Title: In re T.T.G.

State: missouri

Issuer: Missouri Supreme Court

Document:

SUPREME COURT OF MISSOURI 
en banc 
IN THE INTEREST OF:  T.T.G. 
) 
and S.S.G., W.J.K. and C.A.C.K., 
) 
) 
Respondents, 
) 
) 
v. 
) 
No. SC96153 
) 
K.S.G., 
) 
) 
Appellant, 
) 
) 
and 
) 
) 
G.H., et al.,
) 
) 
Respondents. 
) 
Appeal from the Circuit Court of Jackson County, Missouri 
Honorable David M. Byrn, Judge 
K.S.G. (“Mother”) appeals from a judgment terminating her parental rights to her 
twin girls, T.T.G. and S.S.G. (“the twins”).  The circuit court concluded termination was 
proper on numerous grounds under section 211.447.5.1  Mother appeals, challenging, inter 
alia, the sufficiency of the evidence to support the circuit court’s finding that grounds for 
termination under section 211.447 were satisfied.  Assuming a ground for termination is 
1 All statutory references are to RSMo Supp. 2013, unless otherwise noted. 
Opinion issued October 5, 2017
2 
 
supported by the record, Mother does not challenge that termination is in the twins’ best 
interests.  
This Court will affirm a judgment terminating parental rights if any one of the 
grounds on which termination was granted is supported by clear, cogent, and convincing 
evidence.  In re P.L.O., 131 S.W.3d 782, 788 (Mo. banc 2004) (citations omitted).  For the 
reasons set out below, this Court finds the record supports termination on the ground of 
neglect under section 211.447.5(2).  Under section 453.040, Mother’s consent to the 
adoption is not needed where, as here, one of the grounds for termination under section 
211.447 is satisfied.  This Court affirms the judgment without reaching the other issues 
raised.  
I. 
FACTUAL AND PROCEDURAL BACKGROUND 
This Court views the evidence and permissible inferences drawn from the evidence 
in the light most favorable to the judgment.  In re Adoption of C.M.B.R., 332 S.W.3d 793, 
801 (Mo. banc 2011); Rule 73.01(c).  Viewed in that light, the facts are as set out below.   
Mother is the biological mother of five children and has been involved with the 
children’s division of the Missouri Department of Social Services since 2012.  She was 
hospitalized at Truman Behavioral Health, a facility providing psychiatric care, at the time 
she gave birth to the twins in April 2015.  The children’s division removed the twins from 
Mother immediately after birth due to concerns surrounding Mother’s mental health and 
her failure to remain medically compliant with her mental health medication.  Six weeks 
later, the twins were placed in foster care with W.J.K. and C.A.C.K. (“foster parents”).  A 
week thereafter, the circuit court took jurisdiction of the twins.   
3 
 
The initial plan was reunification of Mother with the twins.  Mother’s three older 
children already were in foster care and had been under the circuit court’s jurisdiction since 
2012.  Since that time, the children’s division has offered services to Mother, including 
psychological evaluations, urinalysis drug testing, and parent aide services to include 
one-on-one services, parenting skills training, therapeutic services, and supervised 
visitation.   
Mother’s participation in these services continued after the twins’ birth and 
placement in foster care, and also included individual and group therapy and voluntary 
drug testing.  The record shows, however, that even though Mother was receiving one-on-
one parenting training, Mother’s visits with the twins were inconsistent and not fully 
successful.  Mother struggled with having age-appropriate expectations of the twins and 
also had difficulty bonding with them; the twins instead bonded with their foster family.  
Mother also tested positive for marijuana, opiates, and amphetamines while participating 
in voluntary drug testing.  Her drug use was especially problematic because, as discussed 
further below, she suffered from serious mental health issues and an IQ putting her in the 
mildly mentally retarded range.   
On January 12, 2016, the foster parents filed a petition under section 453.040 to 
terminate Mother’s and Father’s parental rights as to the twins and to adopt the twins.  The 
foster parents alleged Mother’s consent for adoption was not required pursuant to section 
4 
 
453.040(7) because she had abandoned or neglected the children, and further that grounds 
for termination were shown under section 211.447.5(1), (2), (3), (6)(a), and (6)(b).2   
In April 2016, a year after the twins’ birth, Mother’s lack of progress caused the 
circuit court to determine reunification no longer was in the twins’ best interests and to 
enter an order providing: “The permanency plan is termination of parental rights and 
adoption. … Reasonable efforts have included identification of an adoptive resource and 
case management services.  Other reasonable efforts have included encouraging the mother 
to participate in mental health treatment and authorized services per previous Court 
orders.”  The circuit court ordered services for Mother to continue, including supervised 
visits for her and the twins’ maternal grandmother, individual therapy, random urinalysis, 
and continued drug treatment.    
In the meantime, the three older children’s foster parents also filed a petition for 
adoption and for termination of Mother’s parental rights, alleging abandonment of the 
children for six months without good cause under section 211.447.5(1), abuse or neglect 
under section 211.447.5(2), failure to rectify conditions that led to jurisdiction over the 
children under section 211.447.5(3), and parental unfitness under section 211.447.5(6).  
The petition also alleged Mother’s consent to adoption was not required because she 
abandoned or neglected the children under section 453.040(7).  A bench trial was held on 
the petition to terminate Mother’s rights as to the older children while the adoption petition 
                                              
2 Father has been absent from the twins’ life since their birth.  He was not present at trial 
and did not contest termination of his parental rights nor challenge that termination was in 
the best interests of the twins. 
5 
 
as to the twins still was pending.  Following the bench trial, in August 2016, the circuit 
court involuntarily terminated Mother’s parental rights as to her three older children under 
all of the alleged grounds for termination.  Mother did not appeal that judgment. 
The adoption petition as to the twins came to trial three months later, in November 
2016.  Without objection, the circuit court took judicial notice of all five children’s juvenile 
division records, along with the case files and contents of the adoption and termination of 
parental rights proceeding involving the older three children.  At trial, the evidence 
revealed, as part of her involvement with the children’s division, Mother received two 
psychological evaluations, one in 2012 and one in 2015, both of which indicated pervasive 
and ongoing mental illnesses, specifically schizoaffective disorder and adjustment 
disorder, combined with low IQ scores.  Those psychological reports also indicated Mother 
abused cannabis, which was consistent with Mother’s failed drug tests.  By the time of trial, 
Mother had stopped drug testing and stopped participating in individual therapy.   
The children’s division, the twins’ guardian ad litem, and the juvenile office 
recommended terminating Mother’s parental rights.  In December 2016, the circuit court 
found by clear, cogent, and convincing evidence that grounds for termination had been 
established for neglect under section 211.447.5(2), failure to rectify under section 
211.447.5(3), parental unfitness under section 211.447.5(6)(a), and the unrebutted 
presumption of unfitness due to a prior involuntary termination under section 
211.447.5(6)(b)(a).  It further found Mother’s consent to adoption was not necessary under 
section 453.040(7) because she had neglected or abandoned the twins in the six months 
preceding the petition for adoption.  Additionally, the circuit court found termination and 
6 
 
adoption to be in the twins’ best interests.  See § 211.447.6; § 453.005.  Accordingly, the 
circuit court terminated Mother’s parental rights and approved the foster parents’ adoption 
of the twins.  Because Mother alleges the presumption of unfitness set out in section 
211.447.5(6)(b) is unconstitutional, she appealed directly to this Court.  Mo. Const. art. V, 
sec. 3.  
II. 
STANDARD OF REVIEW 
Termination of parental rights under section 211.447.5 requires “the trial court [to] 
find by clear, cogent, and convincing evidence that one or more grounds for termination 
exists under subsections 2, 3 or 4 of section 211.447.”  P.L.O., 131 S.W.3d at 788.  “Proof 
under this standard of only one of the statutory grounds alleged is sufficient to sustain the 
judgment.”  Id. at 789. 
This Court reviews whether there was clear, cogent, and convincing evidence to 
support a statutory ground for terminating parental rights and to support a finding that 
consent is not necessary for adoption under section 453.040 under the standard of review 
set forth in Murphy v. Carron, 536 S.W.2d 30 (Mo. banc 1976): 
[T]he trial court will be sustained by the appellate court unless there is no 
substantial evidence to support it, unless it is against the weight of the 
evidence, unless it erroneously declares the law, or unless it erroneously 
applies the law.  Appellate courts should exercise the power to set aside a 
decree or judgment on the ground that it is ‘against the weight of the 
evidence’ with caution and with a firm belief that the decree or judgment is 
wrong.   
 
Id. at 32; see also In Interest of J.P.B., 509 S.W.3d 84, 90 (Mo. banc 2017); C.M.B.R., 332 
S.W.3d at 819.  “In all of these determinations, the reviewing court is deferential to the 
fact-findings of the trial court and considers all the evidence and reasonable inferences 
7 
 
from the evidence in the light most favorable to the judgment.”  P.L.O., 131 S.W.3d at 789 
(citations omitted).  This Court gives the same amount of deference to the circuit court’s 
determinations in adoption and child custody proceedings as it does in all other civil cases.  
Ivie v. Smith, 439 S.W.3d 189, 199 n.9 (Mo. banc 2014).   
Once one of the grounds for termination has been shown under section 211.447, the 
circuit court also must consider whether termination is in the best interests of the child.  
P.L.O., 131 S.W.3d at 789.  Proof that termination is in the child’s best interests must be 
shown at trial by a preponderance of the evidence.  Id.  This Court will reverse a 
determination that termination is in the best interests of the child when there is an abuse of 
discretion.  Id.  Here, however, Mother does not challenge the circuit court’s determination 
that terminating her rights was in the twins’ best interests if a ground for termination has 
been shown.   
III. 
THE RECORD SUPPORTS TERMINATION OF MOTHER’S PARENTAL 
RIGHTS UNDER SECTION 211.447.5(2) FOR NEGLECT   
 
A. Relevant Statutes  
Chapters 211 and 453 provide two separate means by which a parent’s rights may 
be involuntarily terminated.  C.M.B.R., 332 S.W.3d at 806.  Chapter 211 is primarily used 
by state actors, such as the children’s division or the juvenile office, while chapter 453 
allows prospective parents to request termination incident to an adoption and is more 
frequently used in a private action for termination.  Id.  Under section 453.040(7), consent 
of the natural parent for adoption is not required if the child has been abandoned or 
neglected as defined in that section.  And although chapter 453 does not directly “speak to 
8 
 
termination of parental rights,” id., section 211.447.9 provides, “[i]n actions for adoption 
pursuant to chapter 453, the court may hear and determine the issues raised in a petition 
for adoption containing a prayer for termination of parental rights filed with the same effect 
as a petition permitted pursuant to subsection 2, 4, or 5 of this section.”  Under section 
453.040(8), consent is not required of a “parent whose rights to the child may be terminated 
for any of the grounds set forth in section 211.447.” 
This action was filed by the foster parents under section 453.040 seeking to adopt 
the twins and alleging grounds for termination existed under section 211.447 and neglect 
was shown under section 453.040(7), so consent of the parents was not required under 
section 453.040.3  Although the circuit court found clear, cogent, and convincing evidence 
of numerous grounds for termination, this Court focuses on the finding of neglect under 
section 211.447.5(2).  Because this Court finds the record supports termination, it does not 
reach Mother’s allegations that the circuit court erred in terminating her parental rights 
under sections 211.447.5(3), (6)(a), and (6)(b)(a), her allegation that section 
                                              
3 Section 453.040(7) provides consent is not required if: 
(7) A parent who has for a period of at least six months, for a child one year of age 
or older, or at least sixty days, for a child under one year of age, immediately prior 
to the filing of the petition for adoption, willfully abandoned the child or, for a 
period of at least six months immediately prior to the filing of the petition for 
adoption, willfully, substantially and continuously neglected to provide him [or her] 
with necessary care and protection[.] 
This Court does not separately analyze whether neglect was shown as defined in section 
453.040, as there are grounds for termination under section 211.447.5(2), and therefore 
consent is unnecessary because a parent whose rights have been terminated under section 
211.447 is no longer the child’s parent and, therefore, no longer must consent.  See 
§ 453.040(8); § 211.447.9.  
9 
 
211.447.5(6)(b)(a) violates her due process rights by creating a presumption of unfitness 
of a parent based solely on a prior termination of that parent’s rights as to a different child, 
her allegation that neglect was not shown under section 453.040(7), or her allegation that 
the circuit court misstated the findings necessary under section 211.447(3). 
B. There Is Clear, Cogent, And Convincing Evidence Mother Neglected  
The Twins  
 
The record contains clear, cogent, and convincing evidence to support termination 
of Mother’s parental rights pursuant to section 211.447.5(2).  Section 211.447.5(2) permits 
a court to terminate parental rights if the child has been neglected.  See also J.A.R. v. 
D.G.R., 426 S.W.3d 624, 630 (Mo. banc 2014).  Section 211.447.5(2) also sets out certain 
matters the court must consider and on which it must make findings before it determines 
whether neglect has been shown:  
(2) … In determining whether to terminate parental rights pursuant to this 
subdivision, the court shall consider and make findings on the following 
conditions or acts of the parent: 
 
(a) A mental condition which is shown by competent evidence either to be 
permanent or such that there is no reasonable likelihood that the condition 
can be reversed and which renders the parent unable to knowingly provide 
the child the necessary care, custody and control; 
 
(b) Chemical dependency which prevents the parent from consistently 
providing the necessary care, custody and control of the child and which 
cannot be treated so as to enable the parent to consistently provide such care, 
custody and control; 
 
(c) A severe act or recurrent acts of physical, emotional or sexual abuse 
toward the child or any child in the family by the parent, including an act of 
incest, or by another under circumstances that indicate that the parent knew 
or should have known that such acts were being committed toward the child 
or any child in the family; or 
 
10 
 
(d) Repeated or continuous failure by the parent, although physically or 
financially able, to provide the child with adequate food, clothing, shelter, or 
education as defined by law, or other care and control necessary for the 
child's physical, mental, or emotional health and development[.] 
 
The circuit court considered and made findings as to the presence of the four factors 
listed in section 211.447.5(2), and it found there was no evidence of physical, emotional, 
or sexual abuse under factor (c), but there was evidence of factors (a), (b), and (d).  The 
circuit court found the evidence supportive of each of these factors provided clear, cogent, 
and convincing evidence Mother had neglected the twins.  The juvenile officer and the 
foster parents agree.  Mother disagrees the evidence supports termination under any one of 
these four factors. .  Both of these arguments incorrectly assume the circuit court must find 
clear, cogent, and convincing evidence of the presence of one or more of the four factors 
(a) through (d) independently to support termination.  To the contrary, as this Court 
recently reaffirmed, “there is no statutory requirement that a factor listed under a ground 
for termination be proven by ‘clear, cogent, and convincing evidence;’ rather, that burden 
of proof applies to the ground for termination.”  J.P.B., 509 S.W.3d at 92 (citation omitted); 
accord In re B.H., 348 S.W.3d 770, 773 (Mo. banc 2011) (section 211.447.5(2) “does not 
require that any specific statutory condition or act be proven by ‘clear, cogent and 
convincing evidence’ in order to terminate an individual’s parental rights”).  Factors 
(a) though (d) “are simply categories of evidence to be considered along with other relevant 
evidence, rather than separate grounds for termination in and of themselves.”  In re K.M.C., 
11 
 
III, 223 S.W.3d 916, 923 (Mo. App. 2007); see also In re K.A.W., 133 S.W.3d 1, 16 (Mo. 
banc 2004). 4 
Here, the circuit court found factors (a), (b), and (d) and other evidence supported 
termination for neglect under section 211.447.5(2).  Neglect is defined in section 
210.110(12) as “failure to provide, by those responsible for the care, custody, and control 
of the child, the necessary support, education as required by law, nutrition or medical, 
surgical, or any other care necessary for the child’s well-being[.]”  See also J.A.R., 426 
S.W.3d at 630.  The record provided clear, cogent, and convincing evidence of neglect 
under this standard. 
In considering factor (a), the circuit court found Mother suffers from a mental 
condition that renders her unable to provide the twins with the care, custody, and control 
they need.  Mother has undergone two psychological evaluations.  Mother’s first 
psychological evaluation was in June 2012, just four months after Mother’s three older 
children were placed in foster care.  The psychologist diagnosed Mother with 
schizoaffective disorder and adjustment disorder with disturbance of conduct.  
Schizoaffective disorder, according to the psychologist, made this case “guarded because 
                                              
4 Failure of the circuit court to make any of these findings does not itself provide a basis 
for reversal. The party appealing must object at the trial level to the failure to make a 
finding so the circuit court has an opportunity to correct the error.  Rule 78.07(c).  In the 
absence of objection, the failure to make such required findings is waived and does not 
itself provide a basis for reversal or remand when the evidence supports one or more 
grounds for termination despite the lack of such findings.  J.A.R., 426 S.W.3d at 646 n. 5; 
see also C.M.B.R., 332 S.W.3d at 813.  In any event, here, the circuit court did make 
findings on all four factors. 
12 
 
[s]chizoaffective [d]isorder is a serious and persistent mental illness which can worsen as 
a person matures.”  At the time of this 2012 report, Mother experienced hallucinations that 
would direct her to hurt herself and others.  The report also stated Mother suffers from a 
pervasive intellectual deficit.  Her scores on the Wechsler Adult Intelligence Scale revealed 
mild mental retardation, and her educational scores were at an elementary school level.  
The psychologist declined at that time to medically diagnose her with mild mental 
retardation only because he was unable to determine how much her intellectual deficit was 
affected by the disruptive effects of her mental illness.  The psychologist recommended 
Mother start medication for her mental health issues, stay medically compliant, and 
establish a relationship with an individual therapist.   
Mother had a second psychological evaluation by a different psychologist in July 
2015.  At that time, Mother was medication compliant and residing at The Oaks, a group 
home mental health facility.  Many of the same tests were performed.  The results were 
consistent with the first evaluation, although the analysis was less comprehensive because 
Mother was uncooperative.  The psychologist found the testing was sufficient for him to 
provide a dual diagnosis of “[m]ild intellectual disability” and “at the very least … a bipolar 
disorder with psychotic features, possibly schizoaffective or schizophrenic.”5  The 
psychologist also found Mother had a “full-scale IQ of 65” and believed this deficit and 
                                              
5 While Mother contends the 2015 mental examination was insufficiently recent to support 
termination itself, this Court is not considering Mother’s mental health issues as a separate 
basis for termination but rather as evidence relevant to consider in determining whether 
she neglected the twins under section 211.447.5(2). 
13 
 
her mental disorders together might cause her to “be a danger to herself, in addition, to 
being a danger to her children, due to being too impaired to parent properly.”  
In addition to psychological evaluations, Mother participated in psychiatric care at 
both Truman Behavioral Health and ReDiscover.  Mother had attended ReDiscover since 
she was 14 years old and Truman Behavioral Health since 2011.  Hospital records show a 
history of hospitalizations, failure to maintain safe living outside of the hospital, inability 
to stay medically compliant outside of the hospital, and a lack of communication with 
outpatient providers.  The hospital records also report Mother has “a history of 
experiencing auditory and visual hallucinations, isolating from others, refusing to eat, 
becoming agitated and aggressive, spending recklessly, having speech that is unclear and 
illogical at times, and is unable to focus.”   
Mother’s therapist, in a report dated July 2016, commended Mother’s progress and 
her determination to get her children back but reported, “it is questionable whether she can 
effectively care for [the twins] due to concerns related to her cognitive functions.”  
Mother’s clinical case manager at ReDiscover noted in a July 2016 report that Mother 
“struggles at times expressing her thoughts/stressor/concerns and often becomes irritated 
and compulsive” but believed continued progress was likely and later testified that, at the 
time of trial, Mother was medically compliant and proactive in getting her own apartment, 
paying bills, obtaining food, and being drug tested.  Finally, Mother’s social service worker 
assigned to the family on behalf of the children’s division, in a July 2016 report, 
recommended terminating Mother’s parental rights to the twins based on the worker’s 
observations, since 2013, that Mother had failed to progress in services enough to achieve 
14 
 
reunification, and Mother’s “mental health is a barrier for reunification” and regaining 
custody was not feasible in the near future.  
In addition to the evidence of Mother’s mental health problems, the circuit court 
found, when considering factor (b) concerning whether the parent has a chemical 
dependency, that Mother for some time was participating in drug treatment programs at 
ReDiscover three days per week and voluntarily submitting herself to regular drug testing.  
But the court also found Mother tested positive for marijuana five times from October 2015 
to June 2016 and for opiates and amphetamines four times in October and November 
2015.6  Mother claimed she had stopped using drugs other than marijuana after these tests, 
yet she stopped attending drug testing after moving into independent living in July 2016 
and testified she had used marijuana just weeks before the November 2016 trial and on 
other occasions.  These failed tests are consistent with a finding by the first psychologist 
that Mother abused cannabis.   
The circuit court found there was no evidence of factor (c) abuse, but there was 
evidence supporting factor (d) that Mother “repeatedly and continuously failed, although 
physically or financially able, to provide the [twins] with adequate food, clothing, shelter, 
or education as defined by law, or other care and control necessary for the [twin’s] physical, 
mental, or emotional health and development.”   
Here, the circuit court found Mother “failed to provide financial support or 
necessities for the care of the minor children.”  In her interrogatory answers, Mother 
                                              
6 Mother had two false positives for opiates in April 2016.  
15 
 
responded she had provided “none” when asked how much support she contributed to the 
twins.  The testimony and other evidence introduced revealed Mother lived in a group home 
mental health facility immediately after the twins’ birth in April 2015 until July 2016.  
During that time, she provided no support for the twins.  From July 2016 until trial in 
November 2016, Mother made two child support payments of $105 each for all of her 
children together.  So far as the record shows, these two payments are the only payments 
of any kind Mother made toward support of her children.  “The financial support of a minor 
child is a continuing parental obligation, and a parent has a duty to contribute as much as 
he or she can.”  In re Adoption of C.M., 414 S.W.3d 622, 656 (Mo. App.2013) (internal 
quotation and citation omitted).   
The record also shows Mother never provided the social worker assigned to the 
family with any gifts, cards, or letters for the twins, or with necessities such as clothes, 
shoes, diapers or food.  It shows, during the year and one half the twins were in the care of 
the foster parents, Mother provided a total of three outfits for the twins and provided no 
direct financial support or necessities of any other kind to the foster parents.  The social 
worker assigned to the family testified Mother had not provided any meaningful support 
for the twins since their birth.  
This evidence supported the circuit court’s finding that Mother failed to provide 
more than de minimis support for the twins.  The record also would have permitted the 
circuit court to find she could have provided at least some additional support.  More 
specifically, the record showed Mother received disability checks of $849 per month.  She 
testified somewhat inconsistently that she paid most or all of her check to the group home 
16 
 
and had no extra money to pay for the care of her children while residing there, and also 
that she had money left over after paying to live at the group home and further had some 
money saved before she went to the group home.  She also testified that, if she were given 
custody of the twins, her disability check would be sufficient for her to support herself and 
the twins, yet she made only the two noted payments prior to the trial.  Further, in the 
August trial involving Mother’s three older children – of which the court in the twins’ case 
took judicial notice – Mother testified her disability payments had been enough to support 
and provide for her children, yet she failed to do so.  It was up to the circuit court to 
determine which, if any, part of Mother’s testimony it found credible, and it found she was 
able to financially provide some support.  While Mother notes she did provide at least some 
support for two months and a small number of outfits and diapers, “[t]he court may attach 
little or no weight to infrequent visitations, communications, or contributions.”  
§ 211.447.8. 
The circuit court also made findings concerning Mother’s failure to provide the kind 
of visitation and support necessary for the twins’ mental, physical, and emotional health 
and development.  It noted Mother was granted visitation with the twins from the time they 
came into the circuit court’s jurisdiction until trial, but Mother often came to her visits with 
the twins without making even the most basic preparations to provide items they would 
need.  Sometimes she provided supplies such as food, clothes, diapers, wipes, a diaper bag, 
and a few toys for use during their visits.  But on other occasions, the parent aide would 
have to bring these items for the twins to visits because Mother was unpredictable and 
inconsistent in supplying the items needed.   
17 
 
The most recent parent aide supervising Mother’s visits testified Mother was unable 
to care for both twins simultaneously due to her limited capacity and so had to have separate 
visitation with each child on different days each week.  Mother’s visits were inconsistent; 
sometimes she would stay for the entire visit, but other times would cut the visit short.  She 
rejected one parent aide’s request to increase visit time with the twins and never asked for 
longer visitation.  This, and similar evidence, led the circuit court “to believe that the 
mother would not be able to handle a set of twins full-time while supporting the family.”  
The parent aide believed Mother needed to be more affectionate with the twins and 
worked with her to improve in this area.  Mother did make progress in parenting, but she 
remained inconsistent in her visitation.  Some visits continued to end early because Mother 
became overwhelmed.  Mother also still struggled to appropriately comfort the twins, often 
getting frustrated with the twins when they would cry.  The parent aide, not Mother, would 
often comfort the twins when they became upset during visits.   
Additionally, once Mother moved into her own apartment, she skipped most of her 
visits with the twins.  After making a few visits at the beginning of August 2016, Mother 
showed up for only one of her scheduled visits in September, October, and November 2016.  
Further, although it was Mother’s responsibility to schedule visits, she did not do so once 
she moved out of the group home, forcing the parent aide to initiate contact to try to 
schedule visits.  ReDiscover records indicate Mother admitted she was unsure if she wanted 
to visit with the twins just a month before trial.  Mother testified she missed visits because, 
once in an apartment, she “needed to find resources and assistance.”  Yet the record 
revealed no evidence Mother in fact found additional resources or assistance, while it did 
18 
 
show she had failed to attend most of her scheduled visits with the twins.  It was within the 
circuit court’s discretion to determine whether Mother made reasonable efforts to provide 
support and whether she could have provided more financial, emotional, and other support.  
§ 211.447.8; see also In re Adoption of W.B.L., 681 S.W.2d 452, 455 (Mo. banc 1984) 
(“The trial court is in an especially advantageous position to determine the intent of a 
parent-witness in an adoption case.”).  This Court will not second-guess that determination.   
In B.H., this Court affirmed the circuit court’s finding of clear, cogent, and 
convincing evidence of neglect under section 211.447.5(2) based on the evidence of factors 
(a) through (d) considered together.  348 S.W.3d at 773-74.  B.H. found factors (a), (c), and 
(d) supported termination, even though there was no evidence of (b).  Id.  Specifically, this 
Court held the mother’s mild mental retardation impaired Mother’s ability to reason, 
especially regarding parenting.  Id. at 774.  It also found abuse under subsection (c).  Id.  
Finally, this Court found Mother repeatedly failed to provide the necessary care for her 
child’s development because the child suffered anxiety because of the abuse suffered while 
in Mother’s control.  Id.  Accordingly, this Court found clear, cogent, and convincing 
evidence of neglect when considering the evidence relating to the section 211.447.5(2) 
factors.  Id.   
Just as in B.H., the factors here, considered together, provide clear, cogent, and 
convincing evidence of neglect.  The evidence showed the twins were taken from Mother 
at their birth in April 2015 and have been in foster care ever since.  Mother has ongoing, 
permanent, and pervasive mental diseases and cognitive impairments that make it difficult 
for her to handle even supervised visits with the twins, much less the duties of a parent.  
19 
 
She has a history of hallucinations and of failing to take her medications, as well as use of 
illegal drugs.  She has failed to either financially or emotionally support the twins despite 
the circuit court’s finding that she was able to provide more assistance, and has given only 
token in-kind contributions of food and clothing.  She has provided no gifts, cards, toys, or 
other presents to the twins.  
This evidence, as well as the other evidence detailed above and at the trial, provided 
clear, cogent, and convincing evidence Mother neglected the twins by failing to provide 
for their care, custody, and control, or the necessary support, nutrition or medical, surgical, 
or any other care necessary for the twins’ well-being, and supports termination of her 
parental rights under section 211.447.5(2).  See also J.A.R., 426 S.W.3d at 631 (affirming 
termination of parental rights based on neglect under section 211.447.5(2) when a parent 
failed to provide children with letters, maintained contact with children only through 
irregular telephone calls, and failed to provide financial support despite being able to do 
so);  In re M.W.S., 160 S.W.3d 435, 438 (Mo. App. 2005) (clear, cogent, and convincing 
evidence of neglect existed when parent had a diagnosis of mild mental retardation with 
longstanding history of limited cognitive abilities and was unlikely to improve);  In re L.M., 
212 S.W.3d 177, 184-85 (Mo. App. 2007) (affirming termination of parental rights under 
section 211.447.5(3) of parent with schizoaffective disorder of the bipolar type who would 
need assistance at all times because of his cognitive disabilities);  In re L.N.D., 219 S.W.3d 
820, 827-28 (Mo. App. 2007) (termination under section 211.447.5(2) upheld when the 
father gave only a “few gifts of clothing and toys,” visitation was sporadic, he did not give 
letters, cards, or gifts, and made no efforts to keep apprised of his child’s well-being).  
20 
 
Additionally, the circuit court found by a preponderance of the evidence that 
termination of Mother’s parental rights was in the twins’ best interests.  It found the twins 
have no emotional ties to Mother because she was inconsistent in her visits or failed to 
attend them altogether.  When she did attend visits, Mother was overwhelmed.  Mother’s 
minimal contact with the twins evidenced a lack of interest in them.  Mother failed to 
provide the cost of care and maintenance for the twins despite being financially able.  
Finally, no additional services were available to be offered to Mother beyond those already 
provided.  The record supports these findings, and Mother does not challenge that 
termination is in the best interests of the twins.   
Because Mother’s parental rights were properly terminated by sufficient evidence 
of neglect under section 211.447.5(2) and termination is in the twins’ best interests, 
Mother’s consent to adoption is not required pursuant to section 453.040(8).7  It is not 
contested that the record supports adoption under section 453.040 if termination was 
proper. 
                                              
7 Although the petition did not mention section 453.040(8), it did so in effect by alleging 
grounds under section 211.447.5 for terminating parental rights.  Subsection (8) makes this 
a basis for not requiring consent for adoption, because a parent whose rights have been 
terminated is no longer considered a parent and so has no say as to whether the child should 
be adopted.  Here, because the circuit court found Mother’s parental rights were terminated 
under section 211.447.5(2) for neglect, Mother’s consent for adoption was not required.   
21 
 
IV. 
CONCLUSION  
Clear, cogent and convincing evidence supported the circuit court’s termination of 
parental rights under section 211.447.5(2).  Mother’s consent was not required because her 
rights properly were terminated on a ground set out in section 211.447.5.  Adoption is in 
the twin’s best interests.  The circuit court’s judgment terminating Mother’s parental rights 
and approving the adoption of the twins by the foster parents is affirmed.   
 
 
 
 
 
 
 
 
 
_________________________________  
 
 
 
 
 
 
 
     LAURA DENVIR STITH, JUDGE 
 
 
All concur.