CLIFFORD, J.
[¶ 1] The mother of Michaela C. appeals from the judgment of the District Court (Augusta, Westcott, J.) terminating her parental rights to her daughter pursuant to 22 M.R.S.A. § 4055 (1992 & Supp.2001).1 The mother challenges, inter alia, the trial court’s exclusion of certain medical evidence and the sufficiency of the evidence. We affirm the judgment.
[¶ 2] Michaela was born in February of 1997. She was diagnosed with cystic fibrosis at the age of seven months. She was hospitalized at Maine Medical Center twice in 1998 for, among other things, malnourishment and failure to thrive. During her second hospitalization, in November of 1998, the Department of Human Services sought, and the court (Vafiades, J.) granted, an ex parte preliminary protection order. An agreed on preliminary protection order followed {Perry, J.), giving the Department custody of Michaela. When she was released from the hospital, the Department placed Michaela with her paternal grandmother.2
[¶ 3] At the jeopardy hearing in January of 1999, the mother agreed to an order finding that Michaela was in circumstances of jeopardy to her health and welfare. The stipulated order entered by the court {Vafiades, J.) stated that:
Jeopardy exists because Michaela ... has a serious [eatingj/feeding disorder which complicate^] her cystic fibrosis and failure to thrive diagnosis. If not properly treated and managed these present a serious risk to her health. [The mother] ... has in the past failed [1248]*1248to appreciate the seriousness and complexity of the problem, thus creating jeopardy for the minor child. [The mother] ... is now working to resolve these issues, but is not yet at the point where jeopardy has been alleviated.
[¶ 4] The order provided for continued placement of Michaela with the paternal grandmother. The mother was ordered to follow a reunification/rehabilitation plan that included individual counseling and other services, and to establish independence from her mother. The mother was allowed regular, unsupervised visitation with Michaela, but was ordered “not to provide Michaela with candy, snacks, drinks or meals.”
[¶ 5] After hearing testimony at a judicial review hearing, the court (French, J.) found that during unsupervised visits the mother had fed Michaela in violation of the jeopardy order, and ordered that future visits be supervised. The Department and the mother agreed that Michaela would be referred to an in-patient feeding program at the Kennedy Krieger Institute in Baltimore. Michaela was a patient at Kennedy Krieger for several weeks in early 2000 and then returned to placement with her paternal grandmother, who had been trained at Kennedy Krieger in the detailed feeding program developed there for Mi-chaela.
[¶ 6] In April of 2000, the mother filed a motion for an independent medical examination of Michaela by Dr. William Boyle of the New Hampshire Cystic Fibrosis Clinic. The court {French, J.) granted the mother’s motion, stating that “[t]he issue of jeopardy shall not be relitigated” at the termination hearing but that “[f]or the limited purposes of reviewing the matter, and if necessary, developing a permanency plan, expert [medical] testimony will be considered.”
[¶ 7] Throughout the proceedings confidential information was repeatedly disclosed to the media. At the first hearing in November of 1998, the court {Perry, J.) orally cautioned the parties and others present in court, including Michaela’s maternal grandmother, that by statute the proceedings were confidential and were not to be discussed with the press. Notwithstanding this admonition, the maternal grandmother repeatedly spoke to the press and disseminated confidential information concerning the case to the Kenne-bec Journal and other media outlets, to the extent that on one occasion Michaela saw herself on the television news and asked about it. It does not appear that the mother was the instigator of this disclosure, but she tolerated it and to some degree cooperated in it. In July of 2000, the court {Worth, J.) granted the Department’s motion to allow it to disclose information to counter the inaccurate picture given to the press by the mother and the maternal grandmother. The court (Worth, J.) subsequently denied a motion by the mother for relief from the “gag order.”
[¶ 8] The Department’s petition for termination of the mother’s parental rights was heard over four days between October of 2000 and January of 2001. One major focus of the evidence was the mother’s ineffectual attempts to comply with the rehabilitation goals established at the time of the jeopardy order. A psychologist who evaluated the mother in January of 1999 testified that she needed long-term, motivated treatment. He diagnosed her as having a personality disorder with passive dependent features, leading to her difficulty in focusing on Michaela’s needs and in providing a structured response to Michae-la’s problems. Two counselors testified that the mother had discontinued therapy with them and had made little progress; she did not think she had anything to work on; she wanted independence from her [1249]*1249own mother but was unwilling to do anything about it, so that her mother continued to dominate her; she was shown to be unable to feed Michaela or to give her physical therapy without becoming overly emotional; and she continued to live an immature lifestyle, as evidenced in the past by her associations with abusive men and staying out late so that she was frequently tired and slept through or forgot appointments.
[¶ 9] There was testimony from numerous other witnesses that Michaela’s mother continues to be dominated by her own mother, Michaela’s maternal grandmother, and is unable to live on her own or make decisions concerning Michaela without her mother’s interference. The maternal grandmother suffers from serious psychological problems of her own, has disrupted visitations in the past, has repeatedly given confidential information concerning the child protective proceedings to the media, has given Michaela chocolate milk during a visit in violation of medical instructions, and has disagreed with the opinions of Michaela’s doctors.
[¶ 10] Other witnesses testified that a strong bond exists between the mother and Michaela, and that after the disruptive maternal grandmother was excluded from the visits between the mother and Michae-la, those visits were affectionate and appropriate.
[¶ 11] The paternal grandmother testified that she wants to adopt Michaela, and that if allowed to adopt her she would permit the mother to visit with Michaela. She described her stable, well-organized home life with Michaela and explained the detailed feeding regimen that she had been trained in at Kennedy Krieger and the positive results this has had for Mi-chaela’s eating.3
[¶ 12] Eileen Johnson, L.C.S.W., who performed a “best interest evaluation” for the Department, concluded that termination is in Michaela’s best interest because the paternal grandmother, who Mi-chaela spends most of her time with, is Michaela’s “primary attachment figure.” The guardian ad litem concluded that termination of the mother’s parental rights was not in Michaela’s best interest because of the bond between Michaela and the mother.
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CLIFFORD, J.
[¶ 1] The mother of Michaela C. appeals from the judgment of the District Court (Augusta, Westcott, J.) terminating her parental rights to her daughter pursuant to 22 M.R.S.A. § 4055 (1992 & Supp.2001).1 The mother challenges, inter alia, the trial court’s exclusion of certain medical evidence and the sufficiency of the evidence. We affirm the judgment.
[¶ 2] Michaela was born in February of 1997. She was diagnosed with cystic fibrosis at the age of seven months. She was hospitalized at Maine Medical Center twice in 1998 for, among other things, malnourishment and failure to thrive. During her second hospitalization, in November of 1998, the Department of Human Services sought, and the court (Vafiades, J.) granted, an ex parte preliminary protection order. An agreed on preliminary protection order followed {Perry, J.), giving the Department custody of Michaela. When she was released from the hospital, the Department placed Michaela with her paternal grandmother.2
[¶ 3] At the jeopardy hearing in January of 1999, the mother agreed to an order finding that Michaela was in circumstances of jeopardy to her health and welfare. The stipulated order entered by the court {Vafiades, J.) stated that:
Jeopardy exists because Michaela ... has a serious [eatingj/feeding disorder which complicate^] her cystic fibrosis and failure to thrive diagnosis. If not properly treated and managed these present a serious risk to her health. [The mother] ... has in the past failed [1248]*1248to appreciate the seriousness and complexity of the problem, thus creating jeopardy for the minor child. [The mother] ... is now working to resolve these issues, but is not yet at the point where jeopardy has been alleviated.
[¶ 4] The order provided for continued placement of Michaela with the paternal grandmother. The mother was ordered to follow a reunification/rehabilitation plan that included individual counseling and other services, and to establish independence from her mother. The mother was allowed regular, unsupervised visitation with Michaela, but was ordered “not to provide Michaela with candy, snacks, drinks or meals.”
[¶ 5] After hearing testimony at a judicial review hearing, the court (French, J.) found that during unsupervised visits the mother had fed Michaela in violation of the jeopardy order, and ordered that future visits be supervised. The Department and the mother agreed that Michaela would be referred to an in-patient feeding program at the Kennedy Krieger Institute in Baltimore. Michaela was a patient at Kennedy Krieger for several weeks in early 2000 and then returned to placement with her paternal grandmother, who had been trained at Kennedy Krieger in the detailed feeding program developed there for Mi-chaela.
[¶ 6] In April of 2000, the mother filed a motion for an independent medical examination of Michaela by Dr. William Boyle of the New Hampshire Cystic Fibrosis Clinic. The court {French, J.) granted the mother’s motion, stating that “[t]he issue of jeopardy shall not be relitigated” at the termination hearing but that “[f]or the limited purposes of reviewing the matter, and if necessary, developing a permanency plan, expert [medical] testimony will be considered.”
[¶ 7] Throughout the proceedings confidential information was repeatedly disclosed to the media. At the first hearing in November of 1998, the court {Perry, J.) orally cautioned the parties and others present in court, including Michaela’s maternal grandmother, that by statute the proceedings were confidential and were not to be discussed with the press. Notwithstanding this admonition, the maternal grandmother repeatedly spoke to the press and disseminated confidential information concerning the case to the Kenne-bec Journal and other media outlets, to the extent that on one occasion Michaela saw herself on the television news and asked about it. It does not appear that the mother was the instigator of this disclosure, but she tolerated it and to some degree cooperated in it. In July of 2000, the court {Worth, J.) granted the Department’s motion to allow it to disclose information to counter the inaccurate picture given to the press by the mother and the maternal grandmother. The court (Worth, J.) subsequently denied a motion by the mother for relief from the “gag order.”
[¶ 8] The Department’s petition for termination of the mother’s parental rights was heard over four days between October of 2000 and January of 2001. One major focus of the evidence was the mother’s ineffectual attempts to comply with the rehabilitation goals established at the time of the jeopardy order. A psychologist who evaluated the mother in January of 1999 testified that she needed long-term, motivated treatment. He diagnosed her as having a personality disorder with passive dependent features, leading to her difficulty in focusing on Michaela’s needs and in providing a structured response to Michae-la’s problems. Two counselors testified that the mother had discontinued therapy with them and had made little progress; she did not think she had anything to work on; she wanted independence from her [1249]*1249own mother but was unwilling to do anything about it, so that her mother continued to dominate her; she was shown to be unable to feed Michaela or to give her physical therapy without becoming overly emotional; and she continued to live an immature lifestyle, as evidenced in the past by her associations with abusive men and staying out late so that she was frequently tired and slept through or forgot appointments.
[¶ 9] There was testimony from numerous other witnesses that Michaela’s mother continues to be dominated by her own mother, Michaela’s maternal grandmother, and is unable to live on her own or make decisions concerning Michaela without her mother’s interference. The maternal grandmother suffers from serious psychological problems of her own, has disrupted visitations in the past, has repeatedly given confidential information concerning the child protective proceedings to the media, has given Michaela chocolate milk during a visit in violation of medical instructions, and has disagreed with the opinions of Michaela’s doctors.
[¶ 10] Other witnesses testified that a strong bond exists between the mother and Michaela, and that after the disruptive maternal grandmother was excluded from the visits between the mother and Michae-la, those visits were affectionate and appropriate.
[¶ 11] The paternal grandmother testified that she wants to adopt Michaela, and that if allowed to adopt her she would permit the mother to visit with Michaela. She described her stable, well-organized home life with Michaela and explained the detailed feeding regimen that she had been trained in at Kennedy Krieger and the positive results this has had for Mi-chaela’s eating.3
[¶ 12] Eileen Johnson, L.C.S.W., who performed a “best interest evaluation” for the Department, concluded that termination is in Michaela’s best interest because the paternal grandmother, who Mi-chaela spends most of her time with, is Michaela’s “primary attachment figure.” The guardian ad litem concluded that termination of the mother’s parental rights was not in Michaela’s best interest because of the bond between Michaela and the mother. The guardian ad litem, however, did recommend that reunification efforts cease because the mother had not made the changes in her life necessary to allow her to care for Michaela.
[¶ 13] There was substantial dispute at the termination hearing about the mother’s attempts to present expert medical evidence, in particular, evidence from Dr. Boyle. The evidence sought to be presented by the mother concerned Michaela’s eating/feeding disorder and went to the way the child had gained and lost weight in the past. Several conferences between the court and counsel concerning the purpose for which this medical evidence was being offered occurred throughout the termination hearing. The evidence was originally proffered to demonstrate that the court erroneously relied on Department evidence that Michaela was not being properly cared for when in the mother’s custody, and was much better off medically when placed with the paternal grandmother. The mother argued that her medical evidence showed that the court’s reason for the original removal of the child from the mother’s custody, i.e., that the child failed to thrive while in the mother’s custody causing her to be in circumstances of [1250]*1250jeopardy, was not medically sound. The trial court justifiably excluded the evidence concluding throughout most of the termination hearing that the mother was attempting to relitigate the court’s prior findings that the child was in circumstances of jeopardy while in the custody of the mother,4 findings that had been previously agreed to by the mother.5
[¶ 14] Near the end of the termination hearing, however, the mother made clear that she was offering the medical evidence on the issues involved in termination, and that the evidence was relevant to at least some of the issues involved in termination. The court, however, denied the mother’s motion to allow the record to remain open so that she could submit the medical evidence.
[¶ 15] The mother, at the court’s suggestion, filed a motion for reconsideration, and at the court’s request, presented an offer of proof as to the medical evidence. The proffer was that Michaela had gained weight more quickly when in the mother’s care, than when custody was with the Department. The proffer also included the testimony of Dr. Boyle concerning his examination of Michaela and his opinion that weight gain is an accepted measure in failure to thrive cases and that the mother was not responsible for the child’s failure to thrive. The court denied the motion to admit the medical evidence.
[¶ 16] In terminating the mother’s parental rights to Michaela, the court concluded by clear and convincing evidence that the mother is unwilling or unable to protect Michaela from jeopardy and those circumstances are unlikely to change within a time reasonably calculated to meet Michaela’s needs, 22 M.R.S.A. § 4055(l)(B)(2)(b)(i); the mother is unwilling or unable to take responsibility for Michaela within a time reasonably calculated to meet Michaela’s needs, section 4055(l)(B)(2)(b)(ii); and, the mother has failed to make a good faith effort to rehabilitate and reunify with Michaela, section 4055(l)(B)(2)(b)(iv). The court also concluded that termination of the mother’s parental rights is in Michaela’s best interest, section 4055(l)(B)(2)(a). This appeal by the mother followed the court’s denial of the mother’s motion for reconsideration of its decision to exclude the medical evidence and the entry of the order terminating her parental rights.
I.
[¶ 17] In a termination proceeding, before the court even addresses whether termination of parental rights is in the best interest of the child, the court has to determine whether the parent is fit to parent the child. In re Scott S., 2001 ME 114, ¶ 19, 775 A.2d 1144, 1150. The Department has the burden to prove one or more of the statutory grounds of parental unfitness by clear and convincing evidence. In re Kafia M., 1999 ME 195, ¶ 9, 742 A.2d 919, 923. Where clear and convincing evidence is required, the appropriate standard of appellate review is whether the District Court could reasonably have been persuaded that the required factual findings were proved to be highly probable. In re Christopher J., 505 A.2d 795, 797 (Me.1986).
[¶ 18] The mother challenges the sufficiency of the evidence to support the parental unfitness findings of the court. [1251]*1251She also contends that the court impermis-sibly excluded the medical evidence she presented on the eating/feeding disorder of Michaela, and that the exclusion of that evidence adversely impacted the findings of parental unfitness and best interest.
[¶ 19] The dispute over the court’s rejection of the mother’s medical evidence is complex, and its impact on at least one of the court’s findings as to parental unfitness, in particular the finding that the mother is unable to protect Michaela from jeopardy and those circumstances are unlikely to change within a time reasonably calculated to meet Michaela’s needs pursuant to section 4055(l)(B)(2)(b)(i), is difficult to determine. Although the mother did not make clear to the trial court a proper reason for the admission of the medical evidence until very late in the termination proceedings, at the conclusion of the hearing, and in her motion for reconsideration, she did sufficiently articulate reasons why the evidence should be admitted, and its exclusion by the court was error. The excluded medical evidence, although directed primarily at the trial court’s earlier determinations that the child was in circumstances of jeopardy while in the mother’s care based on the child’s failure to thrive, has some relevance to the court’s finding pursuant to section 4055(l)(B)(2)(b)(i) that the mother is unable to protect Michaela from jeopardy, in particular, jeopardy arising out of the eating/feeding disorder.
[¶ 20] Although the trial court erred in excluding the medical evidence, it is highly probable that the error did not affect the outcome of the termination proceedings and, therefore, is harmless. See In re Scott S., 2002 ME 114, ¶¶ 31-32, 775 A.2d at 1154 (error is harmless when it is highly probable that the error did not affect the outcome of the case). The error is harmless because in order for termination to be ordered, the court needs to find only one of the statutory grounds for unfitness, see In re David G., 659 A.2d 859, 861 (Me.1995), and this case involves much more than whether the mother is able to properly feed Michaela.
[¶21] The court’s finding by clear and convincing evidence that the mother is unable to take responsibility for Michaela within a time reasonably calculated to meet Michaela’s needs, section 4055(l)(B)(2)(b)(ii), is based on the fact that the mother is not an independent, mature, and responsible parent, and is unable to provide Michaela, a special needs child, with the basic daily care that she needs, such as Michaela’s daily chest physical therapy. Moreover, the court also found by clear and convincing evidence that the mother failed to make a good faith effort to rehabilitate and reunify with Michaela, section 4055(l)(B)(2)(b)(iv). Individually, either of those findings constitutes sufficient grounds of parental unfitness on which to base a termination of the mother’s parental rights. In re David G., 659 A.2d at 861. The medical evidence would have had no impact on either finding. Nor was the medical evidence sufficiently relevant to the determination that termination of the mother’s parental rights is in Michaela’s best interest pursuant to 22 M.R.S.A. § 4055(l)(B)(2)(a). The court’s best interest determination involves issues beyond the mother’s lack of competence to feed the child. It is highly unlikely that the court’s best interest finding would be affected by the excluded medical evidence.
[¶22] In reviewing a decision to terminate parental rights, a decision that is highly factual, we recognize “the unique opportunity of the trial court to assess the evidence,” In re Caroline M, 576 A.2d 743, 745 (Me.1990), and view the evidence in a [1252]*1252light most favorable to the Department, In re Chesley B., 499 A.2d 137, 140 (Me.1985).
[¶ 23] Contrary to the mother’s contention, there is ample evidence to support the court’s findings by clear and convincing evidence that the mother has failed to take responsibility for Michaela within a reasonable time, 22 M.R.S.A. § 4055(l)(B)(2)(b)(ii), and has failed to make a good faith effort to rehabilitate and reunify with Michaela pursuant to section 4055(l)(B)(2)(b)(iv). The mother was consistently resistent to following the treatment plan she agreed to at the time of the jeopardy order and she failed to make a serious effort to resolve her own problems, problems that severely compromise her ability to care for Michaela.
II.
[¶ 24] The mother is also unpersuasive in her contention that the evidence is insufficient to support the court’s finding by clear and convincing evidence that termination of her parental rights is in the best interest of Michaela. There is substantial evidence in the record that was relied on by the District Court to justify the conclusion that termination of the mother’s parental rights is in Michaela’s best interest. The mother has a dependency disorder and is excessively dependent on her own mother. The mother is unable to function as a responsible adult, and has little motivation for treatment. She cannot fully appreciate the very special needs (cystic fibrosis and an eating/feeding disorder) of Michaela, and is unable to provide basic daily care for Mi-chaela.
[¶ 25] Michaela has been in the custody of the Department since 1998. Michaela’s paternal grandmother has been Michaela’s custodian for several years and desires to adopt the child.6 Michaela has responded well to the grandmother’s care, and to rehabilitative services that the grandmother has assured she receives. The District Court found that there is “love, affection and strong emotional ties” between the child and the custodial grandmother, and that the grandmother “has the capacity and willingness to nurture the child and provide her with a safe, predictable and comfortable home.” Michaela considers the grandmother’s home to be her home.
[¶ 26] The mother correctly points out that there is “love, affection and an emotional bond” between her and Michaela. Such attachment, however, is only one of several factors that the trial court must consider in determining what is in the best interest of the child. “[T]he child’s ability to integrate into a substitute placement or back into the parent’s home and the child’s physical and emotional needs” are important considerations for the court as well. 22 M.R.S.A. § 4055(2) (Supp.2001).7 Moreover, just because the mother has a relationship with the child that is not disruptive does not mean that termination cannot be in the child’s best interest. In re David G., 659 A.2d at 862. The trial court took into account all of those factors and found that the grandmother “is able to prioritize her time to address [Michaela’s] [1253]*1253special needs ... [and that Michaela] is in need of consistency and patience ... and requires a great deal of parental skill to nurture her. The only person [who ] can do that is [the grandmother ].” (Emphasis added.) Moreover, the trial court considered and specifically rejected the option of long-term foster care, finding that the child had already had multiple disruptions and was in need of consistency.
[¶ 27] The District Court’s judgment on the issue of best interest is entitled to substantial deference because that court is able to directly evaluate the testimony of the witnesses.
The trial justice who hears and is able to appraise all the testimony of the parties and their experts in social work and child psychology ... exercises a broad discretion, and is charged with a correspondingly weighty responsibility, to determine the particularly sensitive question of a child’s best interest[]. His judgment, when properly exercised on the basis of the evidence before him, is entitled to very substantial deference .... An appellate court’s independent evaluation of the evidence is especially inappropriate on a delicate issue of this sort.
In re Misty Lee H., 529 A.2d 331, 333 (Me.1987) (quoting Cooley v. St. Andre’s Child Placing Agency, 415 A.2d 1084, 1086 (Me.1980)).
[¶28] Moreover, the Child and Family Services and Child Protection Act, which governs these proceedings, has a clearly stated policy favoring permanency for children in Michaela’s situation. Section 4003(4) provides that it is the intent of the Legislature that the Act “[p]romote the early establishment of permanent plans for the care and custody of children who cannot be returned to their family.” 22 M.R.S.A. § 4003(4) (Supp.2001). Section 4050 provides that it is the intent of the Legislature that the Act:
Allow for the termination of parental rights at the earliest possible time after rehabilitation and reunification efforts have been discontinued and termination is in the best interest of the child;
... Eliminate the need for children to wait unreasonable periods of time for their parents to correct the conditions which prevent their return to the family; [and]
... Promote the adoption of children into stable families rather than allowing children to remain in the impermanency of foster care....
22 M.R.S.A. §§ 4050(l)-(3) (1992). See In re Kayla M., 2001 ME 166, ¶ 8, 785 A.2d 330, 332-33 (statutory policy favors permanency).
[¶ 29] If the District Court had adopted long-term kinship or foster care as Mi-chaela’s permanency plan, it would have been authorized to enter and periodically review orders designed to address actions by Michaela’s noncustodial relatives that impact upon her well-being. The utility of this authority, however, must be considered in light of the practical limits on the court’s ability to control familial relationships and behaviors. In view of the high level of family conflict demonstrated during the pendency of this case, the District Court was justified in concluding that its indefinite supervision of Michaela’s family relationships would have effectively placed Michaela “in limbo,” and would not have achieved the Act’s goals of certainty and stability.
[¶ 30] Michaela’s future relationship with her mother is a dynamic issue, which will likely have to be revisited throughout Mi-chaela’s childhood. Viewed from the perspective of the remainder of Michaela’s minority, decisions concerning the nature and frequency of Michaela’s contacts with [1254]*1254her mother should primarily be a function of meeting Michaela’s developmental and emotional needs, as opposed to seeking to permanently guarantee a legal right of contact. Because Michaela has been in the primary care of a capable grandparent who is willing to adopt her, the District Court rightfully concluded that it is in Michaela’s best interest for that grandparent, and not the Department or the court, to shoulder the ongoing responsibility for these decisions along with all other aspects of Michaela’s upbringing.
[¶ 31] Our evaluation of the evidence must be undertaken with proper deference to the trial court. The trial court determined that the mother is not able to function as a responsible adult and does not fully appreciate the special needs of Mi-chaela. It further found that the person who can best care for Michaela is her paternal grandmother. The evidence establishes that the court could reasonably have been persuaded that it is highly probable that termination of the mother’s parental rights is in Michaela’s best interest. Accordingly, that finding is not erroneous. The entry is:
Judgment affirmed.