in the Interest of A.K.L. and S.A.A.P. , Children ( 2016 )


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  • Opinion issued December 8, 2016
    In The
    Court of Appeals
    For The
    First District of Texas
    ————————————
    NO. 01-16-00489-CV
    ———————————
    IN THE INTEREST OF A.K.L. AND S.A.A.P., CHILDREN
    On Appeal from the 314th District Court
    Harris County, Texas
    Trial Court Case No. 2009-01360J
    MEMORANDUM OPINION
    The trial court terminated the parental rights of L.M.L.P. to her two children,
    A.K.L. and S.A.A.P. In three issues, L.M.L.P. argues that the evidence was legally
    and factually insufficient to support the trial court’s findings supporting
    termination of her parental rights pursuant to Texas Family Code subsections
    161.001(b)(1)(N) and (O) and 161.001(b)(2). We affirm.
    Background
    A.K.L. and S.A.A.P. are the children of L.M.L.P. (“Mother”) and V.E.P.
    (“Father”).1 A.K.L. is a girl who was born in August 2000, and S.A.A.P. is a boy
    who was born in December 2006. In July 2008, the Texas Department of Family
    and Protective Services (“DFPS”) received a referral of sexual abuse of A.K.L. A
    neighbor had called the Houston Police Department to report that, through a gap in
    the fence, they had observed the perpetrator “dry humping” A.K.L. Both A.K.L.
    and the perpetrator were clothed. The neighbor made a six minute videotape of the
    incident. Mother watched the incident for five minutes before intervening to stop
    the behavior. She “stated that she watched so long because she was waiting to see
    if the perpetrator was going to pull his penis out.”
    DFPS indicated that Mother refused psychiatric treatment for her “mental
    issues,” which had been diagnosed as including bipolar disorder and an unspecified
    learning disorder. DFPS noted that Mother’s “mental illness and refusal to get
    professional mental assistance for herself as well as her daughter, increases risk” to
    the children and that Mother’s “mental illness led to physical neglect of the
    children.” DFPS averred that Mother did not work and the children “suffer various
    forms of neglect while in their mother’s care.” The DFPS caseworker averred that
    Mother “places the children at considerable risk due to the absence of household
    1
    Father is not a party to this appeal.
    2
    routine, misuse of family resources, parental role and boundary problems and
    refusal to seek appropriate mental health care for the children and herself.” The
    caseworker averred that Mother and Father both lacked parenting skills needed to
    meet the special needs of their children and that neither parent “display[ed] a
    concern regarding their children’s special needs” or “place[d] the children’s basic
    needs as a necessity.”
    DFPS also noted Mother’s previous history of referrals that DFPS
    determined there was reason to believe. These included five referrals for incidents
    of physical neglect of both A.K.L. and S.A.A.P. beginning in January 2007, when
    S.A.A.P. was hospitalized due to rapid and substantial weight loss, and ending in
    July 2007, when Mother was referred due to concerns of sexual abuse of A.K.L.,
    who had “been acting out sexually at school” and “been experiencing psychosis.”
    Psychological assessments determined that the children should not return to
    their parents’ care until Mother sought further psychiatric assessment, followed
    any recommendations from that assessment, and sought individual and family
    counseling. The assessment determined that Mother would “always require
    supervision because of her intellectual limitations.” DFPS also determined that
    A.K.L. had ADHD and an unspecific learning disorder and that she had problems
    with her behavior and her performance at school. DFPS observed that S.A.A.P.,
    who was a toddler at the time, was “often strapped in his high chair, even when he
    3
    was not eating.” The DFPS caseworker averred that Mother “reported that she has
    to put him in the high chair so that he does not get into everything or mess up the
    home as she cleaned.” S.A.A.P. was “not very verbal” and “did not communicate
    with anyone.” The DFPS caseworker reported that S.A.A.P. “was never clean
    during the day while in [Mother’s] care.”
    DFPS created a family service plan at that time, but Mother failed to meet its
    requirements. Among other problems, Mother failed to dress appropriately for
    meetings with the DFPS caseworker or other people involved with the children and
    failed to maintain a hazard-free home. The DFPS caseworker observed Mother
    leaving S.A.A.P. unsupervised near a bathtub full of water and that “there was
    laundry piled almost waist high, dirty dishes were piled in the kitchen, the stove
    was [caked] with food, the floors were dirty with trash throughout the house, there
    were chips, coke cans, and food on the floors in the hallway and bedrooms.”
    Mother was also uncooperative and did not participate appropriately in the
    children’s care.
    Thus, in February 2009, DFPS sought to be named the temporary managing
    conservator for A.K.L. and S.A.A.P., and both children were placed in a foster
    home. That case concluded in 2010 when the trial court issued a decree (the “2010
    decree”) finding that appointment of either parent as managing conservator of the
    children would not be in the children’s best interest and appointing DFPS as sole
    4
    managing conservator of the children. The 2010 decree provided for Mother’s
    visitation with S.A.A.P., but it ordered that she have no visitation with A.K.L. until
    both A.K.L.’s and Mother’s therapists agreed that such visits would be in A.K.L.’s
    best interest. The trial court also ordered that Mother and Father undergo
    psychiatric evaluations, continue to engage in therapy and provide therapeutic
    notes and summaries to DFPS, and continue to cooperate with DFPS. DFPS
    continued to work with the parents to obtain stability in the home so that Mother
    and Father could provide sufficient care for the children.
    Both children remained in their foster home and continued to receive
    services. Both were diagnosed with mental health disorders and learning or
    intellectual disabilities. S.A.A.P.’s medical and mental health records demonstrated
    that in early 2014, he began experiencing increased behavioral problems. His foster
    parents reported that he regressed after beginning court-ordered visitation with his
    biological parents. S.A.A.P. was moved to a residential treatment facility, and the
    records demonstrated that his visitation with Mother and Father was suspended due
    to his negative reaction to the visits and the therapist’s recommendation. The
    records also stated that Mother and Father were not involved in his treatment as of
    January 2014. The child advocate likewise reported that Mother and Father failed
    to make adequate progress in making their home safe for their children, that
    Mother and Father had failed to demonstrate that they understood their children’s
    5
    special needs, that Mother and Father continued to lack adequate parenting skills,
    and that Mother and Father were not participating appropriately in either child’s
    care.
    In October 2014, DFPS moved to modify the conservatorship of the children
    and sought termination of Mother and Father’s parental rights. DFPS again placed
    Mother and Father on family service plans, and, following a status hearing, the trial
    court ordered that Mother and Father complete their new family service plans.
    Mother’s service plan identified changes that were needed to reduce the risk
    to the children, including the need for Mother to “demonstrate an understanding of
    and ability to provide for the special needs of the child[ren],” to address her own
    medical and mental health needs, and to “learn to control angry feelings and
    actions to prevent harm to others.” The service plan set out requirements for
    contacting the Mental Health and Mental Retardation Authority of Harris County
    (“MHMRA”) to inquire about services for which she would qualify and to follow
    any recommendations, participating in family and couple’s therapy, and
    completing a “Trust Based Relational Intervention class at the DePelchin
    Children’s Center” by being “successfully discharged from the class” and
    providing a certificate of completion to DFPS. Mother was also required to
    maintain a clean and hazard-free home, and the service plan specifically listed
    things such as removing clutter and nonfunctioning items, removing any buckets
    6
    filled with water and dead rodents, and removing “open electric machines that the
    children” can access. The plan required that Mother provide City of Houston
    inspectors access to the home and that the home pass inspection by October 31,
    2014. DFPS believed that Mother and Father made inadequate progress and moved
    forward with terminating the parents’ rights to A.K.L. and S.A.A.P.
    At the commencement of the trial in May 2016, Father voluntarily
    relinquished his rights to the children. DFPS introduced evidence including the
    2010 decree that it was seeking to modify, the original removal affidavit and other
    records, and the court-ordered service plans for both parents.2 DFPS also presented
    affidavits, medical records and therapy notes, and other documents associated with
    its work with A.K.L., S.A.A.P., Mother, and Father.
    Ashley Prince, the caseworker assigned to the children, testified at the trial.
    She explained the general history of the case and testified that family service plans
    had been developed prior to the 2010 decree and again after DFPS sought to
    modify that decree in 2014. Mother did not complete the services required by
    either plan even though DFPS “tried to work with mom and dad for an extended
    period of time.” Specifically, Mother failed to complete the trust-based
    2
    DPFS also introduced the criminal record of the man who was involved with the
    sexual abuse of A.K.L. in July 2008 that was recorded by a neighbor. The man had
    admitted that he was the person recorded on the videotape (but he claimed he was
    only trying to keep A.K.L. from hurting a cat that had crawled under a nearby
    shed), and he was placed on deferred adjudication for the charge of indecent
    exposure.
    7
    intervention therapy at DePelchin because the provider discharged her “due to
    [Mother] not being able to demonstrate what she was learning.” Prince testified
    that Mother also failed to complete family or couple’s therapy, she failed to follow
    up with her services with MHMRA, and she failed to demonstrate that the family
    home passed inspection with the City of Houston.
    Prince also reviewed photographs of the family home and testified that the
    inside and outside of the home were in “disarray,” which created an unsafe
    environment, especially for S.A.A.P. because of his extreme special needs. Prince
    testified that the photographs demonstrated that Mother had not made progress
    “towards getting [her life] in order.” She identified an unsafe portable heater,
    plumbing problems, and incomplete or inadequate construction projects.
    Prince stated that A.K.L. and S.A.A.P. were fifteen and eight, respectively,
    at the time of trial. A.K.L. was placed in a foster home, and S.A.A.P. was placed in
    the Ablaze Achievement Center. Both children exhibited “severe” special needs:
    A.K.L. had been diagnosed with an intellectual disability, schizophrenia, and post-
    traumatic stress disorder, and S.A.A.P. had been diagnosed with bipolar disorder
    with mixed psychoacoustic features and social communication disorder. Prince
    also stated that S.A.A.P. had suffered from neglect. She testified that both
    children’s placements were meeting all of the children’s physical and emotional
    needs. Prince testified that A.K.L. had responded well to treatment and had made a
    8
    lot of progress, but both children could suffer setbacks if not provided the proper
    care. She stated that S.A.A.P. in particular required a very structured environment,
    and she agreed that “there’s been no . . . evidence that the parents have an
    understanding of even what that structure would look like much less their ability to
    implement it.”
    Prince testified that A.K.L. had told her and the therapist that she did not
    want to go home. A.K.L. “still seemed to be suffering from problems from [the
    sexual indecency] that was perpetrated on her,” as demonstrated by the fact that “if
    you bring up either parent[], [A.K.L.] becomes very aggressive.” Prince testified
    that although A.K.L. “did okay” during face-to-face visits with Mother, prior to
    those visits occurring A.K.L. was “afraid” and “paranoid” that her parents would
    take her away and harm her. S.A.A.P.’s visits with Mother were also “okay.”
    Prince stated that Mother had last visited S.A.A.P. in October 2015, more than six
    months prior to the May 2016 trial, and that “it’s been over a year” since Mother
    last visited A.K.L. Prince testified that she had called Mother regarding scheduling
    visits but was unsuccessful. She stated that Mother had not sent in any requests to
    visit the children.
    Prince testified that termination of Mother’s parental rights was in the
    children’s best interest. She stated that terminating Mother’s parental rights would
    allow DFPS a better opportunity to have the children adopted because it would
    9
    increase the number of potential placements. She further stated that A.K.L. was in
    an adoptive foster placement, but DFPS did not have a prospective placement for
    S.A.A.P. at the time of trial.
    The child advocate, Cynthia Diller, testified that she became involved with
    this case in January 2014. She made frequent visits to the home in 2014 and “also
    attempted to visit in 2015[,] but the parents did not allow [her] admittance to the
    home.” Diller took the photographs of the family home that were admitted into
    evidence at trial. She testified that the photographs showed “that there was
    basically no progress on the things that we had pointed out were safety issues.
    There had been a number of do-it-yourself construction projects that would require
    permitting by the City of Houston and an inspection by the City of Houston.”
    These projects included structural changes and the addition of new construction
    that was not compliant with deed restrictions. These changes also created “a
    particular concern [that S.A.A.P.] could injure himself or there were safety
    hazards” involved with changing natural gas lines and electrical wiring. Diller
    stated that the home could not provide the structure and stability that both children,
    but particularly S.A.A.P., needed to thrive and “get better.”
    Diller also testified that “[a]t this point I do not believe that [Mother] has
    demonstrated that she is able to make the decisions and has the parenting skills to
    parent either child,” and she believed that termination of Mother’s rights would
    10
    provide both children the opportunity to be placed in adoptive homes. She
    acknowledged that DFPS currently did not have an adoptive placement for
    S.A.A.P., but she stated that this was because “we have not been able to broadcast
    [S.A.A.P.] for adoption because his parental rights had not been terminated.” She
    admitted that the siblings would potentially be “separated geographically,” but she
    also believed that it was possible for the siblings to have continued contact with
    each other.
    Diller testified that she had met with both children on numerous occasions.
    Diller testified that A.K.L. had told her that she did not want to see her parents any
    more. Diller stated that S.A.A.P. “vacillates” in that he sometimes expressed a
    desire to go to a foster home and sometimes said “he wants to go home with those
    other parents,” his description for Mother and Father, whom he calls by their first
    names. Dillard also stated that she did not believe that S.A.A.P. was mature
    enough to form a meaningful understanding of this case.
    Dr. Faline Christensen, a therapist with LDS Family Services, began seeing
    Mother and Father in 2012. She stated that had seen Mother approximately eighty
    times, and her last session with the family was in September 2015. She testified
    that Mother “loves [her children] very much and feels a bond with them.” Dr.
    Christensen testified that she was also asked by the trial court to see the family
    together, so she had met with the children separately and as a family unit for a
    11
    period of time in 2013, although her last appointment A.K.L. was in late 2013 or
    early 2014, and her last appointment with S.A.A.P. was in December 2014. She
    believed that the interactions between Mother and the children were appropriate
    and there was affection from both A.K.L. and Mother. S.A.A.P. in particular
    enjoyed seeing Mother and had a close bond with her. Dr. Christensen testified that
    she also observed A.K.L. exhibit paranoia and “fears about people,” but she did not
    believe that A.K.L.’s paranoia was directed at Mother.
    Dr. Christensen believed that termination of Mother’s rights was not in
    S.A.A.P.’s best interest and that he should be able to have some contact with
    Mother. She also acknowledged that both children needed “substantial structure”
    and that there had been some problems in the home that needed to be addressed,
    although she also thought that the parents had made some efforts to improve the
    home environment. Dr. Christenson also acknowledged that Mother had
    demonstrated problems with responding appropriately to the children’s needs and
    that her “own fear response impedes progress.”
    Father testified that he believed his children’s current placements were safe.
    He also stated that he did not think Mother’s parental rights should be terminated.
    However, Father testified that he and Mother still lived together and that he had
    relinquished his parental rights. When asked whether Mother had demonstrated
    some mental health issues, he testified that he “wouldn’t call it mental issues.” He
    12
    believed that Mother was lazy. He also acknowledged that the house would
    become messy. Father stated that he and Mother had been working with DFPS to
    complete their family service plans since 2010 and that it had been a hard process.
    He agreed that he had difficulty working with Mother, and that without help from
    another adult, Mother could not manage to provide for the children’s needs.
    Mother also testified that she went to family and couple’s therapy and that
    she gave copies of the certificates to the caseworker. She acknowledged that the
    house never passed inspection, stating that was “because it’s a very small home.”
    When asked why she had not visited her children in over six months, Mother
    replied:
    Because I had no way to get up there. I do not have a driver’s license.
    I am handicapped. I am developed mentally, just like my son and they
    want to put all those labels on him and I knew he had these problems
    when he was born. I was aware of them. I was aware of [A.K.L.’s]
    too. I am also aware that develop mentally challenged people can pass
    their tests.
    Mother said that she tried to call the caseworker and left a voicemail, but the
    caseworker did not return her call. Mother further testified that she loved her
    children and wanted to continue being their mother. Mother also testified that she
    had been looking for a job, but did not have one at the time of trial. She
    acknowledged that she did not have another adult to help her care for the children
    during the day while her husband worked.
    13
    The trial court terminated Mother’s parental rights pursuant to Family Code
    subsections 161.001(b)(1)(N) and (O) and found that termination was in A.K.L.’s
    and S.A.A.P.’s best interests. The trial court named DFPS as the children’s
    managing conservator. Mother appealed.
    Sufficiency of the Evidence
    In three issues, Mother challenges the sufficiency of the evidence supporting
    the trial court’s determinations that termination of her parental rights was proper
    under Family Code subsections 161.001(b)(1)(N) and (O) and that, pursuant to
    section 161.001(b)(2), termination of her parental rights was in the children’s best
    interest.
    A.     Standard of Review
    In a case to terminate parental rights brought by DFPS under section
    161.001, DFPS must establish, by clear and convincing evidence, (1) that the
    parent committed one or more of the enumerated acts or omissions justifying
    termination and (2) that termination is in the best interest of the child. TEX. FAM.
    CODE ANN. § 161.001(b) (Vernon Supp. 2016); In re C.H., 
    89 S.W.3d 17
    , 23 (Tex.
    2002). “Clear and convincing evidence” is “the measure or degree of proof that
    will produce in the mind of the trier of fact a firm belief or conviction as to the
    truth of the allegations sought to be established.” TEX. FAM. CODE ANN. § 101.007
    (Vernon 2014); In re J.O.A., 
    283 S.W.3d 336
    , 344 (Tex. 2009).
    14
    In conducting a legal-sufficiency review in a parental-rights-termination
    case brought by DFPS under section 161.001, we must look at the entire record to
    determine whether the evidence, viewed in the light most favorable to the finding,
    is such that a reasonable factfinder could have formed a firm belief or conviction
    about the truth of the matter on which DFPS bore the burden of proof. See In re
    
    J.O.A., 283 S.W.3d at 344
    (quoting In re J.F.C., 
    96 S.W.3d 256
    , 266 (Tex. 2002)).
    We “must assume that the factfinder resolved disputed facts in favor of its finding
    if a reasonable factfinder could do so,” and we “should disregard all evidence that
    a reasonable factfinder could have disbelieved or found to have been incredible.”
    Id.; Jordan v. Dossey, 
    325 S.W.3d 700
    , 713 (Tex. App.—Houston [1st Dist.] 2010,
    pet. denied).
    In conducting a factual-sufficiency review, we view the disputed or
    conflicting evidence. See In re 
    J.O.A., 283 S.W.3d at 345
    . We should consider
    whether the disputed evidence is such that a reasonable factfinder could not have
    resolved that disputed evidence in favor of its finding. In re 
    J.F.C., 96 S.W.3d at 266
    . The evidence is factually insufficient only if, “in light of the entire record, the
    disputed evidence that a reasonable factfinder could not have credited in favor of
    the finding is so significant that a factfinder could not reasonably have formed a
    firm belief or conviction” regarding the finding under review. In re 
    J.O.A., 283 S.W.3d at 345
    (quoting In re 
    J.F.C., 96 S.W.3d at 266
    ).
    15
    DFPS must establish both elements—that the parent committed one of the
    acts or omissions enumerated in section 161.001(b)(1) and that termination of
    parental rights is in the best interest of the child. See TEX. FAM. CODE ANN.
    § 161.001(b); In re 
    C.H., 89 S.W.3d at 23
    . Termination may not be solely based on
    the best interest of the child as determined by the trier of fact. Tex. Dep’t of Human
    Servs. v. Boyd, 
    727 S.W.2d 531
    , 533 (Tex. 1987). However, “[o]nly one predicate
    finding under section [161.001(b)(1)] is necessary to support a judgment of
    termination when there is also a finding that termination is in the child’s best
    interest.” In re A.V., 
    113 S.W.3d 355
    , 362 (Tex. 2003).
    B.    Findings Pursuant to Section 161.001(b)(1)(N)
    In her first issue, Mother argues that the trial court’s finding that she
    constructively abandoned A.K.L. and S.A.A.P. pursuant to Family Code section
    161.001(b)(1)(N) was not supported by legally and factually sufficient evidence.
    To prove that Mother constructively abandoned the children, DFPS was
    required to establish by clear and convincing evidence that the children had been in
    DFPS custody for at least six months and: (1) DFPS made reasonable efforts to
    return the children to Mother; (2) Mother has not regularly visited or maintained
    significant contact with the children; and (3) Mother has demonstrated an inability
    to provide the children with a safe environment. See TEX. FAM. CODE ANN.
    § 161.001(b)(1)(N); In re A.L.H., 
    468 S.W.3d 738
    , 744 (Tex. App.—Houston [14th
    16
    Dist.] 2015, no pet). “The first element focuses on [DFPS’s] conduct; the second
    and third elements focus on the parent’s conduct.” In re 
    A.L.H., 468 S.W.3d at 744
    .
    The evidence must be sufficient to support each element set out in subsection N,
    and DFPS bears the burden of proof. See 
    id. (citing In
    re D.T., 
    34 S.W.3d 625
    , 633
    (Tex. App.—Fort Worth 2000, pet. denied), and In re A.S., 
    261 S.W.3d 76
    , 90
    (Tex. App.—Houston [14th Dist.] 2008, pet. denied)).
    Here, the children had been in DFPS custody for well over six months: the
    record indicates that the trial court’s 2010 decree awarded DFPS managing
    conservatorship of both children several years before DFPS sought to modify the
    2010 decree and terminate Mother’s parental rights in 2014. DFPS also made
    reasonable efforts to return the children to Mother, spending several years
    providing services to the family and creating two family service plans with a goal
    of reunifying Mother with A.K.L. and S.A.A.P. See 
    id. (“Generally, implementation
    of a family service plan by [DFPS] is considered a reasonable
    effort to return a child to the parent.”); In re K.G., 
    350 S.W.3d 338
    , 354 (Tex.
    App.—Fort Worth 2011, pet. denied) (holding that evidence was legally and
    factually sufficient to establish that DFPS made reasonable effort to return child
    when caseworker testified that she had tried to facilitate reunification by providing
    services to mother, encouraging mother to seek help for her mental health
    problems, and making efforts to ensure that mother and child had good visits).
    17
    DFPS also presented evidence that Mother had failed to visit or maintain
    significant contact with the children. S.A.A.P.’s mental health records, admitted
    into evidence at trial, indicated that as of early 2014, Mother was no longer
    involved in S.A.A.P.’s care. DFPS records also indicated that Mother would not
    participate in addressing A.K.L.’s behavioral and mental-health problems.
    Prince testified that Mother had last visited S.A.A.P. in October 2015, more
    than six months prior to the trial, and that “it’s been over a year” since Mother last
    visited A.K.L. Prince testified that she had called Mother regarding scheduling
    visits but was unsuccessful in setting up any visitations and that Mother had not
    sent in any requests to visit the children. Mother herself acknowledged that she had
    not visited either child in more than six months because she did not have
    transportation   and    was     handicapped.    See    TEX.    FAM.    CODE     ANN.
    § 161.001(b)(1)(N)(ii); In re J.J.O., 
    131 S.W.3d 618
    , 628–29 (Tex. App.––Fort
    Worth 2004, no pet.) (holding evidence was legally and factually sufficient to
    support finding that mother had not regularly visited or maintained significant
    contact with child when mother made only twelve visits during a nine-month
    period, was late to visits, and sometimes failed to interact with child); In re H.R.,
    
    87 S.W.3d 691
    , 699 (Tex. App.––San Antonio 2002, no pet.) (holding evidence
    was legally and factually sufficient to support constructive abandonment where
    evidence reflected only intermittent visits).
    18
    Finally, DFPS presented evidence that Mother had demonstrated an inability
    to provide the children with a safe environment. See TEX. FAM. CODE ANN.
    § 161.001(b)(1)(N)(iii). The failure to complete a family service plan demonstrates
    an inability to provide a child with a safe environment. See In re A.D., 
    203 S.W.3d 407
    , 411–12 (Tex. App.––El Paso 2006, no pet.). The children were removed from
    Mother’s care because DFPS determined that she could not provide them with a
    safe environment after it discovered that A.K.L. had been the victim of a sexual
    assault while she was in Mother’s presence. DFPS determined that Mother also
    neglected S.A.A.P., who was a toddler at the time, leaving him strapped in his high
    chair even when he was not being fed or leaving him unattended with dangers,
    such as a filled bathtub, within reach.
    The record demonstrated that despite her knowledge of the terms and
    requirements of the court-ordered service plan, Mother failed to meet the
    requirements of that plan. Prince and Diller both testified that Mother had not
    made significant progress in making her home safe, and Mother herself
    acknowledged that her home had not passed inspection by the City of Houston, in
    spite of that being a requirement in her family service plan. Prince and Diller also
    addressed photographs demonstrating dangerous conditions that existed in the
    home, including an unsafe portable heater and plumbing problems. Prince and
    Diller also stated that Mother had failed to adequately address her own mental
    19
    health issues and that Mother did not have the necessary parenting skills to provide
    the care that her special-needs children required. See In re P.R.W., 
    493 S.W.3d 738
    , 743–44 (Tex. App.—Corpus Christi 2016, no pet.) (holding, in context of
    determining whether parent created endangering environment, that “[w]hile mental
    illness alone is not grounds for termination, failure of a parent to take prescribed
    medication is relevant to endangerment”). Prince specifically stated that Mother
    failed to follow the recommendations made by MHMRA and that she failed to
    complete the trust-based intervention class at DePelchin, both of which were
    conditions of her service plan.
    Thus, examining all of the evidence in the light most favorable to the trial
    court’s finding, we conclude that the evidence was legally sufficient for the trial
    court to have formed a firm belief or conviction that Mother constructively
    abandoned A.K.L. and S.A.A.P. See In re 
    J.O.A., 283 S.W.3d at 344
    .
    Mother argues on appeal that DFPS’s evidence that she was unable to
    provide a safe environment was legally and factually insufficient. She argues that
    the “[t]he testimony provided during the trial was very subjective and inaccurate,”
    that the attacks on Mother’s cleanliness were subjective, and that Prince’s
    testimony about the problems with Mother’s home reflected issues that “are typical
    in a household.” However, the record demonstrated more than mere untidiness,
    clutter, or general disorder. The testimony of Prince and Diller, and the other
    20
    information from DFPS’s case file admitted into evidence at trial, indicated that the
    home contained hazards that made it unsafe and other issues that resulted in DFPS
    listing specific requirements in Mother’s family service plan such as removing
    clutter and nonfunctioning items, removing any buckets filled with water and dead
    rodents, removing “open electric machines that the children” can access, and
    passing inspection with the City of Houston. Prince’s testimony and DFPS records
    identified specific problems such as “laundry piled almost waist high, dirty
    dishes . . . piled in the kitchen, [a] stove [caked] with food, . . . floors [that] were
    dirty with trash throughout the house, [and] chips, coke cans, and food on the
    floors in the hallway and bedrooms.” The trial court, acting as the factfinder in this
    case, was entitled to credit this specific evidence in concluding that the condition
    of the home was hazardous, and not merely messy in a way that is “typical in a
    household.” See In re 
    J.O.A., 283 S.W.3d at 344
    –45; In re 
    J.F.C., 96 S.W.3d at 266
    .
    Furthermore, a child’s “environment” includes more than just the physical
    condition of his or her home. Rather, a child’s “‘[e]nvironment’ refers to the
    acceptability of the child’s living conditions, as well as a parent’s conduct in the
    home.” In re S.R., 
    452 S.W.3d 351
    , 360 (Tex. App.—Houston [14th Dist.] 2014,
    pet. denied) (holding that factors such as “[i]nappropriate, abusive, or unlawful
    conduct by a parent or other persons who live in the child’s home can create an
    21
    environment that endangers the physical and emotional well-being of a child”). As
    discussed above, DFPS presented evidence that Mother had neglected her
    children’s medical and mental health needs, that she had not made adequate
    progress in understanding what those needs were, and had not participated
    appropriately in the children’s care during the time DFPS was involved with the
    family. Father testified at trial that he did not believe Mother could provide
    adequate care for the children without the help of another adult, and nothing in the
    record demonstrated that Mother was willing or able to procure that kind of help.
    See In re 
    P.R.W., 493 S.W.3d at 743
    –44 (considering mother’s failure to take
    medication for her mental health condition and her failure to provide adequate
    health care for her child in determining evidence was sufficient that mother created
    endangering environment for child); In re D.S.A., 
    113 S.W.3d 567
    , 573 (Tex.
    App.—Amarillo 2003, no pet.) (holding evidence was sufficient to demonstrate
    parent was unable or failed to provide safe environment because of vague and
    unstable employment history, lack of permanent residence, failure to obtain proper
    medical assistance for children, recurrent alcohol abuse, and failure to abide by
    conditions of parole).
    Accordingly, considering the entire record, we conclude that any disputed
    evidence was not so significant as to prevent the trial court from forming a firm
    belief or conviction that Mother constructively abandoned A.K.L. and S.A.A.P.
    22
    See In re 
    J.O.A., 283 S.W.3d at 345
    . The evidence was legally and factually
    sufficient to support the trial court’s finding pursuant to Family Code section
    161.001(b)(1)(N). See 
    id. Because we
    conclude that the evidence is legally and factually sufficient to
    support the trial court’s finding pursuant to Family Code section 161.001(b)(1)(N),
    we need not address Mother’s second issue challenging the other basis for
    termination of her parental rights under section 161.001(b)(1)(O). See In re 
    A.V., 113 S.W.3d at 362
    (“Only one predicate finding under section [161.001(b)(1)] is
    necessary to support a judgment of termination when there is also a finding that
    termination is in the child’s best interest.”).
    We overrule Mother’s first and second issues.
    C.    Findings on Children’s Best Interest
    In her third issue, Mother argues that the evidence was legally and factually
    insufficient to support the trial court’s finding that termination of her parental
    rights was in A.K.L.’s and S.A.A.P.’s best interest.
    There is a strong presumption that the best interest of the child will be
    served by preserving the parent-child relationship. See In re R.R., 
    209 S.W.3d 112
    ,
    116 (Tex. 2006) (per curiam). Prompt and permanent placement of the child in a
    safe environment is also presumed to be in the child’s best interest. TEX. FAM.
    CODE ANN. § 263.307(a) (Vernon Supp. 2016). The Family Code and the Texas
    23
    Supreme Court have both set out numerous factors to be considered in determining
    a child’s best interest, including, among others: the child’s age and physical and
    mental vulnerabilities; the desires of the child; the frequency and nature of out-of-
    home placement; the magnitude, frequency and circumstances of harm to the child,
    including current and future danger to the child; the willingness and ability of the
    child’s family to effect positive environmental and personal changes within a
    reasonable period of time; the child’s family’s demonstration of adequate parenting
    skills, including providing the child and other children under the family’s care with
    minimally adequate health and nutritional care, guidance and supervision, and a
    safe physical home environment; the stability of the home or proposed placement;
    and the parent’s acts or omissions indicating an improper parent-child relationship
    and any excuses for the acts or omissions. See 
    id. § 263.307(b);
    In re 
    R.R., 209 S.W.3d at 116
    ; Holley v. Adams, 
    544 S.W.2d 367
    , 371–72 (Tex. 1976).
    This is not an exhaustive list, and a court need not have evidence on every
    element listed in order to make a valid finding as to the child’s best interest. See In
    re 
    C.H., 89 S.W.3d at 27
    . The evidence supporting the statutory grounds for
    termination may also be used to support a finding that the best interest of the child
    warrants termination of the parent-child relationship. 
    Id. at 28;
    In re N.R.T., 
    338 S.W.3d 667
    , 677 (Tex. App.—Amarillo 2011, no pet.). Furthermore, the best
    interest analysis may consider circumstantial evidence, subjective factors, and the
    24
    totality of the evidence as well as the direct evidence. See In re 
    N.R.T., 338 S.W.3d at 677
    . The best-interest analysis evaluates the best interest of the child, not the
    parent. 
    Id. Regarding A.K.L.
    and S.A.A.P.’s ages and physical and mental
    vulnerabilities, DFPS presented evidence that the children, who were fifteen and
    eight, respectively, both had severe special needs that required a very structured
    environment and access to regular mental health care and other services. S.A.A.P.
    in particular required a very structured environment, and Prince and Diller both
    agreed that Mother was incapable of understanding or providing for the children’s
    needs. DFPS’s case file, admitted into evidence at trial, demonstrated that, from
    the time DFPS first removed the children from Mother’s care in 2009 until the trial
    in 2016, Mother made insufficient progress in understanding the needs of her
    children or in building the skills she needed to provide for those needs. Thus, this
    factor weighs in favor of the trial court’s best-interest findings for both children.
    Furthermore, A.K.L. told numerous people, including both Prince and Diller,
    that she did not desire to be reunited with Mother. Diller stated that S.A.A.P.
    “vacillates” in that he sometimes expressed a desire to go to a foster home and
    sometimes said “he wants to go home with those other parents,” meaning Mother
    and Father. However, Dillard also stated that she did not believe that S.A.A.P. was
    mature enough to form a meaningful understanding of this case. Because a child’s
    25
    desires are relevant only to the extent that he possesses sufficient maturity to
    express an opinion regarding reunification, we do not find S.A.A.P.’s expressed
    desires here to be compelling evidence. See In re M.H., 
    319 S.W.3d 137
    , 150 (Tex.
    App.—Waco 2010, no pet.). DFPS records introduced at trial also demonstrated
    that his therapist had suggested that visitation with Mother be limited because of
    the negative impact it had on S.A.A.P. See In re D.W., 
    445 S.W.3d 913
    , 926 (Tex.
    App.––Dallas 2014, pet. denied) (holding that child’s love for parent and
    enjoyment of visits is “only marginally relevant” to best-interest determination).
    Thus, the desires of the children weigh in favor of the trial court’s best-interest
    finding.
    Regarding the frequency and nature of out-of-home placement, the evidence
    at trial established that S.A.A.P. had spent the majority of his life under the
    managing conservatorship of DFPS and had spent relatively little time with
    Mother. A.K.L. had likewise spent only a little more than half of her life under
    Mother’s care. Mother had an extensive history with DFPS, including multiple
    referrals before the children were removed in 2009. And, in our analysis of the trial
    court’s finding pursuant to section 161.001(b)(1)(N), we have already determined
    that Mother failed to visit or otherwise maintain significant contact with her
    children. Evidence that a parent has failed to maintain any significant contact with
    the child supports a trial court’s determination that termination is in the child’s best
    26
    interest. See H.N. v. Dep’t of Family & Protective Servs., 
    397 S.W.3d 802
    , 814
    (Tex. App.––El Paso 2013, no pet.).
    Evidence regarding the magnitude, frequency, and circumstances of harm to
    the children, including current and future danger to them, likewise weighs in favor
    of the trial court’s best-interest finding. The children were removed from Mother’s
    care because DFPS determined that she could not provide them with a safe
    environment after it discovered that A.K.L. had been the victim of a sexual assault
    while she was in Mother’s presence. DFPS determined that Mother also neglected
    both children and that her “mental illness and refusal to get professional mental
    assistance for herself as well as her daughter, increases risk” to the children. See In
    re J.D., 
    436 S.W.3d 105
    , 118 (Tex. App.––Houston [14th Dist.] 2014, no pet.)
    (fact finder may infer that past conduct endangering child’s well-being may recur
    if child is returned to parent).
    Furthermore, the evidence demonstrated Mother’s unwillingness or inability
    to effect positive environmental and personal changes within a reasonable period
    of time. Mother failed to demonstrate adequate parenting skills, in that she failed to
    provide either A.K.L. or S.A.A.P. with minimally adequate mental health care, she
    allowed A.K.L. to be assaulted in her presence, and she neglected S.A.A.P.,
    leaving him either confined inappropriately or unsupervised in unsafe conditions.
    Mother failed to provide a safe physical home environment, failed to rectify
    27
    dangerous conditions on the property, such as an exposed electrical heater, and
    failed to obtain the required inspection from the City of Houston, in spite of the
    requirements in her family service plan. It was appropriate for the court to consider
    that Mother did not comply with the court-ordered service plan for reunification
    with the children in evaluating their best interests. See In re E.C.R., 
    402 S.W.3d 239
    , 249 (Tex. 2013) (stating that failure to comply with court-ordered services
    can support best-interest finding); In re E.A.F., 
    424 S.W.3d 742
    , 752 (Tex. App.––
    Houston [14th Dist.] 2014, pet. denied) (considering failure to participate in
    services required for reunification in reviewing best-interest determination).
    The evidence at trial also demonstrated instability in Mother’s home.
    “Stability is important in a child’s emotional and physical development.” See In re
    T.G.R.-M., 
    404 S.W.3d 7
    , 17 (Tex. App.—Houston [1st Dist.] 2013, no pet.).
    Prince and Diller both testified that stability was important for A.K.L. and for
    S.A.A.P., in particular, because of their special needs.
    DFPS sought termination of Mother’s parental rights so that the children
    could be placed in more permanent, stable placements. Prince testified that the
    children’s current placements—A.K.L.’s in a potentially adoptive foster home and
    S.A.A.P.’s in Ablaze Achievement Center—were meeting all of the children’s
    needs. Both children showed improvement in the current placements, where they
    could receive appropriate care and education, and S.A.A.P. in particular was in
    28
    danger of regressing if his caregivers failed to maintain the stability and care that
    he needed.
    Examining all of the evidence in the light most favorable to the trial court’s
    finding, we conclude that the evidence was legally sufficient for the trial court to
    have formed a firm belief or conviction that termination of Mother’s parental rights
    to both A.K.L. and S.A.A.P. was in the children’s best interest. See In re 
    J.O.A., 283 S.W.3d at 344
    Mother argues on appeal that DFPS failed to prove termination was in the
    children’s best interest because it “does not have a direction for S.A.A.P. because
    they have no adoptive placement for him,” stating that DFPS “wants the siblings
    ‘geographically separated’ if [Mother’s] rights [are] removed.”3 However, the
    evidence at trial demonstrated that DFPS sought to terminate Mother’s rights
    because it believed that such termination would allow it to broaden its search for
    3
    In a single phrase, Mother also argues that DFPS “failed to prove that there was a
    material and substantial change to the previous order,” referring, apparently, to the
    trial court’s 2010 decree. It does not appear that Mother presented this argument to
    the trial court. See TEX. R. APP. P. 33.1 (setting out general error preservation
    requirements). Nor has she adequately briefed this issue, because she includes no
    record citations, citations to authority, or other legal argument regarding this point.
    See TEX. R. APP. P. 38.1 (setting out briefing requirements for appellants’ briefs).
    However, we also observe that DFPS presented evidence that, following the
    issuance of the 2010 decree and beginning in early 2014, S.A.A.P. in particular
    experienced an escalation of problematic behavior, the parents became withdrawn
    from care for the children and ceased visiting with them, the parents demonstrated
    a lack of cooperation with DFPS’s efforts to work with the family, and DFPS
    perceived a need to broaden its search for permanent placements for both children,
    which could only be done by seeking modification of the 2010 decree.
    29
    adoptive placements. In particular, Diller testified that she believed termination of
    Mother’s rights would provide both children, including S.A.A.P., the opportunity
    to be placed in adoptive homes. She acknowledged that DFPS currently did not
    have an adoptive placement for S.A.A.P., but she stated that this was because “we
    have not been able to broadcast [S.A.A.P.] for adoption because his parental rights
    had not been terminated.” Separating the siblings was not, as Mother argues,
    DFPS’s goal; rather, Diller testified that although the siblings could potentially be
    “separated geographically,” she also believed that it was possible for the siblings to
    have continued contact with each other.
    Furthermore, even if the trial court later determines that the children’s
    current placement is unsuitable, this consideration does not outweigh the testimony
    and other evidence indicating that placement in a stable, permanent home is in the
    children’s best interest and that Mother cannot supply such a home. See In re 
    C.H., 89 S.W.3d at 28
    (holding that relevant inquiry is whether factfinder could
    reasonably form firm belief or conviction that termination of parental rights was in
    child’s best interest “even if the agency is unable to identify with precision the
    child’s future home environment”).
    Viewing all of the evidence, we conclude that any disputed evidence was not
    so significant that the trial court could not reasonably have formed a firm belief or
    conviction that termination of Mother’s parental rights was in the children’s best
    30
    interests. See In re 
    J.O.A., 283 S.W.3d at 345
    . Thus, we conclude that the evidence
    was both legally and factually sufficient to support the trial court’s finding that
    termination was in the children’s best interest. See 
    id. at 344–45.
    We overrule Mother’s third issue.
    Conclusion
    We affirm the judgment of the trial court.
    Evelyn V. Keyes
    Justice
    Panel consists of Justices Keyes, Higley, and Lloyd.
    31