In Re the Marriage of: Ngozi Beatrice Nnebedum, petitioner, Appellant, vs. Joseph Chimezie Nnebedum, Respondent.

 STATE OF MINNESOTA
 IN COURT OF APPEALS
 C2-99-630
C5-99-640

In the Matter of the Welfare of:
A.S. & D.S., Children.

 Filed November 9, 1999
 Affirmed
Davies, Judge

Redwood County District Court
File No. J59850246

Allen P. Eskens, P.O. Box 3412, Mankato, MN 56002-3412 (for appellant father)

Carrie G. Marsh, 624 South Second St., Mankato, MN 56001 (for appellant mother)

Michelle A. Dietrich, Redwood County Attorney, P.O. Box 130, Redwood Falls, MN 56283 (for respondent county)

Considered and decided by Shumaker, Presiding Judge, Davies, Judge, and Willis, Judge.

 U N P U B L I S H E D   O P I N I O N

 DAVIES, Judge

Appellants challenge the sufficiency of the evidence to support terminating their parental rights. We affirm as to each appellant.

 FACTS

Appellants V.S. (mother) and G.S. (father) presently live in separate residences in Redwood County. They are the biological parents of A.S., who is now eight years old. V.S. is the biological mother of D.S., 13 months old at termination, and, while G.S. is not the biological father, he seeks to raise D.S. as his own. A.S. has been in foster care continuously since July 1997, and D.S. has been in a foster home since one month after his birth.

Both children have special needs. A.S. has been diagnosed with severe emotional disturbance, Attention Deficit/Hyperactivity Disorder, and learning disabilities; she takes medication for breathing and sleeping disorders and exhibits highly sexualized behavior, unusual for a girl her age. D.S. was diagnosed with cystic fibrosis and complications of pancreatic malfunction. Daily and time-consuming treatment is necessary to keep him alive.

Since August 1996, the family has received social services from Renville and Redwood Counties. Children in need of protection or services (CHIPS) petitions were filed for both children in 1997 and 1998, and Redwood County moved to terminate the parental rights of both appellants in August 1998.

At the termination hearing, Redwood County introduced testimony from three psychologists, social workers from both Renville and Redwood Counties, A.S.'s therapist and guardian ad litem, and a pediatric pulmonary nurse specialist from the University of Minnesota cystic fibrosis center. The testimony from the professionals was substantially consistent, with all expressing significant reservations about the abilities of either father or mother to parent the children and predicting harmful effects on the children if they are returned to either parent.

 D E C I S I O N

Terminating parental rights is a grave matter, requiring this court to exercise great caution to see that the evidence clearly mandates the result. In re Welfare of A.D., 535 N.W.2d 643, 647 (Minn. 1995). We must determine whether the district court addressed the statutory criteria and whether the court's findings are supported by substantial evidence. In re Welfare of M.D.O., 462 N.W.2d 370, 375 (Minn. 1990). The child's best interests remain the paramount consideration in every termination case. Id.

I.

The district court found there was sufficient evidence to terminate appellants' parental rights on four statutory grounds: (1) failure to comply with parental duties; (2) palpable unfitness to parent; (3) failure of reasonable efforts to correct conditions following a CHIPS adjudication; and (4) the children were neglected and in foster care. See Minn. Stat. § 260.221, subd. 1(b)(2), (4), (5), (8) (1998). The court concluded that it was in the best interests of the children to terminate both parents' parental rights. See id., subd. 4 (1998) (best interests of the children paramount). The court made extensive findings detailing appellants' continued inability to parent the children despite efforts by county social services to assist them.

  A. Reasonable Efforts to Assist and Reunite

Appellants argue that the county failed to make reasonable efforts, first, to assist them in correcting the conditions that led to the protective orders for their children and, second, to reunite the family.

In determining whether services are reasonable, the court considers whether the services were: (1) relevant to the child's safety and protection; (2) adequate to meet the child's needs; (3) culturally appropriate; (4) available and accessible; (5) consistent and timely; and (6) realistic. Minn. Stat. § 260.012(c) (1998).

The record supports the finding that social services made reasonable efforts to assist and reunite the family. They provided extensive in-home monitoring, offered parenting classes and individual and family counseling, established and monitored visitation while the children were in foster care, provided counseling and educational assistance for A.S., and provided specialized medical care for D.S. The services offered were relevant to the safety and protection of the children, met their needs for food and shelter, and were reasonably consistent and timely. Nothing in the record suggests the counseling services and parenting classes were inaccessible, culturally inappropriate, or unrealistic. The statute does not require the county to provide all assistance possible, merely that it make the efforts that are "reasonable." See id. (social service agency must use appropriate and available services designed to prevent termination). The record supports the conclusion that the county made the efforts that were reasonable.

 B. Failure to Comply with Parental Duties

Appellants challenge the district court's conclusion that they substantially, continuously, or repeatedly refused or neglected to comply with their parental duties under Minn. Stat. § 260.221, subd. 1(b)(2). We find the record supports the court's conclusion.

The court found that: (1) A.S.'s attendance at school was irregular, and when she did attend she often appeared so dirty that she was ostracized by other children; (2) the parents did not follow through on obtaining recommended school services for A.S.; (3) the parents failed to work to improve their behavior problems and complied only minimally with court-ordered plans to provide counseling and parenting classes; (4) neither parent demonstrated an ability to place the needs of their children before their own; (5) both had difficulty relating to A.S. in an age-appropriate way; (6) the parents were homeless for a period of time when A.S. was in foster care; (7) both parents, in direct violation of a court order, failed to protect A.S. from an alleged sexual abuser; and (8) both parents failed to obtain essential training required for the daily medical care of D.S.

Appellants claim the district court based its decision solely on past behavior. Evidence relating to a termination decision must address conditions that exist at the time of the hearing. In re Welfare of Chosa, 290 N.W.2d 766, 769 (Minn. 1980). In this case, the record does not demonstrate that recent changes have been significant enough to overcome the conclusion that appellants' past problems make their future performance as parents uncertain. See In re Welfare of J.L.L., 396 N.W.2d 647, 652 (Minn. App. 1986) (finding minimal improvement not sufficient to avoid termination). At trial, both parents continued to deny the serious allegation of sexual abuse of A.S. Their relationship continued to be chaotic. Their hostility and defensiveness towards outside assistance remained. Experts testified that the parents' learning styles, coping skills, and ability to use outside assistance would make any change occur slowly, if at all.

The record supports a finding that appellants substantially refused or neglected to comply with their parental duties.[1]

 C. Best Interests of the Child

The district court concluded that termination of parental rights was in the best interests of the children. If the district court finds proper statutory grounds to terminate parental rights, then the court must consider the best interests of the child. See Minn. Stat. § 260.221, subd. 4.

The district court relied on the testimony of several experts. That testimony included opinions that A.S. would likely suffer severe and persistent behavioral and emotional problems if exposed to continued chaotic, abusive, or neglectful situations, and that it was important to her emotional health that she be placed in a permanent home as soon as possible. Experts also testified that it was essential to the physical survival of D.S. that he be placed in a stable, clean home, with committed and responsible caregivers who are able to place the needs of a sick child ahead of their own.

The court balanced the interests of appellants in preserving a parent-child relationship against the children's needs for a safe and stable environment and concluded that terminating parental rights was in the children's best interests. The district court's findings are supported by substantial evidence and support the court's conclusion that termination is in the children's best interests.

 II.

The district court concluded that the parental rights of both mother and father should be terminated. Appellant father argues that the district court failed to distinguish his parenting role from that of the mother. We examine the record to determine whether the facts support the court's conclusion with respect to each appellant.

The record shows that both appellants were responsible for the marital conflict and the inadequate food and housing. Both attended parenting classes only reluctantly and neither, with minor exceptions, participated in individual or marital counseling. Both permitted contact between A.S. and the family member accused of inappropriate sexual behavior. Both exhibited marginal cognitive and coping skills, considerable hostility towards social service providers, and both were defensive, evasive, and, on occasion, untruthful in their evaluations.

It is true that appellant mother's parenting skills and ability to relate to her children were particularly problematic. The psychologist who conducted the mother's evaluation noted that her hostility, rigid thinking patterns, and extreme suspicion, bordering on paranoia, make it difficult for her to accept help from professionals. Appellant mother overestimated her ability to cope and denied having parenting problems.

But appellant father has failed to seek treatment following a 1983 conviction of having vaginal intercourse with his 13-year-old stepdaughter. His attempts to deny and minimize his behavior and his failure to get treatment lead the professionals consulted in this case to uniformly express grave concern for the well-being of A.S. Her early highly sexualized behavior puts her at great risk for having contact with an untreated sex offender.

Substantial evidence supports the district court's conclusion that both appellants individually exhibited behaviors that met the statutory requirements and made termination of their parental rights in the children's best interests.

Affirmed.

[1] Because only one statutory ground is needed to terminate parental rights, Minn. Stat. § 260.221, subd. 1, we do not address the court's determination that appellants were palpably unfit to parent, subdivision 1(b)(4), and failed to take corrective measures, subdivision 1(b)(5), and that the children were neglected and in foster care, subdivision 1(b)(8).