In re O.B. , 2022 IL App (4th) 220419 ( 2022 )


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  •                                     
    2022 IL App (4th) 220419
    FILED
    NOS. 4-22-0419, 4-22-0420 cons.                     October 6, 2022
    Carla Bender
    IN THE APPELLATE COURT                          4th District Appellate
    Court, IL
    OF ILLINOIS
    FOURTH DISTRICT
    In re O.B. and E.R., Minors                                 )       Appeal from the
    )       Circuit Court of
    (The People of the State of Illinois,                       )       Peoria County
    Petitioner-Appellee,                          )       Nos. 19JA412
    v.                                            )            20JA487
    Okittous B.,                                                )
    Respondent-Appellant).                        )
    )       Honorable
    )       Derek G. Asbury,
    )       Judge Presiding.
    JUSTICE DeARMOND delivered the judgment of the court, with opinion.
    Presiding Justice Knecht and Justice Turner concurred in the judgment and
    opinion.
    OPINION
    ¶1             Within days of their respective births in November 2019 and October 2020, the
    State filed petitions for adjudication of neglect with respect to O.B. and E.R., the minor children
    of respondent Okittous B. (Father) and Bridget R., who is now deceased and not a party to this
    appeal. In due course, the trial court adjudicated the minors neglected, made them wards of the
    court, and placed custody and guardianship with the Illinois Department of Children and Family
    Services (DCFS). The State filed motions to terminate Father’s parental rights to both children in
    December 2021. Following a hearing on the State’s motions in April 2022, the court found
    respondent an “unfit person” within the meaning of section 1(D) of the Adoption Act (750 ILCS
    50/1(D) (West 2020)). The court then found it was in the minors’ best interests to terminate
    respondent’s parental rights.
    ¶2              In May 2022, respondent moved to consolidate the two cases into this one appeal,
    and we granted the motion. On appeal, respondent argues the trial court erred in terminating his
    parental rights; specifically, he alleges the trial court’s unfitness finding stands against the
    manifest weight of the evidence because the State failed to provide competent evidence that he
    suffered a mental impairment or intellectual disability. We disagree.
    ¶3                                       I. BACKGROUND
    ¶4              On November 7, 2019, the State filed a petition for adjudication of neglect with
    respect to O.B. (born November 3, 2009), alleging her environment proved injurious to her
    welfare, in part, because of Father’s criminal record and a 2010 incident where he left his nieces
    unsupervised. The State’s October 6, 2020, petition for adjudication of neglect regarding E.R.
    (born October 2, 2020) contained the same allegations. After shelter care hearings, the trial court
    found probable cause existed that the minor children were neglected as alleged in the petitions.
    Finding immediate and urgent necessity based upon the neglect, the trial court placed temporary
    custody and guardianship of the children with DCFS.
    ¶5                                  A. Adjudicatory Proceedings
    ¶6              At the adjudicatory hearings (February 2020 and October 2020), Father stipulated
    to the petition’s allegations and the trial court found factual bases for the stipulation. The trial
    court entered concomitant orders, adjudicating O.B. and E.R. neglected based on the contents of
    the State’s petition, i.e., Father’s criminal record and history of leaving two young children
    unattended. In both matters, the trial court held the dispositional hearings immediately following
    the adjudication. The trial court’s two dispositional orders both contained admonishments for
    Father to comply with recommended services and cooperate with DCFS or risk termination of
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    his parental rights. But while the order concerning O.B. found Father unfit to care for, protect,
    train, or discipline her due to the petition’s allegations, the order regarding E.R. found Father
    unable to do so. Beyond instructing Father to complete the tasks assigned to him in the service
    plan, the trial court’s order directed him to visit his children at the times and places set by DCFS
    and demonstrate appropriate parenting conduct.
    ¶7              The family service plan outlined recommended services for Father. Besides
    having to cooperate with DCFS, the plan required the following services: (1) identify supports in
    his life and utilize them when needed, especially when parenting O.B. and E.R.; (2) participate
    and complete individual counseling; (3) participate and complete a parenting course; (4) random
    monthly drug drops; (5) obtain and maintain stable, safe housing; and (6) maintain a legal source
    of income. As these matters proceeded through the juvenile court system, the record reflected
    when Father completed services. Over the course of time, Father obtained employment and
    moved to a house with his sister and her two children. He successfully completed the necessary
    parenting class in May 2020. He began individual counseling in June 2020, made moderate
    progress, and was discharged in December 2020.
    ¶8              On December 3, 2020, Father participated in a psychological evaluation with Dr.
    Richard A. Hutchison, Ph.D., a clinical psychologist, based upon DCFS’s “concern about
    [Father’s] ability to raise his child due to his ‘cognitive functioning abilities and deficits in his
    ability to reason, plan, solve problems, think abstractly, comprehend complex ideas, learn
    quickly, and/or learn from experiences.’ ” Dr. Hutchison reviewed pertinent case records,
    interviewed Father, and administered various tests, including intelligence testing. Dr. Hutchison
    used the Stanford-Binet Intelligence Scales, Fifth Edition, to evaluate Father’s intellectual
    functioning. Father scored the following: nonverbal intelligence quotient (IQ) 83; verbal IQ 78;
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    full-scale IQ 80. Dr. Hutchison interpreted Father’s scores to indicate the following:
    “[Father’s] Nonverbal IQ is in the Low Average range. His
    Verbal IQ is in the Borderline range. His Full Scale IQ is at the
    bottom of the Low Average, top of the Borderline range. The
    difference between his IQ scores is not significant but would
    indicate that his Nonverbal abilities are somewhat more highly
    developed.”
    After all testing, Dr. Hutchison made no diagnoses, but he opined Father’s “scores fit with his
    history of Special Education while in school” and “indicate that he would have difficulty
    learning and retaining new things.” Dr. Hutchison went on to note Father’s scores “indicate that
    his knowledge of the world and how it operates is quite limited” and “would tend to make
    parenting difficult as it would be a new thing with many things to learn and remember.”
    ¶9             Following a May 26, 2021, permanency review hearing, the trial court ordered
    Father to undergo a parenting capacity assessment. Due the service provider’s congested
    schedule, the assessment was delayed until November 2021. Jonna Tyler, LCPC, RPT-S,
    conducted the assessment and was tasked to answer several questions about Father’s parenting
    capabilities, including, “What effect has [Father’s] intellectual deficits had on his ability to
    parent his children?” Tyler’s report recapped part of Dr. Hutchison’s psychological evaluation of
    Father in December 2020, particularly, “ ‘[Father’s] verbal IQ is 78, in the borderline range of
    intellectual abilities. His non-verbal IQ is 83, in the low average range.’ ” Tyler further noted Dr.
    Hutchison’s opinion that Father’s scores indicated the above-referenced difficulties he would
    experience with parenting. As part of the parenting capacity assessment, Tyler interviewed the
    children’s caseworker, who reported, “Dr. Hutchison’s report identified [Father’s] intellectual
    -4-
    disability as in the mild range.” Tyler also interviewed Father, who reported he received special
    education services in school, but he noted he also attended “some mainstream classes.” Tyler
    administered the Marschak Intervention Method (MIM), a test “designed to assess the quality
    and nature of the parent-child relationship.” The MIM showed Father had weaknesses in the
    categories of structure, challenge, and nurturance. Father had limited awareness of when to
    attend to his children’s needs. Tyler next administered the “Child Abuse Potential Inventory” on
    which Father obtained a low abuse score, though Tyler noted Father’s elevated score on the lie
    scale invalidated those findings. Finally, Tyler observed the children’s interactions with Father
    and with their foster parents. Ultimately, Tyler opined, “Father is not able to meet minimum
    parenting standards independently for [O.B.] and [E.R.] due to their complex medical needs.
    Tyler further stated: “It is this examiner’s opinion that [Father’s] intellectual deficits may impair
    his ability to manage the dietary needs and daily care needs of his daughters.” She then opined:
    “[Father] does not have the capacity to care for the safety and security needs of his children or
    attend to the higher level of care they are in need of, due to their complex medical needs.”
    ¶ 10                     B. Termination of Respondent’s Parental Rights
    ¶ 11           On December 10, 2021, the State filed petitions seeking a finding of unfitness and
    termination of Father’s parental rights to O.B. and E.R. The State alleged Father was an unfit
    person pursuant to section 1(D) of the Adoption Act (750 ILCS 50/1(D) (West 2020)). The
    State’s petition identified one ground of unfitness as to Father: “[He] is an unfit person as that
    term is defined in the Illinois Compiled Statutes, Chapter 750, Section 50/1 D(p), in that he is
    unable to discharge parental responsibilities supported by competent evidence from a psychiatrist
    or clinical psychologist of mental impairment, mental illness or mental retardation as defined in
    Section 1-116 of the Mental health and Development Disabilities Code, or developmental
    -5-
    disability as defined in Section 1-106 of that Code, and there is sufficient justification to believe
    that such inability to discharge parental responsibilities shall extend beyond a reasonable time
    period.” See 750 ILCS 50/1(D)(p) (West 2020). The State further contended termination of
    Father’s parental rights was in the children’s best interests and asked for custody and
    guardianship to remain with DCFS, giving it the authority to consent to the minors’ adoption.
    ¶ 12                                         C. Fitness
    ¶ 13           On April 25, 2022, the trial court held a fitness hearing. The State offered one
    exhibit, records of Father’s parenting capacity assessment from the Antioch Group. Father’s
    counsel objected on hearsay and foundational grounds, but the trial court admitted them over the
    objection, noting section 2-18(4)(a) of the Juvenile Court Act of 1987 (Juvenile Court Act) (705
    ILCS 405/2-18(4)(a) (West 2020)), provided that properly certified and delegated records are
    hearsay exceptions. The State called one witness, Tyler, who administered the parenting capacity
    assessment and authored the report. On direct examination, she testified she found Father “to not
    be capable or equipped to parent medically-complex children.” Regarding Father’s inabilities to
    meet his children’s needs or interact appropriately with them, Tyler stated: “All these things
    point toward intellectual disability.” She testified Father’s abilities were unlikely to change in the
    near future.
    ¶ 14           On cross-examination by Father’s counsel, Tyler testified Father could not
    complete services help him meet minimum parenting standards “[b]ecause his deficits appear to
    be due to an intellectual disability not due to not just having a service.” Tyler opined it would be
    impossible for a person with an intellectual disability to become a fit parent, explaining: “You
    can’t change the intellectual capacity of the brain. You can change through services teaching and
    training where there’s deficits, but this was seen to be more than a deficit.”
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    ¶ 15           On examination by the trial court, Tyler testified to her professional
    qualifications, noting she was a licensed clinical professional counselor (LCPC), a registered
    play therapist supervisor, and child therapist. She noted she has performed countless parental
    assessments over the past 15 years, probably averaging one per week with some exceptions for
    holidays and summers.
    ¶ 16           Neither Father nor the guardian ad litem (GAL) presented any evidence.
    ¶ 17           Following brief arguments of counsel and the GAL, the trial court recessed to
    review the parenting capacity assessment the State presented as “Exhibit One.” When the parties
    reconvened, the trial court issued its ruling from the bench. Noting the only evidence presented
    included the one exhibit and Tyler’s testimony, the trial court found Tyler credible. Though
    neither the State nor the GAL made the request, the trial court noted it “probably would have
    found [Tyler] to be an expert in the field of psychology,” given her experience in administering
    parenting capacity assessments. Based on the evidence, the court found Father’s “verbal IQ was
    a 78, which is in the borderline range of intellectual abilities.” The trial court noted a
    psychologist had referred Father to Tyler. The trial court then outlined the assessment and
    Tyler’s conclusions. It noted Father “underwent a full-scale psychological testing” and Tyler
    suggested “that the court refer to and defer to Dr. Hutchinson’s psychological report for more
    information on this referral question.” Reading from Tyler’s report, the trial court observed:
    “The psychological evaluation conducted by Dr. Hutchinson supports this examiner’s concern
    and observations regarding [Father’s] cognitive limitations and how this limitation will impair
    his ability to provide for the care of the children independently, particularly the children that
    have complex medical needs.” The trial court summed up its ruling by saying:
    “So the court believes in this matter that it’s really
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    unrefuted and overwhelming the State has by clear and convincing
    evidence established and proven up Count 1 of its petition to
    terminate parental rights in that [Father] is an unfit person as the
    term is defined in the Illinois Compiled Statutes, Chapter 750,
    Section 50/1(D)(p) [(750 ILCS 50/1(D)(p) (West 2020))] in that he
    is unable to discharge the parental responsibilities supported by
    competent evidence from a psychiatrist or clinical psychologist of
    mental impairment, mental illness, or mental retardation as defined
    in Section 1-116 of the Mental Health and Developmental
    Disabilities Code [(405 ILCS 5/1-116 (West 2020))].
    There is sufficient justification to believe that such inability
    to discharge parental responsibility shall extend beyond the
    reasonable time period.”
    The trial court’s written order noted, “[t]he petition is proved by clear and convincing evidence,”
    but referred to the transcript for detailed findings.
    ¶ 18                                  D. Best-Interests Hearing
    ¶ 19            The trial court, with consent from the parties, immediately transitioned into a
    best-interests hearing. The State called Avery Gutwein, of Children’s Home, who testified she
    had been the children’s caseworker since fall 2020. Gutwein noted O.B. and E.R. lived in the
    same traditional foster home. She testified the foster parents provide for the children’s needs for
    food, clothing, and shelter, as well as their educational and mental development. Similarly, the
    foster parents provided for the children’s emotional needs, and the children look to the foster
    parents for safety and security. Gutwein testified the children share a strong bond with their
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    foster parents, explaining the parents show affection and attention to the kids. She noted O.B.
    and E.R. also share a bond with Father, but she opined their bond with the foster parents was
    stronger. Gutwein stated a doctor diagnosed both O.B. and E.R. with GLUT 1(Glucose Transport
    Type 1 Deficiency Syndrome), which requires specialized diets and seizure management.
    Gutwein testified the foster parents expressed their willingness to adopt O.B. and E.R.
    ¶ 20           On cross-examination by Father’s counsel, Gutwein testified O.B. and E.R. call
    their foster parents “momma” and “dada.” She noted Father will hold the children during visits,
    but the children receive affection from the foster parents. On examination by the trial court,
    Gutwein testified both O.B. and E.R. had lived continuously with their foster parents since they
    were three days old. Neither Father nor the GAL presented evidence at this hearing.
    ¶ 21           After brief closing arguments, the trial court rendered its decision on the record.
    Considering the statutory best-interests factors along with the evidence presented, the trial court
    found, “it is in the best interest of both minor children to terminate *** the parental rights of
    [Father].” The trial court noted O.B. and E.R. are “having all of their educational, medical,
    emotional, physical needs being met by the foster parents, even with the medical complexities
    they have as described by the caseworker since three days from their birth.” Though Father was
    not present, the trial court read the appellate rights into the record and asked Father’s counsel to
    make the appellate admonishment clear should Father choose to appeal.
    ¶ 22           This appeal followed.
    ¶ 23                                       II. ANALYSIS
    ¶ 24           Father argues the trial court erroneously terminated his parental rights;
    specifically, he contends the unfitness finding stands against the manifest weight of the evidence.
    We disagree and affirm the trial court’s judgment.
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    ¶ 25           The Juvenile Court Act (705 ILCS 405/1-1 et seq. (West 2020)) and the Adoption
    Act (750 ILCS 50/1 et seq. (West 2020)) govern how the State may terminate parental rights.
    In re D.F., 
    201 Ill. 2d 476
    , 494, 
    777 N.E.2d 930
    , 940 (2002). Together, the statutes outline two
    necessary steps the State must take before terminating a person’s parental rights. The State must
    first show the parent is an “unfit person,” and then it must show terminating parental rights
    serves the best interests of the child. D.F., 
    201 Ill. 2d at
    494-95 (citing the Adoption Act (750
    ILCS 50/1(D) (West 1998)) and the Juvenile Court Act (705 ILCS 405/2-29(2) (West 1998))).
    Here, Father challenges the trial court’s first-step decision only—the unfitness finding.
    ¶ 26           “ ‘The State must prove parental unfitness by clear and convincing evidence
    ***.’ ” In re A.L., 
    409 Ill. App. 3d 492
    , 500, 
    949 N.E.2d 1123
    , 1129 (2011) (quoting In re
    Jordan V., 
    347 Ill. App. 3d 1057
    , 1067, 
    808 N.E.2d 596
    , 604 (2004)). The Adoption Act
    provides several grounds on which a trial court may find a parent unfit, including the one the
    State alleged here:
    “Inability to discharge parental responsibilities supported by competent evidence
    from a psychiatrist, licensed clinical social worker [(LCSW)], or clinical
    psychologist of mental impairment, mental illness or an intellectual disability as
    defined in Section 1-116 of the Mental Health and Developmental Disabilities
    Code, or developmental disability as defined in Section 1-106 of that Code, and
    there is sufficient justification to believe that the inability to discharge parental
    responsibilities shall extend beyond a reasonable time period. However, this
    subdivision (p) shall not be construed so as to permit a [LCSW] to conduct any
    medical diagnosis to determine mental illness or mental impairment.” 750 ILCS
    50/1(D)(p) (West 2020).
    - 10 -
    ¶ 27           When the State’s termination petition alleges this unfitness ground it must make
    the threshold showing—by competent evidence from a psychiatrist, LCSW, or clinical
    psychologist—that the parent suffers a mental disability, namely a mental impairment, mental
    illness, intellectual disability, or developmental disability. In re K.B., 
    2019 IL App (4th) 190496
    ,
    ¶¶ 68, 70, 
    145 N.E.3d 661
     (citing 750 ILCS 50/1(D)(p) (West 2016)). This court previously
    observed that “by separately referring to ‘mental illness,’ ‘mental impairment,’ ‘[intellectual
    disability],’ and ‘developmental disability,’ the legislature meant to distinguish the meanings of
    these terms.” In re Michael M., 
    364 Ill. App. 3d 598
    , 606, 
    847 N.E.2d 911
    , 919 (2006). The
    terms are not synonymous, and ideally, the State’s evidence should be tailored to the mental
    disability the petition alleges the parent suffers. Illinois’s Mental Health and Developmental
    Disabilities Code (Code) (405 ILCS 5/1-100 et seq. (West 2020)) defines the terms “mental
    illness” (405 ILCS 5/1-129 (West 2020)), “intellectual disability” (405 ILCS 5/1-116 (West
    2020)), and “developmental disability” (405 ILCS 5/1-106 (West 2020)). The Code does not
    define “mental impairment,” but we have noted “the word ‘impairment’ is defined as ‘[t]he fact
    or state of being damaged, weakened, or diminished.’ ” Michael M., 
    364 Ill. App. 3d at 608
    (quoting Black’s Law Dictionary 754 (7th ed. 1999)). The State’s evidence must show the
    parent’s disability meets the applicable definition of the ailment alleged. Here the State’s petition
    listed all four types of statutory mental disabilities, even though it had to provide competent
    evidence of any one of those disabilities.
    ¶ 28           Once the State establishes a mental disability through competent evidence, it must
    then prove: “(1) the mental [disability] makes the parent unable to discharge his or her parental
    responsibilities and (2) such inability will persist for an unreasonably long time.” K.B., 
    2019 IL App (4th) 190496
    , ¶ 67 (citing 750 ILCS 50/1(D)(p) (West 2016)). The evidence necessary to
    - 11 -
    make these two showings need not come from a psychiatrist, LCSW, or clinical psychologist, but
    can come from less qualified mental health professionals or even “from common knowledge and
    experience.” K.B., 
    2019 IL App (4th) 190496
    , ¶ 70.
    ¶ 29            This court pays “ ‘great deference’ ” to a trial court’s fitness finding “ ‘because of
    [that court’s] superior opportunity to observe the witnesses and evaluate their credibility.’ ” A.L.,
    409 Ill. App. 3d at 500 (quoting Jordan V., 347 Ill. App. 3d at 1067). We “will not reverse a trial
    court’s fitness finding unless it was contrary to the manifest weight of the evidence, meaning that
    the opposite conclusion is clearly evident from a review of the record.” A.L., 409 Ill. App. 3d at
    500. Since “ ‘ “[e]ach case concerning parental unfitness is sui generis, requiring a close analysis
    of its individual facts” ’ ” (In re Jacorey S., 
    2012 IL App (1st) 113427
    , ¶ 19, 
    980 N.E.2d 91
    (quoting In re Konstantinos H., 
    387 Ill. App. 3d 192
    , 203, 
    899 N.E.2d 549
    , 558 (2008), quoting
    In re Daphnie E., 
    368 Ill. App. 3d 1052
    , 1064, 
    859 N.E.2d 123
    , 135 (2006))), we now turn our
    attention to the facts of this case.
    ¶ 30            Here, the State presented competent evidence from a clinical psychologist (Dr.
    Hutchison), albeit through Tyler’s report, that Father had a verbal IQ of 78, which placed him “in
    the borderline range of intellectual abilities,” and a “non-verbal IQ [of] 83, in the low average
    range.” Tyler, who is not a competent source per subsection 1(D)(p) (i.e., a psychiatrist, clinical
    psychologist, or LCSW) but whose report contained admissible hearsay from a competent source
    (see In re M.S., 
    210 Ill. App. 3d 1085
    , 1095-96, 
    569 N.E.2d 1282
    , 1288 (1991) (medical records
    of parent created as direct result of ongoing juvenile proceeding which relate to condition also
    directly related to proceeding satisfies statutory requirement of “relating to a minor” under
    section 2-18(4)(a) of the Juvenile Court Act (Ill. Rev. Stat. 1989, ch. 37, ¶ 802-18(4)(a)))),
    quoted the following from Dr. Hutchison’s report, describing Father:
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    “His weakest are[a] was in general knowledge and the next
    to lowest was working memory. Academic screening has his
    ability to comprehend reading sentences in the borderline range at
    a grade equivalent of 6.5. His math ability was in the low average
    range at the grade equivalent of 6.1. These scores fit his history of
    special education while in school. This would indicate that his
    knowledge of the world and of how it operates is quite limited. It
    also would indicate that he has difficulty learning and retaining
    new things. This would tend to make parenting difficulty as it
    would be a new thing with many things to learn and remember. His
    ability to generalize and think abstractly is limited. Therefore
    learning something in the situation may be difficult to apply in a
    similar, but different situation.”
    Since she was not qualified to testify to Father’s mental disability, Tyler deftly testified that
    based on her observations Father’s parenting, “deficits appear to be due to an intellectual
    disability.”
    ¶ 31           The trial court found Tyler credible. But since its written order contained no
    detailed findings, we rely on the trial court’s oral ruling, which found the State proved by clear
    and convincing evidence that Father was “an unfit person *** in that he is unable to discharge
    the parental responsibilities supported by competent evidence from a psychiatrist or clinical
    psychologist of mental impairment, mental illness, or [intellectual disability] as defined in
    Section 1-116 of the [Code].” Though the State seemed to rely on intellectual disability as the
    threshold showing for this unfitness ground, especially considering Tyler’s report and testimony,
    - 13 -
    we conclude the State’s evidence, however, did not clearly and convincingly establish Father
    suffered an intellectual disability according to the statutory definition. Section 1-116 of the Code
    defines “Intellectual disability” as “significantly subaverage general intellectual functioning
    which exists concurrently with impairment in adaptive behavior and which originates before the
    age of 18 years.” 405 ILCS 5/1-116 (West 2020). Courts have “previously described
    ‘[intellectual disability]’ as ‘requiring an IQ of less than 70’ and even ‘less than 75.’ ” People v.
    Wilson, 
    2020 IL App (1st) 162430
    , ¶ 48, 
    170 N.E.3d 83
     (quoting In re S.W.N., 
    2016 IL App (3d) 160080
    , ¶ 73, 
    58 N.E.3d 877
    , citing People v. Jones, 
    2014 IL App (1st) 120927
    , ¶ 59, 
    8 N.E.3d 470
    , and People v. Daniels, 
    391 Ill. App. 3d 750
    , 754, 
    908 N.E.2d 1104
    , 1108 (2009)). Heeding
    the statutory definition for “intellectual disability” alongside the case law interpreting and
    applying it, we observe Father’s IQ scores do not indicate he suffered “significantly subaverage
    general intellectual functioning.” (Emphasis added.) 405 ILCS 5/1-116 (West 2020). Regarding
    proof of intellectual disability, the evidence was sparse. Tyler’s report quoted Dr. Hutchison’s
    report documenting Father’s nonverbal IQ (78) was borderline and his verbal IQ (83) was low-
    average. Tyler’s report also quoted Dr. Hutchison’s observations that Father’s scores placed him
    at a sixth-grade level for reading and math. Tyler quoted Dr. Hutchison’s opinions that Father’s
    knowledge was “quite limited,” and his scores “tend to make parenting difficult” because he
    would have to learn and retain new information. But without the benefit of competent testimony
    from a clinical psychologist, like Dr. Hutchison, explaining Father’s deficiencies vis-à-vis the
    statutory definition for intellectual disability, no court could conclude Father showed
    significantly subaverage general intellectual functioning. Rather, the court is left to compare
    scores. Since Father’s scores do not fall to 75 or 70, we do not find the State clearly and
    convincingly proved Father suffered an intellectual disability by competent evidence.
    - 14 -
    ¶ 32            This leaves either “mental impairment” or “mental illness” for the requisite
    mental disability necessary for this allegation of unfitness. “Mental impairment” is not defined
    by statute, but this court has used the definition from Black’s Law Dictionary for “impairment”
    as “ ‘[t]he fact or state of being damaged, weakened, or diminished.’ ” Michael M., 
    364 Ill. App. 3d at 608
     (quoting Black’s Law Dictionary 754 (7th ed. 1999)). Based on this broader
    guideline—a damaged, weakened, or diminished mental state—we conclude the State met its
    burden for “mental impairment.” Through Dr. Hutchison’s findings, the State provided evidence
    that Father’s “knowledge of the world and of how it operates is quite limited.” Father’s
    borderline and low-average IQ scores “indicate that he has difficulty learning and retaining new
    things” and “would tend to make parenting difficult as it would be a new thing with many things
    to learn and remember.” Even based on this limited information from Dr. Hutchison that was
    quoted in Tyler’s report, we conclude a reasonable fact finder could have determined Father
    suffered a mental impairment. Therefore, the State made the requisite threshold showing for a
    mental disability by competent evidence from clinical psychologist under section 1(D)(p), and
    we need not address the “mental illness” allegation. We move on to consider if the State satisfied
    the next two necessary showings: (1) whether Father’s mental impairment renders him unable to
    discharge his parental responsibilities and (2) whether Father’s inability to parent will persist for
    an unreasonably long time. We take each in turn.
    ¶ 33           Tyler’s report detailed O.B. and E.R.’s complex needs. She noted both girls had
    been diagnosed with GLUT 1, a disorder that can cause glucose deficiencies in the brain and
    result in seizures. Tyler’s report noted O.B. and E.R. “require a strictly managed special diet,
    daily medication, and close supervision due to their seizures.” Tyler noted how the children’s
    caseworker opined “that [Father] is not capable of meeting the children’s daily care needs, given
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    the dietary needs and medical care, and appointments required for their current medical
    condition.”
    ¶ 34           Tyler’s own observation and evaluation of Father mirrored the caseworker’s view.
    Tyler noted that while she was observing Father interact with his children, O.B. began having
    seizures and Father did not notice until Tyler told him. Tyler observed Father had limited eye
    contact and physical touch with O.B. and E.R. When he cared for O.B. and E.R. at the same
    time, he “appeared to have difficulty noticing and keeping track of both of his girls.” Tyler
    explained Father “appeared able to attend to one child’s needs and able to observe one child,
    however, he had difficulty noticing the child’s needs when he was not directly focused on that
    child, in keeping track of what they were getting into or what they were doing with this
    examiner’s assistance.” Though she described Father as “kind and gentle in his approach to his
    children,” Tyler noted Father needed assistance or direction to meet the children’s caregiving
    needs, like feeding and changing diapers. After interviewing Father, observing him with his
    children, and administering him various tests, Tyler concluded Father “is not able to meet
    minimum parenting standards independently for [O.B.] and [E.R.] due to their complex medical
    needs.” Tyler testified in accordance with her report, saying Father’s diminished mental capacity
    rendered him “not *** capable or equipped to parent medically-complex children.”
    ¶ 35           Tyler also testified Father’s inability to parent O.B. and E.R. would continue for
    an unreasonably long time. She noted Father’s capabilities were unlikely to change in the near
    future. She opined Father would not be able to learn (or be taught) because of his deficits. The
    trial court found Tyler credible, and we pay that determination “ ‘great deference’ ”. See A.L.,
    409 Ill. App. 3d at 500 (quoting Jordan V., 347 Ill. App. 3d at 1067). Through Tyler’s testimony
    and report, the State clearly and convincingly established Father’s inability to discharge his
    - 16 -
    parental responsibilities and further established his inability would persist for an unreasonably
    long time. See K.B., 
    2019 IL App (4th) 190496
    , ¶ 70.
    ¶ 36           We find certain aspects of this case troubling, namely the State relying solely on
    Tyler’s report and testimony (and the admissible hearsay statements therein as competent
    evidence) rather than admitting Dr. Hutchison’s report or calling him to testify. But sometimes
    cases are decided by the standard of review. Based on this evidence, not matter how slight, the
    State proved with competent evidence from a psychologist that Father suffered a mental
    impairment, and it then proved Father’s mental impairment rendered him unable to parent O.B.
    and E.R. and he would remain unable to discharge his parenting responsibilities in the near
    future. Accordingly, we cannot conclude the trial court erred in finding Father unfit and
    terminating his parental rights. The trial court’s conclusion does not stand against the manifest
    weight of the evidence. See A.L., 409 Ill. App. 3d at 500.
    ¶ 37                                        III. CODA
    ¶ 38           It bears noting the special concurrence in In re I.W., 
    2018 IL App (4th) 170656
    ,
    ¶ 60, 
    115 N.E.3d 955
     (DeArmond, J., specially concurring), where, like here:
    “This case began with a clear understanding by all parties involved regarding the
    parents’ developmental and/or cognitive delays. Trial courts and the State should
    pay special attention to these cases to ensure the Department of Children and
    Family Services (DCFS) has made reasonable accommodations in providing
    services to aid parents in family reunification, as the Americans with Disabilities
    Act of 1990 (ADA) (
    42 U.S.C. §§ 12101
     to 12213 (2012)) and section 504 of the
    Rehabilitation Act of 1973 (section 504) (
    29 U.S.C. §§ 701
     to 794 (2012))
    demand, which simply was not done in this case.”
    - 17 -
    ¶ 39           Although the record is replete with references to Father’s cognitive limitations,
    and even referenced how he would probably need accommodations, there is no indication they
    were provided. Quoting again from I.W., 
    2018 IL App (4th) 170656
    , ¶¶ 89-91 (DeArmond, J.,
    specially concurring):
    “Title II of the ADA (Title II) provides that ‘no qualified
    individual with a disability shall, by reason of such disability, be
    excluded from participation in or be denied the benefits of the
    services, programs or activities of a public entity, or be subjected
    to discrimination by such entity.’ 
    42 U.S.C. § 12132
     (2012). A
    child-welfare agency or trial court may not engage in any practice
    or administration of a program in such a way as to ‘have the effect
    of discriminating on the basis of disability, or that [has] the
    purpose or effect of defeating or substantially impairing the
    accomplishment of the objectives of the child welfare agency’s or
    court’s program for persons with disabilities.’ U.S. Dep’t Health &
    Human Servs. & U.S. Dep’t Justice, Protecting the Rights of
    Parents and Prospective Parents with Disabilities: Technical
    Assistance for State and Local Child Welfare Agencies and Courts
    Under Title II of the Americans with Disabilities Act and Section
    504 of the Rehabilitation Act (Aug. 2015),
    https://www.ada.gov/doj_hhs_ta/child_welfare_ta.html.
    As that publication notes, individuals with disabilities must
    be provided with opportunities to benefit from participation in
    - 18 -
    ‘child welfare programs, services, and activities that are equal to
    those extended to individuals without disabilities,’ as well as the
    necessary ‘aids, benefits, and services different from those
    provided to other parents and prospective parents where necessary
    to ensure an equal opportunity to obtain the same result or gain the
    same benefit, such as family reunification.’ 
    Id.
     ‘[S]ervices must be
    adapted to meet the needs of a parent or prospective parent who
    has a disability in order to provide meaningful and equal access to
    the benefit.’ Id.; see also 
    28 C.F.R. § 35.130
    (b)(1)(ii)-(iv) (2015).
    Title II requires child-welfare agencies to make all
    reasonably necessary modifications to programs or activities to
    allow disabled participants to fully engage, furnish auxiliary aids
    and services where necessary to ensure effective communication,
    administer services in the most integrated setting appropriate to the
    needs of the disabled participant, and provide, as needed, services
    or advantages beyond those required by regulation to people with
    disabilities. Nat’l Council on Disability, Ch. 5: The Welfare
    System: Removal, Reunification, and Termination, Rocking the
    Cradle: Ensuring the Rights of Parents with Disabilities and Their
    Children, https://ncd.gov/publications/2012/Sept272012/Ch5 (last
    visited Jan. 22, 2018).”
    ¶ 40           Now, 10 years after that groundbreaking report, we find DCFS and the courts
    continue to proceed to termination of parental rights for parents with disabilities with no
    - 19 -
    indication in the record of proceedings that appropriate accommodations were ever sought or
    made before concluding the parent is unfit. Further, just as in I.W., this failure remained
    unquestioned before the trial court. It may be true the father in this case was incapable and, even
    with proper accommodations, would remain incapable of adequately parenting medically
    challenging children, but he is entitled to programs and services through DCFS which
    accommodate his particular limitations first, before reaching that conclusion.
    ¶ 41                                    IV. CONCLUSION
    ¶ 42           For the reasons stated, we affirm the trial court’s judgment.
    ¶ 43           Affirmed.
    - 20 -
    In re O.B., 
    2022 IL App (4th) 220419
    Decision Under Review:     Appeal from the Circuit Court of Peoria County, Nos. 19-JA-412,
    20-JA-487; the Hon. Derek G. Asbury, Judge, presiding.
    Attorneys                  Dana M. Kelly, of Peoria, for appellant.
    for
    Appellant:
    Attorneys                  Jodi M. Hoos, State’s Attorney, of Peoria (Patrick Delfino and
    for                        Rosario David Escalera Jr., of State’s Attorneys Appellate
    Appellee:                  Prosecutor’s Office, of counsel), for the People.
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