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Full Opinion
In the Interest of S.H.A., a Child.
Court of Appeals of Texas, Dallas.
*75 Jesse Cuellar, Joseph Rosenfield, Guardian Ad Litem, Dallas, for appellant.
Maridell Templeton, Asst. Dist. Atty., Gary C. Arey, Elizabeth Parmer-Hail, Asst. Dist. Attys., Dallas, for appellee.
Before the court en banc.
SCALES,[1] Justice.
Appellants, A____ A____ and S____ A____ ("the parents") appeal from the trial court's judgment terminating their parental rights to their son ("the child"). The suit was brought by appellee Dallas County Child Welfare Unit of the Texas Department of Human Resources ("Child Welfare"). Based on the jury's answers to special issues, the trial court entered judgment that: (1) each parent had engaged in conduct, or knowingly placed the child with persons who engaged in conduct, which endangered the physical or emotional well-being of the child, and (2) that termination of parental rights would be in the child's best interest. In six points of error, the parents attack the jury's findings, contending that the evidence is legally and factually insufficient. We overrule the parents' points of error and affirm the judgment of the trial court.
The record reflects that the parents are illegal aliens who came to the United States in 1981. The child, the parents' fourth, was born in the United States on February 12, 1982. The father has been employed, from time to time, working as a construction worker and as a dishwasher at a restaurant. The family's economic situation was characterized by several witnesses as "low-income." At the time of trial in March 1985, the parents had another child. The parents do not speak English, and they testified at trial through an interpreter.
The child's situation was first brought to the attention of Child Welfare in 1983, when the child was approximately sixteen months old. The child had been hospitalized in May 1983 for an ear infection and anemia. The treating physician notified the public health department about the child's condition. Consequently, Barbara Brown, a public health nurse, visited the child's home on May 25, just after the child was released from the hospital. Brown testified that the child was filthy; that he was crying; and that he was eating cookies off of the dirty floor. Brown discussed the child's medication and the need to improve the child's hygiene with the mother. Brown stated that the mother "seemed disinterested in anything I had to say."
After the mother missed a doctor's appointment for the child, Brown made a second visit to the home on June 15. At that time, Brown testified, the child had "pus, very thick, white pus" coming out of his right ear, and he had a burn on his arm that was "pussy and oozing." Brown stated that the child's condition, if left untreated, could be dangerous to the child's health because of the risk of infection. Brown observed that the child appeared to be "very poorly cared for" and that the mother did not pick up the child when he was crying.
After the mother did not keep another appointment for the child at the public *76 health clinic, Brown rescheduled the child's appointment for June 22. Brown performed nutritional, medical, and developmental tests on the child. The child was 28 inches in height and weighed sixteen pounds, eight ounces. This height and weight is below the thirtieth percentile for an average sixteen-month-old infant, and Brown testified that "that is a medical definition for failure to thrive." The statistics indicated that "the child was not growing as a normal child should." The mother told Brown that she fed the child about one-half gallon of milk each day; tortillas; soup once a week; eggs about four times a week; chicken once a week; occasionally fruits and cheese; and soup and beans. Brown stated that this was not a proper diet for an infant. Brown advised the mother that the child should be hospitalized immediately. Brown referred the family to a federally funded program that offers food to infants, and also made a referral to Child Welfare.
As a consequence of Brown's referral, Melba Martinez, an "in-take" worker for Child Welfare, visited the parents' home on June 23. Martinez testified that the child appeared very thin, very weak, and sluggish; his rib cage showed; he had a "protruding stomach or abdomen"; and his face "looked very sad." The older children appeared to be relatively healthy. The mother told Martinez that she fed the child twice a day, and that she fed him "sopas," a mixture of rice and pasta. Martinez expressed concern about the child's health to the mother, but the mother felt that the child was "just naturally thin, as one of her other children had been." Martinez testified that the mother "did not appear to understand that she needed to be concerned." As a result of the home visit, Martinez arranged for food to be provided to the family and to take the child to see a doctor. The next day, June 24, Martinez transported the mother and the child to Children's Medical Center.
The child was hospitalized on June 24 at Parkland Hospital for six days for treatment of the burn on his arm and an ear infection. Part of the diagnosis was that the child was a "failure to thrive" child, and Dr. Paul Prescott was called in as a consultant on the child's case. Dr. Prescott testified that failure to thrive "means a child is not living up to his own growth potential." He said that the "failure to thrive" syndrome is best explained as a "symptom," like a headache or backache; there are "five-hundred and some-odd causes of failure to thrive," including organic, nutritional, and "psychosocial" causes, such as where a mother has failed to nurture the child in some way.
Dr. Prescott stated that once failure to thrive is diagnosed, medical causes are ruled out first. Here, the child's failure to thrive was not due to medical reasons. Dr. Prescott testified that the cause of this child's failure to thrive was malnutrition. Dr. Prescott could not, however, positively exclude the possibility of emotional causes of the child's failure to thrive. The failure to thrive syndrome, in a child of this age, can have long-term effects, such as decreased intelligence, learning disabilities, permanently stunted growth, and increased risk of infection. Prescott testified that it is common for one child in a family of several children to suffer from failure to thrive. He stated that "if there is no medical reason, and it's malnutrition, that's actually more worrisome, because we then start calling it the maternal deprivation syndrome. Then you get into emotional deprivation. And for some reason, this one child is being scapegoated." Dr. Prescott testified that the maternal deprivation syndrome may be based on purely nutritional problems, but that only one child "is neglected, for who knows what reason."
Dr. Prescott stated that his diagnosis of malnutrition as the cause of this child's failure to thrive was in part based on the child's comparative weight gain over three time periods. During the child's May hospitalization, he gained about 1½ to 1¾ ounces in weight each day. During the child's June hospital stay, he gained almost 3 ounces in weight each day. During the thirty-day period between hospital stays, the child gained an average of ¼ ounce in weight per day while he was at home. An *77 average child of this age gains about ½ ounce per day.
For this reason, Dr. Prescott recommended that the child be placed in foster care when he was discharged from the hospital on June 30. Dr. Prescott testified that he then believed the child's health was in danger.
The child was placed in a foster home upon discharge from the hospital. The foster parent, Molly Green, testified that when the child arrived at her home, he had existing bruises, "bite marks," and sores that looked like cigarette burns on his arm. Green stated that the child needed constant attention; that he became "hysterical" if the Greens were out of his sight; that he did not cry, but screamed, "piercing screams," until he was picked up by Green; and that he was a "tremendously emotional child." The child would not eat voluntarily, and Green testified that this was very unusual for a child of this age. Green stated that she had problems in getting the child to go to sleep, and that this, too, was unusual for a child of this age.
The child was removed from Green's home, after he sustained injuries to his head and face. Green stated that she discovered bruises on the child's chin and neck, and determined that the child was injuring himself in the baby bed by jumping up and down, hitting his head on the railing. Green later learned that the child had never before been in a baby bed. Martinez, the first Child Welfare caseworker, testified that the child was removed from Green's home because he needed constant attention in order to protect him from self-inflicted injuries. The child was placed in a home where he was the only child.
The child was placed in the Richmire home on July 9. Marlene Richmire testified that, in July 1983, the child was lethargic and depressed; he did not respond to pain; and he "didn't have the will to live"— "[h]e was just like an inanimate object." The child would wake from sleep at night every thirty minutes, screaming. Richmire stated that it seemed "that he had repressed anger of something." The child did not want to eat; he was a "very picky" eater; and he occasionally hoarded food, putting it in a napkin and taking it to bed with him. Richmire testified that the child "progressed quickly" while in her care; he became more active, gained weight, and seemed "happy and more secure."
Richmire stated that, when the child was returned to her home after a visit with his parents, he was "really unmanageable." The child woke from sleep at night with "terrible anger." During those visits at which Richmire was present, there was nothing "done to the child" by the mother to cause sleepless nights, "unless it would be very little interaction, ignoring him."
Richmire stated that the child has inordinate fears of loud noises, such as sirens; bugs; and Mexican-American men. "Different times, when we've been out in public,... a Mexican-American man has approached him, just being nice and kind and trying to talk with him, and he screams." The child does not react in this manner to other men.
Mario Zuniga was assigned to this case in July 1983 as the permanent caseworker for Child Welfare. He testified at trial that his role was to help the family create a safe environment for the child, so that the child could be returned to the family. Zuniga first visited the parents' home after the child had been placed in foster care. Zuniga stated that the house was unsanitary and that he located a better apartment for the family near a day-care center. He arranged for and transported the mother and the other children to doctors' appointments. Zuniga obtained soap for the family; gave them a heater; provided diapers and formula for the baby, and some clothing and toys for the older children. Zuniga stated that the mother, with four small children at home excluding the child in issue, was "very overloaded" and "very, very depressed." Child Welfare arranged for the three older children to be placed in a nearby day-care center operated by Child Care Dallas. Zuniga testified that the older children in the family were being cared for, as far as Child Welfare was concerned, because they were receiving meals at day care.
*78 From June 30 to December 4, 1983, the child remained in foster care. During this time, various workers from Child Welfare and Child Care Dallas worked with the family and offered support services to the family. The agencies arranged for the parents to attend parenting skills classes; the mother went to four out of the five classes, and the father attended one class.
On December 4, 1983, Child Welfare, in accordance with its goal of keeping the child with his natural parents if possible, returned the child to the parents' home. However, the child was removed and placed in foster care again on December 29. Zuniga testified that during this period he visited the parents' home and found the child outside, barefoot, and in dirty diapers, when it was "very cold" weather. Zuniga testified that the child was removed from the parents' home on December 29 after Zuniga found the child injured and the parents absent from the home.
Zuniga testified that he went to the parents' home on December 29 to take the mother and the new baby to a doctor's appointment, as had been pre-arranged with the mother. When he arrived, he found the family car was gone from the driveway, the parents were not there, and the child, with a "real deep gash over his eye," was lying on a bed. The child was "glassy-eyed" and did not respond to Zuniga when he walked into the room. The child had on a dirty diaper. A "young girl," apparently a baby-sitter, was at the home; Zuniga stated that she "appeared to be mentally retarded." The girl told Zuniga: "They want you to take [the child] to the hospital." Zuniga took the new baby to her doctor's appointment and then took the child to Parkland Hospital.
Zuniga's case notes state that the treating physician at Parkland told Zuniga that the injury had occurred at least one day earlier; that the parents should have immediately sought medical treatment; and that it was too late to put stitches in the cut. Zuniga had to hold the child down while the wound was cleaned because the child "became hysterical due to the pain." After medical treatment, Zuniga took the child to the foster parents' home.
The following day, Zuniga met with the mother and father at the Child Welfare Office. Zuniga testified that the father was "very angry" because "it was not that bad of an accident, [and] that we had no business going in there and taking the child out, and that these things happen all the time." Zuniga's report states: "The parents stated that they had not taken [the child] to the hospital since they were out looking for money to borrow to pay for the rent and that [the child] had sustained that injury jumping off a bed." The mother testified at trial that she and the father had gone to look for "money and transportation" to take the child to a doctor.
Also on December 30, the foster parent, Marlene Richmire, took the child to a general practice physician, Dr. Robert Fong. Fong's affidavit states that the child had a one-inch-long cut above his eye that had caused excessive swelling; multiple cuts, bruises, and contusions on his body; and a first-degree burn on his left hand. Fong testified that, in his opinion, the injury was due to "physical, you know, from some blow." Fong also stated, however, that he did not know with one-hundred-percent certainty exactly how the injury was caused. A photograph of the child's face shows the cut and the child's eye swollen shut. In his affidavit, Fong stated: "It is my opinion that [the child's] life could be in danger if he continues to live with his natural parents." Fong testified that he advised Richmire to treat the cut by applying ointments and ice.
Marlene Richmire, the foster parent, testified that after the child's three-week stay with his natural parents, "he had just regressed terribly." At first, the child was "lethargic." "He appeared to us to have lost the will to live again. He just sat and stared. He didn't respond." Once the child got past that, he became a discipline problem. Richmire stated: "He was self-destructive before, but he wasn't the discipline problem that he was when he came back." Richmire testified that the child was aggressive; that he would hit another *79 child's head against the wall; and that he would spill food or rub it in his own hair. In December 1983, the child was approximately twenty-two months old.
Roxanne Purse, a supervisor for Child Welfare, testified that she was "very alarmed by the regression" of the child after his stay with his natural parents; "when he returned home he regressed so dramatically."
Georgette Speers, a Child Welfare caseworker, has been assigned to this case since June 1984, and she was on the case in March 1985, the time of trial. Speers arranged visits between the child and the natural parents and services to the parents and the other children. She testified that the visits where only the mother is present are "relatively quiet"; when the older siblings are present, however, the visit is "very stressful" for the child. During one visit, the child's older sisters were picking him up, and "they actually started to throw him across the room and throw things at him." Speers had to "extract" the child from the situation; the child was "terrified," and the mother could not control her daughters. Speers testified that she believes "very strongly" that the parental rights should be terminated, because if the child were returned home, he would "suffer profound regression." Speers recommended termination "because of the severely limited capacity of the parents to parent this child."
On January 3, 1984, Child Welfare filed its petition for temporary managing conservatorship over the child. The trial court ordered psychological evaluations of the parents and the child, and Dr. Nadine Palau performed the tests in May.
Dr. Palau testified that the intellectual assessment of the mother and the father indicated they are both in the mentally retarded range (I.Q. tested approximately 65), but this was probably an underestimate due to cultural differences, even though all tests were given in Spanish. Dr. Palau testified that the father's personality tests showed mental confusion; sensitivity to criticism; low frustration tolerance; and a possibility that he may "be given to episodes of explosive behavior," where he reacts "angrily and aggressively." Dr. Palau stated that her impression of the father during her clinical interview with him was that "he was trying hard to say the right things."
During her interview with the mother, Dr. Palau learned that the mother had been a "parental child" in her own family, assuming parenting duties for her siblings, because her mother had a "nervous condition." The mother told Dr. Palau that her mother had committed suicide by setting herself on fire, in front of the mother, about three years previously. The personality tests confirmed that the mother might have a "resistance to wanting to parent as an adult," a product of the parental child experience, and that the mother had difficulty in dealing with the trauma of her mother's death. The tests indicated a very intense anxiety that is internally repressed; a great deal of depression leading to difficulty carrying out every-day activities; and difficulty in being "emotionally available to her children." Dr. Palau testified that the mother had difficulty understanding the seriousness of the child's problems; she thought that the child was only thin.
Based on her observations of the child and his behavioral history, Dr. Palau concluded that the child conformed with battered child syndrome and failure to thrive syndrome. Dr. Palau stated that this child displayed emotional consequences of failure to thrive, such as "not wanting to live and self-destructing." Dr. Palau's written report stated that the child had "special needs for structure," and she explained that in an "unstructured environment, an environment in which he was neglected," the child "could become a very self-destructive child." Dr. Palau testified that "in families such as these, it could be that this one child is what is called the `identified patient,' or the `symptom bearer,'" and that this child is being scapegoated; "[w]hether that is happening to other siblings or not does not necessarily mean that that child is safe in that relationship."
Dr. Palau stated that, as of the time she saw the parents and the child, she would *80 not recommend returning the child to the natural parents. In regard to the family's limited financial resources, Dr. Palau stated that this was a factor in the family's problems in that "financial stress can affect family functioning." Dr. Palau testified that, while the parents may have the intellectual capacity to learn parenting skills, she was "not sure" that they would be able to "follow through" and put into practice what they learned.
Roxanne Purse, the Child Welfare supervisor on this case, was responsible for deciding whether Child Welfare should seek to terminate the parents' parental rights to the child. Purse testified that she decided, after the psychological tests were reported, that the parental rights should be terminated in this case. Child Welfare had been on the case for about nine months at that time. Purse testified that she was concerned "that in spite of all the efforts that had been expended, we seemed to be still at square one, in terms of [the parents'] ability to care for" the child. Purse stated that she strongly believes that the parents do not have the capacity to care for the child, and that the child "cannot survive in that family environment"—if the child were returned, he would "wither emotionally." Zuniga, the Child Welfare caseworker, testified that when he left the case in May 1984, the family still needed "24-hour family services." He stated that, with the various agencies' help, the mother's only responsibilities were to keep the new baby's doctor appointments and to keep the children clean, and that the mother "was not able to do so." He recommended termination of parental rights.
Mary Byrne, a volunteer for a court-appointed agency "Focus," gathered information on the case and also recommended termination. She testified that, in her opinion, if the child were returned, "I don't think he would make it."
At the time of trial in March 1985, the child was approximately three years old, and he was still in foster care at the Richmire home. Richmire testified that, at the time of trial, the child was affectionate, and he hugs and kisses her. She testified that she did not recommend that the child be returned to his natural parents, even if the testimony during the trial indicated that the parents have "the ability to parent" the child, because the child "has such emotional problems." She stated that the child is "emotionally handicapped." On cross-examination, Richmire stated: "No, sir, I have no degrees, but I have experience."
Dr. Carol Owen testified that she examined the child for his complaints about leg cramps on February 20, 1985, about two weeks before trial. She stated that the child was small for his age, three years, but that he was well-nourished, cheerful and affectionate. Dr. Owen did not find any problem with the child's legs, but she did find that one ear was infected. She stated that ear infections are common for small children and that there was not any pus draining out of the infected ear.
Several Child Care Dallas workers testified on behalf of the parents. They testified that the parents had made significant improvement in their "parenting skills" and that the child should be returned to the natural parents. Nancy Morales, a social worker for Child Care Dallas and manager of the day-care center, testified that the family's problems were largely economic; that the parents were capable of addressing the child's needs; and that "with the proper help, I think the family will do well and can do well." Morales stated that the family's problems were due, in part, to cultural differences. She explained that in Mexico, the "extended family is very important, and the care of the children, if the parents don't do one-hundred percent, there is always a grandmother or godmother or a neighbor, even, who can care for the child." When this family moved to the United States, "they were really isolated," and the responsibility of caring for the children fell totally on the mother.
Morales testified that Zuniga, the Child Welfare caseworker, had told her that Child Welfare would not return the child to the parents after the three-week period in December because the parents "did not make any attempt to seek medical care" for the child after he was hurt. Morales *81 also testified that she had asked the mother why she didn't take the child to a doctor after he was injured in December 1983; the mother told Morales that she wanted to, but that the father told her no, because "the case worker was coming tomorrow, and he would take care of it."
Morales explained that failure to thrive is caused by malnutrition and that "another factor is dysfunctional relationship between the mother and infant."
Diane Banda, a social worker for Child Care Dallas, had been on this case since April of 1984. She testified that, with proper support services to the family, the child could be returned to his natural parents. She stated that Child Care Dallas could take care of the child during the day and offer services to the family. Banda did not recommend termination of parental rights.
Joan Weiser, the director of social work for Child Care Dallas, testified that there was not enough preparation for the child's return to the parents' home in December 1983. She also stated, however, that the parents had "progressed enough" for the child to return home at that time. Weiser said that Child Care Dallas had been providing support services to the family for about three-and-a-half months prior to December 1983.
Weiser did not recommend termination of parental rights. She testified that the child could enter the day home program offered by Child Care Dallas. Weiser commented that Child Care Dallas has "raised the children of many families" in Dallas and that they "raise other people's children that can't handle them."
Both of the parents testified at trial through an interpreter. The father stated that he would like the child returned "because before I was mean to him, not mean, but I did not have contact with him." He said that his relationship with the child "wasn't normal, because I did badly with him. My facts weren't right with the children." He stated: "Today I am different." The father testified that, while at his home, the child had never put food in his own hair or appeared fearful of Mexican men.
The mother testified that, at the time of trial, she was 25 years old, and she had six children. She stated that the only reason the child was removed from her care was because he had an ear infection and a burn on his arm. The mother said that they did not seek medical attention for the child when he hurt himself in December 1983 because it was at night and "we didn't have transportation."
The mother testified that if the child were returned to her, she would "feed him better food"; "take care of him"; feed him "three time a day"; "feed him on the hour"; and "take him outside to enjoy himself." She stated that she could care for the child "because now we have improved a lot." She said that she learned how to feed and care for the children at the parenting classes which she attended in November 1983, just before the child was returned to her home in December.
Based on this evidence, the jury answered the following special issues:
SPECIAL ISSUE NO. 1
Do you find by clear and convincing evidence that [the mother] knowingly placed or knowingly allowed [the child] to remain in conditions or surroundings which endanger the physical or emotional well-being of [the child]?
ANSWER "We Do" or "We Do Not"
ANSWER: WE DO NOT
SPECIAL ISSUE NO. 2
Do you find by clear and convincing evidence that [the mother] engaged in conduct or knowingly placed [the child] with persons who engaged in conduct which endangered the physical or emotional well-being of [the child]?
ANSWER "We Do" or "We Do Not"
ANSWER: WE DO
In regard to Special Issue No. 3, you are instructed that if you have answered either Special Issue No. 1 or No. 2 "We Do", then answer the following Special Issue No. 3; otherwise, do not answer Special Issue No. 3.
SPECIAL ISSUE NO. 3
Do you find by clear and convincing evidence that termination of the rights of *82 [the mother] is in the best interest of [the child]?
ANSWER "We Do" or "We Do Not"
ANSWER: WE DO
SPECIAL ISSUE NO. 4
Do you find by clear and convincing evidence that [the father] knowingly placed or knowingly allowed [the child] to remain in conditions or surroundings which endanger the physical or emotional well-being of [the child]?
ANSWER "We Do" or "We Do Not"
ANSWER: WE DO NOT
SPECIAL ISSUE NO. 5
Do you find by clear and convincing evidence that [the father] engaged in conduct or knowingly placed [the child] with persons who engaged in conduct which endangered the physical or emotional well-being of [the child]?
ANSWER "We Do" or "We Do Not"
ANSWER: WE DO
In regard to Special Issue No. 6, you are instructed that if you have answered either Special Issue No. 4 or No. 5 "We Do", then answer the following Special Issue No. 6; otherwise, do not answer Special Issue No. 6.
SPECIAL ISSUE NO. 6
Do you find by clear and convincing evidence that termination of the rights of [the father] is in the best interest of [the child]?
ANSWER "We Do" or "We Do Not"
ANSWER: WE DO
These special issues track the statutory language in section 15.02 of the Texas Family Code. Section 15.02, which provides for the involuntary termination of parental rights, states in pertinent part:
A petition requesting termination of the parent-child relationship with respect to a parent who is not the petitioner may be granted if the court finds that:
(1) the parent has:
* * * * * *
(D) knowingly placed or knowingly allowed the child to remain in conditions or surroundings which endanger the physical or emotional well-being of the child; or
(E) engaged in conduct or knowingly placed the child with persons who engaged in conduct which endangers the physical or emotional well-being of the child;
* * * * * *
and in addition, the court further finds that
(2) termination is in the best interest of the child.
TEX.FAM.CODE ANN. § 15.02 (Vernon Supp.1986).
In order to terminate parental rights under section 15.02, there must be both a finding that the parent has committed one of the enumerated acts under section 15.02(1) and a finding that termination is in the best interest of the child. Richardson v. Green, 677 S.W.2d 497, 499 (Tex.1984). Here, the jury answered affirmatively to special issues based on subsection (E) of section 15.02(1) and to issues based on section 15.02(2); the trial court rendered judgment terminating parental rights based on these findings.
In their first and fourth points of error, the parents contend that there was no evidence, or alternatively, insufficient evidence to support the jury's findings that each parent engaged in conduct which endangered the physical or emotional well-being of the child.[2] Relying on Higgins v. Dallas County Child Welfare Unit, 544 S.W.2d 745 (Tex.Civ.App.—Dallas 1976, no writ), the parents argue that involuntary termination of parental rights under subsection (E) requires evidence of each parent's "aggressive behavior towards the child" and that the evidence in this case does not reflect physically abusive behavior *83 by the parents directed towards the child. The parents also contend that the child's physical problems "cannot be directly or indirectly attributed to conduct on the part of [the parents]." We disagree with the parents' contentions and overrule their first and fourth points of error. In so doing, we overrule the Higgins decision to the extent that it conflicts with this opinion and, applying section 15.02(1)(E) to the facts of this case, hold that the evidence is both legally and factually sufficient to support the jury's findings that each parent engaged in conduct which endangered the physical or emotional well-being of the child.
We first consider this Court's interpretation of subsection (E) of section 15.02(1) of the Texas Family Code articulated in Higgins. In Higgins, the jury answered affirmatively to the special issue tracking subsection (D) and answered negatively to the special issue tracking subsection (E), the reverse situation from the jury's answers in this case.
The Higgins court, in comparing subsections (D) and (E), stated that subsection (E) "was clearly intended by the legislature to be a provision concerning something more than neglect, namely aggressive behavior toward a child resulting in physical or emotional abuse." Higgins, 544 S.W.2d at 749. The court reasoned:
We believe that this interpretation of the two subdivisions explains the rationale of the legislature in separating the two grounds for termination into two separate subsections. If the legislature had intended for both subsections to cover the same evil, there would be no logical reason for separating them into two distinct grounds. Therefore, we hold that subsection (D) is applicable where the child has been neglected while subsection (E) is applicable where the child is subjected to aggressive conduct by a person causing physical or emotional abuse.
Id. The court held that, while the evidence tending to show that the child had been physically abused might have supported a jury finding based on subsection (E), the jury's finding based on subsection (D) "must rest on other evidence." Id. at 750.
We hold that this Court's interpretation of subsection (E) in Higgins is incorrect, and we overrule Higgins to the extent that it construes subsection (E) as requiring aggressive or abusive behavior directed towards the child. See Higgins, 544 S.W.2d at 749. We so hold for four reasons.
First, the Higgins interpretation violates the plain language of the statute. Subsection (E) provides for termination of parental rights, where termination is in the best interest of the child, where the parent has "engaged in conduct ... which endangers the physical or emotional well-being of the child." This provision does not require "aggressive behavior," nor does it require that the conduct be directed towards the child. The language of a statute is presumed to have been carefully selected, and every word or phrase is presumed to have been used intentionally, with a meaning and purpose. Perkins v. State, 367 S.W.2d 140, 146 (Tex.1963); Nichols v. William A. Taylor, Inc., 662 S.W.2d 396, 399 (Tex.App. —Corpus Christi 1983, no writ). Every word excluded from a statute must be presumed to have been excluded for a particular reason. Cameron v. Terrell & Garrett, Inc., 618 S.W.2d 535, 540 (Tex.1981). We cannot insert additional words into a statutory provision, unless it is necessary to give effect to the clear legislative intent. Hunter v. Fort Worth Capital Corp., 620 S.W.2d 547, 552 (Tex.1981). Courts may not, however, under the guise of construction, amend a statute by adding words to it, no matter how desirable such additions might seem. A.M. Servicing Corp. of Dallas v. State, 380 S.W.2d 747, 748 (Tex.Civ. App.—Dallas 1964, no writ). In short, the courts may not usurp the power of the legislature by reading into a statute language that is not there. Goldman v. Torres, 161 Tex. 437, 341 S.W.2d 154, 158 (1960). The Higgins interpretation clearly adds language to subsection (E) which is not in the statute as written.
Second, subsection (E) contemplates conduct which affects the physical or emotional *84 well-being of the child, and termination may be based on emotional endangerment only. Although the Higgins opinion states that subsection (E) is applicable where the parent's conduct causes "physical or emotional abuse," 544 S.W.2d at 749, the Higgins case narrowly defines "conduct" under subsection (E) as "aggressive behavior toward a child," "aggressive conduct," and "abuse." Id. at 749, 750. The rationale in Higgins does not account for the possibility of the parent engaging in "conduct" which endangers only the emotional well-being of the child and, although not physically abusive behavior directed towards the child, nevertheless warrants termination of parental rights. Several cases since the Higgins decision have upheld termination under subsection (E) where the parental conduct endangered only the emotional well-being of the child. See e.g., Stuart v. Tarrant County Child Welfare Unit, 677 S.W.2d 273, 279 (Tex.App.—Fort Worth 1984, writ ref'd n.r.e.) (emotional damage to child from witnessing parents' neglect and abuse of younger sister); Allred v. Harris County Child Welfare Unit, 615 S.W.2d 803, 806 (Tex.Civ.App.— Houston [1st Dist.] 1980, writ ref'd n.r.e.) (conduct, abusing mother during pregnancy and violating parole conditions which caused parent to be incarcerated, endangered emotional well-being of child); Chesser v. Texas Department of Human Resources, 595 S.W.2d 615, 618-20 (Tex.Civ. App.—Corpus Christi 1980, no writ) (loud, obscene, and abusive language towards third persons endangered child's emotional well-being); In the Interest of B.J.B. and C.E.B., 546 S.W.2d 674, 677 (Tex.Civ.App. —Texarkana 1977, writ ref'd n.r.e.) (fears and anxieties of children evidenced emotional damage due to father murdering mother); see also In the Interest of S.K.S., 648 S.W.2d 402, 404 (Tex.App.—San Antonio 1983, no writ) (murdering child's mother "would constitute the conduct described in sub-paragraph (E)"; termination affirmed on subsection (F)).
Third, the Higgins case draws a neglect-abuse distinction between subsections (D) and (E), assigning "neglect" to subsection (D) and "abuse" to subsection (E). The statute does not, however, use the terms "neglect" and "abuse."
Subsection (D), referring to "conditions or surroundings," requires a showing that the child has been placed in an environment dangerous to the child's physical or emotional well-being. Stuart, 677 S.W.2d at 280; In the Interest of T.L.H., 630 S.W.2d 441, 445-46 (Tex.App.—Corpus Christi 1982, writ dism'd). Thus, subsection (D) refers only to the acceptability of the child's living conditions, Stuart, 677 S.W.2d at 280; T.L.H., 630 S.W.2d at 445-46, such as where, for instance, the child is living in a house where there is no electricity or gas, no food, "just a few cockroaches"; or where the child is living with four adult women and twenty-five children in a small, three-room house, and the house is dirty and scattered with decaying food. See Sanchez v. Texas Department of Human Resources, 581 S.W.2d 260, 263 (Tex. Civ.App.—Corpus Christi 1979, no writ). See and compare B-J-M v. Moore, 582 S.W.2d 619, 620-21 (Tex.Civ.App.—Dallas 1979, no writ) (where parent kept "unsanitary and cluttered apartment," children not properly fed and unable to "walk and talk normally," termination affirmed under subsection (D) because "conditions under which small children are living are dangerous to their physical and emotional well-being"). Subsection (D), therefore, does not concern the conduct of the parents, and parental conduct alone is not evidence to support termination under subsection (D). Stuart, 677 S.W.2d at 280; T.L.H., 630 S.W.2d at 441.
In Stuart, the trial court terminated the parents' parental rights under both subsections (D) and (E). 677 S.W.2d at 276-77. The record showed that, although the parents did not abuse the child, they neglected and abused the child's sister, subjecting her to "systematic inhumane treatment." Id. at 279. The Fort Worth Court of Appeals held that there was sufficient evidence to support the first prong of the test for termination, section 15.02(1), under subsection (E), but that there was no evidence to support the trial court's finding of subsection (D). Id. at 280. The court stated that *85 subsection (D) pertains to the child's physical environment.
Thus, subsection (1)(D) refers only to the acceptability of the child's living conditions, and does not concern the conduct of the parents toward the child. In the case at bar, there is no evidence that Jeremy's physical living conditions were at all unsanitary. We ho