.

When I saw the data, I was, quite frankly, elated because I knew it meant we could help. The path to healing was so clear. We just needed the hospitals to notify child welfare any time a girl under the age of sixteen arrived in labor and delivery. It would trigger an enriched family preservation set of activities that might support this young mom’s ability to keep her life on track while she was parenting her newborn. It was the doorway to prevention we’d all been looking for.

To a person, the hospital administrators refused. They offered misinterpretations of privacy laws and walked away from every girl who would parent in town for years to come.

I was incredulous, and I still am today.

I think these notions of privacy—and invoking “big brother” when we start to talk about sharing data—are an antiquated way of thinking about data that is hurting our ability to help families thrive. Making knowable information known is the doorway to prevention at a scale that will alter child welfare and support families in a myriad of ways. For instance, through data sources, it’s knowable that young girls get pregnant, or that five-year-olds miss most days of school, or that children with asthma don’t get their prescriptions filled, or that eight-year-olds get arrested, or that a family with children are evicted, and on and on and on. Each of these life events shows evidence of early signs of distress in families and each has associated solutions that we know will work.

We can help a girl who gets pregnant by wrapping her with support for her new family. We can help a family get their kindergartener on a trajectory for school attendance over the course of their academic career. We can close the gap on the regular use of life-saving medications for children with sub-specialty needs. We can house a family who is homeless, and we can divert a young child from a life of crime.

We can only do it if we decide to make the knowable, known. If the presence of these kinds of challenges is knowable and if the solutions to them are available, how can we justify turning away from the opportunity to know them?

We could leverage gen AI to turn the lights on and reveal opportunities, early and often, to care for and support our neighbors. I feel an urgency to be about the business of doing so responsibly.

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About the Author

Molly Tierney is a Managing Director and Child Welfare Lead at Accenture, where she leverages her 25+ years of expertise to enable states and cities to improve outcomes for vulnerable citizens.